Workers' compensation lawyers.

If you’ve been injured or have become ill because of work, you might qualify for a workers’ compensation payout or benefits under the 2014 Return to Work Act (SA).

Under this law, you could receive income and medical expenses for psychological injuries such as depression or anxiety. In these cases, your work must be the significant contributing cause of your mental injury.

If your claim for compensation is accepted, you could be entitled to the following:

• Weekly income support payments.

• Reasonable and necessary medical treatment and care.

• Workers’ compensation lump sum benefits.

If you can’t perform your role due to a workplace injury, you may qualify for up to two years of income maintenance payments. The first year will be paid at 100% of your average weekly earnings, with the second year being paid at 80%.

Your claims agent, most likely either Employers Mutual Limited, Gallagher Bassett or an independent insurer, can make decisions that affect your income maintenance payments.

Contact our South Australian workers compensation (previously WorkCover) lawyers for advice in respect of your entitlement to any payments, including disputes arising out of assessments of your weekly average earnings, your entitlements’ treatments, or the rejection of your claim. You have one month from the date you receive these decisions to lodge an Application for Review in the SA Employment Tribunal.

In certain circumstances, this time may be extended, but you should seek specific advice from our workers compensation (previously WorkCover) lawyers on this issue.

You are entitled to be reimbursed for reasonable medical expenses while receiving income maintenance, and for a further 12 months after your support payments come to an end. Even if you don’t receive income support, you’re still entitled to a year of reasonable medical and like expenses from the date of injury.

You’re also entitled to claim reasonable travel and accommodation to get treatment for your injury. If you need items that promote rehabilitation, or services like domestic assistance, home modifications, massage, physiotherapy, gymnasium or hydrotherapy, the cost of these therapeutic aids can be claimed.

You can either pay for treatment yourself and be reimbursed by your claims agent, or you can organise pre-approval, so you’re not out of pocket.

Surgery medical expenses

Depending on when you need surgery, you’ll need to apply with your claims agent within a specific timeframe. You can apply for surgery pre-approval any time within your medical expense entitlement period. If a doctor indicates that your surgery should be outside of this period , then the appropriate application needs to be made before your entitlement period ends.

You should discuss the likelihood of future surgeries with your doctor and workers’ compensation lawyers, so that you can apply for approval before your medical entitlement period ends. These applications have been the subject of a number of cases in the SA Employment Tribunal.

You may be eligible for a lump sum payment under the 2014 Return to Work Act (SA) if your workplace injury has caused you a permanent impairment.

There are two types of payments: A non-economic loss payment is available if your injury is assessed as having a 5% whole person impairment or greater; and an economic loss payment on the basis of a medical assessment, if your injury is assessed as having a whole person impairment of between 5% and 29%. Economic loss payments are not available for hearing loss caused by noise at work, and both payments are not available for psychological injury.

You are permitted one permanent impairment assessment per claim, so it's very important that it’s done in your best interest and that all possible related workers compensation injuries are assessed. You can’t be assessed until your doctors have determined that your injuries are stable, also known as having reached maximum medical improvement.

We know this process can be complex, and given its ‘once and for all’ nature, we strongly encourage you to contact one of our workers’ compensation lawyers so you can seek advice before requesting an assessment from your claims agent.

If you’re injured at work and assessed as being a whole person impairment of 30% or more, you are entitled to income support until retirement age at 100% of your nominal weekly earnings in the first year, and 80% of your notional weekly earnings indexed annually. You will also be entitled to treatment, care, and support services for the rest of your life and lump sum compensation for non-economic loss.

If your injury is likely to have caused 30% or more whole person impairment but your injuries are not yet stable, you can make an application to be categorised as an ‘interim seriously injured worker.’ If successful, you’re entitled to the benefits of a seriously injured worker until your final assessment can be undertaken.

