6.2.8.2 Lodgement of table of maims claims
Agents to forward claims to WorkSafe
Agents must forward claims for permanent disability and for pain & suffering to WorkSafe’s Maims Coordinator within two working days of receiving them.
WorkSafe allocates these maims claims to a legal panel firm which assumes responsibility for managing these claims on behalf of WorkSafe.
Under the legislation, to make a claim for compensation for maims and pain and suffering, a worker must:
- lodge on the employer a maims claim form approved by WorkSafe
- include an authority, which enables a provider of a medical or hospital service to the worker to release medical information in connection with the injury being claimed
- if claiming for pain and suffering, include an Affidavit sworn or affirmed by the worker under Direction 6 of the ‘Ministerial Directions - Maims Compensation Claims’.
The Affidavit must detail the nature and extent of the pain and suffering resulting from the injury or injuries that are subject of the claim. The Affidavit must contain the following information:
- the injuries complained of and the date or dates those injuries occurred
- the circumstances under which the injuries arose
- the date the worker first sought medical treatment for the injuries the subject of the claim
- the nature of the treatment received by the worker as a consequence of the injuries the subject of the claim including:
- any operative procedure he or she has undergone
- any period of hospitalisation
- any medical treatment and
- any further treatment proposed
- particulars of all absences from employment or periods on light or modified duties as a consequence of the injuries the subject of the claim
- the nature and extent of the:
- actual pain or
- distress or anxiety suffered or likely to be suffered by him/her resulting from the injuries or any necessary treatment
- the manner in which the injuries and resultant impairment the subject of the claim, has affected or is likely to affect the worker’s:
- ability to perform pre-injury duties and
- ability to engage in hobbies, recreation, sporting pursuits and domestic activities undertaken before the injuries.
Failure to provide an appropriate Affidavit may result in the maims claim being suspended.
Medical information
Maims claims must be lodged with a copy of all medical reports which:
- the worker intends to tender in any proceedings about the claim or
- the substance of which the worker intends to adduce in evidence in support of or as evidence of the extent of any loss, impairment, disfigurement or pain and suffering in any proceedings about the claim.
The medical and other information must support the maims claim. That is, the condition arose out of or in the course of employment and for injuries on or after 1 December 1992, that employment was a significant contributing factor.
Invalid claims
Where a maims claim contains a material defect Material defects, omissions or irregularities can affect the decision to accept or reject a claim., omission or irregularity, it is deemed not to have been made provided it is returned to the worker within 14 days of it being given, served or lodged with a notice.
The Legal Panel firm WorkSafe approved legal representatives is to ensure the notice details the defect, omission or irregularity identified. It should also state the period within which the claim is to be dealt does not commence until the claim is re-lodged without any defect, omission or irregularity.