WorkCover

Benefits to injured workers

WorkCover

Under the Workplace Injury Rehabilitation and Compensation Act 2013, a person who has sustained an injury or illness at work may be entitled to compensation. 

PLEASE NOTE: This diagram is a general guide to dealing with WorkCover claims and is not a substitute for professional advice.

Is there a connection to Victoria?

x

Is there a connection to Victoria?

The injury can occur outside of Victoria however a connection to Victoria needs to be established by showing that:

  • Victoria is where the worker normally works;
  • The worker‘s employment is usually based in Victoria; or
  • The employer’s principal place of business is located in Victoria.

Interstate legislation applies -
seek legal advice

Are you a 'worker'?

x

Are you a worker?

You can be classified as a worker in a number of situations:

  • If an employer has engaged you to perform work at their direction (note: a contract of employment can be written or oral).
  • Contractors are workers if at least 80% of the work is performed by the same individual and at least 80% of the income earned is from the same hirer.
  • Volunteer employees are usually workers.
  • Work experience students are usually workers.
  • Owner drivers are considered employees of the hirer – for example couriers.
  • Taxi drivers who are required to make payments to the operator of the vehicle are employees of the operator.
  • Directors / self-employed persons can be workers if they perform the work of an employee and can lodge a WorkCover claim against their own company.

MAY not be an accepted claim
— Seek legal advice

Was the worker injured
in a car accident?

Is the injury connected to their employment?

x

Can a connection to employment be established?

There needs to be a causal link between employment and the injury.

  • There is no need to show that the injury was the employer’s fault
  • The injury needs to arise out of employment, that is, employment was a significant contributing factor to the injury.
  • The injury needs to occur in the course of employment and include work or services that the worker is required to perform or anything incidental to work. Incidental to work can include:
       • Travelling for the purposes of work;
       • Parking your vehicle;
       • Conferences and work functions;
       • An authorised recess e.g.. lunch break; and/or
       • Attendance at a school/training for the purposes of work.

MAY not be an accepted claim
— Seek legal advice

Was the car accident connected
to their employment?

x

Workcover or TAC?

  • The TAC covers workers who are injured in a transport accident on a journey to or from work.
  • WorkSafe covers workers who are injured in a transport accident during the course of work, including during an authorised recess from work such as a lunch break.

Lodge a TAC claim -
see TAC information

Do any exclusions apply?

x

Are there any exclusions to lodging a WorkCover claim?

  • If you are not a worker (see 'Are you a Worker' information).
  • If there is no connection to employment (see 'Was the worker injured in a car accident' information).
  • If the injury is deliberately self-inflicted.
  • If the injury occurs due to the worker’s serious and deliberate misconduct.
  • If pre-existing injuries were not disclosed when the employer requested such information in writing.

MAY not be an accepted claim
— Seek legal advice

Has the claim been lodged correctly?

x

Requirements in lodging a claim

  • Notice to the employer should be given within 30 days of becoming aware of injury, however the claim can still be accepted if this does not occur.
  • The claim should be lodged as soon as practicable after injury becomes known.
  • The claim form must be submitted to the employer or Worksafe.
  • If a claim is made for lost wages then a certificate of capacity must be submitted with the claim form and every 28 days thereafter.

Accepted WorkCover claim

x

What are a worker’s entitlements once they have an accepted Workcover claim?

  • Medical and like expenses such as doctors, medications, and conservative and operative treatments.
  • Weekly payments when a worker is unfit for work due to a work-related injury. Even when a worker’s entitlement to weekly payments is terminated by the WorkCover insurer, it is possible to have the decision overturned on appeal.
  • When someone sustains a permanent injury they may be entitled to lump sum compensation. Regardless of whose fault the accident is, they may be entitled to an ‘impairment benefit’. In addition to this, if the work injury was caused wholly or partially by the employer’s negligence and the worker has sustained a serious injury, the worker may be entitled to make a larger claim for pain and suffering and economic loss.

MAY not be an accepted claim
— Seek legal advice