Can an Employer Reject a WorkCover Claim? Here’s What you Need to Know.

If you’ve been injured at work and your WorkCover claim has been questioned or rejected, you might be wondering what rights you have — and what steps to take next. This article explains whether an employer can reject a WorkCover claim in Victoria, what happens if your claim is denied, and how to respond. We’ll guide you through your legal rights, common reasons for work injury claim rejection, and the process for disputing a decision. For personalised legal advice, contact Gordon Legal’s experienced WorkCover lawyers today on (03) 9603 3000 — we’re here to help you get the support you deserve.

Can my employer reject my WorkCover claim?

​In Victoria, your employer cannot outright reject your WorkCover claim. Their responsibility is to forward your completed claim form to their WorkCover insurer within 10 days of receipt. Whilst they may express concerns or provide information to the insurer, they are not the decision-makers regarding the acceptance or rejection of your claim – this responsibility falls on the insurer. Rejection may be based upon several reasons, that often differ on a case-by-case basis.

Despite this, employers can still formally object to a claim’s acceptance on specific grounds, such as disputing the employment relationship or the work-relatedness of the injury. Even in these cases, the insurer proceeds with managing the claim, and any benefits continue until a final decision is made.

Navigating a WorkCover claim rejection can be complex and distressing. For tailored advice and support, contact Gordon Legal’s experienced workers’ compensation lawyers at (03) 9603 3000. We’re here to help you understand your rights and guide you through the dispute process.

What reasons can an employer give to reject a WorkCover claim?

While employers are not the decision-makers when it comes to accepting or rejecting a WorkCover claim, they can raise concerns or provide information to the insurer. The insurer is ultimately responsible for deciding whether to approve or reject a claim. There are certain reasons an employer might give to challenge or dispute your claim, which could lead to a rejection by the insurer.

The table below outlines common reasons provided by employers, along with reasons the insurer alone may use to reject a claim:

If your claim is rejected, you have the right to dispute the decision. For legal advice and assistance with your WorkCover claim, contact Gordon Legal on (03) 9603 3000. We’re here to help you understand your rights and guide you through the dispute process.

Do WorkCover claim rejections affect my employment status?

A WorkCover claim rejection does not automatically affect your employment status. In Victoria, your employer is legally prohibited from firing or discriminating against you simply for lodging a WorkCover claim. The law protects your right to make a claim without fear of retaliation.

However, it’s important to understand that a rejected claim could create tensions in your workplace, especially if there are disputes about the injury or its work-related nature. Employers may become frustrated with the process, but this should not impact your job security. If you feel your employment is being affected as a result of your WorkCover claim, this could be a separate issue of workplace discrimination or retaliation, which is also illegal.

If your WorkCover claim is rejected, it’s crucial to take appropriate steps to challenge the decision, such as seeking legal advice or pursuing conciliation. A rejected claim should not change your employment rights. If you need assistance with your claim or are concerned about its impact on your job, contact Gordon Legal at (03) 9603 3000. Our team is here to provide the support and legal advice you need to protect both your health and your employment rights.

How can I challenge a rejected WorkCover claim?

If your WorkCover claim has been rejected, it’s important to know that you have the right to challenge the decision. There are several steps you can take to dispute the rejection and ensure that your rights are protected.

• Seek Legal Advice: Contacting a WorkCover lawyer early in the process is essential. They can help you understand the reasons for the rejection and provide expert guidance on how to proceed. Legal advice for WorkCover claims can ensure you’re equipped with the knowledge to navigate the dispute effectively.
• Request a Conciliation: The first step in challenging a rejection is often conciliation. This is a process where an independent conciliator helps both parties reach an agreement. You are also entitled to have a member from WorkCover assist present with you during the conciliation, to ensure you feel comfortable throughout the process. the outcome of a conciliation may either result in an offer, or a Genuine Dispute Certificate, if the dispute is not resolved.
• Consider Court Action: If the dispute is not resolved through conciliation, you may have the option to take your case to arbitration and court. It is important to engage an experienced Workers Compensation lawyer to assist you throughout this process.

Navigating a rejected WorkCover claim can be complex, but you don’t have to do it alone. For support and legal options after WorkCover claim denial, contact Gordon Legal on (03) 9603 3000. We’re here to help you get the compensation you deserve.

Do I need a lawyer to dispute a rejected WorkCover claim?

While it’s not a legal requirement to hire a lawyer to dispute a rejected WorkCover claim, having professional legal representation can significantly improve your chances of success. Disputing a rejected WorkCover claim can be a complex, time-consuming process and distressing process. A skilled WorkCover dispute lawyer can guide you through each step with confidence.

A lawyer can help in several ways:

• Understanding Your Rights: One of Gordon Legal’s supportive and expert WorkCover lawyers will clearly explain your legal rights and options, ensuring you understand the reasons for the rejection and how best to challenge it.
• Navigating the Dispute Process: From conciliation to independent reviews or even court proceedings, our team can handle the paperwork, negotiations, and deadlines involved.
• Building a Strong Case: Gordon Legal’s work injury lawyers can gather the necessary medical evidence, prepare your case, and represent your interests during disputes with the insurer or employer.

While it’s possible to dispute a rejection without legal representation, having a lawyer by your side ensures that you’re not alone in navigating this complicated process. For expert compensation claim advice and legal support, contact Gordon Legal at (03) 9603 3000. We’re here to help you fight for the compensation you deserve.