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Work Cover Claims

If you have suffered an employment related injury within QLD – you may be entitled to claim for work cover.  At ROC Legal, our role is to assist you in this process and provide expert legal advice to assist you with your work cover claim. While each situation is unique, there are strict time limits that apply to work cover claims and your right to pursue damages. Whether your injury was slight or extremely damaging – get in touch with ROC Legal today for expert opinion on your matter.

When you have experienced the following accidents and are concerned about your future ability to return to work, you need to immediately contact our team for advice.

  • Spinal Injuries
  • Head Trauma
  • Bone breaks or fractures
  • Soft Tissue injuries
  • Shock, anxiety or depression
  • Respiratory Illness
  • Eye injuries
  • Injuries obtained from work travel
  • Pre-existing conditions that may have amplified from work related situations
  • Disease caused by work environments

Work cover can assist with immediate medical expenses including surgery, any travel expense, rehabilitation costs and pharmaceutical costs, as well as provide a portion of your normal weekly salary while you recover. It’s important to contact as soon as possible for an assessment of your work cover claim as time limits and specific conditions are applicable.

Expert Advice for WorkCover Claims and Compensation


ROC Legal are an experienced team of solicitors who provide expert advice on WorkCover claims and can best advise how to proceed.  When you partner with the ROC Legal team, you’re receiving years and years of professional experience to resolve your matter and quality representation to give you peace of mind.

ROC Legal

What Should You Do in the Event of Experiencing Injuries at Work?

  • Seek legal advice on your situation
  • Ensure to keep a record of events, notes, medical records and incident records
  • Maintain notes and witness testimonials

Seek professional medical care as soon as possible after the injury occurs

Frequently Asked Questions

Often defined as a breach in the employers’ duty of care – negligence results in injuries obtained by defective equipment and inadequate training. Negligence is complex in nature and needs to be determined by a lawyer. Even if you may think you are at fault for an accident, it is the employers’ duty to maintain a safe work environment, so negligence between two parties is possible.

Employees that are classified as full-time, part-time, casual, permanent and self-employed workers are eligible to make WorkCover claims.

Yes. Any employee that has been injured at their workplace are entitled to submit a WorkCover claim. Time limits do apply, and you have up to six months to submit a claim form to WorkCover.

The Workers’ Compensation and Rehabilitation Act 2003 (Qld) (“WCRA”) establishes a scheme for Queensland providing benefits for workers who sustain injury in their employment, for dependents if a work’s injury results in the worker’s death and encouraging improved health and safety performance by employers: section 5 WCRA.

There are two types of claims that can be made if you are injured at work.  The first is a statutory claim which can be made regardless of fault and the second type is a common law claim in negligence in which you must prove fault against your employer.

A statutory claim can be made if you are injured at work regardless of fault.  You must satisfy the elements set out in the WCRA however, in order to make the claim.

The key elements of a statutory claim are:-

  1. You are a “Worker” (section 11 WCRA)
  2. In an “Event” (section 31 WCRA)
  3. Who sustains an “Injury” (section 32 WCRA)
  4. Arising out of, or in the course of, employment (section 32 WCRA); and
  5. The employment is a significant contributing factor to the injury (section 32 WCRA).

Yes.  An application for compensation for an injury is valid and enforceable only if the application is lodged by the claimant within 6 months after the entitlement to compensation for the injury arises: section 131 WCRA. 

Yes.  An insurer may waive the time frame if they are satisfied that the failure to lodge the claim within 6 months was due to mistake, absence from the State or a reasonable cause: section 131(6) WCRA. 

The application must be in the approved form, lodged with the insurer and must be accompanied by a medical certificate in the approved form: section 132 WCRA.

Yes.  A claimant, worker, or an employer who is aggrieved by a decision or failure to make a decision may apply for review of that decision: Section 541 WCRA. 

An application for review of the decision must be made within 3 months after the person applying for review receives written notice of the decision or failure to make a decision: Section 542(1) WCRA.

The application for review must be in the approved form, given to the Regulator, state the grounds of the review and may be accompanied by any relevant documents the applicant wants considered in the review: Section 542(5) WCRA.

The Regulator must, within 25 business days after receiving the application, review the decision and decide to either confirm, vary, set aside and substitute another decision or set aside and return the matter to the decision maker with directions: section 545 WCRA.

If an insurer rejection the claimant’s application for compensation, the insurer must also, when giving the claimant notice of its decision, give the claimant written reasons for the decision and the information prescribed under a regulation. Section 134 WCRA.

A claimant or worker who is aggrieved by a decision or failure to make a decision may apply for review of that decision: Section 541 WCRA. 

An application for review of the decision must be made within 3 months after the person applying for review receives written notice of the decision or failure to make a decision: Section 542(1) WCRA.

