Workers Compensation Claim is Concluded After the Injured Worker Dies – Family Still Receive the Benefits

Published 21 Jun 2018

The family of a beneficiary to workers compensation claim had received the full entitlements which were awarded to an injured worker, who had died prior to the conclusion of the claim.

At Gerard Malouf & Partners we had fought vigorously to achieve a result for our client. The claim for workers compensation was denied totally and as a consequence of this, our client was not paid his statutory entitlements for medical expenses and weekly compensation. Further, the claim for his lump sum benefits relating to his impairment was also declined.

In order to proceed with the processes of a claim that is denied under the workers compensation scheme, we were required to obtain and serve supportive and relevant evidence. This included medical opinion on causation of the injury. Further, we needed to obtain various statements to complete our factual evidence pertaining to how the injury was sustained and the consequences that followed. We also had to gather various pay records to show what the injured worker would have continued to earn, had he not sustained the incapacitating injury.

The insurer continued to decline our client his entitlements and had instructed a major law firm to continue the dispute. The dispute was on causation, which was basically an argument by the insurer that employment did not cause the injury. This was despite the fact that we had presented medical and factual evidence in support of the claim.

As with any workers compensation claim that continues to be denied, we were required to commence proceedings in the Workers Compensation Commission. Once it was in the Commission, the appointed Arbitrator determined that the decision on causation was best to be dealt with by an appropriate Approve Medical Specialist (AMS).

Once the AMS had provided a supportive opinion that employment was a substantial contributing factor to the injury, the representative for the insurer conceded that the worker was entitled to his benefits. Unfortunately, our client had passed away prior to the final determination.

As the claim was made for various entitlements including payments of medical expenses, weekly compensation payments and lump sum compensation for impairment, there was a substantial amount of compensation in which the insurer had to pay the claimant. At GMP lawyers we were in an unusual situation as our client had since become deceased.

In order for our client’s family to benefit from the entitlements, we sort leave to change the name of the applicant. The change of name was to include the name of the estate itself. The insurer allowed us leave to do so. Following that we sort to have all the benefits paid to the estate of our deceased client, where the proceeds would thereafter go directly to his family.

With a successful outcome of the substantive claim, the monetary benefits that was payable to the claimant, was paid in favour of his family. This included his spouse and six children.

In this instance, although the claimant had died, the claim did survive. At Gerard Malouf & Partners we believe that our client knew that we were going to protect his family and ensure that all benefits he was entitled to, would be given directly to them.

This is a very sad story as our client leaves his spouse and six children and we know that no amount of money can replace a family member. At GMP Lawyers we can only do what we are skilled at doing and we were comforted to know that at the very least our client’s family reaped the benefit of the compensation claim in which we had succeeded in.

In fighting for the right of our clients’, at Gerard Malouf & Partners we also know that beside the individual is a family and it is our endeavour to ensure that both the individual and his or her family are protected.

For assistance from Gerard Malouf & Partners relating to a work injury or injury occurring other than work, you may contact us by phone on 1800 004 878 or complete our email enquiry form that you will find on our website.