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Do study hours count towards work capacity?

Workers Compensation Lawyer – Hours of work and study not to be aggregated in assessment of working capacity

A worker injured her elbow and wrist when she was employed by Aldi as a buying administration assistant. She had some time off work to recover from her injuries.

When she returned she was involved in a series of conflicts with her employer which led to a psychological injury. Her claim for this injury was denied on the basis that she did not suffer a psychological injury, or if she did, it was the result of reasonable action on the employer’s behalf with respect to performance appraisal and discipline.

The Arbitrator found in the worker’s favour, awarding weekly payments for a closed period and medical treatment expenses.

However the worker appealed the decision on two grounds.

First, that the Arbitrator erred in limiting her payments by one year short of what was claimed. This was conceded by the respondent.

The second issue raised on appeal was concerning the Arbitrator’s findings that the worker had capacity to work for 30 hours per week as a librarian, that work as a ‘librarian’ was reasonably accessible, and part-time online study was ‘in addition to’ her capacity to work.  The worker also argued that more consideration should have been given to treating doctors evidence.
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Medical Assessment Certificates

Workers Compensation Lawyer – How many Medical Assessment Certificates is a worker entitled to?

In a recent workers compensation case, the worker sought a Medical Assessment Certificate for the purpose of proving that she was a worker with high or highest needs (i.e. that she had greater than 20% whole person impairment or greater than 30% whole person impairment, respectively) and was therefore entitled to continuing weekly benefits after 260 weeks of workers compensation payments.

This followed a previous medical assessment and complying agreement received in January 2013 which confirmed her whole person impairment at 12%.  The complying agreement had subsequently enabled the worker to receive lump sum compensation.

The employer disputed the worker’s action on the basis that she was prevented by s 322A of the legislation from obtaining another Medical Assessment Certificate and by s 66(1A) from making a claim for further permanent impairment lump sum compensation.

The Arbitrator found in the worker’s favour.

Firstly, it was determined that s 66(1A) did not have any application in this case. That section only restricts multiple claims for permanent impairment compensation. It does not place any restriction on the number of medical assessments to be made.
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Termination of Weekly Benefits – Don’t ignore a Section 39 Notice!

Have you received a notice from your insurer advising that your weekly workers compensation benefits are coming to an end later this year?

The current legislation provides that for injured workers who do not suffer from greater than 21% whole person impairment, entitlements to weekly benefits cease after 260 weeks of weekly compensation payments.

For workers injured prior to the 2012 NSW Workers Compensation Scheme amendments, this 260 week period will cease near the end of 2017.

Workers approaching the end of this period should receive a Section 39 Notice from their workers compensation insurer inviting them to attend an independent medical examination. This will assist the insurer to determine whether the worker is eligible for ongoing payments after 260 weeks (i.e. whether you have over 20% whole person impairment).

It is important to remember that this determination is not necessarily final. Workers are entitled to challenge the medical assessment, at no cost to them.

The Workers Compensation Independent Review Office (WIRO) can provide funding for legal advice and to meet the expenses of challenging an insurer’s assessment.
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Bull rider successfully claims for rodeo injury

A bull rider who sustained severe injuries was recently successful in a claim for workers compensation, where his industry insurance coverage was inadequate.

Having enjoyed early rodeo success, the claimant had planned to move to the USA to pursue a bull riding career. That dream came to a sudden end just before his 19th birthday.

He was participating in a public performance in Camden when he was thrown from a bucking bull. His head collided with the bull’s and his ear was torn away by its horn.

The doctors at that time did not expect him to survive the incident. He pulled through, but the injury left him with a traumatic brain injury and the need for full time care.

As the industry insurance coverage provided an inadequate $50,000 for his injuries, the claimant’s compensation lawyers approached the case with a strategy that had never been tested before. The compensation lawyers argued that the claimant met the definition of a worker under the workers compensation legislation – specifically, that his bull riding classified him as an ‘entertainer’ under the deemed worker provisions of the Workplace Injury Management and Workers Compensation Act 1998.
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Part 2: Things to know when making a workers compensation claim

Making a workers compensation claim might be important for your long term health and benefit, but at the time it can also be stressful and confusing. Knowing the facts, your rights and what to do next is the first step in resolving a difficult situation.

Continuing on from Part 1 of this article, below are a few things you should remember when considering making a workers compensation claim:

4.  The earlier you make your workers compensation claim, the better

It will ensure that you are provided with the time and resources for early treatment and quick recovery where possible.

Be aware that once you have made a claim, you may be sent for independent assessment by the insurer’s medical doctor, who will provide an opinion for insurance purposes rather than for treatment advice.

Continue to consult your treating doctors (medical expenses may be covered if your claim is successful) to ensure that you are doing all you can to fully recover from your injuries.
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Part 1: Things to know when making a workers compensation claim

Making a workers compensation claim might be important for your long term health and benefit, but at the time it can also be stressful and confusing. Knowing the facts, your rights and what to do next is the first step in resolving a difficult situation.

Below are few things to keep in mind when thinking about making a workers compensation claim:

1.  Giving an accurate and detailed account to your GP is crucial

When you see your GP for treatment of your injuries, they will record a history of the incident and details of your injuries.

In a workers compensation claim, this record is likely to be checked by the insurer as to the nature or cause of your injuries, so it is important this it is as accurate and detailed as possible.

If you need time off work because of your injuries, you should ask your doctor to complete a WorkCover certificate.

2.  Be careful about signing statements

A signed statement is a powerful piece of evidence in any compensation law claim. If you are asked to provide a statement to a WorkCover investigator, it is always best to read it, check it is correct and obtain advice from a compensation lawyer before signing it.
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