Injured at Work

What to Do

Dealing with work related injury or illness is difficult enough without having to deal with the legal set up. It is, however, necessary to deal with the WorkCover system. It is even more problematic if your employer believes that every WorkCover claim is fraudulent.

There are some basic rules that you should follow:

  • Put a record into the workplace Injury Register even if the injury is minor and does not cause you to have to go to a doctor or to go home.
  • Get a copy of the record in the Register - your employer has to give you a copy.
  • Don't let your employer convince you that it is better not to put in a claim. If they try to sack you for putting in a WorkCover claim what they are doing is illegal and we will pursue this.
  • Take your delegate or health and safety representative with you so that there is a witness to your reporting.
  • If you need to see a doctor, choose your own treating doctor.
  • If you need time off work you have to get a special WorkCover Medical Certificate from the doctor, not an ordinary Medical Certificate.
  • Even if you don't need time off work, but need different duties, some form of treatment such as physiotherapy, massage or pharmaceuticals, get a WorkCover Certificate.
  • You have the right to choose the treating practitioner (doctors, surgeons, physiotherapists etc.) management cannot tell you who you have to see for treatment.
  • You have to sign the back of the WorkCover Certificate and tick a box - either you have, or have not been engaged in any form of paid employment.. since the last certificate on the injury.
  • Ask your doctor to give you a photocopy copy of it, you should keep a copy of every certificate as well as giving the original to your employer.
  •  Fill in a WorkCover Claim Form, which is much longer and more complex than the Medical Certificate.
  •  Get your delegate, health and safety representative or organiser to help you fill in the claim form. There are a number of places on that form where making a mistake could reduce your entitlements.
  • If you are claiming lost income (even for a day) you need to give both the WorkCover Medical Certificate and the WorkCover Claim Form to the employer.
  • If you hand the claim in personally, take a witness.
  • If you post the forms, use Registered Mail so that there is a record that the claim was made.
  • Keep a copy of the claim form, you are supposed to be given a duplicate when you hand it in but it is often too hard to read so getting a photocopy is a good idea.
  • If your employer says that they will not accept you lodging the claim, contact your delegate/organiser as soon as you can.
  • If you think that your claim will not be passed on to the WorkCover Claims Agent within 10 days you should send a copy of the Claim Form and the WorkCover Certificate to the Agent yourself.
  • If you don’t know who is the WorkCover Claims Agent, you can call the WorkCover Advisory Service on 1800 136 089 or (03) 9641 1444.
  • If you are not losing time off work or if you are going to have less than 11 days off work, your employer can decide to accept your claim and keep paying you normally. While they do have to provide paperwork to VWA they do not have to wait for the WorkCover investigation before paying you the first 10 days off work.
  • When there is an injury in the workplace, there should be an investigation of the cause of the injury. The health and safety representatives should be involved in the investigation. The changes that are necessary to prevent you (or anybody else doing the work) from being injured further/again should be put into place.
  • If the injury is going to result in more than ten days off work the WorkCover Agency (i.e. the insurer) gets to decide whether the claim is accepted or not.
  • The VWA Agency (insurance company) may make an appointment for you to see a doctor of their choice. You must keep the medical appointment but you should be given a week notice.
  • If you do not keep such an appointment (with an independent doctor) your claim goes into limbo and is not processed any further.
  • You may be contacted by an Investigator (sometimes called a Loss Adjustment Officer) asking to meet with you. You do not have to see such a person. This kind of interview is often used to find an excuse to reject your claim. Often we advise you to refuse to talk to the investigators, certainly never see them by yourself and if you do feel that you must speak to them, organise the interview on neutral ground (not at home) and make sure that you have your delegate/organiser with you. The kind of situation where it might be in your interest to participate is when the cause of your stress is the behaviour of a person at your work (like a bully) and you need to make a complaint and have it investigated.
  • While the WorkCover investigation is happening (this is up to 28 days after the paperwork has been given to the VWA Agency) you may not get any wages.
  • In this case it can be possible to negotiate with your employer to allow you to use accrued entitlements such as sick leave or annual leave.
  • Once your claim has been accepted you are entitled to receive back pay, from the date of injury.
  • If you are a casual employee you will not have any entitlements to use. In this case you can claim Social Security from Centrelink.
  • If you have used accumulated entitlements they must be re-accredited to you. Check that they have been.
  • If you relied on Social Security the Claims Agent repays them and pays you the difference.
  • Keep every letter that you receive and keep copies of everything that you send to your employer or the claims agent.
  • Also keep a diary with a note against the date when you speak to anybody in the system about your claim or your injury. If you speak to somebody from the claims agent or the Victorian WorkCover Authority keep a record of the topic discussed and the name of the person with whom you speak.
  • If you are offered alternate or modified duties (light duties) at work, the offer should be in writing and you should take it to your doctor to discuss the duties.
  • Your doctor should be able to go to the workplace and to look at how it works in order to see whether the duties are appropriate.
  • In any discussion with management you have the right to have your delegate or health and safety representative with you.
  • You should always have a witness with you in such discussions.
  • If an Occupational Rehabilitation Provider is involved in your claim, you have limited choice about who provides those services.
  • Your employer, or the WorkCover Claims Agent, should give you a list of at least three Occupational Rehabilitation Providers from which you can make a choice.
  • In the workplace there should be a Rehabilitation Policy which has to be developed in consultation with the workforce.
  • If management claims that there is a Policy but if it was not negotiated then you should get the delegates/health and safety representatives to re-open the negotiations with management and they have to consult with workers, not to develop it unilaterally.
  • One major issue that has to be negotiated is which Occupational Rehabilitation Providers can be used.
  • If your doctor provides a WorkCover Certificate that states that you are able to return to work on 'alternate duties' or 'modified duties' your employer has to try to find appropriate duties and make you an offer.
  • Make sure that your doctor puts details about what kinds of limitations should be placed, e.g. no lifting more than 10kg, no twisting, no bending, no repetitive use of right arm (or whatever is appropriate). It is not in your interest if they put ‘light duties’ with no details.
  • If your employer simply says that there will be no duties for you until you are able to do your pre injury duties, talk to your delegate or health and safety representative and get it taken up with the organiser if necessary.
  • Your employer has to provide suitable alternate duties if it is at all possible for the first year of incapacity. This does not mean that they can automatically sack you after a year but the situation is more complex and relates to the Workplace Relations Act more than the Accident Compensation Act.
  • If you have an accepted claim the insurer may send you to a doctor for an 'independent opinion' on a reasonably regular basis (e.g. every six months) you must co-operate.
  • They may also have you observed by private investigators if they think that you are more physically capable than your certificate says. The investigators might follow you and video you doing things such as hanging out washing or doing exercises. The investigator is not allowed onto your property but it is legal for them to sit in a car outside if they have notified the police. If you feel that you are being followed or watched you can ring the police and report the person. That way if they have notified the police you will know that it is a formal investigation and not somebody who is casing your house for burglary or a person who is threatening you.
  • If you are offered suitable alternative duties (an offer that must be in writing) that your treating doctor says are suitable, you must co-operate. If you do not, your WorkCover entitlement will be terminated immediately.
  • In other cases that the VWA intends to terminate your weekly payments, or medical and like expenses, they have to give you written notice. This is either two weeks notice or four weeks notice.

There are probably other issues that could go on such a list of 'what to do' and, if you have questions, ask them and we can add them to the list.