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Common Pitfalls in Workers’ Compensation Claims and How to Avoid Them

Workers’ compensation schemes around Australia, including in Queensland, operate as a vital safety net for employees who sustain injuries or illnesses in the workplace. But navigating the claims process can be complex, and many people who make a claim under the scheme can inadvertently fall into common pitfalls that can hinder their chances of receiving fair compensation.

This article offers more detail on understanding some of these pitfalls and taking proactive measures to avoid them in order to achieve a smooth and successful claims process.

Pitfall 1: Failing to get a prompt medical assessment and keeping a thorough record of all treatment

A crucial aspect of any workers’ compensation claim is prompt medical assessment of the workplace injury, whether physical or psychological.

A common pitfall here is that failing to properly assess and document a workplace injury as soon as possible after the incident can lead to disputes and delays in the claims process. Incomplete or inconsistent medical records may raise doubts about the severity or cause of the injury, jeopardising the claimant’s eligibility for compensation.

From the moment an injury occurs, it is essential to seek medical attention and ensure that every detail related to the injury is recorded by healthcare professionals. Additionally, workplace incident reports, police reports and statements of any witnesses are all very important as evidence supporting the medical assessment of the injury. A claimant should also be sure to closely follow recommended injury treatment plans – the ultimate aim of workers’ compensation is to allow the injured employee to return to work as soon as possible.

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Pitfall 2: Missing important deadlines for making a claim

In most compensation claims, including those for workers’ compensation, specific deadlines operate under the legislation to ensure the prompt resolution of all claims and fairness to all parties involved. Failure to meet these deadlines can result in the rejection or dismissal of a claim, leaving injured workers without the compensation they rightfully deserve.

Key deadlines governing claims in Queensland are:

  • The workers’ compensation claim should be made within six months of the injury. There are exceptions but only in special medical circumstances or in some cases of mistake.
  • A common law damages claim – in which the claimant claims their injury occurred because of the negligence of the employer – must generally be made within three years from the date of the accident.
  • Claims made within 20 days of the injury occurring can result in WorkCover backdating payments to cover the period between the injury occurring and the claim being made.

To avoid this pitfall on deadlines, a claimant should seek professional legal advice to help keep track of key dates related to filing deadlines and ensure that all required forms and documents are submitted in a timely manner.

Pitfall 3: Returning to work too soon

Whether through subtle pressure by an employer or the injured person’s own fears about losing their job if they’re away too long, many people return to work prematurely before they’re fully recovered. This is a common mistake that can undermine both the recovery process and the validity of a workers’ compensation claim. While the desire to resume normal duties may be understandable, rushing back to work before fully recovering can exacerbate injuries and complicate the claims process.

By returning to work too soon, insurers and employers may think that the injury is less severe than initially claimed, potentially leading to reduced compensation or a rejected claim. It can also prolong the recovery period and increase the risk of re-injury, ultimately affecting the claimant’s long-term health and well-being.

It’s important to consult with medical professionals to determine the appropriate timeline for returning to work based on the severity of your injury and the recommendations for rehabilitation and recovery. Communicate openly with your employer and insurer regarding your medical status and limitations, and adhere to any restrictions or accommodations recommended by healthcare providers.

Discuss your case with our professional team

With the right advice and guidance, workers’ compensation claims can be straightforward and ensure a worker recovers and gets back to work as soon as possible. But as we’ve demonstrated with just a few examples, there can be pitfalls which should be avoided in filing a claim. By avoiding common pitfalls such as inadequate medical documentation, missed deadlines, and prematurely returning to work, injured workers can maximize their chances of securing fair compensation and achieving a successful outcome to their claims. Discuss your case with our experienced team at ROC Legal.

Check if you’re eligible for a Compensation Claim

Find out if your injury or illness is eligible to make a compensation claim. Your online check only takes 3 minutes.

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