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How to claim for an accident at work?

From the relatively minor to life-threatening, accidents can happen in even the safest work environments. The circumstances that led to an injury and how your employer responds, however, may vary greatly. Across the board, however, there are several steps you can take to claim for an accident at work and maximise a potential payout.

As an injured worker, you may have a right to a certain level of compensation. If you or a loved one feels that you are being unfairly denied workers’ compensation or that your injury was the result of a negligent workplace, a skilled solicitor may be able to help you achieve a favourable outcome.

What injuries qualify for workers' compensation?

Workers’ compensation is a form of insurance that employers pay into a payout to employees if they become sick or injured while working on the job. In specific cases benefits may extend to situations where an employee was coming to and from work or working off a job site, such as a transport accident. Payment may cover anything from short- and long-term medical treatment to lost wages and superannuation.

The kinds of issues that can be covered by workers’ compensation vary widely — including everything from physical overuse injuries to psychological damage. Likewise, the kinds of damages you can seek for a workplace accident also range widely, but often include:

Medical and rehabilitation costs

This can include both short-term medical expenses, such as emergency room and specialist care, and long-term treatment, like physical therapy and in-home assistance.

Economic loss

This category includes any lost wages and superannuation benefits that result from an injury. In some cases, this can also include any expected future losses.

Pain and suffering

A possible lump sum compensation for pain and suffering or if you suffered permanent impairment. This form of compensation only occurs in some cases, usually if a worker is permanently unable to return to work.

Legal costs

If your WorkCover claim or medical negligence claim goes to court and a judge rules in your favor, your legal fees may be covered.

Each state has its own program and regulations for workers’ compensation insurance. New South Wales, for example, is managed by SafeWork. No matter where you live, however, it is the responsibility of your employer to take out a workers’ compensation insurance policy in case you or a fellow employee is injured. What that means for you is that negotiations over the specifics of payment will usually be handled by an insurer, rather than directly with your employer.

“GMP is small enough to care intimately for their clients and large enough to have the financial, medical and expert resources clients need to receive maximum compensation.”


Gerard Malouf

Steps to take following an injury

If you are involved in a work-related accident, there are a number of steps you should take in the days and months after the injury occurs to handle the situation correctly.

Seek medical treatment

First, you will need to seek medical treatment. The severity of your accident will dictate what sort of attention you require — and compensation may be available to you. Depending on the accident, you may need on-site first aid, counselling or, in more extreme cases, to be taken to hospital. In addition to being the smart thing to do for your health, having a record of your treatment is essential to getting it covered down the road.

It’s vital that you inform whatever health care professional treats you that the injury is work-related. This will be important down the road for applying for a WorkCover Certificate of Capacity, or similar form depending on your state, or potentially claiming for workplace negligence damages.

Apply for a Certificate of Capacity or similar form

The specific regulations for receiving workers’ compensation can vary from state to state. However, in every case, you’ll need some kind of official documentation of your injuries.

New South Wales, for example, uses the WorkCover Certificate of Capacity. This form is very important for your WorkCover claim, as it is “the primary tool” through which your health care professional can explain to all involved the severity of your injury, according to WorkCover New South Wales. It is also the only document that an insurance provider is allowed to base “work capacity assessments and decisions” on.

You may be required to sign the Certificate of Capacity, and you must provide it – completed – to your employer and insurance provider to be eligible for compensation. Throughout this process, transparency is key — for both you and your employer. Typically, if you do not report your injury to your employer within a 30-day window, you may become ineligible to make a claim. Similarly, it is the responsibility of the employer to place your Certificate of Capacity in their register of injuries and inform WorkCover of what has occurred. Failure to do so could result in a large fine for your employer.

Apply for Works Compensation

Once the immediate impact of your injuries has been seen by a medical professional and recorded by your employer, it’s time to focus on actually applying for benefits.

Of course, not every workers’ compensation claim is created equal. Your employer’s insurer may not provide a level of compensation that covers all of your expenses or decide that your injuries do not qualify for an additional lump sum payment. Your employer’s return-to-work plan may also not fully address your situation — leaving you nursing your injuries while trying to make a living. If you don’t receive the amount of compensation to which you believe you are entitled, enlisting the legal services of a compensation solicitor may be able to help.

Next steps

As a part of your benefits package, you will then most likely need to “participate and cooperate” in any injury management plan that your employer introduces following your accident, as well as doing everything in your power to return to work as soon as you’re able. In situations where your injuries leave you impaired for life, a lump sum may be available, at which point your claim would be over. While this is intended so the permanently impaired don’t have to continually deal with insurance for life, it can lead to problems down the road.

Workplace negligence and claims against an employer

Of course, a work injury claim won’t always work out the way you expect. Your insurer may not offer enough compensation to cover what you feel you’re owed. In addition, if your injury is the result of the negligence of your employer, you’ll need to file for separate damages to rectify the situation.

In order to make a successful workplace negligence claim, you must be able to prove that your injury was the direct result of an unsafe work environment at work and that your injuries are related to the damages you are pursuing. Examples of an unsafe work environment include inadequate equipment, safety training or other violations of NOHSC regulations.

The most lucrative negligence claims with the highest success rates are those which are assessed as being 15% or greater whole person impairment. This means that an injury has caused significant, lasting damage. Workers who have been hurt in this manner are entitled to both lost wages and superannuation and an additional lump sum payment for their pain and suffering. If your claim is assessed below the 15% threshold there’s a high chance that your suit will not be able to move forward as an Australian Common Law claim.

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Gerard Malouf & Partners
 — Personal Injury Compensation Lawyers

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