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Published: 25 October 2017
Author: Ross Inglis

How to maximise WorkCover payments

The question of maximising your WorkCover payments has two parts.

Ensure the calculations used to pay benefits are correct

The first is to ensure that the calculations used to pay your weekly payments are correct; that is say that, to make sure you put down the right information on the claim form in relation to your ordinary rate of pay and your shift penalties and allowances.

The claim form allows for that and if you're uncertain then you need to go and speak to your employer and make sure that the information is properly recorded on the claim forms. You don't just put down your ordinary time rate of pay because there is provision to add on your shift penalties and allowances. Again, if you're uncertain you need to check with the employer.

You also need to make sure that you’re being paid at the correct rate on the basis that the pre-injury average weekly earnings are being properly calculated, including shift penalties and allowances, and that this information is properly recorded in the claim form. This will maximise your weekly payments of compensation.

Entitlement to a lump sum for permanent impairment

The second part of the issue of maximisation is to determine if you are entitled to a lump sum for permanent impairment.

You may well be if you have an impairment that is 5% of a whole person as assessed on the system of the American Medical Association guides which is the standard against which these assessments are made. If you meet the threshold you may be entitled to a lump sum for permanent impairment.

That is quite separate to your entitlement to weekly payments and medical and like expenses. Taking a lump sum has no effect whatsoever on other rights. And you may also be entitled to pursue a common law claim, so if you have a serious injury and your injury occurred in certain circumstances of negligence, you may well be entitled to proceed with a common law claim.

Some time ago, a lot of people were confused because the then Kennett Government made an attempt to remove common law from the system, thankfully unsuccessfully. And although common law does require you to establish that you've got a serious injury and in circumstances of negligence - and regrettably those injuries and circumstances do occur - then there are a lot of people who are entitled to a common law claim, and in some instances also for pain and suffering.

Again, that is separate from your weekly income entitlements and medical and like expenses.

If however you suffer an economic loss either completely or that you can only work to 60 percent of your premium earnings, you may also be entitled to pursue the common law claim for economic loss as well.

The resolution of a common law claim under what we call "both heads", that is weekly payments and pain and suffering, does not have any effect on the entitlement to expenses. So lump sum claims and common law claims do not curtail any rights to claim ongoing living and medical and like expenses, they remain open. It one of the big advantages of the system.