Healthcare Providers - Adviceline Injury Lawyers
Work Injuries
Is my patient entitled to WorkCover?
Yes, if they have been injured at work in Victoria.
WorkCover is a no-fault system, covering people who are injured at work regardless of how it occurs. Even if it does not occur at your patient’s normal workplace, it can still be considered a ‘work injury’.
Work injuries can be caused by a particular incident (for example, a fall at work), or over time (for example, repetitive injuries, heavy work over time, or stress). Injuries can be both physical and psychological.
If your patient is unsure of their rights, they can get free, obligation-free advice by calling our lawyers directly. WorkCover processes can take time, so the earlier they find out their rights, the better.
What benefits can WorkCover provide?
Payment of ‘reasonable’ medical and like expenses
- Weekly payments of income compensation
- A once-off ‘impairment benefit’ lump sum if the injury is considered permanent
- If your client has a serious injury caused by negligence at work or while performing work duties, they may be able to bring a common law claim for lost earnings, and pain and suffering damages.
What medical expenses will WorkCover pay for?
WorkCover will pay for the 'reasonable medical and like expenses' needed as a result of a work-related injury. This can include GP visits, surgery and medication, as well as a range of approved services including dentistry, massage, hydrotherapy, physiotherapy and even gym memberships.
In addition, upon request from a medical practitioner, personal and household services can be provided by WorkCover, including household help, orthopaedic aids, and even gardening services.
If your patient reasonably requires treatment or care that WorkCover has declined to pay for, we may be able to assist in taking the matter to Conciliation.
How can my patient access WorkCover?
The injured person needs to complete a WorkCover claim form, which can be obtained from their employer, the Victorian WorkCover Authority, a local post office, or from Adviceline Injury Lawyers. This claim should be lodged as soon as possible after suffering the injury.
He or she needs to give the completed form to their employer, along with any receipts for reimbursement. If the worker wants to claim weekly payments, they also need to provide a WorkCover Certificate of Capacity completed by his or her treating doctor, which is generally the GP, surgeon or psychiatrist.
If the claimed injury is psychological and/or has occurred over time, or if the worker has any questions, we recommend seeking legal advice. Our advice is obligation free and may avoid disputes or unnecessary complications down the track.
How should I fill out the Certificate of Capacity?
The first Certificate of Capacity should be for 14 days, and all subsequent Certificates for up to 28 days. You can back date a Certificate of Capacity for up to 3 months in the past, as long as you were treating patient during that period, and you certify that the patient was incapacitated during that period.
Partial incapacity
If you consider that your patient is able to work, but only with restrictions due to their work-related injury, tick the box “fit for modified duties”. Then, be specific about his or her restrictions. For example – “no lifting above 5 kilograms, no bending”, or “no classroom teaching”, or “fit for 4 hours per day, 4 days per week”. The employer then has an obligation to try to provide duties consistent with those certificates.
If your patient is unfit for their pre-injury duties, but can perform alternative work duties, they will not be entitled to weekly payments of compensation beyond 130 weeks.
Total incapacity
If you consider that your patient is totally incapacitated for all work by reason of their work-related injuries, tick the box “unfit for all duties”.
An injured worker is only entitled to weekly payments of compensation after 130 weeks if the WorkCover or a Medical Panel determines that they are totally unfit for all duties, due to the work injury, and this is likely to continue indefinitely.
When do I need to write a report for WorkCover or the Accident Compensation Conciliation Service? And how do I charge my fee?
From time to time, WorkCover will request medical reports from patient’s treating practitioners. If your patient takes a matter to conciliation, the ACCS (Accident Compensation Conciliation Service) may also request a report directly from you. Sometimes, your patient will ask for your written opinion to take to the Conciliation.
Your tax invoice can generally be sent to the agency requesting your report for pre-payment.
See our checklistHow do I write a report for solicitors? And how do I charge my fee?
To investigate our clients’ potential entitlements, Adviceline Injury Lawyers often write to doctors and health care providers directly to request reports.
We will usually ask specific questions in our letter – and it is important for your patient’s claim that you address each separate question. If you have any queries at all in relation to a report request that you have received, we invite you to contact our office directly.
We are happy to pre-pay for the report if a tax invoice is provided to our office. We understand that medical practitioners are busy, and greatly appreciate the time and effort that you spend in preparing these reports.
Why does my patient have to see ‘Independent Medical Examiners’?
WorkCover will periodically have your patient examined by independent specialists (Independent Medical Examiners – IMEs) to assess whether they can return to work, and what treatment is reasonable.
An IME may have an opinion which is different from yours. While the IME may be a specialist in their field, as a treating doctor or medical practitioner, you may have better knowledge or understanding of your patient. If you disagree with the report of an IME, it is helpful to clearly state your opinion and reasoning in your own medical reports.
Although these appointments can be stressful for patients, it is important that your patient attends appointments with IMEs, because WorkCover can cut off their compensation payments if they do not cooperate.
Problems with WorkCover – what can I do to help my patient?
Dealing with WorkCover can be frustrating. If your patient disagrees with a WorkCover decision, they can request Conciliation. Conciliation can also be requested where an insurance agent has failed to respond to a request within 60 days.
Request for Conciliation forms can be obtained from WorkCover, or from our offices. We can also provide advice about conciliation and arrange free assistance at the conference.
If there is a medical question in dispute the ACCS (Accident Compensation Conciliation Service) may request a report from you. Writing a clear and supportive report prior to any conciliation date is of invaluable assistance to your patient. For further information “When do I need to write a report for WorkCover or the Accident Compensation Conciliation Service?” (link back to question).
Do I have to provide my patient records?
Under the Health Records Act 2001 (Vic), individuals have a right of access to their health information. You are required to provide a copy of patient records upon a valid request from the patient or their authorised representative.
You are entitled to charge a fee for the provision of these records. The maximum fee allowed to be charged is specified in the Health Records Regulations 2002.
For further information about your obligations regarding the provision of health information to individuals, refer to the website of the Health Services Commissioner.
What should I expect if I am asked to give evidence in court?
What does AdviceLine Injury Lawyers do for my patient?
We assist injured workers with:
- Having their injury recognised by WorkCover as work-related
- Claiming medical and like expenses
- Claiming weekly payments while they cannot perform their pre-injury duties
- Claiming lump sum compensation, in the no-fault scheme and/or under the common law of negligence. This can involve running court proceedings, obtaining and assessing medical and other evidence, instructing barristers, negotiating settlements, and fully advising our clients so that they can make informed decisions about their injury claim.
- We act No Win, No Fee in most cases and abide by strict regulation on legal services fees in Victoria.
- We are expert personal injury lawyers, and several of our lawyers are Law Institute Accredited Personal Injury Specialists.
