How long can you be on WorkCover in Victoria?
Most people can stay on WorkCover payments for up to 130 weeks. Longer if they have no capacity. They’re entitled to medical expenses, generally speaking, for one year after their last weekly payment.
However, the above answer needs to be unpacked a bit more to provide a better answer.
The better answer is – it depends
With a WorkCover claim, you’ve got four general entitlements.
Medical and like expenses, weekly payments, impairment benefit lump sum and in some cases if the injury was caused by negligence, a common-law claim for damages.
Let’s take a look at each of those individually and see how long each entitlement can go for in Victoria.
Table of Contents
Medical and like expenses
The law says that once your weekly payments have ceased, then your entitlement to medical and like expenses should cease 52 weeks after your last payment.
However, there’s a few exclusions that you need to keep in mind.
If you have return to work but you struggle to stay at work if a particular medical treatment was not provided to you, say physiotherapy or certain type of medication, then your medical expenses can continue.
Also, surgery is required 52 weeks after your last weekly payment was paid, then the insurer is liable to pay for the surgery.
If you have a serious injury, then medical and like expenses can continue. Finally you require modification of a prosthesis and again medical expenses will continue.
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Your payments will cease at 130 weeks if you have a work capacity.
If you don’t have a work capacity and that’s likely to continue indefinitely, then your weekly payments can continue to be paid will be paid at the rate of 80%.
You’ll continue to get weekly payment on going at this rate if you’ve got no work capacity.
From time to time the WorkCover insurance company may organise an independent medical examiner to assess you and to determine whether you’ve still got any capacity for work.
If your injury subsides or a medical practitioner determines that you’re in capacity for work so no longer related to the original injury, then the WorkCover insurer can seek to terminate your entitlement to weekly payments.
Your weekly payments will also cease if you have resolved a common law claim with an economic loss component. Your weekly payments will cease from the time of settlement of that common law claim.
If you have settled a common law claim for pain and suffering only, your weekly payments will continue unaffected.
For most injuries you get one go at an impairment benefit claim. Once it’s resolved, even if you get significantly worse, then there’s nothing that can be done.
If you have a hearing loss claim though, you can pursue a further impairment claim if you can show that since the last impairment claim you’ve suffered diagnosable further hearing loss.
Common law claim for damages
Like an impairment claim, you get one go to common-law claim and that’s it. So once he has resolved, you cannot re-open it and go again even if your injury gets worse.