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FAQs for your workers compensation claim in New South Wales – 5 important things to know

Published on September 6, 2024 by Nada NajjarNada Najjar

When it comes to workers’ compensation claims in New South Wales (NSW), employees often have many questions about the process, their rights, and the types of compensation they can receive. Here are some of the most common frequently asked questions (FAQs) specific to workers’ compensation claims in NSW:

1. What is workers compensation and am I entitled to claim?

Workers’ compensation is a type of insurance that provides financial and medical benefits to employees who suffer work-related injuries or illnesses. Workers’ compensation is mandatory insurance and acts as a safety net, ensuring that injured workers receive the care they need to recover and maintain financial stability while they are unable to work.

In NSW all employees can claim workers’ compensation regardless of whether you are employed on a full-time, part-time, or casual basis.

2. What is workers compensation and am I entitled to claim?

If you suffer an injury at work, the first steps you take are crucial for both your health and your workers’ compensation claim. Here’s what you should do:

• Seek medical attention – your health should be your top priority. See a doctor as soon as possible, even if the injury seems minor. Make sure to inform the doctor that the injury is work-related, as this will be important for your claim.
• Notify your employer – you should inform your employer within 24 hours. This notification should be in writing, and it should include details of the injury and how it occurred. Failure to notify your employer promptly could delay or jeopardise the administration of your claim.
• Complete a workers’ compensation claim form – your employer should provide you with a workers’ compensation claim form. Fill this out with as much detail as possible and return it to your employer. Your employer will then forward the claim to their workers’ compensation insurer.
• Keep detailed records – you should keep copies of all documents related to your injury and claim, including medical reports, receipts, and correspondence with your employer and the insurer.

Taking these steps will help ensure that your claim is processed smoothly and that you receive the benefits you are entitled to.

3. What types of injuries are covered?

The Workers Compensation Act 1987 (NSW) covers a wide range of injuries and illnesses that occur in the course of employment. These include:

• Physical injuries – such as fractures, sprains, cuts, and burns. These injuries typically result from accidents, falls, or equipment malfunctions.
• Occupational diseases – illnesses that develop over time due to exposure to hazardous substances or environments in the workplace. Examples include asbestos-related diseases, and respiratory conditions caused by exposure to dust or chemicals, or the nature and conditions of work being heavy and repetitive and being performed over a long period of time.
• Psychological injuries – mental health conditions that arise due to work-related stress, harassment, bullying, or trauma. Claims for psychological injuries can be more complex and typically require detailed medical evidence. The psychological injury must be diagnosed by a mental health professional and must be a recognised psychological or psychiatric illness, such as Post-traumatic Stress Disorder (PTSD) or Depression or Anxiety.
• Aggravation of pre-existing conditions – if your employment exacerbates a pre-existing injury or illness, you may be entitled to workers’ compensation. However, it must be shown that work significantly contributed to the worsening of the condition.

To be eligible for workers’ compensation, the injury or illness must arise out of or in the course of employment.

4. What can I claim on workers compensation?

While every claim is different, depending on your circumstances, you may be eligible to claim a number of benefits, including: –

• Weekly payments – to replace a percentage of your lost income while you’re unable to work, typically calculated at 95% of your pre-injury earnings for the first 13 weeks and 80% thereafter.
• Medical expenses – covering the costs of doctors, specialists, hospitals, medication, and other necessary medical treatment related to your injury or illness.
• Rehabilitation expenses – supporting your recovery through physiotherapy, occupational therapy, and other rehabilitation services.
• Home care expenses – if your injury causes you to require assistance with daily living activities, then workers compensation may cover expenses for in-home care and support.
• Modifications to your home or vehicle – to accommodate any permanent disabilities resulting from your injury and help you to live independently.
• Permanent impairment lump sum – a one-time payment if your injury results in a lasting disability assessed by a doctor.
• Death benefits – paid to your dependents if your work-related injury or illness leads to your death.

5. What happens if I can’t return to my previous job due to my injury?

If your injury prevents you from returning to your previous job, several options are available under the workers’ compensation scheme:

• Suitable duties – your employer may offer you suitable duties that are within your physical and medical capabilities. These duties should be meaningful and appropriate, considering your injury.
• Retraining programs – if returning to your previous role is not possible, you may be eligible for retraining or vocational rehabilitation programs to help you transition into a new job or career path.
• Partial capacity to work – if you can work but only in a limited capacity, you may still receive partial workers’ compensation benefits, which supplement your reduced income.

If none of these options are viable, and you have a significant permanent impairment, you may be eligible for ongoing weekly payments or a lump sum settlement. It is important to work closely with your doctor, employer, and lawyer to explore the best options for your specific situation.

Please note that this article does not constitute legal advice. If you are seeking professional advice on any legal matters, you can contact Carroll & O’Dea Lawyers on 1800 059 278 or via our Contact Page and one of our lawyers will be able to assist you.