The Workers’ Compensation system can be overwhelming and difficult to understand at the best of times, let alone in the midst of dealing with an unexpected workplace injury. You probably have a million questions running through your mind – where to start, where it ends and what to do from here.
At PPIL, we have a team of lawyers who specialise in Workers’ Compensation Claims to help lay your thoughts to rest.
Below we have listed our top 5 pointers to those pursuing a Workers’ Compensation Claim in Western Australia:
1. It can be a long and exhausting journey
The ‘how long?’ question is one that we are asked more often than not, and sometimes the answer is not always the one you’re hoping for.
It is important that you wait until stabilisation of your medical condition (Maximum Medical Improvement) before moving to settle your claim. This will allow for assessment of your Permanent Impairment and this assessment will assist in determining how, and when your claim should be settled. It will also allow an assessment of Whole Person Impairment to be made to determine if you have a viable Common Law Claim against your employer.
According to WorkCover WA’s Annual Statistical Report | 2023/24, the average length of time between insurer lodgement and finalisation of claim was 11.7 months. However, it should be noted that the length of your Workers’ Compensation claim heavily depends on a multitude of factors, and cannot be accurately estimated until all factors are taken into consideration.
If you are wanting to know a more accurate estimate of how long your Workers’ Compensation claim will take to reach a lump sum settlement, click here to book a Free Initial Consultation with one of our solicitors.
2. You will be required to attend regular appointments with your General Practitioner
Throughout the entirety of your Workers’ Compensation claim, you will be required to obtain and provide a current Progress Certificate of Capacity from your General Practitioner. As stated on the WorkCover WA Website, the purpose of Progress Certificates of Capacity are to “[keep] the employer and insurer updated on [your] progress, ongoing treatment requirements and capacity to return to work.” (WorkCover WA, FAQs: “What is the difference between the Certificates of Capacity?”).
The provision of the certificates will ensure that you continue to be paid Income Compensation Payments.
The costs of these appointments are covered by the insurer until the Medical and Health Expenses General Limit has been reached. To see what this limit is for the year your injury occurred in, view the WorkCover WA Indexation of Workers’ Compensation Payments here.
To read more about the Certificates of Capacity, click here.
3. You may engage a Workplace Rehabilitation Provider to assist with you Return to Work (RTW) Program
An approved Workplace Rehabilitation Provider (WRP) may be engaged to assist you in returning to your workplace duties throughout the course of your claim.
As stated on the WorkCover WA website, “You are entitled to claim for reasonable workplace rehabilitation expenses, but there is a limit to your entitlement that is determined by the General Maximum Amount.” (WorkCover WA, Workplace rehabilitation providers: “Who covers the costs?”). This means that the insurer will cover the cost of engaging an approved WRP for your RTW program until that limit is reached.
4. You will be required to attend Independent Medical Examinations (IMEs) with specialist doctors.
An essential part of finalising your Workers’ Compensation claim is obtaining medical evidence to outline what your injuries are, the extent of the injuries and whether you have suffered a permanent impairment as a result of your injuries. To do this, you will be required to attend Independent Medical Examinations with specialist doctors. The insurer decides which doctor you will be seeing for your examination, and this is an appointment you must attend.
At PPIL, we will also arrange an IME with a specialist doctor who is best suited to your specific injuries, as we like to ensure that you obtain a second opinion. This helps to reduce the risk of your claim being undervalued due to limited medical opinions.
5. The insurer may not immediately accept your claim (if at all).
It is not uncommon for a Workers’ Compensation insurer to issue a Declined Decision Notice or Deferred Decision Notice. This does not mean that you are no longer entitled to pursuing a Workers’ Compensation claim. A Declined decision, can and should be challenged. An experienced Personal Injury lawyer can, and will challenge this decision on your behalf by obtaining relevant medical evidence in support of your claim. In fact, it is possible to achieve a lump sum settlement even when the insurer maintains their Declined Decision Notice.
For more information regarding the WorkCover WA dispute resolution process, contact PPIL on (08) 9581 4339 to book a Free Initial Consultation with one of our Solicitors.
