Archive for the ‘Uncategorized’ Category

What to do if you have a slip and fall

Posted on: August 6th, 2019 by Development

By Pania Watt

 

 

 

 

 

 

 

 

 

 

 

A slip and fall can happen anywhere, but often occurs in a public place like a shopping centre, supermarket, a restaurant, a pub, or a café.

It’s easy to think that a slip and fall won’t cause significant injury, but that is often not the case. A slip and fall generally occurs when the person is least expecting it, and consequently the injury can be more serious because the person is not able to arrest or stop their fall. It’s not uncommon to hear of broken hips, legs, arms, serious shoulder or back injuries being sustained due to a slip and fall.

The consequences of a slip and fall can be very serious and result in a need for expensive medical treatment and time off work. A person without the benefit of sick leave, such as a casual worker, or a person who has just started a new job, or a person without savings or a personal policy of insurance to rely upon for support, could find themselves in a difficult situation, quickly.

If you suffer a slip and fall, take the following actions to ensure that you are able to make a claim for personal injury:

 

1. Report the injury

Don’t leave the scene of the accident without reporting it. It’s understandable you may be embarrassed that it has happened and just want to get away, or you may be in pain and needing medical assistance. Do your best to ensure that you report the incident to a staff member – preferably a manager.

Make sure your name, phone number, and details of the incident, including time and location and how it happened, including the hazard you slipped in/on (water, milk, oil, a hot chip etc), are taken down. Ask for the name and contact details of the staff member to whom you reported the fall, and ask that a copy of the report completed be provided to you.

Don’t make the mistake of assuming that the employees of the business will note the details of the accident correctly, or that it will even be reported at all. It is up to you to ensure that the report is made.

 

2. Take photographs

These days, most people carry cameras around in their pockets – in their mobile phones. If you are able, before you leave, take your phone out and photograph the area where the incident occurred, as soon as possible after the incident.

If there is a skid mark in liquid or material on the floor, try to get a clear photograph of that.

If there is liquid or other material on your body, or your clothes, as a result of the fall, take a photograph of that as well.

If you have bruising to any area of your body, take a photograph of that too.

Ensure that you note the time and date of each photograph, and make a note of whether there was a “wet floor” sign present at the time you fell.

 

3. Don’t get rid of or throw away the shoes you were wearing

Take a photograph of the footwear you were wearing at the time of the fall, both of the top (to identify the brand and type of footwear) and the bottom (the tread).

Don’t throw the footwear away. It may be needed later.

 

4. Keep tax invoices and receipts

It is best to seek medical treatment at the earliest opportunity, particularly to ensure that your injuries and disabilities are recorded.

If you seek treatment from any practitioner (GP, physiotherapist, psychologist etc), keep invoices and receipts.

If you need medication, keep invoices and receipts.

If you need to buy or rent bandages, creams, or other medical equipment (crutches, a walker), keep invoices and receipts.

If the store invites you to submit your invoices for reimbursement, make sure you keep copies.

 

5. Seek legal advice

Don’t delay seeking legal advice. Slip and fall injuries are complicated. Whether the injury occurred on public or private property, and whether you think you might be able to make a claim or not, you should obtain a legal opinion about your rights. Ensure you seek advice at the earliest opportunity so that your compensation can be maximised, and relevant evidence is not lost.

At Bourke Love Lawyers, we have offices at Lismore, Ballina and Kingscliff, and if you aren’t able to travel due to your injuries, we can make arrangements to come to you.

 

The information in this blog is not intended to be legal advice, and should not be taken as such. If you have any queries, contact us now on 1300 15 15 45 to discuss your specific circumstances.

All initial consults with our firm are free of charge and all of our services are No Win, No Pay, with the exception of NSW workers compensation claims, which are funded by WIRO and therefore free to all non-exempt workers covered by the NSW workers compensation scheme.

What does “Exempt Worker” mean?

Posted on: July 22nd, 2019 by Development

By Pania Watt

 

 

 

 

 

 

 

 

 

 

 

In NSW, major changes were made to the workers compensation scheme in amendments to the Workers Compensation Act 1987 in 2012, and again in 2015. An “exempt worker” describes those classes of worker to whom these changes do not apply.

An exempt worker, being a worker who is exempt from the amendments, is a person who is employed as one of the following in NSW:

1. Police Officer;

2. Paramedic; or

3. Fire fighter.

In other words, an “exempt worker” is an Emergency Services Worker.

There are significant differences between the compensation payable to exempt workers as opposed to other workers in NSW. These differences are, briefly, as follows:

 

Lump sum compensation

–   The minimum level of whole person impairment is 1% for an exempt worker, whereas the threshold is 11% for other types of worker.