The application for review must be in the approved form, given to the Regulator, state the grounds of the review and may be accompanied by any relevant documents the applicant wants considered in the review: Section 542(5) WCRA.

In a WorkCover Statutory claim, the insurer must make a decision on the application for compensation within 20 business days after the application is made.  If the insurer rejects the application, it must also give the claimant written reasons for the decision.  If a decision is not made within 20 busines days then the insurer must within 5 business days after the 20 business days have ended, advise the claimant of its reasons for not making the decision and that the claimant may have the application reviewed. See section 134 WCRA.

The entitlement to compensation starts on the day the worker’s injury is either assessed by a doctor, nurse practitioner (minor injury) or dentist (if oral injury): Section 141 WCRA.

The entitlement to weekly payments of compensation stops when:

  • the incapacity due to the work-related injury stops, or
  • the worker has received weekly payments for 5 years, or
  • compensation has reached the maximum amount: Section 144A WCRA

The entitlement of a worker to payment of medical treatment, hospitalisation and expenses for an injury stops when the entitlement to weekly payments stops and medical treatment by a registered person is no longer required for the management of the injury because the injury is not likely to improve with further medical treatment of hospitalisation: Section 144B WCRA.

In a nutshell, the entitlement to compensation arises when a worker is assessed as requiring treatment for the work-related injury and ceases when treatment is not required further or treatment is not going to assist the worker for the work-related injury.  How long the claim takes depends on how long your recovery takes.

The compensation payable to a totally incapacitated worker whose employment is governed by an “industrial instrument” (modern award, certified agreement or bargaining award or arbitration determination), for each week:

  • For the first 26 weeks of incapacity, the greater of either 85% of the worker’s normal weekly earnings (N.W.E) or the amount payable under the worker’s industrial instrument;
  • From the end of the first 26 weeks of incapacity until the end of the first 2 years of the incapacity, the greater of 75% of the worker’s N.W.E or 70% of QOTE (Queensland full-time adult persons ordinary earnings declared by the Australian Statistician);
  • From the end of the first 2 years of the incapacity until the end of the first 5 years of incapacity, if the workers has an injury that could result in a permanent impairment of more than 15% the greater of 75% of the worker’s N.W.E or 70% QOTE or otherwise an amount equal to the single pension rate. Section 150 WCRA.

If you are not governed by an industrial instrument or you fall within certain contract workers’ then differing amounts may apply.

The insurer must pay the cost of the medical treatment or hospitalisation that the insurer considers reasonable, having regard to the worker’s injury: section 210 WCRA.

An insurer must pay for the travelling expenses, that the insurer considers are necessary and reasonable, incurred by a worker for obtaining medical treatment, undertaking rehabilitation, attending a medical assessment tribunal or undertaking examination by a registered person: section 219 WCRA.

Yes, an insurer must take all reasonable steps to secure the rehabilitation and early return to suitable duties of workers who have an entitlement to compensation and workers who are participating in an accredited rehabilitation and return to work program of the insurer: section 220 WCRA

A worker receiving compensation for an injury must give notice to the insurer within 10 business day of the worker’s return to work or engagement in a calling: section 136 WCRA.  A calling means any activity ordinarily giving rise to receipt of remuneration including self-employment or performance of an occupation, trade, profession, or carrying on a business, whether or not the person performing the activity received remuneration: Schedule 6 WCRA.

A worker must satisfactorily participate in rehabilitation as soon as practicable after the injury is sustained and for the period for which the worker is entitled to compensation: section 232 WCRA.

If a worker fails or refuses to participate in rehabilitation without reasonable excuse, the insurer may suspend the worker’s entitlement to compensation until the worker satisfactorily participates in rehabilitation.

An insurer may decide, or a worker who has made an application under section 132 may ask the insurer, to have the worker’s injury assessed to decide if the worker’s injury has resulted in a degree of permanent impairment: section 179 WCRA.

The insurer must have the degree of permanent impairment assessed by either an audiologist (for industrial deafness) or by a medical assessment tribunal (for psychiatric or psychological injury) or a doctor (for another injury): section 179 WCRA.

If a worker is assessed as having sustained a permanent impairment, the worker is entitled to a payment of lump sum compensation for the permanent impairment.   In particular circumstances, the worker may be entitled to a payment of additional lump sum compensation: section 178 WCRA.

The insurer must, within 10 business days after receiving the assessment of the worker’s permanent impairment, give the worker a notice of assessment in the approved form: section 185 WCRA.

If you receive a notice of assessment, call us for a no obligation consultation to discuss your possible options.

Statutory Claim

At the end of a statutory claim, if a worker is entitled to lump sum compensation then the amount of the lump sum compensation must be calculated under a regulation having regard to the degree of permanent impairment: section 180 WCRA.  This is your statutory lump sum compensation. 

