Making a claim for compensation if you’ve been injured in an accident can be a stressful and complicated process at the best of times. In order for your injury to be properly assessed, the reports of medical practitioners can be very important in helping determine the eventual success of your claim and the amount you will receive.
But do you need to wait until you’ve seen a doctor before lodging a claim for compensation? The answer varies depending on the type of claim. In this article, we’ll deal with a couple of the most common claims for compensation – for injuries sustained in the course of your employment, and for injuries resulting from motor vehicle accidents. For other injuries where you believe you have a claim for compensation, seek the advice of an expert personal injury lawyer as to the importance of a medical assessment.
Workers’ compensation claims
Most Australian employees are protected by state-based statutory insurance schemes in the unfortunate event that they are injured at work.
To make a WorkCover claim in Queensland, you need to report an injury sustained at work to your employer within 30 days of becoming aware of the injury. One of the ways to do this is to lodge a WorkCover claim for compensation.
If you do not need to take any time off work, but you want WorkCover to cover any medical expenses you incur because of the injury, your claim form needs to include any accounts/invoices relating to your medical treatment, meaning you need to see a doctor for treatment and give them details about how you were injured before making the claim.
If you need to take time off work because of the work injury, the WorkCover claim form must be accompanied by a Work Capacity Certificate completed by a doctor.
This certificate helps insurers assess and determine the employer’s liability for the claim, and determine the type of treatment and rehabilitation required to help the injured worker return to work. It also helps employers identify the duties an injured worker is capable of undertaking.
So whether you take time off work or not due to the injury, you will need to see a doctor before making a claim.
Motor accident insurance claims after injury
In order to make a claim under Queensland’s compulsory third-party (CTP) insurance scheme, an injured person must complete a Notice of Accident Claim Form (Non-Fatal Injury). A key part of completing this form is a medical certificate filed with the claim. The certificate provides the insurer with a diagnosis of your injury and indicates the extent of your injuries and any proposed treatment.
The physical examination of your injuries must be performed by the medical practitioner before, or when, the medical certificate is completed by the doctor. Your claim is likely to be significantly delayed if this physical examination does not take place before you make a claim. As insurers are only liable for injuries arising from the accident, an incomplete certificate or unclear diagnosis will require further investigation of your claim and delay the process. This can be particularly worrying if you are relying on the insurer to fund ongoing treatment and rehabilitation.
As the medical certificate is part of the claim form, it’s generally you who will present the certificate to the doctor for completion.
A CTP insurer or your legal representative may also request medical reports from either your doctor or another medical practitioner. These could include different types of reports, including treatment plans and medico-legal reports.
In making a decision on liability, the CTP insurer will also generally require you to attend a medical examination with a doctor of its choice.
Other types of claims
Personal injury claims that are not workers’ compensation or motor vehicle accident claims, such as medical negligence claims, are governed under Queensland’s Personal Injuries Proceedings Act 2002.
A claim for medical negligence, for example, requires an attached written report from a medical specialist qualified to assess the conduct of the person against whom it is alleged they failed to provide an appropriate standard of medical care.
Other personal injury claims such as slips and trips in a public place differ in the requirements for a medical report before making a claim, though in general you are advised to see a doctor and document any medical treatment as soon as possible after the accident.
As discussed, this can be a complicated legal area and the claims process can cause a lot of stress and uncertainty for the injured person. If you have been injured in any of the scenarios outlined above and have questions and concerns about how to proceed, contact specialist personal injury firm Lifestyle Injury Lawyers today. We can provide a free initial consultation to assess your case, either through our website, by email at firstname.lastname@example.org, or by phone at (07) 5627 0321.