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MAURICE BLACKBURN LAWYERS COMCARE

MAURICE BLACKBURN LAWYERS COMCARE · Comcare or your employer. 3 Lodge a claim form. After the injury is reported, you should lodge a claim form for time off work or medical expenses

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Page 1: MAURICE BLACKBURN LAWYERS COMCARE · Comcare or your employer. 3 Lodge a claim form. After the injury is reported, you should lodge a claim form for time off work or medical expenses

MAURICE BLACKBURN LAWYERSCOMCARE

Page 2: MAURICE BLACKBURN LAWYERS COMCARE · Comcare or your employer. 3 Lodge a claim form. After the injury is reported, you should lodge a claim form for time off work or medical expenses

02

MAURICE BLACKBURN

YOU’RE WORTH FIGHTING FOR.If you are hurt, injured, or are facing an unfair

situation, you and your family shouldn’t have

to suffer. That’s why we never stand back when

bad things happen to good people.

At Maurice Blackburn we believe that the law

should serve everyone. Who you are or where

you’re from, it doesn’t matter. You’re worth

fighting for.

Maurice Blackburn was born from one man’s

belief in making a difference to people’s lives.

Nearly 100 years on these values remain a

powerful influence on everything we do.

We exist to fight for your rights. For what you

deserve. When life isn’t fair we’ll help you to

fight for everything you’re entitled to.

Because at Maurice Blackburn, we fight for fair.

Page 3: MAURICE BLACKBURN LAWYERS COMCARE · Comcare or your employer. 3 Lodge a claim form. After the injury is reported, you should lodge a claim form for time off work or medical expenses

03

COMCARE

Who can claim compensation?

If you are a Commonwealth or ACT Government employee, or an employee of a company licensed to operate under the Comcare Scheme, and you suffer an injury at work, you can claim compensation under the Safety, Rehabilitation and Compensation (SRC) Act 1988 (Cth). You are covered whether you work full-time, part-time or as a casual.

You can claim for compensation for injuries sustained at work or diseases caused, or contributed to, by your employment. Diseases include psychological conditions, cancers, strokes, asthma, heart conditions and degenerative conditions. These are often aggravated or exacerbated by employment.

What illnesses and injuries are covered?

Compensation is payable for injuries sustained at work, or an illness caused or contributed to by your employment. This includes the following:

• Physical injuries such as an injured back, arms or legs. It also covers an aggravation, i.e. worsening of an existing injury or disease by the work-related injury or illness.

• Injuries suffered while you are temporarily performing a work activity away from your place of work.

• Injuries suffered travelling for work or while travelling to or attending an approved place of work or education.

• Injuries suffered whilst obtaining a medical certificate, medical treatment or undergoing a rehabilitation program or medical examination required by Comcare or your employer.

• Injuries suffered before 13 April 2007 while travelling between work and home.

• Any disease caused by or contributed to by work is covered. This includes pre-existing disease if work has aggravated the condition. Examples are:

— psychological conditions caused or aggravated by work,

— cancers and degenerative conditions aggravated by employment,

— lung conditions caused or aggravated by work, and

— the effects of strokes and heart conditions suffered at work.

Maurice Blackburn are the experts when it comes to workers’ compensation. It is the backbone of what we do.

If you’ve been injured at work, your place of employment determines which workers’ compensation scheme applies to you. All Commonwealth and ACT Government employees and employees of certain licensed corporations (such as Linfox, Commonwealth Bank, National Australia Bank, Optus, Telstra and Australia Post) are covered by the Comcare compensation scheme.

Page 4: MAURICE BLACKBURN LAWYERS COMCARE · Comcare or your employer. 3 Lodge a claim form. After the injury is reported, you should lodge a claim form for time off work or medical expenses

04

MAURICE BLACKBURN

What is excluded?

The SRC Act allows your claim to be denied if it can be shown that an exclusionary provision applies. The following exclusions may apply to your claim:

• You may not be covered if your claimed condition arose as a result of reasonable administrative action taken in a reasonable manner in respect of your employment. This can include employment-related performance appraisals, counselling, suspension action, disciplinary action, re-classification, transfer or retention of a benefit.

• Injuries suffered while travelling between work and home are not covered. However, you may still be able to lodge a compulsory 3rd party claim.

• You may not be covered if you voluntarily and unreasonably submitted to the risk of sustaining your injury.

• You may not be covered if you make a wilful and false representation to your employer that you have not previously suffered from the condition which you are claiming compensation for.

