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Will my workers compensation insurer pay for house and garden help while I am incapacitated?

Will my workers compensation insurer pay for house and garden help while I am incapacitated?

The South Australian workers compensation laws include many entitlements for workers beyond the payment of weekly income and medical expenses.

Injured workers are often not fully aware of all of their legal rights and entitlements through the Return to Work system. One such entitlement involves assistance around the house and garden.

In many circumstances, injured workers are not able to perform their usual activities of daily living, including the performance of domestic chores. For example, a worker may have severely damaged their neck at work, and therefore cannot clean the house or work around the garden.

Similarly, if a worker is severely psychologically injured as a result of work (for example, they suffer from severe Post Traumatic Stress Disorder or major depression), they may be limited in the types of domestic chores that they can perform.

How do I get assistance with housework and gardening?

If you've suffered a work related injury and need help with your normal household activities and chores then you're entitled to ask your Case Manager that this be included in a rehabilitation plan and paid for by the relevant insurer.

Often the insurer requires confirmation from your treating doctor that assistance with the domestic services is necessary due to your injury.

Your doctor may write on your Return to Work Capacity Certificate that you need assistance with activities such as lawn mowing or general household cleaning. If this occurs, then you can ask your Case Manager to implement a Rehabilitation Plan which approves the costs for providing these services.

What if my request for assistance is refused?

If your Case Manager refuses to implement a Rehabilitation Plan or refuses to reimburse you for reasonable expenses relating to domestic services, you may be able dispute their decision in the South Australian Employment Tribunal.

If your treating doctor states that you require specific 'equipment' to help with your rehabilitation, this may also be included in your Rehabilitation Plan. This type of equipment may include:

  • an ergonomic chair for your desk;
  • an orthopaedic mattress for your bed;
  • a back-brace to provide support whilst lifting at work, etc.

Most decisions by the insurer regarding a worker’s entitlements, including a refusal to pay for these reasonable expenses can be disputed in the South Australian Employment Tribunal and you should seek immediate legal advice if you think that the insurer or Case Manager has made an unreasonable or unfair decision in relation to your workers compensation claim.

If you are experiencing difficulties with your Case Manager in relation to obtaining home help or equipment to assist with your rehabilitation, you should seek advice from a lawyer experienced in workers compensation claims.

Please note, this Blog is posted in Adelaide, South Australia by Andersons Solicitors. It relates to South Australian 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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