Workers Compensation from 2 perspectives

Workers Compensation from 2 perspectives – which one would you choose?

Thank you to my 4 year old for the inspiration for this article!

Bob the Builder was climbing up a ladder while at a worksite when he suddenly fell landing heavily on his lower back. Bob was in pain but wasn’t sure what he should do – report the injury to his employer and go see a doctor, or try to shake it off and go back to work?

In scenario 1, after seeking some advice Bob reports the injury to his employer and consults a doctor. The incident is noted in an incident report by the employer. Bob’s GP advises he has a lumbar spine injury and needs some time off work to recover. The GP issues a Certificate of Capacity noting that Bob is totally unfit for work until the next review date in 28 days. Bob provides his employer with the certificate and lodges a worker’s compensation claim with his employer’s workers compensation insurer. The claim is accepted by the insurer given the injury noted by the GP is confirmed by the employer’s incident report. The insurer pays weekly benefits for the period that Bob is incapacitated and pays for all medical expenses. Bob’s condition improves and he is able to return to work on light duties in a gradual return to work plan negotiated with his employer, the insurer continues to make up his wage. Unfortunately, Bob’s condition deteriorates, surgery is recommended. The insurer approves the costs of the surgery and pays Bob’s wages while he is recovering. Following the surgery Bob is unable to return to heavy manual labour so the insurer pays for his rehabilitation and retraining into a Project Management position. Bob also receives a lump sum payment for the permanent impairment he has due to his lumbar spine injury.

In scenario 2, Bob decides to continue working as he does not want to get his employer offside and risk losing his job. Bob experiences ongoing lower back pain over the next few months which affects his ability to perform his work duties. The employer is unhappy with Bob’s performance at work and their relationship deteriorates. Bob finally decides to go see his GP and explains that his back pain began when he fell off the ladder at work. The GP provides a Certificate of Capacity noting that Bob is totally unfit for work due to a lumbar injury sustained 7 months ago. Bob provides his employer with the certificate and lodges a worker’s compensation claim with the insurer. The claim is denied because it was lodged more than 6 months after the injury. There is also no evidence that Bob sought any medical treatment for a back injury in the previous 7 months and the employer has no knowledge of his fall from the ladder. To make matters worse, Bob needs lumbar spine surgery, but this will need to be delayed while Bob disputes the denial of liability by the insurer in the Workers Compensation Commission. Unfortunately, the only witnesses to the fall were the machines on the work site and since they do not talk in real life, they are unable to provide any evidence to support Bob’s claim.

In NSW injured workers can access funding grants for legal advice and assistance in respect to workers compensation claims. The advantages of getting advice soon after an injury can make all the difference as outlined in the scenarios above. KC Hilton is an Accredited Specialist in Personal Injury with a particular interest in workers compensation claims. If you have been injured at work and want some advice, call WNB Legal on 0419 464 946 to arrange a consultation with KC.