Workers compensation

[rustyg70]

Just wondering if anyone here could help me with a few questions I have?

I've just had my 2nd back operation from the same job, and have just been to see an assessor for GIO regarding my level of permanent disability and compensation.
I have been cleared to go back at my job by my Doctor and their choice of Back To Work people.
I'm just worried that I might be getting hood winked by the big company because I don't know the ins and outs of the law.


1) I did not ask for any compensation, I was told that I had to go to it by GIO or I would forfeit any other claim I had.
I have know idea why they said that.

2) Why did they insist I went there?

3) Anyone else been in this position themselves?


Thanks in advance.

 

[Hudu Gurusingha]

Just wondering if anyone here could help me with a few questions I have?

I've just had my 2nd back operation from the same job, and have just been to see an assessor for GIO regarding my level of permanent disability and compensation.
I have been cleared to go back at my job by my Doctor and their choice of Back To Work people.
I'm just worried that I might be getting hood winked by the big company because I don't know the ins and outs of the law.


1) I did not ask for any compensation, I was told that I had to go to it by GIO or I would forfeit any other claim I had.
I have know idea why they said that.

2) Why did they insist I went there?

3) Anyone else been in this position themselves?


Thanks in advance.

Hi rusty. I do the workers comp shit for my company. F***ing shit job dealing with fraudulent lazy f***s most the time just wanting a pay out - its jaded my whole view of the system and of humanity, but that's another story....

What did you do to your back?

Did you have concurrent workers comp claims for a previous employer?

You had the right to decline going on workers comp. This should have been outlined to you. But all medical expenses would have to be covered by yourself, and you would get no wage entitlements, and your employer would not be obligated to keep you at work - it would be deemed an out of work injury. Probably not a good idea.

You have a set entitlement pool of about $400,000 under workers comp- to cover medical expenses, wages and vocational rehab (the return to work people). And no you just cant take money out of this like a bank....

GIO would be your employer's workers compensation insurer. GIO have sent you to an independent medical examiner for a permanent impairment assessment and will probably looking at settling your claim - called a Schedule 2 Settlement. Im guessing your claim has been going on for a long time and your specialists have indicated that you will never be able to undertake your pre-injury role? And your rehab provider hasn't been able to get you back to your pre-injury role? Have they got you in a new role, or into a new employer? Cos this permanent impairment process normally wouldnt happen until way down the track, post 52 weeks since date of injury.

For each body part, there is a maximum % impairment that will be assessed. For example, if you lose an eye, you have a 50% permanent impairment, which means that upon settling your claim you will receive 50% of whatever is left of your workers comp entitlements (whats left of the $400,000). So if youve exhausted most of your entitlement of paying wages while youve been off work, and to pay for operations there is likely to not be much left. For a back, I believe the maximum % impairment is 50%. Youd have to be completely disabled to get this. If you can still move around ok you'll be very unlikely to get the full 50%. Average for a fused vertebrae for example would probably be about 10-20%.

If you have over 20% permanent impairment then you can go common law to try prove your employer was negligent and beached their duty of care, and try get a bigger 'A Current Affair' like payout - but you have 1 year from the date of injury to do this - and you need to get lawyered up.

When the insurer comes to the table with a settlement offer, they will take into consideration other things too. Dangle the carrot so to speak. Your employer might say they cant accommodate you anymore given your permanent impairment in a permanently modified role (they dont have to after 12 months) and negotiate a settlement with resignation, and you get more for loss of potential earnings. They, or the insurer might do the same if they deem that keeping you in the workplace is too much of a risk. From experience, Id say the former is a likely scenario.

My advice would be to get legal advice. They can help you work out if what the insurer offers you is a fair deal, and give you advice about pushing back and asking more. A common course of action if for the lawyers to send you to their own 'independent' medical examiner which challenges the report of the insurer's IME to give grounds in making a counter-offer.

All the best mate.

EDIT: just read that you have been cleared to go back to work. Doing full duties? If so, this is great. If you have been medically cleared to undertake all the inhrerent requirements of your pre-injury role then good luck to your employer trying to get rid of you. If they do, go to your union or Fair Work Australia. They would have no chance.

If you have a permanent impairment then whatever they offer you then definitely consider, and get legal advice if youre worried its not fair. For example, you might be worried youll need further treatment or surgery down the track, and the amount they offer you wouldnt be enough to cover this treatment for your back. But saying that, the insurer might say "we'll only offer you more money if you accept a resignation cos youre too big a risk" - which is common.

 

[Triptanes]

As there isn't too much detail about your situation I think a good starting point is probably WorkCoverWA - http://www.workcover.wa.gov.au/ - if you don't already know about it. It has a whole section for employees on understanding your rights, obligations and entitlements. You can also read the sections for employers about what they should be doing.

