Work Related Injuries - Comcare
Hurt at work?
If you are a government employee, or an employee of companies
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 compensation for injuries sustained at work or a
disease caused, or contributed to, by your employment. Diseases
including cancers, strokes, asthma, heart conditions, psychological
conditions and degenerative conditions are often aggravated or
exacerbated by employment.
It's important to get advice from experts
Accessing your entitlements under Comcare can be a very
complicated process and time limits apply to many steps you need to
take to pursue a claim for compensation.
If you are injured, you should seek advice from your union or a
legal expert who can guide you through the Comcare claims
process.
No matter who you are up against, Maurice Blackburn will fight
to protect you.
FAQ about Comcare claims
What injuries are
covered?
Under the Comcare Scheme, compensation is payable for:
- physical injuries, such as an injured back, arms or legs
- injuries suffered while you are temporarily performing a work
activity away from your place of employment
- injuries suffered travelling for work or while travelling to,
or attending, an approved place of work or education
- injuries suffered while obtaining a medical certificate,
medical treatment or undergoing a rehabilitation program or medical
examination required by Comcare or your employer, and
- any disease caused, or contributed to, by work, including
pre-existing disease if work has aggravated the condition (this may
include cancers, degenerative conditions, strokes, heart
conditions and psychological conditions).
The SRC Act allows your employer or Comcare to deny your claim
if they can show that an exclusionary provision applies. This can
occur where it is alleged that an injury, disease or an aggravation
is a result of:
- reasonable disciplinary action
- failure to obtain a promotion
- failure to obtain a transfer, and
- failure to obtain a benefit in connection with employment.
Since 13 April 2007, a claim can also be excluded if it arose as
a result of reasonable administrative action. This can include
employment-related performance appraisals, counselling, suspension
action, disciplinary action, re-classification or retention of a
benefit.
Also, injuries suffered after 12 April 2007, while travelling
between work and your home, are no longer covered. However, you may
still be able to lodge a claim with the TAC.
If Comcare or your employer uses an exception or exclusion to
reject your claim, contact a Comcare lawyer at Maurice Blackburn
for advice. Freecall 1800 810 856.
How do I make a
claim?
To make a claim you must:
- report your injury in writing to your employer as soon as
possible and complete an incident report
- visit your own doctor for treatment and ensure the injury or
condition is recorded
- lodge a claim form for time off work or medical expenses -
these are available from your union, your employer or from www.comcare.gov.au, and
- obtain a medical certificate from your doctor if you are
claiming for time off work - it should describe the injury, include
the doctor's opinion about whether the injury is work-related, and
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. You should also forward all
accounts and receipts for medical treatment 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
responses are usually received within 4-8 weeks. If your claim is
rejected, and you want to appeal the decision, you must apply for
reconsideration within 30 days.
Our Comcare experts can give you more information about the
claim process. Freecall 1800 810 856.
What benefits are
available?
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.
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 not on your usual hours, you
are entitled to a top-up payment.
After 45 weeks, if you are still unable to return to work, you
will then be paid 75% of your normal weekly earnings. If you are
able to return to work, but you are working less than your usual
hours, you receive between 80% and 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.
If you suffer a permanent impairment due to your work-related
injury, then you may be entitled to claim a lump sum permanent
impairment benefit. This does not impact your ongoing benefits,
such as compensation for medical expenses. 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 permanent.
Lump sum compensation and a pension payment are payable to the
dependants of a worker who has died of a work-related injury or
disease. Funeral expenses may be claimed to a maximum of $9000.
What if they stop my
benefits?
Comcare or your employer may decide to stop your 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 that happens, and you
want to appeal the decision, you must apply for 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. Such a decision
has severe consequences because it stops all benefits being paid to
you or claimed by you.
If you are asked to sign a rehabilitation program, or to accept
a return to work program, seek the advice of your doctor and obtain
written advice about the duties you are able to perform before you
sign the program. If your benefits are suspended, and you want to
appeal the decision, you must apply for reconsideration within 30
days.
If the reconsideration (known as a reviewable decision) is not
in your favour, Maurice Blackburn can advise you about the next
steps to take. This may include 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.
Can I sue?
If your injuries have been caused through the fault or
negligence of your employer, the SRC Act requires that you choose
between either a common law claim for damages (suing your employer)
or a lump sum permanent impairment benefit. You cannot claim both.
Once a decision is made, it cannot be changed. It is therefore
vital that you obtain legal advice before making your decision.
To sue, you must have a permanent impairment assessment of at
least 10%. You have three years from the date of your injury to
make a common law claim.
If you were injured due to the negligence of a third party (a
person or organisation other than your employer), you can sue them.
You generally have three years from the date of your injury to
pursue a common law claim. In the case of claims against another
driver involving the TAC, the time limit is six years from the date
of injury.
Common law claims against third parties can affect your ongoing
entitlements. Our Comcare lawyers can give you more information
about your options. Freecall 1800 810 856.