Compensation Laws are complex and often confusing. The following questions and answers detail the most frequently asked questions that our clients as us every day. To see the answers, please click on the appropriate question below.

FAQ 1: Do I have a claim?
FAQ 2: Are there time limits?
FAQ 3: What are my rights to compensation?
FAQ 4: What do I need to prove?
FAQ 5: How is the compensation paid, ie, periodically or in a lump sum?
FAQ 6: How long will my claim take?
FAQ 7: Will I have to go to court?
FAQ 8: Is my claim likely to be settled?
FAQ 9: Who pays the legal costs?
FAQ 10: What costs will I have to pay?
FAQ 11: Will I have to pay tax on the compensation I receive?
FAQ 12: What will the insurer pay whilst the case is being prepared?
FAQ 13: Can I go back to work?
FAQ 14: What if I lose?
FAQ 15: What if I am held to be partially to blame for the incident?
FAQ 16: Will I have to see any doctors?
FAQ 17: Is the insurance company likely to follow me around and spy on me?
FAQ 18: How often will I need to see you?


Compensation FAQ 1: Do I have a claim?

Work Incident
Workers Compensation is awarded if you have been injured at work or have become ill because of your working conditions. As a consequence of this, you may be able claim compensation to cover both your time off work and your medical expense bills. If your injuries are found to be permanent, you may also be able to claim some lump sum compensation and possibly further lump sums for pain and suffering.
You may also have a claim for damages if your employer or another individuals negligence is responsible for your incident.

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Compensation FAQ 2: Are there time limits?

Work Incident
Yes. work incident claims require you submit a compensation claim within a specified time limit. Under s261 of the Workplace Incident Management and Workers Compensation Act 37714, a claim for workers compensation is to be made within 6 months of incident or of first becoming aware of the incident.

However, if your claim is made over 6 months after but within 3 years of when the injuries were sustained, your claim may still be accepted if you can explain why your claim was not made within 6 months. Your reason must be valid and must be reasonable. The claim can sometimes be made after 3 years if it is a death claim or claim for serious and permanent disablement of the worker. There are also instances where the claim can be accepted after the 3 year time limit.
A claim for damages must be made within 3 years of the date of incident, although there are some exceptions to that time limit depending on circumstances.

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Compensation FAQ 3: What are my rights to compensation?

Work Incident
You have been injured at work or have become ill because of your working conditions. As a consequence you may be eligible to claim compensation to cover your time off work and to pay for your medical expenses. If your injuries are found to be permanent, you may also be able to claim some lump sum compensation and possibly further lump sums for pain and suffering.
You may also have a claim for damages if your incident has been caused by the negligence of your employer or someone else.

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Compensation FAQ 4: What do I need to prove?

Work Incident
That your employment has been a substantial contributing factor to your incident.

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Compensation FAQ 5: How is the compensation paid, ie, periodically
or in a lump sum?

Work Incident
A combination of periodic payments and lump sum payments.

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Compensation FAQ 6: How long will my claim take?

Work Incident

The length of time that will be involved in obtaining your personal incident compensation depends on a lot of factors. If your claim is not disputed, you will
be paid the weekly benefits quickly. Any claim for permanent incident cannot be
started until the incident has stabilised (this could take anything from weeks to
years) depending on the nature of the incident. Once an incident has become permanent,
and a claim can be made, it could take anywhere between 2 months and 9 months for
a payment to be received, depending on whether agreement can be reached easily with
the insurer, or whether your entitlements have to be determined by a hearing in
the Workers Compensation Commission.
A claim for damages cannot be commenced until any dispute about permanent impairment
is resolved. It will then normally proceed to mediation.

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Compensation FAQ 7: Will I have to go to court?

Work incident

Probably not. If your claim is disputed, the compensation claim will be assessed
by a WorkCover medical specialist or by an Arbitrator appointed by the Workers Compensation
Commission. A claim for damages will probably be referred to mediation.

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Compensation FAQ 8: Is my claim likely to be settled?

Work Incident
Yes

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Compensation FAQ 9: Who pays the legal costs?

Work incident (workers compensation)
By law, you are protected from paying any fees for your lawyers’ work on your case,
with the exception of cases of fraud. Your lawyer will be paid for his or her work
by the insurance company if your case succeeds. If you lose your case, and it is
determined that the whole of the claim was a fraud or sham, the insurance company
is entitled to seek an order that you pay its costs for the claim, and your own
lawyer may also choose to ask the court for an order that you pay his or her fees.
Your own lawyer should tell you in advance whether it is his or her policy to seek
an order for payment of costs in a case of fraud.

Work incident (damages)
If your claim is successful the insurance company will pay most of the legal costs.
You will pay the difference between what the insurance company has to pay and the
actual costs. As a rule of thumb the difference is about one third. We will pay
all the disbursements (e.g. fees for medical reports) and be reimbursed at the end
of the case. In the unlikely event that your case is lost we will not charge any
fees or seek reimbursement of disbursements. The insurance company may however seek
to recover its costs from you.

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Compensation FAQ 10: What costs will I have to pay?

