I’m on compensation, what do I need to know?

KEY TAKE-OUTS:

• Understanding workers compensation can be a minefield in New South Wales, support is provided to workers who are injured through the workers compensation scheme.
• There are several ways your compensation claim can be funded such as through IRO funding or “no win, no fee” (conditions can apply).

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Workers compensation is a complex area of law but is extremely important as it provides support to workers who are injured at their place of work.

What is workers compensation in NSW?

In New South Wales, the support provided by the workers compensation scheme can take the form of compensation for lost income, medical, hospital or rehabilitation treatment, return to work assistance, and in some cases compensation for non-economic loss. In NSW, the State Insurance Regulatory Authority (SIRA) is responsible for regulating the workers compensation system.

Generally, there are three broad types of insurers in NSW who pay workers compensation:

• iCare;
• Self-insurers; and
• Specialised

iCare is a government agency that provides insurance and other care services to statutory authorities and people injured at work. iCare often engages insurers such as Employers Mutual NSW Limited, Allianz, GIO, or QBE to manage compensation claims.

Self-insurers are employers who are approved by SIRA to manage their own workers compensation claims. This means that the employer is not required to obtain a workers compensation policy from iCare.

Specialised insurers are licensed by SIRA to provide insurance and manage workers compensation claims.

How can a claim for workers compensation be funded?

There are two main ways a compensation claim can be funded.

The first way is through a grant from the Independent Review Office (IRO). Lawyers who are approved by IRO can apply for funding on behalf of their clients. The purpose of IRO funding is to ensure injured workers are able to:

• Obtain legal advice regarding their claim;
• Access legal assistance to attempt to resolve any disputes;
• Have their claim determined in the Personal Injury Commission where a dispute is unable to be resolved by other dispute resolution options; and
• Access legal representation at the Commission or other Courts.

IRO funding can be used to cover professional fees, counsel’s fees, medical report fees, and the cost of other disbursements and incidental expenses necessary to lodging a claim for workers compensation.

Certain workers, known as exempt workers, are unable to obtain IRO funding such as police officers, firefighters, paramedics, coal miners, workers suffering from a dust disease and workers subject to the Workers Compensation (Bush Fire, Emergency and Rescue Services) Act 1987.

Workers who are not eligible for IRO funding may choose to see a lawyer who offers a “no win, no fee” service. A no-win-no-fee arrangement is:

• An arrangement that covers costs and disbursements. If your case is lost, the lawyer will incur professional costs and barrister’s fees and you will only reimburse disbursements.

As not all lawyers offer the same no-win-no-fee arrangement, it is important to read the solicitor’s cost agreement so you are aware of all fees and charges you may need to pay.

FAQs about workers compensation

How do I make a workers compensation claim?

Before making a claim for compensation it is important that you notify your employer of your injury as soon as possible and make a record of this injury, generally in the form of an incident report.

Next, you should obtain a Work Cover Medical Certificate of Capacity from your general practitioner or hospital.

Additionally, you should notify the insurer of your injury. The details of your insurer can be given to you by your employer. You should give a copy of all medical bills and Certificates of Capacity to your employer and insurer. The employer has 48 hours to notify its insurer.

Once this has occurred, the insurer will contact you and your employer, they will review your claim. Generally, the insurer will begin to make provisional liability payments to you within 7 days of being notified of the injury. Whilst they investigate it before determining full acceptance.

Are there any time limits on claiming for compensation?

A workers compensation claim should be made as soon as possible after an injury or 6 months from the date of injury.

If a claim is not made within 6 months and it is due to ignorance, common mistake or absence from the state a claim can still be made.

No claim can be made after 3 years from the date of injury unless the injury resulted in the death or serious injury of the worker. However, some exceptions could apply.

What happens when my claim is successful?

If your claim is successful, the insurer will pay you benefits as set out in the Workers Compensation Act 1987. There are several kinds of benefits including:

• Payment of weekly compensation;
• Payment of lump-sum compensation for permanent impairment;
• Medical and hospital expenses;
• Rehabilitation expenses;
• Death benefits and funeral expenses; and
• Compensation for property damage.

Nb: Comcare and except workers may be different.

Tips

If you have been injured at work, you must get advice from a lawyer as soon as possible. Additionally, it is important to understand your rights, your lawyer should be able to advise you of these.

Making a claim for workers compensation is an extremely difficult time in a person’s life so you must connect with your lawyer and have a good relationship with them. It is vital that you feel like you can trust them, and that they will achieve the best outcome for you.

It is vital that you have a good support system around you and “build a village”, that will stand by you during this very difficult time.

The team at Coutts can help you

At Coutts, we are proud of our no-win-no-fee policy as we understand the financial burden obtaining a solicitor can have on an individual. We also have IRO approved lawyers, meaning if you are eligible we can assist you in accessing this funding. We also provide a free Initial consultation and case assessment advice at the beginning of your matter. At Coutts, we pride ourselves on providing flexible services to our clients and we will commute to you for appointments. We endeavour to respond to our clients within a 24-hour time frame and have one-on-one point of contact.

Our dedicated team understands the complex nature of a Workers Compensation Claim. Our Lawyers are experts in the field of personal injury claims specialising in Workers Compensation Claims. We recognise that a compensation claim is highly stressful, and our team are here to provide the support you need.

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