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Do I Need a Lawyer for My Workcover Claim?

Published on 19 June 2019
Navigating the Victorian WorkCover Scheme can be a challenging and confusing task.

At Zaparas Lawyers, our specialised WorkCover lawyers can help guide and support you through the complications of the Victorian WorkCover laws, to ensure your claim is as seamless and as stress-free as possible.

Below, we set out the reasons why having a lawyer to represent your interests can be vital.

The Victorian WorkCover Scheme

The Victorian WorkCover Scheme provides a framework for compensation for Victorians who have suffered an injury in the course of their employment.

Suffering a workplace injury can result in long-term consequences for both a worker and their family. Along with the impact on a worker’s physical and mental wellbeing, a workplace injury can also create significant financial stress.

Generally, in order to have an accepted WorkCover claim in Victoria, you must be considered a ‘worker’ under the relevant legislation, and your injury must have arisen out of or in the course of your employment.

Whilst a successful workers compensation claim can help ease the financial burden and provide the requisite medical treatment, the laws surrounding Workers Compensation in Victoria are complex and often difficult for the everyday worker to interpret.

Rights and Entitlements of an Injured Worker

If your WorkCover claim is accepted at the first instance, then as an injured Victorian worker you are entitled to ongoing weekly payments of compensation, and the costs of reasonable medical and like treatment.

Generally, for the first 13 weeks, weekly payments are payable at 95% of your pre-injury average weekly earnings, and subsequently at 80% of your pre-injury average weekly earnings. Weekly payments are typically payable to an injured worker for a total of 130 weeks, however can continue beyond this time period if specific criteria are met.

Under the Victorian WorkCover Scheme, an injured worker is also entitled to make claims for lump-sum compensation. The first of such claims is a claim for Impairment Benefits. This lump-sum claim does not point to liability of your employer, but rather, considers the whole person impairment flowing from your injury by way of a restrictive, diagnostic assessment.

The second lump sum claim you may be entitled to as an injured worker is a negligence-based claim for compensation. Compensation may be awarded if you have suffered a serious injury, and if your employer has been negligent in their conduct. The amount of compensation is dependent upon the unique circumstances of your case.  At this stage of your claim, having an experienced lawyer on your side is important in order to understand the merits of your case and the complex legal issues in dispute.

Why having a Lawyer can make all the Difference 

When attempting to deal with your WorkCover claim, there are a number of instances where having a lawyer to guide you through the process can make a significant difference to the ultimate outcome of your claim.

This is especially relevant when the insurer makes decisions on your claim without adequately explaining the basis for their decisions. Throughout the course of your claim the WorkCover insurer may form the view that you have regained a capacity for your pre-injury work, and may consequently issue a decision to cease your weekly payments on the grounds that you can return to your pre-injury role. Similarly, at 130-weeks or any time thereafter, many workers are issued with a decision terminating their weekly payments on the basis that they have regained a capacity to undertake work – whether that be pre-injury work or work of a different nature.

Often, without the representation of a lawyer, many workers are unaware of their right to dispute these decisions, or the time limits within which such decisions can be opposed. Worker’s are often stressed and confused by these decisions to cease weekly payments, and also unaware of the appropriate forum to challenge them. By engaging a lawyer, we can assist you in interpreting the reasons that have been relied upon by the insurer, whether their reasons are lawful, and the most effective and practical way to dispute the decision.

Having a lawyer can also be a significant advantage in the face of decisions to terminate specific medical treatments. Often these medical and like expenses are imperative to your recovery, and so determining the most efficient means of having treatment reinstated is extremely important for any injured worker. Having a lawyer to fight on your behalf by obtaining the appropriate medical evidence to appeal your insurers decision, can mean the difference between having your ongoing medical treatment funded or not.

This is also the case for an insurer’s decision regarding a lump-sum claim for compensation. Workers often do not realise that any decision made by the insurer regarding their claim for impairment benefits, and the level of permanent impairment they have been assessed at, is in fact open to dispute. With the guidance of a lawyer, you may be able to successfully challenge the insurers determination and fight for a higher level of compensation.

Having a lawyer on your side also places you on a more even playing field with the insurer. Often, workers understandably find it frustrating and stressful to personally liaise with insurers. We are highly experienced in dealing with insurers, and will engage with them on your behalf in order to keep them accountable and ease the burden on you.

Making an Appointment 

At Zaparas Lawyers we are driven by our strong client-focus and our passion for helping injured Victorian workers. We strive to achieve the best outcomes for our clients when they are in the face of some of the most challenging and trying times of their lives.

We understand that being injured due to a workplace injury can often create tough financial circumstances for both you and your family, and to help with this we operate on a strictly No-Win-No-Fee basis. This ultimately means that unless you are successful in a lump-sum claim for compensation, there will not be any fees charged to you for our work.

If you have recently lodged a WorkCover claim and are having difficulty navigating the WorkCover scheme, or even if you are simply seeking some preliminary advice, Zaparas Lawyers can help. Contact our team now to arrange an obligation-free appointment with one of our experienced WorkCover lawyers.

*This piece was written by Claudia Costantino, Lawyer in the Zaparas Lawyers WorkCover team.