–   The threshold of 15% whole person impairment for a psychiatric injury applies to both types of worker.

–   Exempt workers who are assessed with 10% or more whole person impairment are still entitled to claim an extra amount of lump sum compensation for “pain and suffering”, up to a maximum of $50,000, under section 67 of the Act. The 2012 amendments to the Act removed that entitlement from other types of workers.

–  The 2015 amendments however increased the maximum lump sum payment for permanent impairment injuries from $220,000 to $577,050, and allowed for the amount of those payments to be indexed annually. These amendments apply to all types of worker but exempt workers.

 

Weekly compensation

–  Weekly payments of compensation are payable to an exempt worker whilst ever he or she suffers a partial or total incapacity for work. Such payments can be made up to the age of 67, plus one year. Other types of worker will in most cases, be restricted to payments for a maximum of 5 years in total.

–  For the first 26 weeks (6 months) of weekly payments, an exempt worker will receive benefits based upon the award which applies to his or her job.

–  After the first 26 weeks of weekly payments, exempt workers who remain partially or totally unfit for work will be paid a fixed rate referred to as the “statutory maximum” rate. As at the date of writing, the statutory maximum for a single worker with no dependants is $512.10 gross.

–  Exempt workers cannot receive Work Capacity Decisions, as this type of decision may only be made in relation to other types of worker. If the insurer wishes to decrease, or stop, payments of weekly compensation to an exempt worker, it may only do so by issue of a declinature notice.

 

Medical expenses

–  There is no restriction on how long an exempt worker can claim medical expenses relating to his or her injury. Even if he or she has returned to work, and the insurer is no longer paying weekly benefits, medical expenses may still be claimed. An exempt worker also does not have to meet a certain threshold of whole person impairment in order to continue claiming medical expenses.

 

Legal costs

–  Exempt workers requiring legal advice and representation in relation to a workers compensation claim will be entitled to recover their costs from the insurer on the successful conclusion of the matter.

–  It is not necessary for an exempt worker to be represented by their union solicitor to be able to recover their costs. A union lawyer doesn’t have any advantages over any other lawyer, and in many circumstances, does not have an office near to where the exempt worker lives and works.

–  At Bourke Love Lawyers, we represent exempt workers in relation to their workers compensation claims on a no win, no pay basis. We will also pay for the clinical records and medical reports required to evidence the case, and these costs are recoverable from the insurer when the case is resolved. We specialise in workers compensation claims for exempt workers, in particular those suffering psychiatric injury as a result of workplace trauma.

 

The NSW workers compensation system is not easy to understand, and it can be very difficult to work out whether the correct benefits are being paid. Knowing where to go to get advice, and most importantly, knowing that free, independent legal advice is available to all exempt workers, is invaluable.

 

The information in this blog is not intended to be legal advice, and should not be taken as such. If you have any queries, contact us now on 1300 15 15 45 to discuss your specific circumstances.

All initial consults with our firm are free of charge and all of our services are No Win, No Pay, with the exception of NSW workers compensation claims, which are funded by WIRO and therefore free to all non-exempt workers covered by the NSW workers compensation scheme.

To know more information, feel free to contact us here.

Returning to work after a work related injury? Here’s 5 hot tips to ensure you get the most out of your claim

Posted on: July 15th, 2019 by Development

By Pania Watt

 

 

 

 

 

 

 

 

 

 

 

The NSW workers compensation scheme is complicated, particularly if you fall within the class of workers affected by the 2012 amendments to the Workers Compensation Act 1987. If you’re not sure whether this is you (a work related injury) or not, you will be in that class if you are not a Paramedic, a Firefighter or a Police Officer. If you are one of these types of workers, you are exempt from the amendments. See our other blog posts on what exempt workers can expect from the scheme.

If you are a worker affected by the amendments, it’s very important that you pay careful attention to the management of your claim while you are returning to work.

 

Hot tip # 1 – Your Nominated Treating Doctor is very important

I can’t emphasise enough how vital it is to have a trusting relationship with your doctor. He or she is the “gateway” to your path to recovery. You must be able to speak openly, and honestly with your doctor about the issues you are facing during your return to work, because your doctor will be completing your Certificate of Capacity for the insurer.

If you have suffered a psychiatric injury, you may wish to consider asking your treating Psychiatrist to be your Nominated Treating Doctor, rather than your General Practitioner. Psychiatric injuries are very specific and can be complicated, so in those circumstances the assessment of treatment required and capacity for work may best be completed by your treating Psychiatrist.