Work incident (workers compensation)
Generally, nothing. We will pay for all medical reports required to prove your case.
We will be reimbursed for those costs by the insurance company.
You are protected, by law, from having to pay any fees for your lawyers’ work on
your case, with the exception of cases of fraud. Your lawyer will be paid for his
or her work by the insurance company if your case succeeds.

If you lose your case, and it is determined that the whole of the claim was a fraud
or sham, the insurance company is entitled to seek an order that you pay its costs
for the claim, and your own lawyer may also choose to ask the court for an order
that you pay his or her fees. Your own lawyer should tell you in advance whether
it is his or her policy to seek an order for payment of costs in a case of fraud.

Work incident (damages)
If your claim is successful the insurance company will pay most of the
legal costs. You will pay the difference between what the insurance company has
to pay and the actual costs. As a rule of thumb the difference is about one third.
We will pay all the disbursements (e.g. fees for medical reports) and be reimbursed
at the end of the case.
In the unlikely event that your case is lost we will not charge any fees or seek
reimbursement of disbursements. The insurance company may however seek to recover
its costs from you.

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Compensation FAQ 11: Will I have to pay tax on the compensation
I receive?

Work Incident
Tax is payable on weekly compensation payments but not on lump sum payments.

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Compensation FAQ 12: What will the insurer pay whilst the case
is being prepared?

Work incident

1. Weekly Payments: If the insurance company does not commence your weekly payments
of compensation within 7 days of lodgement of your workers compensation claim form
your solicitor can lodge an Application for Interim Payment Direction with the Workers
Compensation Commission on your behalf. The Registrar of the Commission will generally
order that the insurance company should commence payment of your weekly compensation
benefits for a period of not more than 12 weeks unless the Registrar feels that
the claim does not have good prospects of success, you have returned to work, your
incident was not reported as required or there is insufficient medical evidence
available. At the expiration of the 12 week period, you can apply for another interim
payment order which will last for another twelve weeks. You can apply for as many
interim payment directions as you require until you have come to some sort of agreement
with the Insurance Company or the Workers Compensation Commission hears your case.
2. Medical Expenses: If the insurance company does not commence payment of your
medical expenses within 21 days of lodgement of your claim form an Application for
an Interim Payment Direction can be made by your solicitor, the same as for wages,
however, you are restricted to a maximum amount of $7,500.00 being paid per payment
direction. If you need more than $7,500.00 paid for your treatment expenses and
the insurer does not agree then you will need the assistance of a Solicitor to lodge
an Application for Resolution of a Dispute in relation to same and the Workers Compensation
Commission will appoint an Arbitrator to hear your case and make a decision concerning
the Insurance Company’s liability in relation to the expenses.

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Compensation FAQ 13: Can I go back to work?

Work Incident
If you can return to work, you should – provided your doctor certifies you as fit
to return to work. Your employer and workers compensation insurer should assist
you in returning to suitable work.

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Compensation FAQ 14: What if I lose?

Work incident (workers compensation)
You are protected, by law, from having to pay any fees for your lawyers’ work on
your case, with the exception of cases of fraud. Your lawyer will be paid for his
or her work by the insurance company if your claim succeeds.

Work incident (damages)
In the unlikely event that your case is lost we will not charge any fees or seek
reimbursement of disbursements we have paid. The insurance company may however seek
to recover its costs against you.

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Compensation FAQ 15: What if I am held to be partially to blame
for the incident?

Work incident (workers compensation)
It does not matter.

Work incident (damages)
If you were partly responsible for the incident the amount of compensation you receive
will be reduced by the level of your responsibility(e.g. 50% your fault means a
50% reduction in compensation.)

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Compensation FAQ 16: Will I have to see any doctors?

Work Incident
The insurer will make appointments for you to be medically assessed by its own medico-legal
doctors.
You will need to:
1. Attend all medical appointments arranged for you, promptly and co-operate with
doctors who have been asked to assess you, whether they be doctors appointed by
us or by the insurer.
2. Keep us informed of your medical condition, progress, employment situation, change
of address, change of circumstances. There is no need to phone on a regular basis.
Rather you should make a note of all the changes and bring us up to date at our
regular meetings or pre-arranged phone conferences.
3. Get on with your life, if possible e.g. if you can return to work, you should,
provided your doctor certifies you as fit to return to work.

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Compensation FAQ 17: Is the insurance company likely to follow
me around and spy on me?

Work Incident
Maybe, but there is nothing to fear if you act honestly and tell the truth at all
times.

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Compensation FAQ 18: How often will I need to see you?

Work incident

From time to time we’ll need to communicate with you to obtain updates in relation
to your medical condition, etc.

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If you are in need of legal advice, contact Stacks/Goudkamp today. Stacks/Goudkamp
is a Sydney based law firm with Accredited Specialists in Compensation Law and Compensation
matters. We are situated in the heart of the Sydney CBD and also have offices in
Parramatta, Liverpool, Newcastle. Call us today on 1800 25 1800 or
alternatively, fill out the form on the right.