Workers' compensation claims arising out of psychological injuries sustained at work have seen a significant rise over the past decade. Please see link to State Insurance Regulatory Authority (SIRA) report here.
If you have sustained a psychological injury at work, there are certain things you should do to assist in making your claim run as smoothly as possible.
What are my obligations to the insurer?
If you have been injured at work, you should try to:
- report your injury as soon as practicable;
- receive appropriate medical and rehabilitation treatment. This would include whoever is first available, including your General Practitioner or a hospital;
- obtain a WorkCover Certificate of Capacity, then report the injury in writing to your employer;
- if relevant, make a time to see a counsellor or psychologist on referral from your General Practitioner;
- authorise your treating doctor to provide relevant information to the insurance company or your employer to establish an Injury Management Plan or rehabilitation plan for you;
- participate and cooperate in the establishment of an Injury Management Plan or rehabilitation plan; and
- you must make all reasonable efforts to return to work with your pre-injury employer as soon as possible, taking into account the nature of your injury.
It is important to note that if, in the context of a work injury, you fail to do the things listed above without a good reason, you will not be entitled to receive any weekly compensation payments.
You should also complete and submit a Worker's Injury Claim Form which can be found here.
What if I can't afford to attend the medical appointment?
If you are required to travel to attend a medical appointment arranged by the insurance company, you are entitled to have your travel expenses paid in advance. If you do require pre-payment of your travel expenses, please ensure that you telephone our office as soon as you receive notification of the appointment and provide us with details of approximately how much you will need in order to attend the appointment.
In many cases, if you need to fly from a country town to Sydney, the insurance company may book your flights or make an advance. If you must drive your own car, you are able to recover the equivalent of $0.55 per kilometre.
If we ask you to attend an appointment, you will have to pay your own travel expenses to see the doctor.
Am I entitled to see the medical reports obtained by my employer, the insurance company or the insurance company's solicitors?
If you have been in a work accident or motor vehicle accident, it is a condition of lodging a claim that you authorise your employer, or the insurance company, to obtain reports from your treating practitioners (your GP, specialist, physiotherapist, psychologist etc). You are entitled to see those reports and you should try to obtain copies.
However, if the insurance company arranged "medicolegal" appointments with specialists of their own choosing and the resulting reports are considered to have been obtained for the "dominant purpose" of your claim, then you are not entitled to see such reports if the insurance company or your employer choose not to rely on them.
This may seem unfair, but you are given the same privilege, as if we obtain a report from one of your doctors that is not as favourable as we would have copied, we are not required to disclose its existence to the other side.
How do I pay for the treatment for my injury?
Unless the insurance company is paying your treatment expenses, you will be faced with the difficult situation of having to pay for your own treatment. In this situation, you can use your Medicare card for all services for which a Medicare benefit is paid - for example, x-rays, CT & MRI scans, consultations with GPs, specialists, and psychiatrists.
Unfortunately, Medicare does not cover all consultations - for example consultations with physiotherapists are not covered. You may however be able to utilise the services of a public hospital near you, which often provide physiotherapy and/or other services free of charge.
Workers Compensation treatment expenses must be pre-approved.
For any expenses paid for by you, make sure you keep your receipts and give them to the insurer.
The content of this article is intended to provide a general guide to the subject matter. Specialist advice should be sought about your specific circumstances.