 

Hot tip # 2 – The Certificate of Capacity must be completed carefully

The Certificate of Capacity is a very important document. Not only does it confirm your doctor’s view that your injury is work related, it tells the insurer what treatment is required, and most importantly, it tells the insurer what your capacity for work is.

Even if you are fit for full-time work, the certificate still tells the insurer what treatment you need, and any restrictions which apply to your capacity for work.

If you think your doctor may not understand the requirements of your specific job, I recommend that you obtain a Job Description from your employer – as this is essential in a work-related injury claim. If you don’t have one, write down all of your duties at work, and give it to your doctor. He or she will appreciate understanding what you will be required to do when you return to work, and in particular, have an understanding of what “Pre Injury Duties” means. More on this below.

 

Hot tip #3 – Pre Injury Duties means no restrictions whatsoever – nothing, nada, zero

At some point during your claim, you may reach full pre-injury hours, but still need to observe some restrictions in relation to your injury. At this stage, your doctor may suggest to you that you are now fit for “Pre Injury Duties” and want to tick that box on your Certificate of Capacity.

It is important that you understand what being “being fit for Pre Injury Duties” means.

It means that you can return to your pre-injury job, with no restrictions whatsoever, now and in the future.

How this could go is illustrated in the below examples.

Example A:

Andy is a labourer who sustains an injury to his right shoulder. Following surgery and physiotherapy, his right shoulder has stabilised and he is able to return to work as a labourer, but he will never be able to work more than 20 hours per week or lift more than 10 kilograms using his right arm. His doctor says this restriction will be permanent, and provides him with a certificate certifying that he is permanently fit for 4 hours per day, 5 days per week, with a permanent restriction to not lift any weight of more than 10 kilograms using his right arm. Andy continues to receive benefits from the workers compensation insurer on the basis of that certificate, which support him and allow him to continue working in a job that he enjoys, despite his injury.

Example B:

Rachael is a process worker who sustains an injury to her lower back. She undergoes surgery and has a very good result following rehabilitation, and she is keen to get back to work at the meatworks. Her doctor provides her with a certificate certifying her fit for pre-injury duties. When Rachael submits the certificate to the insurer, she is told that because she is fit for pre-injury duties, she has no incapacity for work, and therefore no entitlement to weekly benefits. Her payments are therefore ceased, even though she has not yet attempted a return to work and is not sure whether she will be able to manage working on the line for even half of her pre-injury hours.

Let me be clear – getting back to work is an important stepping stone in your recovery from a work related injury. Don’t let it be derailed by not understanding the meaning of “Pre Injury Duties” and how that might affect your claim.

 

Hot tip #4 – DO NOT let your Certificate of Capacity lapse

I can’t emphasise this enough.

A Certificate of Capacity is usually only able to be provided for a maximum of 28 days. The only exception to this is if you have a long term, chronic injury and the insurer has agreed that your doctor can provide a certificate at longer intervals of up to 3, 6 or even 12 months.

An important part of the Certificate of Capacity is that it tells the insurer what your capacity for work is for the period it covers, and the insurer will pay your weekly benefit accordingly. If you don’t provide a Certificate of Capacity, the insurer will not pay you. If you provide a certificate late, or back dated, you may find yourself in a complicated argument with the insurer over whether you can be paid your benefit for a disputed period.

Avoid all of this drama. When you are leaving your doctor’s surgery after obtaining your certificate, stop at the receptionist’s desk and book your next appointment for the day before your certificate expires. Send your certificate straight to the insurer. By email is best, so that you have a record of it being sent, and you have a copy in your email account in case of any dispute.

 

Hot tip #5 – The rehabilitation adviser does not have the right to attend all of your treatment appointments

I frequently hear from my clients that the rehabilitation adviser appointed to manage their work-related injury claim has been attending all of my client’s appointments with their doctors. I have been told by clients of rehabilitation advisers arguing with doctors, including treating surgeons, about their recommendations for treatment, or assessment of capacity for work, arranging treatment appointments for my client, changing my client’s appointment dates and times with their treating doctors to suit the adviser, and during those appointments aggressively insisting upon changes to my clients’ certificate of capacity.

This is, frankly, outrageous behaviour. Your consultations with your treating doctors are private. Sometimes, depending on the type of injury you have sustained, you may need to remove your clothing for examination. Sometimes, you might want to discuss matters in a full, and frank manner, one on one with your doctor. That is your right.

A rehabilitation adviser is only entitled to attend appointments which are case conferences. These are conferences which you, your doctor/s, the rehabilitation adviser, and the insurer attend, on a regular basis, to discuss your claim. Nothing else. If you want the rehabilitation adviser to attend other appointments with you, you are welcome to allow them to do so. If you don’t want to, all you need to do is say so.

