What does WorkCover do?
Think of WorkCover as insurance that your employer takes out to cover their workers in case they get injured.
WorkSafe Victoria is responsible for managing WorkCover, the states workers compensation scheme. They are also responsible for enforcing the relevant occupational health and safety legislation.
In Australia, every state and territory has it’s own workers compensation scheme specific to workers in the particular state or territory.
WorkSafe Victoria engages a number of insurance companies to act as their agents to manage WorkSafe claims in the state. These insurance companies are;
- Gallagher Bassett
- CGU (soon to cease managing WorkCover claims in mid 2021).
Insurer contact information
Find below contact information for each of the major insurance companies:
XChanging (sometimes incorrectly spelled as exchanging) is another insurance company that handles WorkCover claims in Victoria. Their contact details are as follows:
Phone number: 1800 801 070
Fax number: (03) 9947 3005
Email address: [email protected]
Postal address: Xchanging, GPO Box 751, Melbourne 3001
Their contact details are:
Phone number: 1300 975 609
Fax number: (03) 8623 9701
Postal address: Locked Bag 3570, GPO Melbourne, VIC 3000
In Victoria, the legislation that deals with WorkCover matters is the Workplace Injury Rehabilitation and Compensation Act 2013 (Vic) (WIRC Act).
Employers are required to have WorkCover insurance which covers employers for the cost of benefits if any employees become injured or ill as a consequence of their employment.
Sole traders and some contractors are not covered by the Victorian WorkCover scheme, and therefore need to purchase their own form of insurance.
If you are injured at work or suffer an illness, WorkCover will offer you a number of benefits. These are:
The first benefit is the payment of reasonable medical and like expenses. This is any medical expenses that are related to the treatment of the injury or condition.
The second benefit is the payment of weekly payments of compensation if you are not able to work to the extent that you were prior to the injury, or not at all.
WorkCover will pay you 95% of the average of what you were earning in the 12 months prior to your injury, for the first 13 weeks and thereafter they will pay you at 80% of that average. The average figure of your prior earnings over the last 12 months before your injury is called your pre-injury average weekly earnings.
The WorkCover insurer will pay payments up until 130 weeks. An injured person is able to obtain weekly payments beyond 130 weeks if they can show that they have no work capacity and that is likely to continue indefinitely.
For an injured person to obtain weekly payments they need to obtain certificates of capacity from their doctor or other medical practitioner. Certificates of capacity medical certificates that are specifically used for the purposes of WorkCover claims. They are different to normal medical certificates.
These certificates of capacity need to be obtained I am going basis if one wishes to continue to claim weekly payments.
The third entitlement is a claim for impairment benefits. This is a lump sum claim that a person who is injured is able to pursue they are left with a permanent impairment as a consequence of an injury.
The process for this particular lump sum claim is that the insurance company will organise an assessment for you to be assessed by an independent medical examiner who grade the severity of the injury and put a percentage figure on it. That percentage figure will then match up to a compensation amount.
If you are not happy with the assessment completed by the independent medical examiner you can appeal their assessment to the medical panel who will form their own opinion after assessing you.
For more detail on impairment benefits please visit this link.
The final entitlement is a common law claim for damages.
This is another lump sum claim which can be pursued by anyone that has suffered injury at work as a consequence of someone else’s negligence.
Two things must be proven. The first as alluded to above is it there must be negligence on behalf of another party that caused or contributed to the injury. There must be negligence otherwise there is no entitlement to common-law damages.
The second thing that must be proven is that the injury its self is a serious injury. This is a legal term.
For more information in relation to common law damages claims please visit this link.
It’s important to note that in Victoria we have what’s called a no fault compensation scheme. This means that anyone that is injured in connection with their employment in Victoria is able to lodge a WorkCover claim for assistance. They do not need to prove that their employer was negligent to claim the majority of benefits, only that their injury or condition is related to their employment.
The only time that fault is required to be proved in the Victorian WorkCover scheme is if a person wishes to pursue a common law claim for damages.