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WorkCover Claim Rejected? Here’s What To Do

If your WorkCover claim has been rejected, it doesn’t always mean you can’t claim again.

in Compensation Law by on
WorkCover Claim Rejected? Here’s What To Do

If you’ve been injured, or become sick, at work and you have had your compensation claim rejected, you might be wondering what your options are now.

Laws, regulations and processes in this area can be confusing and, while most employers want to do the right thing, in some cases (either inadvertently or to avoid payouts) they may provide the incorrect information or advice to affected employees.

It can be a tricky situation to navigate, during a difficult time, which is why we’ve written the following guide to give you an idea of what do from here:

Don’t be disheartened

The first thing to keep in mind is that an initial rejection of your claim is almost never the end of the matter. In many cases, so long as you want to pursue the situation, it can open up the process of investigation and give you a better chance to present your evidence and have your story heard.

Initial disappointment is understandable – but don’t let this stop you from taking things further.

It’s also important to remember that while there are legitimate reasons for a claim to be rejected, they usually refer to the fact that an injury or condition doesn’t relate to a person’s work.

It’s also important to know that being a casual worker, a cash-in-hand worker or a labour hire worker doesn’t exclude you from workers’ compensation.

Disputing a rejected claim

If you believe your claim has been unfairly rejected, your first option is to dispute the finding.

If you choose this option, you’ll go to conciliation, which is a free, state government service set up to be more straightforward and convenient (and less formal) than the court system.

It’s important to keep in mind that there is a time limit for applying for conciliation, and this time frame differs in each state.

You can bring a friend, a family member or a union official to conciliation but you can only bring a lawyer if both parties agree. That said, we recommend getting legal advice in advance, whether or not you wish to have a solicitor with you during the process. 

What if conciliation doesn’t work?

In the majority of cases, a workers’ compensation dispute will relate to an injury or medical condition, so, the Conciliation Officer may refer the case to a Medical Panel. This will involve your case being examined by experienced doctors who specialise in the areas related to your condition(s). They’ll talk to you about your claim and review your documents.

Previously, you may have found that an insurer has sent you to a doctor of their choosing and their examination may not have worked in your favour. The Medical Panel is completely independent and will report with total impartiality.

In some parts of Australia (Western Australia, for example) there is a more formal level of non-court resolution known as Arbitration. 

The final dispute resolution stage is court. This is the point at which you should definitely contact a workcover claim lawyer, if you haven’t already.  

Can I make a second claim?

You can’t make a second claim after your first claim is rejected – you can only dispute a rejected claim.

Depending on the advice from your lawyer, we may, however recommend that you submit a second claim for an injury or illness that you may not have mentioned in your initial claim. This can include, for example, an injury caused by long-term repetitive work as opposed to a fall mentioned in the initial claim.

We’re here to help. If you or somebody you love has had your workcover claim rejected, simply get in touch online or call us on 1800 555 777.