Navigating your workers compensation rights and entitlements is difficult. If you’re in need of answers, direction and support with your workers compensation claim, contact us now on 1300 15 15 45 to discuss your specific circumstances.

 

The information in this blog is not intended to be legal advice, and should not be taken as such.

All initial consults with our firm are free of charge and all of our services are No Win, No Pay, with the exception of NSW workers compensation claims, which are funded by WIRO and therefore free to all non-exempt workers covered by the NSW workers compensation scheme.

 

Do you need more information about this? Simple contact us here anytime.

 

What does “minor injury” mean if I’ve had a motor vehicle accident?

Posted on: July 10th, 2019 by Development

By Pania Watt

 

 

 

 

 

 

 

 

 

 

 

If you have been injured in a car accident after 1 December 2017, the CTP insurer may have advised you that you have suffered a “minor injury”. If you’re not sure what this means, read on for more information.

The changes to the NSW CTP scheme which took effect on 1 December 2017 divided compensation payable to people injured in a motor vehicle accident between minor, and non-minor injuries.

 

What can a minor injury be?

A minor injury can be physical, or psychological.

An example of a minor physical injury is a soft tissue injury, which usually a muscular type injury. The most common soft tissue injury sustained in a motor vehicle accident is whiplash, which is an injury to the neck area sustained due to the force of an accident throwing your upper body/head quickly forwards and then quickly backwards.

An example of a minor psychological injury is adjustment disorder or acute stress disorder, which are both recognised psychological disorders resulting from being involved in, or witnessing traumatic events. Both disorders are injuries where you are expected to recover well and in a short period of time. If you don’t recover within the timeframe expected, the diagnosis of the injury may need to be changed.

 

When is an injury non-minor?

If your injury is more than a soft tissue injury, or a diagnosed psychiatric or psychological illness that is more than adjustment disorder or acute stress disorder, it is likely your injury will be classified as non-minor.

Non-minor physical injuries could include nerve injuries, ligament or cartilage injuries, fractured bones, or injuries to the spine with radiculopathy (also known as sciatica).

Non-minor psychological injuries could include depression or Post Traumatic Stress Disorder.

 

Who makes the decision?

The decision as to whether an injury is classified as minor is made by the CTP insurer, who will consider the medical evidence and the diagnosis given by your treating doctor in making the decision, and provide you with a “liability notice letter” within three months of your claim being lodged. The liability notice letter will tell you whether the insurer considers your injury is minor, or non-minor, and whether the insurer will agree to pay statutory benefits to you.

If you don’t agree with the insurer’s decision, you must lodge a request for the insurer to reconsider it (called an “internal review”) within 28 days of receiving the liability notice letter.

If you don’t agree with the insurer’s internal review, you can request SIRA’s Dispute Resolution Service to help you to resolve the dispute with the insurer.

 

What support can I get if I have a minor injury?

A person who has suffered a minor injury can expect support from the CTP insurer for a period of up to 26 weeks. For details of what that support might entail, see here.

 

The information in this blog is not intended to be legal advice, and should not be taken as such.

If you have had a motor vehicle accident, and you wish to make a claim for compensation, contact us now on 1300 15 15 45 to discuss your specific circumstances. All initial consults with our firm are free of charge and all of our services are No Win, No Pay, with the exception of NSW workers compensation claims, which are funded by WIRO and therefore free to all non-exempt workers covered by the NSW workers compensation scheme.

 

To find out more information, feel free to contact us here.

What is life insurance?

Posted on: July 1st, 2019 by Development

by Pania Watt

insurance claims

 

 

 

 

 

 

 

 

 

Life insurance is a policy of insurance intended to protect you, and your family, from suffering financial difficulty after a certain event – for example, if you get sick, suffer an injury, or pass away.

 

Types of Life Insurance

1. Total and Permanent Disablement (TPD) insurance is to provide financial support to you if you suffer an injury or illness which permanently prevents you from working to your normal retirement age. The funds paid to you are intended to help you to cover the cost of rehabilitation, including medical expenses, debt repayments and your future cost of living.

2. Income Protection insurance (also referred to as temporary salary continuance) is to replace your lost wages if you cannot work for a certain amount of time due to being sick or injured. The funds paid to you, normally on a monthly basis, are intended to help you to manage your day-to-day expenses whilst you are not working and receiving your normal wage.

3. Trauma insurance is to pay a set amount if you are diagnosed with a specific illness (for example, cancer, a specific heart condition, kidney failure). The funds paid to you, normally in a lump sum, are intended to help you manage the cost of medical treatment, specialised therapies, debt repayments, and also to provide an income stream (in circumstances where you do not also have Income Protection insurance).

