Workers’ Compensation Claims Assessed in Queensland

We live in a country where we are fortunate to count on workers’ compensation schemes if we are injured in the course of doing our jobs. Workers’ compensation in Queensland for those who can’t work due to being injured through work is available through the statutory ‘no-fault’ scheme managed by WorkCover Queensland.

It’s also possible to make a common law claim for damages if an injured person can demonstrate that an employer was negligent. A workers’ compensation claim can be made for an injury sustained during work, travelling to work or on a work break, and for both physical and/or psychological harm.

A claim under the statutory scheme can provide for weekly payments to compensate for lost wages, hospital and medical expenses as a result of the injury, and a lump sum in the case of permanent impairment.

The no-fault scheme is governed by the Workers’ Compensation and Rehabilitation Act 2003, which also prevents workers’ compensation from being paid if a worker’s injury is intentionally self-inflicted or was caused by the employee’s serious and wilful misconduct (with some exceptions).

In this post, we’ll concentrate on how workers’ compensation claims are assessed in order to work out what can be provided to an injured person.

What is required to make a workers’ compensation claim?

There are a number of basic steps a person injured at work needs to take in order to make a workers’ compensation claim.

First priority is to have the injury assessed by a medical professional and obtain a workers’ compensation medical certificate. Reporting the injury, and the circumstances in which it occurred, to the employer is also essential. Many employers will have a formal reporting process for injuries sustained on the job as part of their health and safety commitments. once these things are done, the paperwork begins.

Specifically, a copy of the medical certificate needs to be provided to the employer and the claim form needs to be promptly completed and lodged with WorkCover Queensland. An injured person should ensure they keep all documents and other evidence relating to the injury and the claim from the moment the incident occurs.

How does the process work?

In the first phase of the compensation process, the majority of an injured person’s wages, medical treatment and rehabilitation expenses will be covered by the no-fault scheme, until you’re able to return to work.

But if your injury is more severe and prevents you from returning to work, or results in permanent impairment, you may be offered a lump sum compensation amount by WorkCover or the employer’s chosen insurer to settle the matter.

In this situation, you should seek the legal advice of specialist compensation professionals. This lump sum may be far less than you would be paid through a common law claim for damages so it’s best to check with an experienced lawyer before accepting the claim. The lump-sum amount will be based on an injured person’s degree of permanent impairment (DPI), as assessed by a medical practitioner once the injury has stabilised. Examples of permanent impairment include spinal cord injuries, disfigurement, amputation, permanent loss of movement and serious mental disorders.

Those whose DPI is assessed as 20% or above may accept the lump sum offer and also seek a common law damages claim. Those under 20% must either accept the lump sum offer and end their claim or instead pursue a common law claim for damages encompassing the injury, loss of past and future earnings, the costs of past and future care, superannuation benefits and interest.

Case example

In Hargreaves v Telstra Corporation Limited [2011] AATA 417, a Telstra employee slipped and fell downstairs at home not once, but twice, injuring her shoulder. On one occasion she was wearing socks. Nevertheless, the Administrative Appeals Tribunal found that the company was liable for the employee’s medical and legal costs because the fall had occurred during the course of her employment.

Cases such as this remind that employers must ensure a home workplace meets the required health and safety standards before agreeing to the employee working in the location.

There should be clear policy guidelines for working from home and a reporting process for when an injury occurs.

Contractors, freelancers and the self-employed who are injured while working from home are unlikely to be able to make a workers’ compensation claim against the entity they are doing work for unless they can show they are entitled to employee status.

This class of worker will more likely have to rely on personal injury insurance to cover any work-related injury or illness.

Common law claims

Your expert compensation lawyer can advise on this type of claim. It requires the injured person to prove negligence on behalf of the employer which caused the injury, pain and suffering, and loss of income.

It should be noted that once a person decides to make this claim, the statutory no-fault claim ends.

If you need advice or guidance on either of the claims discussed in this post or more detail on how permanent impairment is assessed, contact our compensation specialists Personal Injury Lawyers Gold Coast today for an obligation-free initial consultation.