What Does a Workcover Claim Cover in Queensland?

Worker’s Compensation Insurance is an accident insurance for work-related injuries and will pay compensation to employees who are injured at work. WorkCover Queensland is the primary provider of this insurance in Queensland. We've provided some plain English answers on what Workcover covers below.

What injuries does workers’ compensation cover?

WorkCover insurance covers a broad range of injuries including:

1. Physical injuries

Common physical injuries include back strains, other muscular strains, fractured bones, soft tissue damage, burns, cuts and wounds.

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2. Psychiatric or psychological injuries (PPI)

Psychiatric or psychological conditions, such as anxiety disorders may be covered by WorkCover as long as they are caused by employment. A PPI may be caused by excessive fatigue, bullying, work pressure or stress, violence, poor working conditions or a traumatic event.

A psychiatric or psychological injury might not be covered if:

  • other circumstances in your life were a significant contributing factor;
  • the injury arises out of reasonable management action taken by your employer such as a decision not to promote you or grant you requested leave or working conditions, demotion, discipline, retrenchment or dismissal;
  • the injury arises because of some action taken by your employer or insurer in relation to your worker’s compensation claim.

When deciding a psychiatric or psychological injury claim, WorkCover will discuss the events that gave rise to the injury with you, your treating doctors and your employers.

3. Injuries occurring over a period of time

WorkCover also covers injuries that do not occur because of one particular event. Injuries such as industrial deafness or repetitive strain injury that result from exposure to certain conditions over a period of time, are also covered.

4. Late onset injuries

This includes injuries that only surface or are able to be identified a long time after they were caused. For example, prolonged exposure to certain chemicals may result in an employee contracting a disease which only manifests many years later. WorkCover will cover such an injury even though the worker didn’t make a claim at the time the injury was being caused.

5. Aggravations of pre-existing conditions

WorkCover covers injuries that are aggravations of a pre-existing condition whether or not the pre-existing condition resulted from a work-related injury. For example, if a worker has a pre-existing back strain and he does further damage by lifting something at work it may be considered an aggravation of a pre-existing condition. An aggravated injury can be the subject of a new claim in its own right. However, WorkCover will only pay for the treatment and costs associated with the aggravation, not the original injury. In some circumstances however, WorkCover may reopen an initial claim if a worker experiences ongoing symptoms after returning to work from a workplace injury.

6. Death from a work-related injury or disease

If a person dies as a result of a work-related injury or disease, their family may make a WorkCover claim on their behalf. NOTE: Since not every case is the same, WorkCover will examine your particular case and make a personal decision on whether your injury is covered based on the circumstances.

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What benefits does WorkCover pay for a statutory claim?

When you make a statutory claim  that is accepted, WorkCover will pay a range of benefits including:

  1. Weekly compensation for lost wages for the time you cannot work

This may be up to 85% of your average pre-accident declarable income (what you would declare to the Tax Office). It is paid directly into your bank account by WorkCover like your salary. This compensation table can be used as a guide.

  1. Medical and rehabilitation expenses

WorkCover will pay for your medical and rehabilitation costs such as:

  • medical appointments with a registered health professional (e.g. a doctor, dentist, physiotherapist)
  • hospital expenses up to four days or as otherwise agreed by WorkCover for non-elective treatment, and only when agreed by work cover for elective treatment*.
  • surgical costs
  • medicines, drugs and other reasonable chemist expenses relating to the injury
  • rehabilitation treatment
  • equipment required for rehabilitation or return to work (e.g. a wheelchair or crutches)

*Elective treatment is a procedure that you and your doctor decide is appropriate for the effective treatment of your injury, but does not involve urgent life-threatening injuries or injuries where there is a risk of serious damage to a limb or organ.

  1. Travelling expenses

WorkCover will pay for your travel expenses to appointments for medical treatment, rehabilitation, medical examinations and with the Medical Assessment Tribunal which are over 20km in one direction. They may not pay travel expenses to a medical appointment if there is a closer medical provider you could attend instead. Travel expenses are calculated based on what is the most reasonable mode of transport for you to take. WorkCover may also pay for your parking when required and meals if need to travel a whole day or overnight.

  1. Lump sum payments

If a work-related injury or disease results in a permanent impairment, a compensation payout may be offered by WorkCover. A permanent impairment is a physical limitation from an injury that persists after treatment over a period of time and is not likely to improve with any more treatment. WorkCover may have your permanent impairment assessed in order to calculate an offer of lump sum compensation to you.

  1. Death benefits

If a person dies as a result of a work-related injury or disease, their family may make a WorkCovers compensation claim. In this case WorkCover may pay a lump sum compensation payment, quarterly payments for loss of income to dependants, as well as the cost of the deceased’s funeral.

What does WorkCover not pay in a statutory claim?

Under a statutory claim, WorkCover will not pay for:

  • expenses relating to injuries that are not sustained while you are at work;
  • treatment by non-registered medical professionals including alternative medical treatments;
  • travel expenses to medical appointments if less than 20km one way or if there is a closer medical provider that the worker could see instead;
  • hospital costs which are not agreed with WorkCover first; and
  • domestic paid care, cleaning and home maintenance assistance (e.g. lawn mowing, gardening)

What expenses can be claimed in a common law claim?

Because a common law claim requires you to bring a law suit, there is no automatic rights to benefits. You must make a claim against your employer for an amount that compensates you for the damage you have suffered because of your injury. However the court will ultimately decide how much you should receive. To figure out how much compensation you are entitled to, the court will add up all the different damages that you are entitled to. These include damages to compensate you for;

  • your pain and suffering from the injury;
  • your lost future earning capacity including superannuation payments;
  • your past and future medical expenses; and
  • domestic care or assistance (e.g. cleaning, lawn mowing, personal care) which you have had to pay for or will need to pay for, or that have been provided by family members.
Strict time limits apply - seek legal advice ASAP - In most circumstances, the time limit to start a compensation claim is 3 years from the date of incident. Some processes need to be started much sooner. Seek expert legal advice ASAP. Call us on 1800 266 801 or start a live chat.

Next steps - get advice now

It’s important to get advice for your specific situation. Check if you can make a risk-free compensation claim and get free initial advice from our Principal lawyer, Greg Smith.

Last update on:
May 29, 2018
Disclaimer: This information is designed for general information in relation to Queensland compensation law. It does not constitute legal advice. We strongly recommend you seek legal advice in regards to your specific situation. For expert advice call 1800 266 801 or chat via live chat to arrange free initial advice with our Principal lawyer, Greg Smith.

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