 

How can you get a Life Insurance policy?

You can obtain a life insurance policy through your superannuation, as part of a “Group Life Policy”. It’s usually less expensive to hold a life insurance policy in this way, because superannuation funds purchase the policies in bulk. You also often don’t need to undergo any medical examinations in order to obtain insurance through your superannuation fund.

You can also purchase a life insurance policy:

1. From an insurance broker; or

2. From your financial adviser; or

3. Direct from the insurer.

 

How to claim

The first thing you need to do is find out whether you have any life insurance policies. At Bourke Love Lawyers, we often receive enquiries from people who have suffered an injury or illness affecting their capacity to work, who want to know if they can claim TPD or income protection, but aren’t sure whether they actually have a policy.

Bottom line – you can’t claim on a policy you don’t have.

Call your superannuation fund. Ask if you have any policies of insurance upon which you could claim. If you have more than one superannuation fund – call them all and ask the same question. While you generally cannot claim income protection on more than one policy at the same time, if you have more than one policy for TPD, critical illness, or trauma, you may be able to do just that.

 

Legal advice

Each policy of insurance is different, and understanding the definitions by which your entitlements will be determined is no easy feat.

You should be wary of organisations without legal training, certification or experience offering their advocacy services.

If you are looking for assistance, support and advice regarding your entitlement to claim on a life insurance policy, Bourke Love Lawyers can assist. We charge for the work that we do, not a flat percentage of your benefit, and all initial consults with our firm are free of charge.

 

The information in this blog is not intended to be legal advice, and should not be taken as such. If you have any queries, contact us now on 1300 15 15 45 to discuss your specific circumstances.

All of our services are No Win, No Pay, with the exception of NSW workers compensation claims, which are funded by WIRO and therefore free to all non-exempt workers covered by the NSW workers compensation scheme.

 

Five things to know about making a compensation claim after a car accident in NSW

Posted on: June 24th, 2019 by Development

by Pania Watt

If you have been injured in a car accident after 1 December 2017, read on for five things to know about making a compensation claim in NSW.

 

1. The NSW system is a no fault system

The system in NSW is now, as of 1 December 2017, a no fault system. This means that if you are injured in a motor vehicle accident, whether you are a:

– Driver or a passenger in a vehicle;

– Rider or a pillion passenger;

– Pedestrian; or

– Cyclist,

you will be entitled to make a claim, regardless of who caused the accident.

However, you will not be entitled to claim if you have been charged with, or convicted or a serious driving offence in connection with the accident, or, you caused the accident and were driving an uninsured car (which you knew was uninsured).

2. Time limits apply.

It’s important to act early in order to ensure that your rights and entitlements are protected, and that you minimise any out of pocket costs for your treatment by ensuring that the CTP insurer will cover them.

You must lodge a claim form (called an “Application for personal injury benefits” within 3 months of the date of the accident.

If you want to receive early income payments (if you need time off work due to injuries sustained in the accident, as is commonly the case), you need to lodge a claim form within 28 days of the accident. You will also need to provide proof of your earnings, such as payslips, or a statement from your employer.

3. Injuries can be physical or psychological

An injury sustained in a motor vehicle accident can be physical or psychological.

A person injured in a motor vehicle accident can sustain physical injuries ranging from whiplash, to very serious injuries, including orthopaedic or neurological injuries.

A person involved in a motor vehicle accident may also suffer mental trauma, resulting in a diagnosis of depression, anxiety, or Post Traumatic Stress Disorder. Such injuries are serious, and require specialist care and attention.   

4. There are certain types of benefits payable in relation to a claim

For up to six (6) months, you can claim:

– Reasonable and necessary medical and treatment expenses relating to your injury.

These expenses could commonly include examinations by your General Practitioner or treating specialist doctor, physiotherapy or radiological investigations, or psychological counselling.

– Weekly income payments, if you should need time off work (even if you are self-employed).

Even minor car accidents can cause whiplash type injuries which cause pain and stop you from being able to carry out your usual work duties. This can be even more likely if you work in a physically demanding job – for example, if you are a tradesperson, or a labourer. Weekly income payments are even more important if you don’t have leave entitlements with your employment – for example, if you are a casual worker, or if you have just started a new job.

– Domestic and personal care services, if you need help around the home as a consequence of your injuries.

Your injury may cause you to have difficulty performing heavier household chores, such as vacuuming or mowing the lawn. If you have had a very serious injury, you may need a nurse, or specialised carers, to attend you at home.

5. If you have been injured in a motor accident, your treatment in a public hospital is not covered by Medicare

Medicare does not cover people who are injured in motor vehicle accidents in NSW.