If you have an accepted workers compensation claim, you can apply to the South Australian Employment Tribunal to seek an order compelling your employer to provide you with suitable employment, within a reasonable period of time.

To make this application, you need to be (or have been) unable to work as a result of your injury and have sought an alternate role with your employer. You must have contacted your employer in writing seeking suitable employment, and the employer must have denied this request.

You should seek advice about making an application of this nature from our workers’ compensation lawyers in Adelaide and regional South Australia.

If you were injured before 1 July 2015, then the “transitional provisions” set out in the 2014 Return To Work Act will apply. These provisions are complex, so we recommend that you seek legal advice from workers compensation lawyers who specialise in Return to Work (previously WorkCover) about how they might apply to you.

Workers' compensation lawyers can provide you with advice on your entitlements under the relevant workers’ compensation legislation. In South Australia, this is the 2014 Return to Work Act (SA).

This scheme contains many time limitations for when certain entitlements are available to you as an injured worker. The scheme also dictates when applications and claims have to be made. For example, a future surgery application needs to be made before the end of the expiry of medical expense entitlement period.

A workers’ compensation lawyer will not only provide you with advice about your entitlements, but will actively assist you in lodging relevant claims and applications to ensure that your entitlements are maximised, and applications are made within the time limitation periods.

Workers' compensation lawyers will also represent you in the South Australian Employment Tribunal if the relevant compensating authority or insurer makes a decision about your claim that you wish to dispute. They will help you obtain evidence by way of witness statements and specific medical evidence to support your claims and disputes.

Injured workers with an accepted physical work compensation injury are entitled to an assessment for lump-sum compensation. This is a once-and-for-all assessment. Our workers’ comp lawyers in Adelaide and regional SA can assist in this complex assessment process from start to finish, and ensure that any lump-sum compensation entitlements are maximised.

There are many steps to a works compensation claim, including;

1. Lodging the claim.

2. The determination of the claim process.

3. Applications for medical treatment, including surgery if required.

4. Disputes in respect of determinations. For example, average weekly earnings disputes, rejection of medical expenses, rejection of initial claim or rejection of consequential injuries.

5. Permanent impairment assessment to determine lump-sum compensation.

You can, and should, seek legal advice for each stage of the process, including from the outset to assist with lodging your claim from workers’ comp lawyers.

If a determination on your claim is made by the compensating authority or issuer, you have 28 days from receipt of the determination to issue a dispute in the SA Employment Tribunal. If you receive a determination that you don’t agree with or, if you have any concerns about it, seek legal advice from workers' compensation (previously WorkCover) lawyers as soon as possible and certainly within the 28 days.

You can maximise your workers’ compensation entitlements by:

1. Reporting your injury to your employer, and any doctors or specialists treating you (like psychologists, physiotherapists and chiropractors) as soon as possible.

2. Lodge a claim for compensation as soon as possible following the injury. The steps to lodge a claim can be found on the Return to Work SA website. Or, you can contact our team of work injury lawyers in Adelaide and regional SA so that we can provide advice on lodging your claim.

3. If you experience new symptoms or injuries related to your initial injury or treatment (such as medication induced side effects), it’s important to notify your treating specialists as soon as possible. You should also notify your workers’ compensation lawyers so that the relevant additional claims can be made.

4. Keep records of the time that you have been unable to work due to your injuries.

5. Record any and all out of pocket medical expenses, including travel to and from medical appointments.

6. Obtain legal advice from specialised WorkCover lawyers.
   

In order to satisfy the criteria for a successful claim for psychological injury you must:

1. Have a diagnosable psychiatric condition (you can’t claim compensation for emotional distress).

2. Employment must be the significant contributing cause of your diagnosable psychiatric condition.

3. The psychiatric condition must not be caused by a reasonable administrative action taken in a reasonable manner by your employer.

It’s critical to seek medical advice and treatment for any psychiatric injury so that medical professionals can establish the diagnosis and cause of your psychiatric condition.