• Injuries may not be covered if you inflicted that injury upon yourself intentionally.

• If the injury was caused by your own serious and wilful misconduct, such as being under the influence of alcohol or an illegal drug, then you may not be covered.

If Comcare or your employer uses an exception or exclusion to reject your claim, contact Maurice Blackburn for advice.

How do I make a claim?

To claim compensation, you must:

1 Report your injury in writing to your employer as soon as possible and complete an incident report form. Write down the name of any witnesses and their telephone number in case your employer disputes the circumstances of the accident or injury.

2 Visit your own doctor for treatment and ensure the injury or condition is recorded. You can insist on seeing your own doctor before you see any doctor nominated by Comcare or your employer.

3 Lodge a claim form. After the injury is reported, you should lodge a claim form for time off work or medical expenses. These are available from your union, your employer or from comcare.gov.au.

4 Get a medical certificate. This must be signed and completed by your doctor if you are claiming for time off work. It should describe the injury and include the doctor’s opinion about whether the injury is work-related. It should also detail any time off work and further treatment required.

Always keep a copy of all documents related to your claim, including copies of your incident report form, claim form, receipts and invoices and any correspondence.

All accounts and receipts for medical treatment should be forwarded to Comcare or your employer. If the claim is accepted, you will be reimbursed.

There is no time limit for a response to a lodged claim. However, a response is usually received within 4–8 weeks. If your claim is rejected, and you want to appeal the written decision, you must request a reconsideration within 30 days.

Page 5: MAURICE BLACKBURN LAWYERS COMCARE · Comcare or your employer. 3 Lodge a claim form. After the injury is reported, you should lodge a claim form for time off work or medical expenses

05

COMCARE

What benefits are available if my claim is accepted?

Medical and similar benefits

You are entitled to payment of all reasonable medical expenses. This includes surgery, hospital fees, nursing care, dental treatment, prescription medicine, medical aids, and treatment from registered physiotherapists, chiropractors, osteopaths and massage therapists.

Income support benefits

If you can’t return to work, you are entitled to receive 100% of your normal weekly earnings for the first 45 weeks you are off work. If you can return to work but are earning less, you may be entitled to a top-up payment.

After 45 weeks, if you are still unable to return to work, you will be entitled to 75% of your normal weekly earnings. If you are able to return to work, but you are earning less you may be entitled to a top-up up to 80% to 100% of your normal weekly earnings, depending on the number of hours you are able to work. This includes regular overtime, penalty rates, higher duties and some other allowances. Not all allowances are covered.

Lump sum payments for permanent impairment

If you suffer a permanent impairment as a result of your work-related injury, then you may be entitled to claim a lump sum permanent impairment benefit. This does not affect your ongoing benefits, such as compensation for medical expenses or income support, although your claim may be reviewed when you bring a permanent impairment claim.

To be entitled to receive a lump sum payment, you need to establish that your injuries have stabilised, which usually happens 6–12 months from the date of your injury or your last operation. You also need a medical assessment that the injury is stable and permanent.

To be entitled to pursue a permanent impairment claim you require a work-related injury causing a minimum level of whole person impairment. This is usually assessed by a specialist. For most injuries that level is 10%, however there are some exceptions. Injuries causing impairment to fingers, toes, taste and smell require a minimum of 1% impairment. Hearing loss which involves both ears needs to rate 5% or more. An accepted claim for permanent impairment at 10% can result in a tax free benefit between $23,000 and $40,000.

If you receive a lump sum permanent impairment benefit you are still able to claim ongoing medical and income support benefits.

Page 6: MAURICE BLACKBURN LAWYERS COMCARE · Comcare or your employer. 3 Lodge a claim form. After the injury is reported, you should lodge a claim form for time off work or medical expenses

06

MAURICE BLACKBURN

Can I sue?

Common law non-economic loss damages

If your injuries have been caused through the fault or negligence of your employer or another employee, the SRC Act requires that you choose between either a common law claim for non-economic loss damages (suing your employer or another employee) or a lump sum permanent impairment benefit. You cannot claim both and once a decision is made, it cannot be changed. It is therefore vital that you obtain legal advice before making your decision.

To be entitled to pursue a claim for common law non-economic loss damages you require a minimum level of impairment, usually assessed by a specialist. This level needs to be as high as would be required for a permanent impairment claim for that injury. This is usually 10% with some exceptions, being impairment to fingers, toes, taste and smell. Hearing loss claims require a 5% degree of impairment. You generally have three years from the date of your injury to make a common law claim, although this might be extended if your injury has not yet stabilised.

