Mi Compañía de Seguros ha dejado de pagar mis beneficios del seguro de protección de ingresos. ¿Qué debo hacer? Si...
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Everyone has the right to go to work each day, knowing they’ll come home safely. If you’ve been injured or become ill at work you may be entitled to make a claim for workers’ compensation to cover lost wages, medical and rehabilitation costs, retraining expenses or a lump sum payment for permanent injuries.
There have been a lot of changes to arrangements in NSW for seeking workers’ compensation in recent years. You could be forgiven for being a little confused about where to start. After all, workers’ compensation laws and entitlements are already a little hard to keep up with because they vary between states and territories and may be known as WorkCover, CTP or WorkSafe. Compensation and benefits can vary greatly depending on your injury and on the law you’re covered by.
1. Who can make a claim for compensation?
The definition of a worker includes:
· those that work for an employer as an employee under a written or oral contract of service, and
· a “deemed worker”.
If you fall into one of the above categories and have sustained an injury either in the course of your employment, or travelling to or from work then you can make a claim for compensation.
2. How do I make a claim?
To make a claim, you must advise your employer that you have sustained an injury and provide medical information. An employer has 24 hours to advise the relevant workers’ compensation insurer of the injury. You do not need to provide a written claim form. Instead, once the insurer has been told of the injury, the following will generally occur:
· provisional liability and payments start within 7 days (although the insurer can sometimes seek up to an additional 3 weeks to do this), and
· the insurer will investigate the facts and decide to either stop or continue further payments.
The insurer may ask you to provide a written claim at a later date. After accepting provisional liability and investigating the matter, the insurer needs to determine if the following has occurred:
· the person is a worker or deemed worker, and
· the injury occurred at work on the way to or from work and that work is a substantial contributing factor to the injury.
If the insurer declines liability for your claim, don’t despair! Get in touch with specialist lawyers like Littles, who can provide you with high quality legal advice on how you can proceed.
3. What am I entitled to claim?
If your injury has been caused by the negligence of your employer, compensation may be payable for:
· lost income (both past and future)
· lost superannuation, and
· your permanent disability / impairment.
When claiming damages, strict time limits apply and relevant parties must be notified within a certain timeframe.
Read more here: Help! My NSW workers’ compensation claim has been rejected. What do I do? – Littles
4. What is SIRA?
SIRA is the State Insurance Regulatory Authority, and is a NSW Government statutory authority responsible for overseeing the workers’ compensation system in NSW. SIRA collects all workers’ compensation premiums, and is responsible for the payment of workers’ compensation benefits. It appoints scheme agents (insurance companies such as QBE, Employers Mutual, GIO, etc.) to act as claims handlers on behalf of SIRA. These scheme agents work as claims handling agents on behalf of SIRA.
5. What is the Personal Injury Commission?
The Personal Injury Commission is an independent statutory tribunal that replaced the Workers’ Compensation Commission and resolves disputes between people injured in motor accidents and workplaces in NSW, insurers and employers. If you have a dispute with your insurer about a workers’ compensation claim, the Commission can assist. It’s important to note that most applicants to the Commission are legally represented, as it is generally their last chance to make a successful claim.
Don’t delay – seek advice now
Clearly, the workers’ compensation system can be complex, which is why it helps to seek quality legal advice as soon as possible. At Littles, we are experts in workplace injuries, and can help manage the process to ensure that you receive all appropriate entitlements and support. With Littles on your side, we can ensure that you get the fair treatment you deserve.
If your workers’ compensation claim has been rejected, or you would like to understand how to claim benefits to support you and your family while you are injured or ill, please get in touch for a no-obligation chat.
IMPORTANT: There are strict time limits for making and disputing a claim, so take advantage of our FREE initial consultation and get in touch. You have nothing to lose by speaking to one of our compensation law experts. The sooner we determine your eligibility to make or appeal a claim, the sooner we can help you to obtain or continue getting funding from the insurer so your rehabilitation can proceed smoothly.
Free advice and no upfront fees
Not only do we offer a FREE initial consultation we handle most insurance claims on a no win, no fee basis.
The Head of our NSW team, Jessica Cheung, is an expert in NSW workers’ compensation claims. If you think you might have a claim, reach out to Jessica and her team for high quality legal advice.
Please note that this information is intended to provide general guidance only. You should not act or refrain from acting on the basis of such information. Appropriate professional advice should be sought based upon your individual circumstances. For further information, please contact Littles.
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