If you need an ambulance, the cost of that, and most of your hospital costs will be covered by the Fund levy.

The Fund levy will also pay for the majority of your expenses whilst you are in a public hospital, but there may be some doctors bills which are not covered by the Fund levy.

These doctors will send you a bill for their services, which you will have to pay yourself if you do not make a CTP claim.

 

The information in this blog is not intended to be legal advice, and should not be taken as such.

If you have had a motor vehicle accident, and you wish to make a claim for compensation, contact us now on 1300 15 15 45 to discuss your specific circumstances. All initial consults with our firm are free of charge and all of our services are No Win, No Pay, with the exception of NSW workers compensation claims, which are funded by WIRO and therefore free to all non-exempt workers covered by the NSW workers compensation scheme.

Want to know more information, please feel free to contact us here.

PSA: Check your superannuation before 1 July

Posted on: June 17th, 2019 by Development

by Pania Watt

When did you last check your super?

Many, if not most, people hold life insurance, or total and permanent disability insurance, through a superannuation fund, and don’t know it – until becoming unable to work due to injury or illness.

On 1 July 2019, major changes will be made to superannuation which could have a serious impact on you, or your family. These changes are being made under the Federal Government’s “Protecting Your Super” package.

While some of the changes are positive, some have the consequence of people whose account has been “inactive” for more than 16 months, and the account has a balance below $6,000 having their superannuation balance consolidated – that is, having the balance transferred to the Australian Taxation Office (ATO), and the account closed.

How a person may find themselves in this position is more common than you might think.

At Bourke Love Lawyers, we often represent people who have found themselves unable to work, and therefore contribute to their superannuation funds, for lengthy periods of time due to illness or injury.

For example, a person who is receiving workers compensation payments, will generally not be entitled to have superannuation paid on those payments, because the ATO superannuation guarantee ruling states that payments of workers compensation where no work is being performed by an employee are not included in the employee’s ordinary time earnings when calculating superannuation payable.

A person with an injury or illness which takes a long time to heal and rehabilitate can easily find themselves in a situation, through no fault of their own, where their superannuation account has not received a contribution for over a year, but payment of fees and insurance premiums has eroded the account to below $6,000.

This situation is even more likely to happen to a person with a short working history prior to suffering an injury or illness – for example, a young worker at the start of his or her career.

The intention behind the changes is to stop people’s superannuation balances being eroded by paying unnecessary fees, including fees for insurance within your superannuation.

In effect however, it could have the effect of people who have paid for insurance policies out of their superannuation for many years, could have those policies expire. Years of policy payments could go “down the drain” because the person isn’t aware of the changes being made starting on 1 July 2019. What’s worse is there will be people out there who aren’t even aware their policies have expired due to the impending changes, and will not realise this until their claim is rejected – because the policy has lapsed.

 

What can you do?

Check your mygov account, which you can link to the ATO, for details of every superannuation fund you have, and make contact with each and every one before 1 July, to make an informed and deliberate choice about your superannuation.

If you’ve been contacted by your superannuation fund in any way, please take heed of the communication and get back to them as soon as possible.

Don’t leave it too late.

If you are looking for assistance, support and advice regarding your entitlement to claim on a life insurance policy, Bourke Love Lawyers can assist. We charge for the work that we do, not a flat percentage of your benefit, and all initial consults with our firm are free of charge.

 

The information in this blog is not intended to be legal advice, and should not be taken as such. If you have any queries, contact us now on 1300 15 15 45 to discuss your specific circumstances.

All of our services are No Win, No Pay, with the exception of NSW workers compensation claims, which are funded by WIRO and therefore free to all non-exempt workers covered by the NSW workers compensation scheme.

 

What is whole person impairment?

Posted on: June 5th, 2019 by Development

by Pania Watt

If you have a claim for workers compensation, during your claim you may be asked to submit to an Independent Medical Examination for the purpose of assessing your level of whole person impairment.

Whole person impairment (“WPI”), is also referred to as permanent impairment. A whole person impairment assessment is an assessment of the degree of permanent impairment of any body part, system or function which is impaired as a result of an injury.

 

What is involved in an assessment?

The insurer, or your solicitor, will refer you to a doctor of a speciality relevant to your injury, who is a SIRA approved assessor of permanent impairment. Generally, this will not be your treating specialist. The list of doctors who are SIRA approved assessors can be found here.

 

Why do I need an assessment of whole person impairment?

Prior to the changes to the Workers Compensation Act 1987 in 2012, the assessment of whole person impairment was only for the purpose of determining an injured worker’s entitlement to claim lump sum compensation.