Your employer has to develop and implement a return to work program, with your input, now a doctor has notified them of your capacity. And, if after doing all the reading on the WorkCover website you think you are being hoodwinked it is possible to use the Conciliation and Arbitration Service. As already suggested time is important for some of these things, and you could go see a lawyer.

If you have over 20% permanent impairment then you can go common law to try prove your employer was negligent and beached their duty of care, and try get a bigger 'A Current Affair' like payout - but you have 1 year from the date of injury to do this - and you need to get lawyered up.

15% or more, isn't it?

 

[Hudu Gurusingha]

As there isn't too much detail about your situation I think a good starting point is probably WorkCoverWA - http://www.workcover.wa.gov.au/ - if you don't already know about it. It has a whole section for employees on understanding your rights, obligations and entitlements. You can also read the sections for employers about what they should be doing.

Your employer has to develop and implement a return to work program, with your input, now a doctor has notified them of your capacity. And, if after doing all the reading on the WorkCover website you think you are being hoodwinked it is possible to use the Conciliation and Arbitration Service. As already suggested time is important for some of these things, and you could go see a lawyer.





15% or more, isn't it?

Pretty sure its 20%. In WA anyway

 

[rustyg70]

Cheers guys.
Much appreciated.

 

[Scotland]

One of my mates does exercise rehab for workers comp cases as well as private patients (sports injuries etc.).

Says there is a noticeable difference between how people treat their appointments, follow up exercises etc. when it's their own dime compared to the company's.

Not relevant, just thought I'd share an anecdote.

 

[Hudu Gurusingha]

One of my mates does exercise rehab for workers comp cases as well as private patients (sports injuries etc.).

Says there is a noticeable difference between how people treat their appointments, follow up exercises etc. when it's their own dime compared to the company's.

Not relevant, just thought I'd share an anecdote.

Works the other way too. Many doctors and treatment providers milk the system for all its worth. Cos its workers comp they can charge at a much higher rate, so they keep having injured workers back for appointments and treatment sessions to 'see how they're going', dragging things out for months - easy money.

Absolute farce of a system.

 

[MrsEddieBetts]

Works the other way too. Many doctors and treatment providers milk the system for all its worth. Cos its workers comp they can charge at a much higher rate, so they keep having injured workers back for appointments and treatment sessions to 'see how they're going', dragging things out for months - easy money.

Absolute farce of a system.

I've got one case like that now. They took us to conciliation and won approvals for all kinds of things.......but now the GP and the worker are refusing the treatment.

 

[Herne Hill Hammer]

One bit of advice I will give is, you may have friends / acquaintances that are aware of your situation and will offer their advice on all sorts of alternative treatments. Kindly thank them and don't follow it. Mention it to your treating specialist if you like but don't do anything off your own bat without approval.

I was in the military and did my back. Surgery and months of rehab. I was cleared to return to full duties, which I did for 6 months before re-doing it whilst taking a class for PT one afternoon. No more surgery due to the number of levels damaged. 16 months of re-hab. Physio, hydro, even a 4 week pain and injury management course to modify daily tasks so that I was able to perform them.

I had the same treating gp and specialist the whole time. What did change on an almost monthly basis was my case worker with DVA. When it was coming time for my assessment for TPI, DVA told me that it would be conducted by my treating specialist, he was an Army reservist who also happened to own the pain and injury management clinic too. He gave me his TPI assessment on my final appointment which he put at anywhere from 40-60%. When I next spoke with my case worker about having the official assessment done, they told me that it would now be done by someone else. They flew rent-a-doctor down from Sydney who was in town for the week to assess dozens of claims for varying insurers. I found out afterwards that DVA had spoken with my specialist (who they told me would be assessing me) and he had given them his preliminary findings.

Get copies of everything and keep it, take notes of phone conversations, include dates, times, who you spoke with and the content.

 

[Hudu Gurusingha]

One bit of advice I will give is, you may have friends / acquaintances that are aware of your situation and will offer their advice on all sorts of alternative treatments. Kindly thank them and don't follow it. Mention it to your treating specialist if you like but don't do anything off your own bat without approval.

I was in the military and did my back. Surgery and months of rehab. I was cleared to return to full duties, which I did for 6 months before re-doing it whilst taking a class for PT one afternoon. No more surgery due to the number of levels damaged. 16 months of re-hab. Physio, hydro, even a 4 week pain and injury management course to modify daily tasks so that I was able to perform them.

I had the same treating gp and specialist the whole time. What did change on an almost monthly basis was my case worker with DVA. When it was coming time for my assessment for TPI, DVA told me that it would be conducted by my treating specialist, he was an Army reservist who also happened to own the pain and injury management clinic too. He gave me his TPI assessment on my final appointment which he put at anywhere from 40-60%. When I next spoke with my case worker about having the official assessment done, they told me that it would now be done by someone else. They flew rent-a-doctor down from Sydney who was in town for the week to assess dozens of claims for varying insurers. I found out afterwards that DVA had spoken with my specialist (who they told me would be assessing me) and he had given them his preliminary findings.

