Time limits for WorkCover claims

When you hurt yourself at work, you may be entitled to make a claim for workers’ compensation benefits, such as medical and like expenses, lost wages and lump sum benefits. It is important to know that there are several time limits that apply to these claims. In this blog, we explore some of the more common time limits that might apply to your claim.

You must notify your employer of any injury you incur at your workplace or during the course of your employment. (Note: notifying your employer of your injury is different to lodging a workers compensation claim.)

You have 30 days from the date of your injury (or from when you become aware of your injury) to notify your employer of your injury. You should do this by completing the injury register at your workplace. If you have not done this and you need to later make a claim for worker’s compensation benefits, your claim may not be accepted.

If you have not notified your employer within 30 days of your injury, you may still be able to make a claim for worker’s compensation benefits. A WorkCover agent (insurer) or self-insurer has the ability to waive or extend this time limit in certain circumstances.

For example, if you were unaware of the time limit or unable to complete your claim form due to your injuries (eg, you were seriously injured and in hospital for an extended period) or because you were not in Victoria, the time limit may be extended or waived. Consideration will also need to be given to any prejudice suffered by your employer because of your delay and also any injustice to you in not receiving compensation.

If at the time of notifying your employer of your injury you know you will require time off work or that you will have medical expenses to pay, you should also submit a WorkCover claim by completing a Worker’s Injury Claim Form as soon as possible.

Below, we look at the various benefits available to injured workers and the specific time limits associated with each.

If you require time off work due to your injuries, you need to make a WorkCover claim for weekly payments of compensation as soon as reasonably practicable after the incapacity arising from the injury becomes known.

You do this by submitting a Worker’s Injury Claim Form together with a Certificate of Capacity from your treating medical practitioner. A Certificate of Capacity is a specific WorkCover certificate and a general “sick certificate” will not suffice.

This time limit can be waived or extended if there is a special excuse for not making the claim within time; for example, you are hospitalised with serious injuries.

If you pay for any medical or like expenses such as medication, medical appointments, aids or travel expenses to medical appointments, you have 6 months from the date of the service/expense to seek reimbursement.

Again, this time limit can be waived or extended if there is a special excuse for not making the claim within time.

In certain circumstances, you may be able to make a claim for lump sum compensation called an impairment benefit.  There is no time limit to make this claim.

You can learn more detailed information about this in our blog “WorkCover claims and lump sum compensation”.

If your WorkCover Agent or self-insurer make a decision that you disagree with, for example, a decision to refuse a request for surgery or a decision to terminate your weekly payments, you have 60 days from the date of the decision to make a referral to the Accident Compensation Conciliation Service (“ACCS”).

It is important to know that if you raise an internal review of the decision, this does NOT stop the 60 day time limit from running. Therefore, even if you are attempting to resolve your dispute with the agent or insurer directly, you should still submit a referral to the ACCS before the expiration of 60 days.

The ACCS can decide to accept your referral outside this 60 day time limit if it is satisfied that the reasons for the delay are appropriate.

Some decisions that have been referred to the ACCS but remain unresolved may be referred to the Workers Compensation Independent Review Service (“WCIRS”).

Such a referral must be made within 2 years of receiving a genuine dispute certificate from the ACCS and prior to either a final hearing date being listed or a referral made to a Medical Panel in relation to the decision in dispute.

If you have suffered a “Serious Injury” and your injuries were caused by the negligence of your employer or another person/entity, you may be entitled to claim common law damages. Generally, you have 6 years from the time of your injury to claim common law damages for a work related injury.

You can make an application to the court for an extension of time in limited circumstances. For a court to allow an extension, it must consider that it is just and reasonable to do so after giving consideration to a number of important factors including the length of and reasons for the delay and any prejudice suffered by the defendant.

In some circumstances, you may be entitled to compensation for dependency payments following the death of a worker. You have 2 years from the date of the death to claim for both weekly payments of compensation and a lump sum dependency payment.

Furthermore, you may be entitled to common law damages in relation to your financial dependency on the deceased worker and/or if you suffered a nervous shock injury upon learning of the death. In both circumstances, you have 3 years from the date of the death to bring a claim for these common law damages.

Again, you can make an application to the court for an extension of time in limited circumstances.

Whilst there may be options to extend or waive the above time limits in certain circumstances, it is not guaranteed that you will obtain these extensions or waivers. It is therefore crucial to obtain legal advice well before your right to bring a claim expires. A failure to make a claim in time can often mean that your right to make a claim is lost forever.

At Polaris, we are experts in WorkCover compensation claims. We’ve successfully represented many clients in relation to their workers’ compensation claims.

For advice or assistance in relation to any aspect of your WorkCover claim, please get in touch with a Polaris team member. It doesn’t cost you anything to find out if you have a claim.