Navigating workers’ compensation claims in the health care industry
Health care workers have the highest risk of workplace injury out of any industry. As with any industry, health care workers should know their rights when it comes to claiming compensation.
It is essential that health care workers report incidents to their employer and seek medical assistance and advice.
What are the most common health and safety related injuries in the workplace for health care workers?
COVID-19: The pandemic has highlighted the risks that health care workers are exposed to every day. Overseas, a high proportion of those who have contracted the virus are health care workers. Fortunately in Australia, access to high quality PPE has kept the rate of infection in our health care workers comparatively low. Until a vaccine is developed, however, health care workers continue to face the risk of exposure and contraction of the virus as part of their working lives.
Occupational violence: This occupational health and safety issue is particularly prevalent in the health care sector. Nurses, ambulance officers, paramedics, hospital staff, personal care attendants and aged care workers are often subjected to acts of violence and aggression from patients and the general community. These incidents can cause injuries such as concussive injuries, broken jaws and bones, and soft tissue injuries.
Psychological injuries: These can occur as a direct consequence of occupational violence, or as an indirect consequence of exposure to tragic circumstances, injury, illness, disease and heartache by patients.
Musculoskeletal injuries: When an ambulance officer attends an emergency at someone’s home and the person is in a confined space or in a space that is difficult to access, they are susceptible to injuries. Health care workers suffer a high incidence of musculoskeletal injuries such as back, shoulder, knee and hip injuries.
Injuries which develop over time: Due to the physical nature of health care work, workers often suffer injuries which increase in pain and limitation of movement over time – a sore back could develop into a disc bulge or prolapse over time. If you have a sore back, knee or hip as a result of your work, it is essential to report it and seek treatment.
How do I make a workers’ compensation claim? Do I need a lawyer?
- Firstly, report the injury immediately. You have 30 days to report the injury to your employer in Victoria.
- Compensation for a work injury is accessed by lodging a Workers Injury Claim Form. An injured worker is required to lodge the claim form with their employer as soon as practicable after they have suffered their injury.
- You can choose to lodge the form with your employer, or you can send it via post (we recommend registered post).
- Once the employer has received the form, they must forward it on to their workers’ compensation insurer within 10 days. Within 28 days, the insurer must provide a written response to the injured worker, either accepting or rejecting their claim.
How is workers’ compensation calculated?
Once your claim is accepted, you will be entitled to receive weekly payments, as well as your reasonable medical and like expenses.
Weekly payments (wages on WorkCover) are calculated by taking the average of your regular income in the 12 months prior to the date of injury. Weekly payments can be paid at a maximum of $2380 (indexed annually) on a sliding scale.
- For the first 13 weeks, they are paid at 95 percent of your pre-injury average weekly earnings (PIAWE).
- From week 13 to 52, they are paid at 80 percent of your PIAWE.
- Between weeks 52 and week 130, they are paid at 80 percent of your base wage.
- Beyond 130 weeks they are paid in discrete circumstances.
If you are on weekly payments and have received weekly payments for 130 weeks and your entitlements are terminated by the insurer, it is essential you seek advice about whether you are a candidate to continue to receive weekly payments. Please contact us for advice.
Lump sum claims
If you have suffered a permanent injury, you may also be entitled to a lump sum claim. In the WorkCover system, there are two lump sum claims you may be able to access.
The Impairment Benefit Claim is a one-off, no-fault lump sum claim for people who have a permanent injury which is stable and over 12 months old. Contrary to popular belief there are no time frames for lodging an Impairment Benefit Claim, so if you still suffer from a permanent physical injury and you have pain and limitation of movement, it is essential that you seek immediate advice as to whether you may be a candidate for an Impairment Benefit Claim.
A common law claim for damages is the other lump sum claim that you may be entitled to. You must have a “serious injury” and it must have occurred in negligent circumstances for you to access this compensation.
The common law claim must be brought within six years of the date of injury. In some circumstances the time limits can be extended, so it is important to obtain legal advice as soon as possible.
What to do if this information applies to you
For personalised and individual advice, we offer consultations to discuss your matter.
Please call Gordon Legal on 1800 21 22 23 or our Geelong office on 1800 21 22 23 to speak with a member of our team.
Given the current environment, we are providing consultations over the phone or via video conferencing platforms.