Experiencing a workplace injury can be overwhelming and confusing. Understanding your entitlements under the Victorian WorkCover scheme is essential for protecting your health and financial wellbeing. Whether you’re currently injured or simply want to be prepared, knowing your rights helps you navigate the system effectively. Workers Compensation lawyers in Melbourne recommend familiarising yourself with these rights before you need them.
Key Takeaways
- All Victorian workers are entitled to compensation for work-related injuries regardless of who was at fault
- You have the right to reasonable medical treatment, weekly payments, and rehabilitation services
- Employers must provide safe return-to-work opportunities and cannot discriminate against you for making a claim
- There are specific timeframes for reporting injuries and lodging claims that must be followed
- You have the right to dispute decisions about your claim through formal review processes
Overview of the Victorian WorkCover scheme
The Victorian WorkCover scheme provides compensation and support to workers who suffer injuries or illnesses in the course of their employment. The scheme covers physical injuries, psychological conditions, and aggravations of pre-existing conditions, provided they arise from your work.
Coverage extends to most employees in Victoria, including full-time, part-time and casual workers. Some contractors and volunteers may also be covered depending on their working arrangements. Self-employed individuals generally need their own insurance.
WorkSafe Victoria oversees the scheme, while approved insurers handle most claims. Your employer pays premiums to fund the system and has obligations to maintain a safe workplace and assist with your recovery.
Your right to make a claim
After a workplace injury, you should notify your employer as soon as possible. Formally, you must report your injury within 30 days to protect your entitlements. Your employer must give you a claim form within three business days of your request.
To lodge a claim, complete the Worker’s Injury Claim Form, attach a Certificate of Capacity from your doctor, and submit both to your employer. Your employer must then forward these to their insurer within 10 days.
Prompt reporting is critical – delays can complicate the claims process and may affect your entitlements. The insurer generally has 28 days to decide on your claim.
Medical treatment and rehabilitation rights
The WorkCover scheme entitles you to reasonable medical treatment related to your work injury. This includes doctor visits, hospital care, physiotherapy, medications, and other necessary treatments.
You have the right to choose your own treating doctors and health practitioners. However, some treatments may require pre-approval from the insurer. If a treatment is denied, you can challenge this decision.
“Every injured worker deserves access to appropriate medical care that supports their recovery and well-being. This is a fundamental right under Victorian workers compensation law.” – Prime Injury Lawyers
The scheme also covers rehabilitation services designed to help you recover and return to work. This might include occupational therapy, vocational assessment, retraining, or workplace modifications.
Income support (weekly payments)
If you’re unable to work due to your injury, you may be eligible for weekly payments to replace lost income. Generally, these payments are calculated as a percentage of your pre-injury earnings.
For the first 13 weeks, most workers receive 95% of their pre-injury average weekly earnings (PIAWE), reduced to 80% thereafter. These payments can continue for up to 130 weeks (2.5 years) for most workers, though longer in some circumstances.
If your weekly payments are reduced or stopped, you’ll receive written notice explaining the decision and your review rights. You can challenge these decisions through formal review processes if you disagree.
Return to work and workplace adjustments
Your employer has legal obligations to help you return to work safely. This includes providing suitable employment that accommodates your injury and developing a return-to-work plan in consultation with you and your doctor.
As an injured worker, you’re expected to participate in planning your return to work and make reasonable efforts to recover and resume duties. However, you shouldn’t be forced to perform tasks that could worsen your condition.
If disagreements arise about suitable duties or necessary workplace modifications, the Return to Work Inspector at WorkSafe can help resolve these issues. You also have the right to seek review if you believe your employer isn’t meeting their obligations.
Claim decisions, reviews and dispute options
Insurers assess claims based on medical evidence, employment details, and the circumstances of your injury. They may accept your claim, request more information, or reject it if they believe it doesn’t meet the criteria.
If you disagree with a decision, you can first request an internal review by the insurer. If still unsatisfied, you can apply to the Accident Compensation Conciliation Service (ACCS) within 60 days. The ACCS attempts to resolve disputes through conciliation.
For unresolved disputes, you may proceed to the Medical Panel (for medical questions) or the Victorian Civil and Administrative Tribunal (VCAT) for certain matters. Each review pathway has specific time limits and procedures.
Privacy and access to records
During your claim, insurers and employers can collect information relevant to managing your case. However, this must be handled according to privacy laws.
You have the right to access your claim file and medical reports. Requests for access should be made in writing to the insurer, who must respond within a reasonable timeframe.
Personal information about your injury and claim should be handled confidentially. Information should only be shared with those directly involved in managing your claim or treatment.
Practical steps after a workplace injury
When injured at work, take these immediate steps:
- Seek appropriate medical treatment and keep all receipts
- Report the injury to your supervisor or manager
- Document how the injury occurred, including photos if possible
- Get a Certificate of Capacity from your doctor
- Complete a Worker’s Injury Claim Form
Throughout your claim, maintain copies of all documents, including medical reports, correspondence with your employer and insurer, payslips showing pre-injury earnings, and receipts for medical expenses. This documentation can prove invaluable if disputes arise.
Conclusion
Understanding your rights under the Victorian WorkCover scheme empowers you to access the support and compensation you’re entitled to following a workplace injury. From medical treatment and income support to return-to-work assistance and dispute resolution, the system offers various protections for injured workers.
If you’re struggling with a WorkCover claim or believe your rights aren’t being respected, seeking professional advice can make a significant difference. Prime Injury Lawyers specialises in helping injured workers navigate the WorkCover system and secure their full entitlements. Remember that knowing your rights is the first step toward a successful recovery and return to work.
