The workers compensation scheme ‘WorkCover’ helps people who have been injured at work access financial assistance; predominantly lost wages and medical expenses. If that person has suffered a ‘serious injury’, they are able to sue for compensation.
Most injury claims are for injuries that are physical – but increasingly we are asked to assist people who have suffered a psychological injury at work.
Psychological illness in Australia
According to the Australian Institute of Health and Welfare, 45 per cent of Australians aged between 16-65 will experience a psychological health disorder in their lifetime.
Such injuries/illnesses can be caused by stressors in the workplace (i.e. bullying or sexual harassment/discrimination) or may be a secondary consequence of a physical injury.
Can I receive workers compensation if I have a psychological injury/mental injury?
Although psychological illness claims can be more complex than a physical injury, people who have developed a mental injury where work was a significant contributing factor or ‘in the course of employment’ are able to access entitlements under the WorkCover scheme.
Certain exclusions apply, however, and make the law extremely complex.
Is it possible to have both a physical injury and a psychological injury?
Yes. A person can develop a psychiatric or psychological injury as a result of a physical injury. These symptoms and conditions can be accepted as part of a claim.
Why are psychological injury claims so difficult?
The symptoms and treatment of a physical illness is more consistent than with a psychological illness. Although the diagnosis may be the same for two people with a mental injury, the symptoms and treatments can greatly vary between each person.
It can be difficult to separate out the consequences of the psychiatric injury caused by employment and the consequences caused by other factors. The further complexity of some psychological injuries resulting from management action being excluded adds an additional layer of complexity.
What happens if my claim is rejected?
Whilst sometimes claims can be relatively straight forward, it can be a rude shock when the insurer rejects a claim under WorkCover and the injured person is left without payment for the medical expenses and time off work.
There are a number of reasons why a claim might be rejected. There may be medical disputes or factual disputes that need to be challenged.
Some of the most common reasons for rejection include that:
- the insurer deems the injury did not occur in the course of employment
- the insurer deems a pre-existing medical condition is the cause of the worker’s ongoing problems
- the worker did not report the injury in a timely fashion
- the worker was injured as a result of reasonable management action and is therefore excluded from claiming compensation in accordance with law. This is a standard reason for rejection for claims dealing with psychological injury.
If your claim has been rejected, it is important to seek legal advice quickly.
At Adviceline Injury Lawyers, we can explain the steps needed to overturn that rejection, arrange for someone to assist you and provide advice as to possible further action.
The doctor said that it is too difficult to lodge a workers comp claim with a psych injury
While we acknowledge the challenging nature of the workers compensation regime, a person with work-related psychological problems may still be entitled to ‘no fault’ benefits even if the injury is not ‘severe’.
We encourage all people with a psychological injury to seek advice as to whether they are entitled to financial assistance. If you would like advice about your circumstances and potential entitlements, call Adviceline Injury Lawyers on (03) 9321 9988.