How complicated and frustrating is WorkCover?
Very! – Ask any injured worker! Many WorkCover agents (insurers) seem to start with the general view that your injury is not genuine and you are not entitled to payments. You are put to enormous lengths to prove on medical grounds that your work was a significant cause of your injury and that the injury you sustained reaches the various thresholds required for you to be compensated. This often requires you to be medically examined and on a regular basis, by a host of medical specialists, psychologists and psychiatrists appointed by WorkCover, almost all of whom are located in Melbourne.
TAC (Transport Accident Commission) – Contrast this with the attitude of the TAC, which is far more user friendly and whose motivation is to assist in your rehabilitation and to compensate you for your impairment, loss of income, medical and like expenses. Working in both areas, I am constantly amazed at the difference in the attitude of WorkCover compared to the TAC.
Medical Panels – these have been set up to decide disputes independently of WorkCover or indeed in any personal injury matter where insurers are involved. If your matter is referred to a Medical Panel during the course of your claim, it can be a two-edged sword. That is because the Medical Panel decision is final and binding – both on you and on the defendant insurance company. There is no appeal possible from a Medical Panel decision except in extremely rare cases by way of Supreme Court review. Therefore, if the Medical Panel finds in your favour, there is nothing the WorkCover agent or defendant can do about that and they are stuck with the decision meaning they must pay you your entitlements. However, if the Medical Panel finds against you, then that is generally the end of your case for compensation, except for your claims to special damages such as medical and like expenses.
WorkCover – is complicated by a host of procedures, thresholds for impairment and in particular, strict time limits known as ‘suicide clauses’ in the industry because if you or your lawyer miss them, your case is over, particularly in Serious Injury Applications for pain and suffering and loss of income. Therefore, only lawyers who specialise in this area should be retained to advise in WorkCover matters and who can navigate through the maze of procedural requirements.