Common Law Claim for Damages

In a common law claim for damages a worker can claim for:-

  1. General Damages – this is an amount for pain and suffering, loss of amenities of life, loss of expectation of life and disfigurement
  2. Past Economic Loss – this is loss of earnings due to the injury or the deprivation or impairment of earning capacity
  3. Future Economic Loss – is the loss of prospective earnings or the deprivation or impairment of prospective earning capacity
  4. Past/Future Medical & Rehabilitation Expenses
  5. Past/Future General Expenses
  6. Paid Services – assisting with personal hygiene needs, changing bandages, cleaning, cooking, gardening, mowing the lawn
  7. Interest on past monetary loss

The differences between statutory lump sum compensation and common law claim for damages can be vast.  It is important to seek advice early on when you are injured at work.

A common law claim can be made on the basis that your employer was negligent and that negligence caused your injury.  This means that your employer has breached their duty of care and that breach of duty has caused your injury.

A claim of this nature can be made once your statutory claim has finalised.  You are entitled to commence a common law claim if you have received a notice of assessment: section 237 WCRA.  There may be other options to commence a common law claim and it is important you call us to discuss your options.

In a WorkCover claim a duty of care means a duty to take reasonable care or to exercise reasonable skill (or both duties): section 305 WCRA.

A person does not breach a duty to take precautions against a risk of injury to a worker unless:-

  • The risk was foreseeable (that is, it is a risk of which the person knew or ought reasonably to have known); and
  • The risk was not insignificant; and
  • In the circumstances, a reasonable person in the position of the person would have taken the precautions: section 305B WCRA.

In deciding whether a reasonable person would have taken precautions against a risk of injury, the court is to consider the following (among other relevant things)-

  • The probability that the injury would occur if care were not taken;
  • The likely seriousness of the injury;
  • The burden of taking precautions to avoid the risk of injury: section 305B WCRA

A decision that a breach of duty caused a particular injury comprises of the following elements

  • The breach of duty was a necessary condition of the occurrence of the injury;
  • It is appropriate for the scope of liability of the person in breach to extend to the injury so caused: section 305D WCRA

In deciding liability for a breach of a duty, the worker always bears the onus of proving, on the balance of probabilities, any fact relevant to the issue of causation: section 305E WCRA.

The process for a common law claim is

  1. Notice of claim for damages served on Workcover and the employer: section 275 WCRA
  2. Compliance response from WorkCover (to be provided 10 business days after receiving the notice of claim for damages: section 278 WCRA
  3. Co-operation between the parties: section 279 WCRA
  4. Liability response from WorkCover (to be provided 6 months after the insurer receives a complying notice of claim for damages or waives the claimant’s non-compliance: section 281 WCRA
  5. Medical examination/s: section 282 WCRA
  6. Compulsory settlement conference (to be held within 3 months after the insurer gives notice under section 281 WCRA): section 289 WCRA

If a claim is not resolved at settlement conference, each party must ensure that it makes a written final offer at the conference that would dispose of the claim if the offer was accepted: section 292 WCRA.

If a claim has not resolved at settlement conference, then Court proceedings must be filed and served on the employer within 60 days after the conference was held: section 300 WCRA.

If you have been injured at work and have not made an application for compensation, then you should contact us for a no obligation consultation to discuss your options.

What NOT to Do in the Event of Experiencing Injuries at Work?

      X Fail to seek professional medical care after your injury

       X Don’t keep any records or file incident reports to your employer

       X Continue working if it puts you at risk for further injuries

 

If you have been injured at work and believe you have a WorkCover claim, then it is essential you contact the team at ROC Legal for professional advice. Whatever your situation or injury, it’s important that the first step you take is to receive professional medical care, followed by seeking legal advice so you fully know your rights.

The ROC Legal Point of Difference

We specialise in compensation law, and we’d love to help you with your compensation claim and get your life back on track. Working through a compensation claim can be tough, but when you have ROC Legal on your side, the whole process is smooth. We’re a boutique firm who treat every client with respect, courtesy and care, but we’re big enough to be able to handle even the most complex of claims and compensation issues. 

We’re compensation legal experts, and we’re waiting to take your call. Get in touch with the legal professionals who care at ROC Legal on 1300 196 219

Get the Care and Attention You Need with ROC Legal

If you are curious about the process involved in motor vehicle incident claims or would like some more information on how best to proceed with a compensation claim, we can help. 

Our boutique firm means that you will always get personalised, one-on-one service from people who know your concerns and who are happy to help. Our motor vehicle accident lawyers are on hand to answer your questions and will work with you to offer support and guidance for your particular situation, standing by your side during what can be a potentially difficult time. 

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