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WorkSafe battles continue despite ‘overhaul’

Construction worker and digger | Shine Lawyers

Shine Lawyers has called for greater action from WorkSafe, saying that dozens of vulnerable and injured Victorian workers continue to face protracted and unnecessary battles to recover their entitlements, despite the Victorian WorkCover Authority’s assurances that a ‘major overhaul’ is underway.

The calls come following reports by the ABC of further allegations against the authority, which was criticised by the Victorian Ombudsman in 2016 for mishandling, deliberately delaying and financially rewarding agents for terminating claims.

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Shine Lawyers Stuart Le Grand says that while he welcomes the steps the authority has taken to improve practices for the benefit of injured workers, he continues to see large numbers of injured workers left battered by the system.

“We have dozens of clients who remain in dire circumstances because of terminated or delayed benefits, or denied treatment. Many of these cases wreak of blatant unfairness including unreasonable delays in getting treatment approval, termination of benefits with no or illogical reasoning, workers being sent off to unnecessary independent medical examinations and the rejection of essential surgery. Instances of workers being forced to fight the system are not few and far between and have become commonplace. This offends commitments WorkSafe has made to demonstrate best practice in its claims handling process,” Mr Le Grand said.

“This behaviour goes against everything the authority stands for and is actually in breach of the model litigant guidelines, to which WorkSafe is a signatory. Under the guidelines, the authority has given assurances it will act fairly in handling claims, deal with claims promptly and not cause unnecessary delay. In essence, the agency is required to act with complete propriety, fairly and in accordance with the highest professional standards,” he said.

“Furthermore, it is entirely inappropriate to offer incentives to employees that protract or terminate claims arbitrarily,” Mr Le Grand said.

“When people come to WorkSafe, they are usually in a desperate situation where they can no longer work, support their families or cover the costs of expensive medical treatment. For injured workers to then have to battle the very agency that’s meant to support them can lead to mental anguish, extreme financial pressure leading to the fracturing of families, relationship breakdowns and the loss of family homes,” he said.

“It’s really important that WorkSafe continues to improve its claims handling practices to minimise any further harm coming to vulnerable Victorian workers.”

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Shine Lawyers – WorkSafe claim experts

If you currently have a claim with WorkSafe and have experienced significant delay, early termination or other questionable conduct, there is help available. At Shine Lawyers, we have workers compensation lawyers across Victoria who are experts at managing WorkSafe matters. We can assess your case and liaise with WorkSafe to ensure your matter is handled according to best practices. Get in touch today to make sure your rights to compensation aren’t lost.

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Written by Shine Lawyers on . Last modified: March 14, 2018.

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  • Tom Vernham wrote:

    Hi Stuart,
    Personally I think you are 100% correct in this article. I believe it is time for a Law Firm to take Worksafe (and it’s Insurance Agents) to Court via the ACCC for Unconscionable Conduct for especially Worksafe for it’s use in employing insurance agents to engage in said unconscionable conduct by paying them bonuses for “claims management” that deny’s injured workers fair and reasonable resolution of their claims.

    Unconscionable conduct – ACCC

    https://www.accc.gov.au/business/anti-competitive-behaviour/unconscionable-conduct

    Unconscionable conduct is generally understood to mean conduct which is so harsh that it goes against good conscience. Under the Australian Consumer Law, businesses must not engage in unconscionable conduct, when dealing with other businesses or their customers
    * Understanding what unconscionable conduct means
    * Determining whether conduct is unconscionable
    * How to avoid becoming a victim of unconscionable conduct
    * How to avoid engaging in unconscionable conduct
    * Penalties and remedies
    * Relevant sections of the Competition and Consumer Act
    * Report potential unconscionable conduct
    * More information
    Understanding what unconscionable conduct means
    Unconscionable conduct does not have a precise legal definition as it is a concept that has been developed on a case-by-case basis by courts over time. Conduct may be unconscionable if it is particularly harsh or oppressive. To be considered unconscionable, conduct it must be more than simply unfair—it must be against conscience as judged against the norms of society.
    Business behaviour may be deemed unconscionable if it is particularly harsh or oppressive, and is beyond hard commercial bargaining.
    For example, Australian courts have found transactions or dealings to be ‘unconscionable’ when they are deliberate, involve serious misconduct or involve conduct which is clearly unfair and unreasonable.
    Determining whether conduct is unconscionable
    There are a number of factors a court will consider when assessing whether conduct in relation to the selling or supplying of goods and services to a customer, or to the supplying or acquiring of goods or services to or from a business, is unconscionable.
    These include:
    * the relative bargaining strength of the parties
    * whether any conditions were imposed on the weaker party that were not reasonably necessary to protect the legitimate interests of the stronger party
    * whether the weaker party could understand the documentation used
    * the use of undue influence, pressure or unfair tactics by the stronger party
    * the requirements of applicable industry codes
    * the willingness of the stronger party to negotiate
    * the extent to which the parties acted in good faith.
    This is not an exhaustive list and it should be noted that the court may also consider any other factor it thinks relevant.

    Kind Regards

    Tom Vernham

  • Wanda wrote:

    I have just been told my request for an operation has been denied. I have been waiting for an answer since September 2017. which I spoke with union assist and the said lodge a request for conciliation. which we did we had postphoned the conciliation meeting to agree to more IME meets. One with a vascular surgeon who know was pretty old and wouldn’t have preformed a vascular surgery in a number of years. He said I did not have a vascular issue that it was neurogenic and then had an appointment with a neurosurgeon where he said I difinetely have venous thoracic outlet syndrom and that work had pushed me over the edge and should have the operation. The insurer then said they wanted to ask both specialist extra question before they reach a decision, where the neurosurgeon would defer to the vascular surgeon decision. So now it is deciding what is the next step. I don’t agree with there decision and the vascular surgeon in his report if I do have vascular outlet syndrome my symptons don’t match. Which is in correct and can find data to prove it. So now the confusion do I go to a medical panel, I cannot offered a lawyer and with the pain and disabiility of the arm I am not sure I could handle a drawn process to get the operation that could help me.

    • Shine Lawyers wrote:

      Hi Wanda, we work on a no-win, no-fee basis for almost all of the work we do so this might be something our Workers Compensation team are able to help with. If you’d like to see if we can help with your situation, get in touch with our New Client Team who will be able to get more details from you and put you in touch with our Workers Compensation team if we are able to assist. You can find our contact details here: http://bit.ly/Shine-contact. ~Steph

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