Navigating workers’ compensation claims in Tasmania – The Essentials
Published on November 17, 2023 by Lucinda Gunning
Suffering a workplace injury can be a daunting experience, both physically and emotionally. However, if you are an injured worker in Tasmania, you have certain rights and resources available to support your recovery and future financial stability. This article will guide you through the process of navigating your workers’ compensation claim in Tasmania, outlining your entitlements under the Workers Rehabilitation and Compensation Act 1988 (Tas), the initial steps you should take after an injury, and the subsequent steps to expect after your claim is lodged.
What am I entitled to?
Tasmania’s workers’ compensation legislation, primarily governed by the Workers Rehabilitation and Compensation Act 1988 (Tas) (the Act).
The Act has two main purposes which include:
1. returning an injured or sick worker to work as quick and safely as possible; and to ensure an injured worker is compensated for lost wages, medical and other expenses while they are unable to work, and that dependents of a deceased worker are compensated. As an injured worker in Tasmania, you may be entitled to:
- Weekly payments – if you are totally or partially incapacitated for work (you can’t undertake your normal job), and you have a workers’ compensation medical certificate from your doctor, you are entitled to receive weekly payments of compensation to compensate you for the loss of your usual income. You will receive between 80% and 100% of your pre injury average weekly income, depending on your level of incapacity and the amount of time that you have been receiving weekly benefit payments.
- Medical and rehabilitation treatment and associated expenses – you are able to claim all reasonable and necessary medical, hospital, rehabilitation and pharmaceutical costs from your employer. This will extend to things such as physiotherapy treatment and any rehabilitation needs or equipment and home modifications required as a consequence of your injury.
- Lump-sum compensation for permanent impairment – in cases of permanent impairment, you may be eligible for lump-sum compensation based on the severity of your injury and its impact on your ability to work. This entitlement is assessed by a medical specialist and the entitlement depends on the degree of your impairment.
- Compensation for your travel expenses – if you need to travel for medical treatment, you can claim reimbursement for reasonable travel expenses.
Initial steps to take after your injury
1. Report the injury or illness to your employer
The first step for injured Tasmanian workers is to report your work-related injury or illness to your employer as soon as possible. You can notify them verbally and in writing or by email, providing details about the incident, the date and time it took place, as well as the nature of your injury. Keep a copy of all your reporting for your own records. Prompt reporting helps establish a record of the incident and ensures that you meet the statutory notification requirements. If you do not notify your employer within 6 months from the date of your injury your claim may be rejected. Your employer must provide to you notice which provides details regarding how you can make a claim for workers compensation and issue you with the relevant forms.
2. Seek medical attention
After reporting the injury, you should seek medical attention from your doctor also as soon as possible. It is important to see your doctor even if you think your injury might be minor. Sometimes, it takes some time for the extent of your injury to present itself and it’s important to see your doctor to ensure you have explained everything that happened to you around the time that it occurred. When you visit your doctor, you should request that they complete a Workers Compensation Certificate of Capacity.
3. Lodge a workers’ compensation claim form and medical certificate with your employer
To initiate the formal workers’ compensation claim process, you must provide the completed claim form and accompanied workers compensation medical certificate to your employer within 6 months of the date of your injury. Your employer then must notify the insurer within 3 workings days and provide the completed forms to their insurer within 5 working days after receipt of your claim form. As mentioned above, your employer should provide you with the necessary forms and guide you through the process, however, the relevant forms can also be located on the WorkSafe Tasmania website.
You should ensure that you complete the claim form accurately, providing detailed information about the incident, your injuries, and any medical treatment you have received. You should also attach the relevant supporting documents, including any medical documents, invoices, and witness statements you have, if there are any available.
What happens next?
Once your claim is lodged, your employer must start weekly payments of compensation if you have been certified as being totally or partially incapacitated for work and they must also pay for your reasonable medical and associated expenses up to $5,000.
Your employer must then notify you in writing within 28 days outlining the status of your claim; this could mean a decision to accept, dispute or outlining what further information they require to allow them to determine your claim. They may also request additional information or documents to assist them make a determination.
Your employer has 84 days to dispute liability to pay compensation to you in your claim. If you do not receive a dispute notice within 84 days, it is taken that liability for your claim is accepted.
If your employer disputes liability for your claim, they will issue you with what is known as a section 81A notice, stating that they consider that they have a reasonable excuse for disputing liability. Your matter will then be listed before TASCAT, who will make a decision on whether the employer’s decision to dispute liability is reasonable. If the Tribunal makes a determination in favour of your employer, you can still seek to challenge the insurer’s denial of liability at a later date. However if you are issued with a section 81A notice you should seek urgent legal advice.
As part of the claims’ process, your employer may arrange for you to undergo an independent medical examination. You have a responsibility to attend any reasonable medical assessments as scheduled, as they help assess your condition, determine the extent of your injuries, and evaluate your work capacity.
Throughout the claims process, your employer has a legal obligation to keep your job open for a period of 12 months to allow you to rehabilitate and return to work, unless there is evidence that it is highly improbable that you will be able to return to your job within this timeframe. You should engage in the return-to-work planning process and collaborate with your employer, doctors, and rehabilitation providers to develop a suitable plan tailored to your capabilities and limitations. You should participate actively in any rehabilitation programs or treatment prescribed by your doctor. This may include physiotherapy, counselling, or vocational retraining. You can regularly communicate with your employer regarding your progress, any changes in your condition, or adjustments needed to your return-to-work plan.
Duration of Entitlement
The maximum period that weekly payments can be paid depends on the worker’s level of whole person impairment (WPI):
- a worker with a WPI of less than 15% is entitled to weekly payments for up to nine years
- a worker with a WPI of at least 15% but less than 20% is entitled to weekly payments for up to 12 years
- a worker with a WPI of at least 20% but less than 30% is entitled to weekly payments for up to 20 years
- a worker with a WPI of 30% or more is entitled to weekly payments until the worker reaches pension age.
Lump sum compensation for permanent impairment
In addition to any other compensation, a worker who suffers permanent impairment from a work-related injury or disease may be entitled to receive a lump sum payment. To be entitled to lump sum permanent impairment compensation, you must meet the appropriate ‘whole person impairment’ (WPI) threshold. These are:
- for the loss of part, or all, of a finger or toe: no threshold applies
- for any other permanent physical impairment: a threshold of 5% WPI applies
- for permanent psychological impairment: a threshold of 10% WPI applies
- for industrial deafness: a threshold of 5.1% binaural hearing loss, suffered since 16 August 1995, applies.
A worker who suffers a WPI of 20% or higher for an injury that occurred on or after 1 July 2010 may be entitled to pursue common law damages. There are strict time limits for commencing common law damages, so you should seek urgent legal advice if you have reached this threshold or believe you are likely to.
Navigating a workers’ compensation claim in Tasmania can be complex, but knowing your rights and the proper steps to take is crucial to a successful outcome. You can contact us at Carroll & O’Dea Lawyers on 1800 059 278 or via our Contact Page if you have been injured in a workplace accident and one of our lawyers will assist you. You can also complete our Personal Injury Claim Check here.