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Comcare – the national scheme for work injury compensation

Comcare is the workers compensation scheme that covers Commonwealth employees such as those who work for federal government departments, and those who work for large national employers such as Australia Post, LinFox, National Australia Bank, Commonwealth Bank, Medibank Private, Telstra and Optus.

The Comcare compensation scheme is similar to the Victorian WorkCover scheme, but is run by the Federal Government. If you are injured or hurt in an accident at work, and your workplace is covered by the Comcare scheme, you can make a claim for compensation under the Safety, Rehabilitation and Compensation Act 1988 (Cth).

We have a team of Comcare lawyers who are dedicated to understanding and assisting you with this complex compensation scheme.

Our Comcare lawyers can help you:

  • Lodge a Comcare claim
  • Understand your entitlements under the Comare scheme
  • Calculate your entitlements under the Comcare scheme
  • Pursue a claim for a lump sum Comcare payout
  • Appeal adverse determinations by seeking a reviewable decision
  • Represent you in the Administrative Appeals Tribunal

Our firm is an acknowledged leader in workplace injury compensation, having fought and won compensation for more than 70,000 clients.

Importantly, unlike many other law firms, our No Win No Fee OR Expenses* policy means that we will take care your legal fees and costs, such as expensive medical fees, even if you don't succeed.

Am I covered by the Comcare scheme?

In addition to Commonwealth employees, Comcare covers those who work for large national firms such as Australia Post, LinFox, National Australia Bank, Commonwealth Bank, Medibank Private, Telstra and Optus.

Can I claim Comcare compensation?

You can make a can make a claim for compensation under the Safety, Rehabilitation and Compensation Act 1988 (Cth) if you are injured:

  • While at work
  • While travelling for work-related activities;
  • While attending work-related activities outside your normal workplace.

In order to be entitled to compensation, you must establish that your injury or illness was contributed to by your employment. If your injury or illness was pre-existing, you must establish that your employment has aggravated or exacerbated the condition.

You can claim compensation for injuries or illnesses such as:

  • Musculoskeletal injuries
  • Back injuries
  • Shoulder injuries
  • Arm injuries
  • Hand injuries
  • Hearing loss
  • Effects of strokes and heart conditions
  • Psychological conditions

What if I am part time or casual?

You can make a claim for compensation whether you work full time or part time. You can also claim Comcare benefits if you are employed as a casual.

Some exclusionary provisions do apply. For example, if you suffer a psychological condition, your claim for compensation may be denied if your condition is alleged to have arisen as a result of reasonable administrative action taken in a reasonable manner may not be covered.

If you are a family member of a deceased worker, you may also be entitled to compensation.

Where do I start? A checklist for Comcare claims

1. Report the injury

You should report the incident or accident as soon as possible. You should always submit an incident report to your supervisor, no matter how minor it may seem at the time.

2. Obtain a medical certificate from your own doctor

You should visit your own doctor, and ensure that the doctor understands that your injury occurred at work. You should ensure that your doctor provides you with a medical certificate on one of the Comcare approved forms.

Examples can be downloaded here:

Your medical certificate should be given to your supervisor, or your lawyer, who will then attach it to your claim form for forwarding to Comcare.

3. Lodge a claim form

Incident reports and claim forms are available from your supervisors or union. The Comcare claim form can be downloaded here: http://www.comcare.gov.au/Forms_and_Publications/forms2/claims_forms2?result_101687_result_page=1.

However some licensees have specific forms to be completed. The Comcare claim form is detailed. A Ryan Carlisle Thomas Comcare lawyer can help you lodge your claim and ensure that all the right steps are taken.

It is important to note that neither Comcare nor your employer is required to respond to your claim within a specified time. However, if you have not received a response within 30 days of lodging your claim, call a lawyer.

What am I entitled to? Comcare at a glance

If you are hurt or injured at work, and your Comcare claim is accepted, you are almost certainly entitled to some level of compensation.

1. Incapacity benefits (loss of income compensation)

If you are unable to return to work, or you are partially incapacitated for work as a result of your injuries, you may be entitled to incapacity benefits.

You must submit valid medical certificates on one of the Comcare approved forms in order to claim incapacity benefits.

The table below is a guide to help you calculate your Comcare benefits:

Incapacitated for up to 45 weeks 100% of your normal weekly earnings.
Incapacitated for more than 45 weeks 75% of normal weekly earnings
Partially incapacitated after 45 weeks If you return to work but work fewer hours or at a lower pay, you can have a salary top-up of between 80 and 100%.

Calculating your entitlement to incapacity benefits can be tricky. Some, but not all allowances are included. A Ryan Carlisle Thomas Comcare lawyer can provide you with advice and ensure that your incapacity benefits are being paid correctly.

2. Medical and like expenses

If as a result of your injuries you require treatment or assistance, you are entitled to payment of all "reasonable" medical and like expenses.