This letter is not only to inform you that I received my cheque,

but more importantly to express my gratitude to you for all your effort and expertise in securing such a fantastic settlement and

outcome for me.

—Comcare client

Page 7: MAURICE BLACKBURN LAWYERS COMCARE · Comcare or your employer. 3 Lodge a claim form. After the injury is reported, you should lodge a claim form for time off work or medical expenses
Page 8: MAURICE BLACKBURN LAWYERS COMCARE · Comcare or your employer. 3 Lodge a claim form. After the injury is reported, you should lodge a claim form for time off work or medical expenses

08

MAURICE BLACKBURN

Common law damages claims against third parties

A third party is a person or organisation other than your employer. It is common for workers to be injured due to the negligence of a third party. Time limits are generally three years from the date of your injury. Common law claims against third parties can affect your ongoing entitlements and legal advice is essential.

Disputes

what if they refuse, stop or suspend any of my benefits?

Comcare or your employer may make a decision (called a “determination”) to stop your incapacity payments or medical treatment. This may occur where Comcare determines that you no longer have an incapacity for employment or you no longer need some or all of your medical treatment. If you disagree with such a decision you must request a reconsideration within 30 days.

Comcare or your employer can also decide to suspend your benefits if you do not comply with, or refuse to sign, a rehabilitation program or a return to work program without reasonable excuse. Such a decision could have severe consequences because it may stop all benefits. If you are asked to sign a rehabilitation program or to accept a return to work program, first seek the advice of your doctor and obtain written advice as to what duties you are able to perform before you sign the program. If your benefits are suspended you must request a reconsideration within 30 days.

In all disputes a written reconsideration will be provided called a “Reviewable Decision”. If it is not in your favour, Maurice Blackburn can advise you about the next steps to take, including taking your case to the Commonwealth Administrative Appeals Tribunal (the AAT). An application to the AAT must be made within 60 days of receipt of the Reviewable Decision.

Payment on the death of a worker

Lump sum compensation of $504,449.16 and a weekly pension payment of $138.72 are payable to the dependent children of a worker who has died of a work-related injury or illness. Reasonable funeral expenses may also be claimed to a maximum of $11,267.70.

Key time limits

Notify employer of injury

As soon as practicable after injury (or death of the worker).

Reconsideration of a determination

30 days from the date you receive the determination.

Application for review at the AAT

60 days from the date you receive the Reviewable Decision.

Common law negligence claim

Generally, three years from the date of injury.

Permanent impairment claim

No time limit but should be brought after the injury has stabilised.

Page 9: MAURICE BLACKBURN LAWYERS COMCARE · Comcare or your employer. 3 Lodge a claim form. After the injury is reported, you should lodge a claim form for time off work or medical expenses

09

COMCARE

Protecting your benefits is our business

If you have questions about a proposed or existing compensation claim, you should contact your union first. We can then assist as required. The first consultation is free, and in most cases we will be able to represent you on a no win, no fee* basis.

Time limits apply to many steps that need to be taken to pursue a claim for compensation. Maurice Blackburn is ready to advise you on this often complex area, making the process easier and less daunting and ensuring you receive what you’re entitled to.

At Maurice Blackburn, we are committed to getting a fair outcome for our clients so that they can get on with their lives without disadvantage. If you would like free preliminary advice on a potential Comcare claim, call our office and speak to one of our professional, expert staff on 1800 810 812.

From the very beginning, we fought for the rights of ordinary people. We continue this tradition today.

*Conditions apply

The Comcare scheme covers employees of:

• Employees of Commonwealth Government agencies and statutory authorities,

• Members of the Australian Defence Force for injuries that occurred before 1 July 2004,

• Employees of the ACT Government and its agencies, and

• Employees of corporations who have been granted a licence to self insure, provided the date of injury was after the date of the licence.

I would like to sincerely thank you for the time and patience

you expended in assisting me to achieve this outcome. Claims

processing can seem frustrating and impenetrable to the people on the ‘non-legal’ side of things, and

your knowledge and assistance was invaluable to me.

