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What are my entitlements under Comcare?

Entitlements under Comcare compensation

The Comcare system is very complicated, and the law is constantly evolving with new matters being disputed all the time. If you injure yourself at work and you go to all the trouble of submitting a Comcare claim form, you need to know what rights you are fighting for. A successful claim entitles you to:

  • Reasonable medical expenses – medical expenses can quickly add up (just think of the cost of regular physiotherapy or chiropractic treatment) and you should not be liable for these expenses if the injury/disease is work related. An accepted claim also means that any reasonable surgery expenses, hospital fees, ambulance fees, nursing care and dental treatment is paid for by Comcare or the employer.
  • Income support – if you are off work because of your injury/disease, you are entitled to receive your full normal weekly earnings for up to 45 weeks. If you are only able to work reduced hours, you are entitled to receive ‘top-up’ payments so you are not financially disadvantaged because of your injury/disease. After 45 weeks, you are entitled to receive 75% of your full normal weekly earnings, and if you are only working reduced hours, you are also entitled to top-ups. The calculation of your normal weekly earnings can be complex depending on whether you usually worked overtime, received penalty rates, received other allowances, etc.

In addition to payment of medical expenses and income support, you may be entitled to additional lump sum compensation as a result of your injury because you are suffering a ‘Permanent Impairment’. Permanent Impairment compensation is a discreet area that does not impact on your other entitlements under the law.

To determine if you are entitled to this type of compensation, your condition needs to be ‘stable’ and permanent (in other words, enough time has gone by since the injury, and your impairment is unlikely to get much better or worse in the future) and a specific accredited medical assessor needs to assess your injury. No time limit applies to making a claim for permanent impairment compensation in the Comcare system.

Generally, to be eligible for compensation, your permanent impairment needs to exceed 10% which might not seem a lot, but it is often difficult for an injury to meet this threshold (some injuries do not need to meet the 10% threshold, including hearing loss,  but you should seek legal advice regarding this).

Permanent impairment compensation can be very complex, particularly if you are suffering from multiple injuries and you have also suffered psychologically as a result of the workplace. A specific claim form is required to be filled out if you wish to seek compensation for your permanent impairment, and this complex form requires input by your GP and/or treating specialist.

If your injury resulted from the negligence of your employer, the Comcare system allows you to elect to sue the employer under ‘common law’ for your ‘non-economic loss’. Once you make a decision to sue under common law, you cannot change your mind, and this decision should not be made without careful consideration. Furthermore, you may also be entitled to sue a negligent third party who is not your employer (for example, a negligent colleague, a supplier of plaint/equipment that caused the injury). Restrictions and strict time limits apply in relation to making a common law claim under the Comcare system.

If you are injured or suffer a disease caused by your employment, and your employer is covered by the Comcare system, you should seek legal advice from a lawyer experienced in workers compensation claims, as soon as possible to ascertain your rights and entitlements.

Please note, this Blog is posted in Adelaide, South Australia by Andersons Solicitors. It relates to Australian Federal legislation. Andersons Solicitors is a medium sized law firm servicing metropolitan Adelaide and regional South Australia across all areas of law for individuals and businesses.

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