It is often overwhelming for an injured worker to cope with a work-related injury or illness and understand their right to claim workers’ compensation benefits. In Queensland, a successful claim provides financial support for medical costs, weekly payments, and rehabilitation services to aid in their recovery.
The Queensland workers’ compensation scheme is complex, particularly when you have not previously made a work injury claim. So, our QLD workers’ compensation benefits guide helps you understand the claims process and when an experienced personal injury lawyer can help you access lump sum compensation.
The QLD Workers Compensation Insurance Scheme
Workers’ compensation is a type of insurance policy that covers employees’ wages and medical costs in the event of work-related injuries. In Queensland, WorkCover is the leading work injury insurer.
The primary goal of this compensation scheme is to provide rehabilitation services and financial support to people who sustain illnesses or injuries at work. Consequently, if you’re injured at work, you can rely on this system to cover your medical expenses and compensate for lost wages, regardless of who was at fault for your harm.
What is my claim worth?
Types of Workers Compensation Benefits
In Queensland, WorkCover offers a range of benefits designed to improve workers’ compensation arrangements, including:
| Medical Expenses | Reimbursement of medical expenses incurred for prescription medications, seeing a doctor, therapy sessions, and other treatments for workplace injuries, including medical aids. |
| Weekly Payments | You receive weekly benefits that replace some of your lost wages, even if you are still work some hours. |
| Rehabilitation Services | WorkCover funds the rehabilitation you require to recover from your injuries, including if you are permanently disabled. or cannot work again. The workplace insurer might also cover retraining costs so you can resume work. |
| Permanent Impairment Lump-Sum Settlement | When you have severe physical or mental injuries that result in permanent damage, you could claim a lump-sum payout. |
| Death Benefits | If an employee dies due to injuries sustained on the job, death benefits are paid to the worker’s financial dependents, including burial and funeral costs. |
Medical Benefits
When you have an accepted claim, you can seek reimbursement for your treatment and hospital costs. Medical benefits under workers’ compensation mean payment of your:
- Medical treatment and rehabilitation services
- Hospital expenses related to a work injury
- Cover for ongoing medical care
For mental injuries, services such as general practitioner appointments, counselling, psychology, psychiatry sessions, and medication are covered.
Income Support Through Weekly Payments
Your compensation begins with regular weekly payments when you have an approved claim for a work-related injury or illness. WorkCover or, in rare instances, the self-insurer is responsible for paying these funds. How much you receive in benefits is based on your pre-injury average weekly earnings. This is the calculation:
- 85% of regular wages for periods up to 26 weeks
- 75% of regular wages from 26 weeks to 104 weeks
- After 104 weeks, you are likely unable to return to work, but you could receive compensation based on your degree of permanent impairment using the ISV scale.
The standard weekly wage calculation is based on your income for the previous 12 months. If you don’t have a 12-month income history, WorkCover may use your existing employment period or the income of an employee in a similar position (working under the same award)
Dispute Resolution and Appeals
When a worker disagrees with the decision on their workers’ compensation claim, they have the right to appeal the decision through the Workers’ Compensation Regulator. If there’s dissatisfaction with a decision on a claim, an appeal can be lodged with the Queensland Industrial Relations Commission within 20 business days of receiving the review decision.
Do I Have a Valid Claim?
Other Compensation Considerations
Beyond the basic workers’ comp benefits, there are options to claim lump sum compensation. In Queensland, all workers’ compensation claims must be initiated as statutory (no-fault) claims, which means you do not need to prove who was to blame for your injury or illness. When you are nearing the end of your WorkCover case, you can pursue other types of personal injury compensation claims.
Compensation for Permanent Impairment
Workers who incur permanent impairments due to workplace injuries may be entitled to compensation based on the extent of their impairment and other specific criteria. The Workers’ Compensation and Rehabilitation Act 2003 outlines procedures for evaluating permanent impairment and provides for independent medical assessment tribunals and avenues for review and appeal.
Common Law Claims
The Queensland worker’s compensation system allows you to sue your employer for damages, known as a common law claim. To win this type of case, you must show:
- Your employer breached their duty of care
- Their negligence caused you to suffer a loss
Economic loss, pain, and suffering can all be compensated for through common law payouts, which can be substantial. However, you can be blocked from lodging a claim depending on your choices earlier in your case, so please seek legal advice before making any decisions.
6 Steps to Claiming Workers Compensation Benefits
You increase your chance of receiving workers comp benefits when you have some understanding of the claims process. Here are the steps.
1. Immediate Medical Attention
Not all injuries (particularly soft tissue injuries) are immediately apparent, so seek medical treatment immediately. Explain how your accident happened and follow your doctor’s advice, including your treatment plan. Request a referral to a psychologist or psychiatrist for medical health conditions. Remember, your medical practitioner’s report will form part of your compensation claim, so disclose all relevant details
2. Obtain a Work Capacity Certificate
Your doctor will give you a work capacity certificate once you explain that you will be making a workers’ compensation claim. This document is a vital part of the WorkCover claims process.
3. Lodge a work injury report with your employer
Part of the claims process is reporting your injury to your employer. Please be honest and do not exaggerate your injuries or the circumstances of the accident, as this could damage your outcome. WorkCover will contact your boss once you lodge a claim. Additionally, your personal injury lawyer will manage conversations with your employer.
4. Start a workers’ compensation claim with WorkCover QLD
Next, you lodge your claim with WorkCover Queensland. Using the online form, you explain how and when the accident happened and attach your work capacity certificate. You must provide copies of these when you meet with your workers’ compensation lawyer.
5. Wait for a decision from WorkCover
Within 20 business days, WorkCover must decide whether to approve or deny your claim.
6. Seek legal advice from Splatt Lawyers
You could be eligible for a permanent impairment payout and common law damages claim when you have an accepted WorkCover claim. These compensation cases generally have higher settlement amounts. To access all your entitlements, you will need expert legal advice from our experienced personal injury lawyers. Know your rights for free by Calling 1800 700 125
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FAQs for Workers Compensation Claims
What is the purpose of workers’ compensation?
In Queensland, workers’ compensation provides financial support and rehab services to employees who have suffered work-related injuries or illnesses. The primary goal is to get them well enough to return to work.
What benefits does workers’ compensation offer?
Workers’ compensation offers a range of benefits for injured workers, including coverage for the following:
- Medical expenses
- Income support
- Rehabilitation services
- Lump-sum settlements for permanent impairments.
- In some cases, you also get payment for the cost of domestic assistance.
What are the responsibilities of employers and insurers in the workers’ compensation process?
Employers and insurers must ensure Queensland employees have workers’ compensation insurance and inform the insurer of any work-related injuries. They must also report any compensation or equivalent payments made to the worker.
How do I initiate a workers’ compensation claim?
To initiate a workers’ compensation claim, you must:
- First, obtain a work capacity certificate from your doctor
- Report the injury to your employer
- Lodge the claim with WorkCover Queensland.