—Comcare client

Page 10: MAURICE BLACKBURN LAWYERS COMCARE · Comcare or your employer. 3 Lodge a claim form. After the injury is reported, you should lodge a claim form for time off work or medical expenses

MAURICE BLACKBURN

10

Current licensees

There are currently 30 licensees under the SRC Act

Licensee Former/Trading name Commencement date of licence

Current licence expiry date

Asciano Services Pty Ltd Pacific National (ACT) Limited 01/07/2001 30/06/2017

Australian air Express Pty Ltd 01/07/1999 30/06/2017

Australian Postal Corporation 30/06/1992 30/06/2018

Avanteos Pty Ltd 31/03/2008 30/06/2018

BIS Industries Ltd 01/10/2008 30/06/2015

Border Express Pty Ltd 01/01/2008 30/06/2018

Colonial Services Pty Ltd 31/03/2008 30/06/2018

Commonwealth Bank of Australia Ltd 31/03/2008 30/06/2018

Commonwealth Insurance Ltd 31/03/2008 30/06/2018

Commonwealth Securities Ltd 31/03/2008 30/06/2018

CSL Ltd 03/06/1994 30/06/2015

DHL Supply Chain (Australia) Pty Ltd 01/07/2014 30/06/2016

Fleetmaster Services Pty Ltd 01/04/2009 30/06/2015

John Holland Group Pty Ltd 01/01/2007 30/06/2016

John Holland Pty Ltd 01/01/2007 30/06/2016

John Holland Rail Pty Ltd 01/01/2007 30/06/2016

K&S Freighters Pty Ltd 01/07/2006 30/06/2016

Linfox Australia Pty Ltd 03/04/2006 30/06/2015

Linfox Armaguard Pty Ltd 03/04/2006 30/06/2015

National Australia Bank Ltd 13/04/2007 30/06/2016

National Wealth Management Services Ltd

MLC 13/04/2007 30/06/2016

Optus Administration Pty Ltd 30/06/2005 30/06/2015

Prosegur Australia Pty Limited Chubb Security Services Ltd 01/07/2007 30/06/2017

Reserve Bank of Australia 01/05/1996 30/06/2015

StarTrack Retail Pty Ltd AaE Retail Pty Ltd 01/07/2011 30/06/2017

Telstra Corporation Ltd 30/06/1992 30/06/2018

Thales Australia ADI Ltd 07/02/1996 30/06/2017

TNT Australia Pty Ltd 01/07/2008 30/06/2018

Transpacific Industries Pty Ltd 01/07/2008 30/06/2018

Visionstream Pty Ltd 01/07/1999 30/06/2015

Page 11: MAURICE BLACKBURN LAWYERS COMCARE · Comcare or your employer. 3 Lodge a claim form. After the injury is reported, you should lodge a claim form for time off work or medical expenses

CONTACT US Comcare

Work Related Injuries

Road Accident Injuries

Medical Negligence

Asbestos Diseases

Superannuation & Insurance Claims

Public Liability

Faulty Products

Will Disputes

Employment & Industrial Law

Class Actions

Social Justice

If you are considering legal action or want to fight for your rights, get in touch and we can assess what you need or arrange for a meeting with one of our lawyers.

For most practice areas, your first consultation is free.

1800 810 812 (business hours)

mauriceblackburn.com.au

You are welcome to drop into one of our offices nationwide.

Call us or visit the website for more details:

Victorian Offices (03) 9605 2700

Melbourne Dandenong Frankston Geelong Greensborough Mildura Reservoir Ringwood Sunshine Traralgon Wangaratta

NSW Offices (02) 9261 1488

Sydney Parramatta

ACT Office (02) 6120 5000

Canberra

Queensland Offices (07) 3016 0300

Brisbane Browns Plains Caboolture Cairns Gold Coast Ipswich Mackay Rockhampton Strathpine Sunshine Coast Toowoomba Townsville

Western Australia Office (08) 9331 1120

Perth

Page 12: MAURICE BLACKBURN LAWYERS COMCARE · Comcare or your employer. 3 Lodge a claim form. After the injury is reported, you should lodge a claim form for time off work or medical expenses

Maurice Blackburn is a leading Australian law firm certified to the international ISO 9001:2008 quality standard. Information correct at 1 July 2014. This brochure is a general guide to dealing with Comcare claims and is not a substitute for professional advice in this area. Maurice Blackburn is proud to be carbon neutral (see our website for details). This brochure is printed on ecoStar Silk. Made with 100% certified post consumer waste fibre, it is produced with a carbon neutral manufacturing process and has been made in a facility that operates under the ISO 14001 Environmental Management System. MB4184_NATCC 07/14