Hurt at work?
If you are a government employee, or an employee of companies licensed to operate under the Comcare Scheme, and you suffer an injury at work,
you can claim compensation under the Safety, Rehabilitation and Compensation (SRC) Act 1988 (Cwth).
You are covered whether you work full-time, part-time or as a casual.
You can claim compensation for injuries sustained at work or a disease caused, or contributed to, by your employment.
Diseases including cancers, strokes, asthma, heart conditions and degenerative conditions are often aggravated or exacerbated by employment.
It's important to get advice from experts
Accessing your entitlements under Comcare can be a very complicated process and time limits apply to many steps you need to take to pursue a claim for compensation.
If you are injured, you should seek advice from your union or a legal expert who can guide you through the Comcare claims process.
No matter who you are up against, Maurice Blackburn will fight to protect you.
Five FAQ about Comcare claims
What injuries are covered?
Under the Comcare Scheme, compensation is payable for:
- physical injuries, such as an injured back, arms or
legs
- injuries suffered while you are temporarily
performing a work activity away from your place of employment
- injuries suffered travelling for work or while
travelling to, or attending, an approved place of work or education
- injuries suffered while obtaining a medical
certificate, medical treatment or undergoing a rehabilitation program or
medical examination required by Comcare or your employer, and
- any disease caused, or contributed to, by work, including pre-existing disease if work has aggravated the condition (this may include cancers, degenerative conditions, strokes and heart conditions).
The SRC Act allows your employer or Comcare to deny your claim if they can show that an exclusionary provision applies. This can occur where it is alleged that an injury, disease or an aggravation is a result of:
- reasonable disciplinary action
- failure to obtain a promotion
- failure to obtain a transfer, and
- failure to obtain a benefit in connection with employment.
Since 13 April 2007, a claim can also be excluded if it arose as a result of reasonable administrative action. This can include employment-related performance appraisals, counselling, suspension action, disciplinary action, re-classification or retention of a benefit.
Also, injuries suffered after 12 April 2007, while travelling between work and your home, are no longer covered. However, you may still be able to lodge a claim with the TAC.
If Comcare or your employer uses an exception or exclusion to reject your claim, contact Maurice Blackburn for advice. Freecall 1800 810 812.
How do I make a claim?
To make a claim you must:
- report your injury in writing to your employer as
soon as possible and complete an incident report
- visit your own doctor for treatment and ensure the
injury or condition is recorded
- lodge a claim form for time off work or medical expenses - these are available from your union, your employer or from www.comcare.gov.au, and
- obtain a medical certificate from your doctor if you are claiming for time off work - it should describe the injury, include the doctor's opinion about whether the injury is work-related, and detail any time off work and further treatment required.
Always keep a copy of all documents related to your claim, including copies of your incident report form, claim form, receipts and invoices, and any correspondence. You should also forward all accounts and receipts for medical treatment to Comcare or your employer. If the claim is accepted, you will be reimbursed.
There is no time limit for a response to a lodged claim. However responses are usually received within 4-8 weeks. If your claim is rejected, and you want to appeal the decision, you must apply for reconsideration within 30 days.
Our Comcare experts can give you more information about the claim process. Freecall 1800 810 812.
What benefits are available?
You are entitled to payment of all reasonable medical expenses. This includes surgery, hospital fees, nursing care, dental treatment, prescription medicine, medical aids, and treatment from registered physiotherapists, chiropractors, osteopaths and massage therapists.
If you can't return to work, you are entitled to receive 100% of your normal weekly earnings for the first 45 weeks you are off work. If you can return to work, but not on your usual hours, you are entitled to a top-up payment.
After 45 weeks, if you are still unable to return to work, you will then be paid 75% of your normal weekly earnings. If you are able to return to work, but you are working less than your usual hours, you receive between 80% and 100% of your normal weekly earnings, depending on the number of hours you are able to work. This includes regular overtime, penalty rates, higher duties and some other allowances.
If you suffer a permanent impairment due to your work-related injury, then you may be entitled to claim a lump sum permanent impairment benefit. This does not impact your ongoing benefits, such as compensation for medical expenses. To be entitled to receive a lump sum payment, you need to establish that your injuries have stabilised, which usually happens 6-12 months from the date of your injury or your last operation. You also need a medical assessment that the injury is permanent.
Lump sum compensation and a pension payment are payable to the dependants of a worker who has died of a work-related injury or disease. Funeral expenses may be claimed to a maximum of $9000.
What if they stop my benefits?
Comcare or your employer may decide to stop your payments or medical treatment. This may occur where Comcare determines that you no longer have an incapacity for employment or you no longer need some or all of your medical treatment. If that happens, and you want to appeal the decision, you must apply for reconsideration within 30 days.
Comcare or your employer can also decide to suspend your benefits if you do not comply with, or refuse to sign, a rehabilitation program or a return to work program. Such a decision has severe consequences because it stops all benefits being paid to you or claimed by you.
If you are asked to sign a rehabilitation program, or to accept a return to work program, seek the advice of your doctor and obtain written advice about the duties you are able to perform before you sign the program. If your benefits are suspended, and you want to appeal the decision, you must apply for reconsideration within 30 days.
If the reconsideration (known as a reviewable decision) is not in your favour, Maurice Blackburn can advise you about the next steps to take. This may include taking your case to the Commonwealth Administrative Appeals Tribunal (the AAT). An application to the AAT must be made within 60 days of receipt of the reviewable decision.
Can I sue?
If you suffered an injury at work on, or after, the 20 October 1999, you have the right to sue. Your right to sue, however, depends on whether you suffered a serious injury, unless you were injured by a third party outside of your workplace. By suing, you may be able to recover damages for economic loss and pain and suffering, or for pain and suffering only.
If your injuries have been caused through the fault or negligence of your employer, the SRC Act requires that you choose between either a common law claim for damages (suing your employer) or a lump sum permanent impairment benefit. You cannot claim both. Once a decision is made, it cannot be changed. It is therefore vital that you obtain legal advice before making your decision.
To sue, you must have a permanent impairment assessment of at least 10%. You have three years from the date of your injury to make a common law claim.
If you were injured due to the negligence of a third party (a person or organisation other than your employer), you can sue them. You generally have three years from the date of your injury to pursue a common law claim. In the case of claims against another driver involving the TAC, the time limit is six years from the date of injury.
Common law claims against third parties can affect your ongoing entitlements. Our Comcare experts can give you more information about your options. Freecall 1800 810 812.