Since the changes, an assessment of whole person impairment and (if applicable) payment of lump sum compensation does not finalise your other entitlements to weekly payments and medical expenses, but the assessment itself will determine how long you are entitled to weekly payments and medical expenses (unless you are a Police Officer, a Paramedic or a Firefighter).


How is whole person impairment or permanent impairment assessed?

Your level of permanent impairment is calculated by a doctor who is trained to assess your injury in accordance with the AMA5 and the Workers Compensation Guidelines for assessment of permanent impairment.

The doctor will assess:

1. Whether your injury has reached Maximum Medical Improvement (in other words, it is as good as it’s going to get);

2. Whether the injury or condition results in an impairment;

3. Whether that impairment is permanent;

4. What the degree of permanent impairment is;

5. If applicable, the proportion of permanent impairment due to a previous injury or pre-existing condition.

 

What does “lump sum compensation” mean?

There are three basic components to a claim for workers compensation – weekly payments, medical expenses, and lump sum compensation.

Lump sum compensation is intended to compensate you for “pain and suffering” as a consequence of your injury. The calculation is made by an independent medical examiner, who is a doctor with the required training and approval to assess permanent impairment in relation to a NSW workers compensation claim. That assessment is evidence, but is not conclusive of your condition, your fitness for work, or any other medical question.

 

How is the amount of compensation worked out?

In order to claim lump sum compensation for a physical injury, you must be assessed with whole person impairment of 11% or more.

In order to claim lump sum compensation for a psychological injury, you must be assessed with whole person impairment of 15% or more.

The amount of money payable for a certain percentage of impairment is dependent upon the date of the injury, and the type of injury. The amounts payable are set out in the SIRA Workers Compensation Benefits Guide.

 

 

The information in this blog is not intended to be legal advice, and should not be taken as such. If you have any queries, contact us now on 1300 15 15 45 to discuss your specific circumstances.

All initial consults with our firm are free of charge and all of our services are No Win, No Pay, with the exception of NSW workers compensation claims, which are funded by WIRO and therefore free to all non-exempt workers covered by the NSW workers compensation scheme.

 

 

Five things to know about making a compensation claim after a car accident in Queensland

Posted on: May 29th, 2019 by Development

by Pania Watt

If you have been injured in a car accident, read on for the five things to know about making a compensation claim in Queensland.

 

1. The system in Queensland is different to the system in New South Wales.

This seems like it’s obvious, but people are often surprised by it.

Even if you’re from New South Wales, your car is registered in New South Wales, and the car at fault is registered in New South Wales – if the accident happened in Queensland, the law of Queensland will apply to any claim for compensation you need to make.

In Queensland, the Motor Accident Insurance Commission (MAIC) is the regulatory authority responsible for managing the Compulsory Third Party (CTP) scheme in Queensland.

In New South Wales, SIRA is the regulatory authority responsible for managing the CTP scheme in New South Wales.

 

2. Time limits apply.

If you don’t know the details of the vehicle that caused the accident, you must lodge your claim form within three months of the date of the accident.

In all other situations, whichever of the following dates is earlier:

– Within nine (9) months of the date of the accident, or, if symptoms of the injury or injuries aren’t immediately apparent, within nine (9) months of the first appearance of symptoms;

– If you engage a solicitor to manage your claim, within one (1) month of your first consultation with the solicitor.

 

3. The insurer has rights in relation to the conduct of your claim.

Once you make a claim, the insurer has a number of rights, which include:

– Using the authority that you sign in the notice of accident claim form to obtain documents from your current and past doctors, the hospital/s that you attended for treatment, the police and Centrelink and your current and past employers. If you state in your notice of accident claim form that you have had previous significant injuries, the insurer can also obtain documents relating to those injuries.

– Appoint an investigator to investigate the factual basis of your claim. These investigators might take statements from witnesses, or conduct video surveillance of you.

– Require you to provide information regarding the circumstances of the accident and the amount of loss and damage you are claiming. Generally, this information will be required to be provided in a statutory declaration, which involves you swearing that the information contained in that declaration is correct.

– Require you to undergo independent medical examinations.

 

4. Rehabilitation costs may be paid by the insurer, but not always.

Rehabilitation costs for treatment like physiotherapy treatment, chiropractic treatment, counselling or even surgery costs are all commonly required to assist with your recovery in the immediate aftermath of an accident.

Unfortunately, the insurer is under no obligation to meet the cost of any rehabilitation expenses you might incur unless, and until, they admit liability. The insurer has six (6) months in which to investigate the circumstances of the accident and either accept or deny liability. During this period of time, the insurer may agree to pay for some rehabilitation costs on your behalf.

