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Apr 02

WorkCover Rejected my Serious Spinal Injury Claim in Brisbane!

Thursday, April 02, 2015

A common WorkCover scenario that we find with hard-working clients all over Queensland including Brisbane and the Gold Coast is this:

They are employed in a heavy labour position such as in mining, construction work, heavy duty cleaning or a similar demanding job. Sometimes, these workplaces may not have adequate safety equipment, training or processes to address the nature of their job. Perhaps they slipped while carrying a heavy piece of machinery, or they may have been hit by a moving work vehicle or even had something or someone fall on them that caused the injury.

A Common Injury: The Slipped Disk

One of the most common problems experienced may be a herniated disk when the inner portion of the spine’s vertebrae protrudes through the outer ring.

A visual example can be seen through this diagram.

Sadly, injured workers know all too well how difficult this injury is to deal with. The pain can be excruciating to a point where it can get in the way of daily living such as spending time with children, friends and other family, enjoying intimacy with their partner, engaging in sports and fitness, etc. It can also affect their ability to make a living. It is sadly common for many workers to face serious financial hardships when they are unable to work.

Options after a work injury: Applying for WorkCover

After a work accident, a claimant may need to rely on WorkCover to help compensate them for their lost wages and medical expenses.

For information on how to file a WorkCover claim, you can find it here.

Hopefully, WorkCover may accept the claim and provide initial treatment costs and wage compensation for a few weeks.

Has this happened to you?

However, there may come a time when an injured worker might receive a decision from WorkCover that could be distressing, such as in the following scenario:

“My doctor’s recommendation for spinal surgery to treat my injury has been denied! My Independent Medical Examiner says that my injury was not caused by the work accident. It is degenerative due to ageing. Not only are they refusing to pay for my medical treatment for surgery despite my surgeon’s advice, but they are also stopping my claim completely!”

What next? Reviewing a WorkCover decision

A very common mistake that injured workers make when they come across this issue is they underestimate the review process and try to approach it themselves with little knowledge about the law.

Though the WorkCover review generally entails submitting a written explanation to prove why there is compelling grounds for your claim to be accepted, some workers do not know how to communicate what those ‘compelling issues’ are. They also do not know how to apply the relevant law to strengthen those arguments.

What do they do wrong?

Injured workers who try to apply for review on their own often send their written submissions without taking consideration of how to properly present their case.

  • 1)They fail to produce relevant medical evidence to substantiate their claim.
  • 2)They may also make mistakes in explaining the facts of how the accident happened and how their injuries are tied to that accident.
  • 3)They make mistakes in referencing or applying the law.

The consequences of a poor first approach

Even though a WorkCover review carries no cost for an injured worker, be careful. If your claim is still rejected after a WorkCover review, the next step is to lodge an appeal with the Workers’ Compensation Regulator (Q-Comp.)

Appealing a decision is a lot more difficult and can be very costly. The appeal process requires a significant application of the law as well as the necessity of appearing in a court-like setting.

Attempting to try and cut corners around in the initial process may result in a costly and risky appeal process where the standards needed to succeed are even higher.

A more professional approach

Your WorkCover QLD claim in Brisbane, Gold Coast or anywhere else in the state can greatly benefit from the assistance of a personal injury firm. An accredited specialist in personal injury has the experience and specific training to maximize the chances of success compared to someone pursuing the same claim with little or no legal experience.

Why East Coast Injury Lawyers?

Our accredited specialists in personal injury are also very experienced in both the areas of plaintiff claims and insurance defence. Knowing ‘both sides of the story’ allows your claim to be comprehensively analysed with objective measures of success based on the law and experience from previous claims. Being able to know how the insurance company operates is a critical benefit that regular lawyers with no personal injury experience may lack.

Contact us today

Do not hesitate in finding more information about your Work Injury or WorkCover claim. Workers Compensation QLD is a complicated area of law and you can benefit from a free initial consultation by giving us a call or filling in our case review form. Strict time limitations apply to your work injury claims so take advantage of free legal initial advice so that you can make an informed decision about your legal rights.