Workers Compensation Payout Guide

What is workers compensation?          

Workers compensation is a form of insurance that provides benefits to workers who suffer an injury or develop a medical condition in the course of, or as a result of, their employment.

These injuries might include suffering an injury at work on a specific day or developing a medical condition over a period of time due to the nature of the work performed.

Workers compensation is often referred to as WorkCover.

Workers compensation claims are managed by several insurance companies on behalf of the Victorian WorkCover Authority, also often referred to as WorkSafe.

Our workers compensation payout guide will provide you with an overview of how payouts work.

 

How are workers’ compensation settlements calculated?

Injured workers can make claims in relation to physical injuries and diagnosed psychological injury. Workers can also make claims in relation to workplace diseases and illnesses.WorkCover compensation payments can be in the form of weekly compensation payments for loss of income, compensation/reimbursement for reasonable medical and like expenses, a lump sum impairment benefit payment and/or a claim for damages. Below are the four types of WorkCover compensation payments and how they are calculated:

 

  1. Weekly compensation payments

If you have suffered a work-related injury or illness, you may be entitled to weekly compensation payments. Weekly compensation payments are calculated by assessing your ‘pre-injury average weekly earnings in the 12 months prior to your injury. A percentage of this calculated figure is paid weekly – the percentage of payment decreasing based on the length of time payments is required according to relevant statute.

 

  1. Medical and like expenses

The nominated WorkCover insurer  will pay the reasonable costs of approved medical and hospital expenses which does not always equate to the full treatment amount. The WorkCover insurer will determine what costs should be compensated based on what they deem to be reasonable expenses. There may, in some instances, be a difference between treatment cost and the compensation payment amount the WorkCover insurer provides.

It is also important to note that some types of treatment can be claimed without a referral, while others require a referral or approval from your WorkCover insurer.

 

  1. Impairment benefit

If your workplace injury has left you with a permanent impairment, you may be entitled to a one-time lump sum payment called an impairment benefit. To be eligible for an impairment benefit payment, you need to meet certain thresholds of injury.

If you have a permanent injury, it is essential that you seek advice as to whether you may have an entitlement to an Impairment Benefit Claim.

If you believe you may be entitled to an Impairment Benefit Claim, contact Gordon Legal’s team of experienced workers’ compensation lawyers, to advise you on your likelihood of success.

 

  1. Claim for damages

If you have sustained a serious work-related injury or illness due to your employer’s negligence, you may be entitled to a serious injury/common law claim.

 

How long does a WorkCover compensation payout take?

The length of time taken to receive a WorkCover compensation payout can vary depending on the severity of your injury and the amount of compensation being sought.

 

Weekly payments

Decisions regarding weekly payments are usually made within 38 days of your WorkCover claim being submitted. If your claim is accepted weekly payments will usually commence within 7 days of the acceptance of the claim.

 

Medical and like expenses

Approved hospital and medical and like expenses can be invoiced to your employer. If you pay a medical expense bill at the time of treatment, you are entitled to reimbursement within a reasonable time of the WorkCover insurer receiving your receipt. It is important to note that the WorkCover insurer will only pay for the reasonable costs of treatment.

 

Impairment benefit

An Impairment Benefit Claim cannot be lodged until any permanent injury suffered has stabilised and at least 12 months after your injury occurs. Once your level of impairment has been assessed, the WorkCover insurer has up to 120 days to determine whether you are entitled to an impairment benefit lump sum payment.

 

It is important to note that these claims are “no-fault”.  You do not have to be injured in negligent circumstances to bring an Impairment Benefit Claim.

 

Claims for damages

Claims for damages arising from an employer’s negligence can be complicated and time-consuming.  To successfully pursue these claims you also need to have suffered a serious permanent injury.

The resolution of these types of claims can vary greatly depending on individual circumstances.  It is essential to seek legal advice in these matters in order to fully understand your rights and entitlements of whether there is the prospect of a successful claim.

There are also strict time limits to pursue a common law claim for damages.

 

How much will workers’ compensation settle for?

Many factors contribute to the amount and type of compensation you are entitled to. Maximising your WorkCover compensation settlement can be difficult and time-consuming, which is why it is essential to seek legal advice.

 

What to do if this information applies to you

At Gordon Legal, we understand that workers compensation payouts are a personal issue.

For personalised and individual advice, we offer consultations to discuss your matter.

Please call Gordon Legal on (03) 9603 3000 or our Geelong office on (03) 5225 1600 to speak with a member of our team.

Given the current environment, we are providing consultations over the phone or via video conferencing platforms.

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