 

5. If you settle your motor accident claim, you will have to pay refunds.

If you are successful in a common law claim for damages and receive a payment of compensation, any payments made to you, or on your behalf, in relation to your injury by:

– Centrelink; and/or
– Medicare Australia; and/or
– Your private health insurer,

must be repaid to these agencies from any compensation agreed with the insurer, or awarded by a court. These payments will generally be paid by the insurer direct to these agencies, before your settlement funds are paid to you.

If your case is resolved without statements of the amounts paid by these agencies for the insurer to make payment upon, those agencies will seek reimbursement from you direct. That is why we always ensure we have up to date statements of the amounts paid by these agencies prior to the conclusion of your case.

 

The information in this blog is not intended to be legal advice, and should not be taken as such. If you have any queries, contact us now on 1300 15 15 45 to discuss your specific circumstances.

All initial consults with our firm are free of charge and all of our services are No Win, No Pay, with the exception of NSW workers compensation claims, which are funded by WIRO and therefore free to all non-exempt workers covered by the NSW workers compensation scheme.

 

What does an Independent Medical Examination (IME) mean?

Posted on: May 13th, 2019 by Development

by Pania Watt

Independent Medical Examination

If you have a workers compensation claim, at some point it is very likely that the workers compensation insurer, or your solicitor, will ask you to submit to an Independent Medical Examination, or IME.

At Bourke Love Lawyers, we see a lot of workers injured in NSW who tell us in their initial appointment, when asked the question “who is your treating specialist?”, that the specialist IME doctor they have seen, is their treating specialist. It’s a common misunderstanding that the IME doctor is a treating doctor, when they are not.

The IME doctor is not there to treat you. You are not his or her patient – there is no patient-doctor relationship between you. The doctor will report back to the insurer, or your lawyer, on the examination, and everything you say during the examination.

 

What is an Independent Medical Examination?

An IME is an examination by a doctor with a specialty relevant to your type of injury. If you have a psychiatric injury, you might be asked to see a Psychiatrist. If you have a back injury, you might be asked to see an Orthopaedic Surgeon or a Neurosurgeon. If you have a brain injury, you might be asked to see a Neurologist.

 

The doctor is provided with a brief of information by the referrer. The doctor will:

1. Review that information;

2. Interview you (which may involve asking a range of questions about your medical history, what caused your injury, how the injury affects you now, and the treatment you have received); and

3. Depending on the type of injury you have:
– administer various tests; and/or
– carry out a physical examination (if you have a physical injury).

 

Why might I be referred for an Independent Medical Examination? 

The insurer, or your solicitor, might need an opinion on what caused your injury, the medical treatment which is reasonably necessary for your injury, your capacity for work, or the level of permanent impairment you have sustained as a result of your injury.

 

What happens after the Independent Medical Examination? 

If the IME referral was by the insurer, the doctor will provide a copy of that report (or sometimes just a part of it) to your nominated treating doctor (usually your General Practitioner). The insurer will only provide a copy of that report to you if the insurer decides to use the report to:

1. Decline liability for all, or part of, your claim; or
2. Reduce your workers compensation benefits.

If the IME referral was by your lawyer, your lawyer will review the report and explain to you what it means and how it is to be used in relation to your claim.

 

Who pays for the Independent Medical Examination?
The referring party pays for the cost of the report.

What about my costs of getting to and from the appointment?
If the referring party is the workers compensation insurer, the insurer will also pay for the cost of travel – whether that be flights, accommodation, mileage or meal expenses.

If the referring party is your lawyer, and you have funding from WIRO for your claim, WIRO will pay the cost of travel – including flights, accommodation, mileage or reasonable meal expenses. If you are an exempt worker (a police officer, firefighter or paramedic) and unable to obtain funding from WIRO, your lawyer will usually pay the cost of travel, and will be reimbursed by the insurer for these costs at the successful conclusion of your claim.

 

What do I do if I have a problem with the examination?
If you’re not happy with anything during the examination, you should tell the doctor immediately.

If you need to undergo a physical examination, you should not be in pain during, or after the examination. If you feel your injury has been worsened by a physical examination, you should immediately report this to the doctor, the insurer, and your lawyer.

More information on your rights in relation to Independent Medical Examinations can be found here.

 

The information in this blog is not intended to be legal advice, and should not be taken as such. If you have any queries, contact us now on 1300 15 15 45 to discuss your specific circumstances.

All initial consults with our firm are free of charge. If you have a NSW workers compensation claim, you may be eligible for funding by WIRO, or, if you are an exempt worker, your legal costs will be paid by the insurer upon the successful conclusion of your claim.