WHY WAS YOUR WORKER'S COMPENSATION CLAIM REJECTED? REASONS FOR REJECTED CLAIMS IN QUEENSLAND
When you make a claim for worker’s compensation, certain criteria will need to be met for the claim to be accepted.
WorkCover considers the following;
• Was the claim made in the correct timeframe?;
• Is the person claiming compensation considered a worker?;
• Was the injury sustained because of a work-related incident?; and/or
• Is the person’s employment the significant cause for the injury?
If your claim through WorkCover has been rejected, it could be because one or move of the above points wasn’t met. Of course, a rejected claim could be due to a number of reasons depending on the circumstances at hand. There are ways to appeal or request a review of your unaccepted claim, however, if you wish to take action like this you should seek legal guidance first.
Below are a few reasons why your claim could have been rejected.
Possible Rejection Reason: Out of Time
Did you know that there are time limitations in bringing forth a claim?
These time limitations could vary depending on your state or territory- however, WorkCover claims need to be lodged within six months of when the injury occurred for the claim to be accepted. This can be a difficult timeframe for many to adhere to, especially if you have been focused on recovering from your injuries.
There are special cases where this six-month time limit can be extended, but it is not a common occurrence. Nonetheless, it is important to speak to a Personal Injury lawyer about these options.
So, if you were unable to bring forth your claim within this time (within six months), your claim may have been rejected.
To increase the likelihood of claim acceptance within the time limit we recommend that you (1) report the incident to your workplace promptly after its occurrence, (2) compile all necessary evidence (medical records, correct timelines or statements) and (3) lodge your claim; preferably within a few weeks of the incident.
Unfortunately, this can be an unrealistic expectation of achievement for those who are recovering from an injury.
The most effective way of ensuring your rights are protected is to seek professional legal assistance as soon as you are able. This will help to take away your burden of acting swiftly through the claims process. Further, you will have more time to get adequate rest and recovery.
Possible Rejection Reason: Work Was Not a Significant Contributor to the Injury, Or the Injury Did Not Occur Whilst Working
WorkCover will assess the main cause of your injury and/or where it occurred. It needs to be proven that your work was a significant contributor to the injury, or that a workplace incident was directly responsible.
If your incident occurred outside working hours such as a cycling accident or a fall on public footpaths, your WorkCover claim would not be accepted. If you were injured on your way to or from work, however, you could still be eligible.
There will be other avenues of compensation for you to pursue if your injury occurred out of hours. A Personal Injury lawyer will be able to assist you in understanding those avenues.
If you are unhappy with the decision made by WorkCover Queensland or self-insurer, you may be able to lodge an application for review or take further action to appeal the decision. (worksafe.qld.gov.au)
Just as you are unique to other workers- your injuries, losses and expenses will be as well. So, when situations can vary so heavily from case to case, every claim is going to be different.
No one should have the heavy burden of corresponding with insurers to-and-fro, amid tight guidelines, all with no success. This stress can worsen the severity of your injuries.
Your ability to achieve a comfortable recovery or return to work should be your top priority, and it’s best achieved with some professional help. Legal professionals will take these compensation matters a step further on your behalf; so you don’t have to.
Personal Injury Lawyers in Toowoomba, Brisbane and Roma – Queensland
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