Get copies of everything and keep it, take notes of phone conversations, include dates, times, who you spoke with and the content.

I dont get how your treating specialist would be allowed to do the TPI. Pretty sure it has to be completely independent.

Dealing with DVA -what a f***ing nightmare. So many unbelievably dodgy claims too. No one on this earth has a greater sense of entitlement than an Australian soldier - most of the claimants have never seen any action at all. The amount of entitlements available to them, and how easy it is to access it all is a joke.

Seriously, if you want the cushy life, join the army, fake a knee injury from kicking a ball around during playtime, pull out the old PTSD card and its happy dayz. Join thousands of others.

I cringe to think the massive amount of tax payer money being thrown at dodgy compo claims.

 

[Herne Hill Hammer]

I dont get how your treating specialist would be allowed to do the TPI. Pretty sure it has to be completely independent.

I used to do a bit of work for DVA. What a f***ing nightmare. So many unbelievably dodgy claims too. No one on this earth with a greater sense of entitlement that a soldier - even if they have never seen any action at all. The entitlements available to them, and how easy it is to access it all is a joke.

If you want a cushy life, join the army, fake a knee injury from kicking a ball around during playtime, pull out the old PTSD card and its happy dayz.

There's blokes that I was in the Navy with who had shoulder and knee reco's who were back to full mobility, playing footy again etc etc When they discharged me I was barely mobile. They were both graded higher for TPI. I got royally bent over. In the end I just wanted to be done with them and get out.

I loved being in the Navy, I was doing my dream job. Shame DVA soured things so much for me in the end. I had actually submitted my forms with Centrelink for a DSP because no one from DVA had bothered to inform me that I would be receiving weekly incapacity payments. Someone at DVA who wasn't even my case manager, mentioned it to me casually in passing at 4pm on a Thursday afternoon, I was being discharged and driving out of Canberra at 7am the next morning.

I deadset thought I was going to be left destitute.

It took me 3 years, but I finally got back to pretty much full mobility and started to work full time again. I could wash my hands of the pricks.

 

[rustyg70]

Gday guys,
I've just been offered a lump sum payment from the GIO for my back injury.
I have not accepted it at the moment.

My major question is when they state from the document I received:

'Should you elect to accept the above lump sum settlement your right to any further entitlement under this claim will be extinguished.'

Does this mean, that I can no longer claim for workers compensation if I hurt my back later in life, or I can not claim anything else from this injury?


Thanks again.
Rusty.

 

[Bunk Moreland]

Gday guys,
I've just been offered a lump sum payment from the GIO for my back injury.
I have not accepted it at the moment.

My major question is when they state from the document I received:

'Should you elect to accept the above lump sum settlement your right to any further entitlement under this claim will be extinguished.'

Does this mean, that I can no longer claim for workers compensation if I hurt my back later in life, or I can not claim anything else from this injury?


Thanks again.
Rusty.

I'd say yes, absolutely.

Get yourself a workplace injury lawyer, it'll be more than worth your while.

 

[Hudu Gurusingha]

Gday guys,
I've just been offered a lump sum payment from the GIO for my back injury.
I have not accepted it at the moment.

My major question is when they state from the document I received:

'Should you elect to accept the above lump sum settlement your right to any further entitlement under this claim will be extinguished.'

Does this mean, that I can no longer claim for workers compensation if I hurt my back later in life, or I can not claim anything else from this injury?


Thanks again.
Rusty.

Yep - thats why they are offering you a lump sum payment - to supposedly cover any treatment expenses in the future.

Its in your best interests to take it and get back to work.l Theyll probably only dangle the carrot once.

 

[Herne Hill Hammer]

Gday guys,
I've just been offered a lump sum payment from the GIO for my back injury.
I have not accepted it at the moment.

My major question is when they state from the document I received:

'Should you elect to accept the above lump sum settlement your right to any further entitlement under this claim will be extinguished.'

Does this mean, that I can no longer claim for workers compensation if I hurt my back later in life, or I can not claim anything else from this injury?


Thanks again.
Rusty.

My first question would be, 'Is my medical care, if required, relating to this specific injury going to still be taken care of, or will I be left to my own devices?'

As far as your question about reinjuring your back later in life goes and speaking from my own personal experience only. I received ongoing care for my back as needed (haven't needed to use if for over a decade). The only way I could claim for my back again would be if it was a completely different back injury or if my claimed injury deteriorated due to the prior injury ie more discs went because they were weakened but the already injured ones.

As Hudu has suggested though, if you're not debilitated to any great degree, take it and get on with things.