This may include:

  • Surgery
  • Hospital fees
  • Medication
  • GP visits
  • Physiotherapy
  • Osteopathy
  • Chiropractic treatment
  • Massage
  • Travel to medical appointments
  • Household services
  • Gardening services
  • Attendant care services
  • Aids, appliances and modifications

3. Comcare lump sums / permanent impairment claims

If your work-related injury leaves you with a permanent impairment, you may be entitled to a lump sum payment under the Comcare scheme. A lump sum claim for permanent impairment is a "no fault" claim.

There are a few important things to note:

  1. You cannot make a permanent impairment claim until your injuries stabilise (which is usually 6-12 months after your sustain your injury or undergo an operation).
  2. In order to be entitled to lump sum compensation, your impairment must be assessed as meeting the relevant threshold. For most injuries, that threshold is 10%. Your level of impairment will be determined according to the Comcare Guides.
  3. You will need to undergo a medical assessment in order for your level of impairment to be determined. Comcare and licensed employers may ask you to undergo a medical assessment by a doctor of their choosing. Remember that Comcare and licensed employers instruct lawyers to advise them. They will not necessarily offer to pay you your full entitlement at first instance. You do have a right to undergo a medical assessment with a doctor of your choosing, and there is often a significant gap between the medical assessments of their doctor and doctors we appoint.
  4. Making a permanent impairment claim does not affect your right to claim incapacity benefits (loss if income compensation) or medical and like expenses. Accepting a permanent impairment lump sum does, however, extinguish your right to make a common law claim for damages resulting from employer negligence.

Calculating your entitlement to permanent impairment lump sum compensation can be tricky (see below for some examples), and resolving your claim for permanent impairment does have significant implications, so it is important to seek advice from one of an experienced Comcare lawyer about your options and rights.

4. Common law claims and employer negligence

If your work-related injury results in death or leaves you with a permanent impairment that meets the 10% permanent impairment threshold and you can establish that your injuries were caused by the negligence of your employer or another party, you may be entitled to sue for common law damages.

There a couple of important things to note:

  1. You have three years from the date of your injury within which to issue a common law claim.
  2. If your work-related injury leaves you with a permanent impairment that meets the 10% permanent impairment threshold, under the Safety, Rehabilitation and Compensation Act 1988 (Cth) you will be required to choose between accepting a permanent impairment lump sum or pursuing a common law claim. You cannot pursue both claims.

Choosing between accepting a permanent impairment lump sum or pursuing a common law claim is a big decision. You cannot change your mind once a decision is made. If you are at this point, you should call us immediately for free initial advice from one of our experienced Comcare lawyers.

5. Compensation for death

If you are a family member of a deceased worker whose death was contributed to by their employment (and their employment is covered by the Comcare scheme), you may be eligible for a compensation payout.

The maximum lump sum compensation payment is $517,000, regardless of the size of the family. In addition to a lump sum, a weekly payment of $142 per week for dependent children may be payable, and reasonable funeral expenses may be claimable.

How big a payout? A rough guide

Often, the first question that our Comcare compensation lawyers are asked is: "How large a sum will I get?"

Your level of impairment and other factors determine the size of a permanent impairment lump sum claim. Therefore, it is difficult to estimate how large a sum you will get, and the amounts are variable. Here, for your use, is a rough guide to the compensation for the following levels of impairment:

  • 10% – $25,000
  • 15% – $40,000
  • 20% – $50,000

Can I appeal?

You have a right to appeal any decision made by Comcare or your employer.

There are a number of steps in the process:

  1. Request reconsideration of the determination. The request must be made within 30 days of receiving the determination. At this stage, Comcare or your employer will review the determination internally.
  2. Wait for the reviewable decision. It is important to note that there is no time limit imposed on Comcare or your employer within which to respond.
  3. Lodge an application of review of decision with the Administrative Appeals Tribunal (AAT) (if the reviewable decision affirms the original determination). The application must be lodged within 60 days of receiving the reviewable decision.

It is important to remember that Comcare and licensed employers instruct lawyers to advise them. If you have received an adverse determination, it is vital that you contact us promptly and before the 30 day deadline. Our experienced Comcare lawyers can advise you about your potential entitlements and options, and can assist you to arrange medical assessments and gather evidence and in support of your claim.

Fees – not all No Win No Fee policies are the same

Under our No Win No Fee OR Expenses* policy on fees and out of pocket expenses, we will waive our fees if you don't win a case we have agreed to fund and pick up the tab on your out of pocket expenses. Out of pocket expenses are counted as medical reports, court fees and many other expenses other firms would typically require you to pay in the event the case was lost.

The terms of our policy will be fully explained to you during your first free consultation.

For more information on our Fees, see http://rct-law.com.au/our-firm/no-win-no-fee-or-expenses

Lump sums can be pursued through Comcare or through the Courts. But if you are at this point, you should call us on 1300 366 441 or find us at an office near you for free advice on Comcare, or download our Comcare brochure.