What to expect after lodging a WorkCover claim

If the Claim is accepted:

You will be notified by mail and will receive most of your pre-injury average weekly earnings (PIAWE). In Victoria under WorkCover, the amount received for the first 13 weeks is 95% of PIAWE, including regular shift penalties/allowances and even overtime, in some circumstances. View our page on Calculating PIAWE for more information. Check with your Union for advice if you believe the PIAWE is not calculated correctly.

The level of payments drops after 13 weeks to 80% of your PIAWE and still includes regular shift penalties/allowances and any overtime. At 52 weeks the payment drops again to 80% of your base wage without any shift penalties, allowances of overtime.

Check your Award or Agreement, as there is sometimes a "Make-up Pay" Clause that specifies that the employer must make up the difference for a certain period of time.

During the time you are on Workers Compensation, you may receive letters from the insurance company with instructions to visit more doctors (or specialists) known as Independent Medical Examiners. A failure to cooperate in good faith with these requests may be used to terminate your claim. If there are difficulties attending these appointments, you should contact the insurance company in the first instance. They may be able to accommodate your needs by providing assistance such as cab vouchers or other items that will facilitate your attendance. 

If you feel like you are being asked to visit too many doctors, contact Injured Worker Support. 

Severance/redundancy pay may affect Workers Compensation payments. Also, being on compensation may affect Superannuation. If you have any concerns, you can contact your Union.

If the claim has been accepted, you may also be eligible for other types of compensation. In cases of permanent disability, you may be eligible for a lump sum payment under the compensation scheme. Also, if there was some negligence on the part of the employer involved, there may be the possibility of a Common Law claim. For further information and advice, contact your Union. If there is a possibility that the member is eligible for either of these, you will likely be referred to solicitors.

If the Claim is not accepted, or payments are cut off or reduced:

You should be notified if your WorkCover claim is not accepted or your payments are cut off or reduced. However, this does not always occur. In this case, you should contact your Union or Injured Worker Support immediately to ensure the proper steps are taken to dispute the decision.

Remember:

1. All accidents, injuries or conditions must be reported and recorded in the accident book at your workplace - even they don't involve time off work.
2. Claims for Workers Compensation should be submitted as soon as possible, and certainly within 30 days after an injury or after a worker becomes aware of any condition.
3. Make sure the doctor provides the correct Workers Compensation certificate.
4. The Union should be contacted immediately if the worker receives any papers from either the insurance company or the Workers Compensation Authority.
5. No one should sign anything or talk with any investigators/assessors. Call the Union for advice and assistance.
6. Contact the Union if there are any problems with payments.
7. Make and keep copies of ALL documents.
8. Do not go to a solicitor down the road without contacting the Union first - it could end up being costly both in terms of money and the success of the claim.

Last Modified: 01/07/2021

The information on this website produced and distributed by the IWSN is of a general nature. We do our best to ensure the information is accurate and up to date, but cannot take any responsibility for any loss arising out of its use. You should not rely on it applying in your own circumstances and should always take further advice from those with appropriate qualifications.