What is an injury and how do I know I can make a workers’ compensation claim?
You can make a claim for a physical injury or a psychological injury.
In Western Australia, the statutory workers’ compensation scheme is a no-fault scheme.
If you can show that your injury was sustained during the course of your work duties, you are entitled to make a claim. Exceptions apply to some stress claims and it is recommended that you seek legal advice to assist determining whether you can make a claim.
What do I do if I suffer an injury at work?
You must report the accident to your employer and attend your doctor for medical treatment, advice, and assessment of work capacity.
You can make a claim whether you need time off work or not.
You must complete and provide both of those documents to your employer.
Remember to keep a copy of your claim form and certificate for your records.
What happens after I submit my claim form and first certificate of capacity?
Your employer must provide the documents to its workers compensation insurer within 5 working days, and the insurer must provide you with its decision with regards to liability within 14 days after that.
If my claim is accepted what does the insurer pay for?
For the time that you require off work, the insurer will pay weekly compensation payments, medical treatment costs (e.g. doctors, specialists, physiotherapy, chiropractic, hospital, psychological), travelling expenses for treatment and vocational rehabilitation costs.
There are maximum amounts which apply, and you should seek advice to learn about the consequences of these amounts exhausting. (PDF under “Indexation of Workers Compensation payments 2020/2021)
What if the insurer pends or declines liability for my claim?
It is not unusual for a workers’ compensation insurer to pend liability for a claim. This means that they are unable to make a formal decision on liability as further information is required. The further information is usually of a factual and a medical nature and the notice pending liability must outline what further information is required. An insurer may then go on to make a formal decision on liability, however this process must be monitored and hastened as it is not usually a quick process. We can assist you in this process to drive the insurer to obtain the information and make a decision.
If the insurer declines liability for your claim, they must issue a notice advising why they decline liability. It is important to note that just because an insurer declines liability for your claim, it does not mean that you do not have a valid claim. It is simply the decision that an insurer has made.
You cannot take it for granted that an insurer’s decision to pend or decline liability is the correct decision. It is usually not. It is advisable that you contact us to discuss the merits of your claim and the dispute resolution process which is available to you.
What if I can’t return to the work I was doing before the accident?
You are entitled to have a vocational rehabilitation provider appointed to assist with your return to work and you can choose the rehabilitation provider you wish to appoint.
What is the time limit for making a workers’ compensation claim?
If you have been injured in an accident at your place of work, or have suffered a stress condition due to working conditions, it is important to claim as soon as is practicable, preferably within 12 months of the injury. If you are outside 12 months, you should seek legal advice from PPIL immediately.
If you have a common law claim against your employer in negligence, legal proceedings must be commenced within 3 years from the date of the accident. For more information on a common law claim arising from a work accident or injury click here.
The following is a list of what you may be entitled to as a lump sum payment:
- Schedule 2 lump sum payment
- Redemption of past and/or future wages
- Past and/or future medical treatment costs
- Future vocational rehabilitation costs
- Past and/or future travelling expenses.
It is important that we obtain all the relevant medical evidence for your including an assessment with an Approved Medical Specialist who is qualified to make assessments in the workers’ compensation system.
To determine what your lump sum entitlements are please contact us to arrange an appointment. Further information is provided here.
When is the right time to settle my claim?
It is recommended that your claim is settled when your medical condition has reached maximum medical improvement, or stabilisation, and an assessment of your impairment, your work capacity and future treatment needs has been made.
The right time to settle your claim could be more than 12 months from the date you suffered your injury. You should have all medical and other evidence available prior to settling your claim to maximise your entitlement.
If you think that your employer was at fault in causing your injury, you should not settle your claim until your Whole Person Impairment has been assessed, as you may have a common law claim.
To determine whether the time is right to settle your claim please contact us to arrange an appointment.
A common law claim is commenced in the District Court of Western Australia and is a claim for damages (compensation) against your employer for negligence in causing your injury. "Workers compensation claim v common law claim…What is the difference?"
Do I have a common law claim?
You are not able to pursue a common law claim unless your Whole Person Impairment is assessed at least at 15% and you make an Election to Retain the Right to Seek Common Law Damages by the Termination Date. The Termination Date is the date 12 months from the date you make the claim for weekly compensation payments. To ensure that you do not miss your opportunity to determine whether you have a common law claim please contact us for an appointment at least 3 months prior to your Termination Date.
What compensation am I entitled to at common law?
Common law damages are:
- General Damages (Pain and Suffering/Non-Pecuniary Loss)
- Past and Future Economic Loss (Pecuniary Loss)
- Past and Future Medical Treatment costs
- Past and Future Gratuitous services/Voluntary Assistance
- Past and Future Travelling Expenses
- Out of Pocket Expenses.
For more information click here.