Frequently Asked Questions
Workers' Compensation QLD
What is a Notice of Assessment?
A Notice of Assessment is a document issued by WorkCover at the conclusion of your Statutory Claim. The Notice of Assessment indicates the percentage of work related impairment you have sustained and provides a monetary offer to compensate you for the impairment and financial losses you may experience in future due to your injuries. If you wish to seek further compensation relating to these work related injuries, you cannot accept that offer. To safeguard your rights and entitlements, it is vital you DO NOT respond to the Notice of Assessment until you have spoken with your legal team first.
What is the claims process?
Here is a general overview of WorkCover claims process in Queensland. It’s okay if it looks a little scary or confusing, Shine Lawyers will assist you each step of the way!
In Queensland there are two (2) phases to the WorkCover claims process. Firstly, there is the statutory phase. The statutory phase is a no-fault scheme. WorkCover will pay for your treatment and time away from work (i.e. your wages) until your injuries are stable and stationary (or have reached maximum medical improvement). Once your injuries are stable, they will look to close your statutory claim. You may then be issued with a Notice of Assessment. Once you are issued with a Notice of Assessment you can make a decision whether or not to proceed with a common law claim for negligence.
The common law phase is the second stage of the WorkCover claims process in Queensland and that is a fault based scheme. That is, we must be able to show your Employer is at fault in order to make it viable to proceed with a common law claim.
The stages of the common law claim are as follows:
1. Lodgement This involves submitting a Notice of Claim for Damages form (Notice of Claim) with the Workers Compensation Insurer. The Notice of Claim must contain certain content. There are time limits for claim lodgement. Shine Lawyers will draft the Notice of Claim for you and arrange for your signature and return.
2. Compliance This involves the Workers Compensation Insurer advising whether you have complied with your legal obligations regarding the Notice of Claim content and format. Any non-compliance issues will need to be addressed. We will assist in obtaining compliance and addressing any non-compliance issues. Our aim is always first time compliance!
3. Disclosure This involves Shine Lawyers (on your behalf) and the Workers Compensation Insurer (or their Representatives) exchanging any documents relevant to the claim. This could include accident reports, receipts or material regarding your injury and treatment. If requested, both parties are also obliged to provide information about the accident and injuries. We will help you comply with these steps. During this phase we may send you to independent medical experts to assess your permanent impairment (future impact of your injury/s).
4. Liability Response The Workers Compensation Insurer (or their Representatives) has 6 months from compliance to investigate the accident and tell us whether they admit, partially admit or deny liability (fault). We will ask for an early response so your claim can progress.
5. Negotiation At the appropriate time, the parties will commence negotiations to try to resolve your claim. This could be at any stage of the claims process, however, we recommend awaiting until your injuries have stabilised and we have all the appropriate evidence to provide advice on the value of your claim. We will prepare a Claim Valuation and wait for your decisions regarding settlement. The most common way to enter into negotiations for your type of claim is to attend a Compulsory Conference.
6. Collection Once your claim settles, there are a number of steps we need to follow before money is received. This includes formally agreeing to settlement terms, advising government departments and other organisations about the settlement, calculating settlement distribution, and receiving and distributing funds.
What is compliance?
Compliance is where the Workers' Compensation Insurer (or their Representatives) confirms that your Notice of Claim for Damages form (Notice of Claim) is fully completed and complies with the appropriate laws. We will assist and advise you during this step in the claim process.
What you need to know about compliance:
The Workers' Compensation Insurer (or their Representatives) has 28 days from claim lodgement to advise whether the Notice of Claim is compliant
If they confirm compliance (or are prepared to waive any non-compliance), they have 6 months to investigate the accident and provide their liability response
If they advise the Notice of Claim is non-compliant, they are required to tell us why and provide a reasonable period (at least 1 month) for us to respond. We will work with you to address any compliance issues
If they fail to respond to your claim, we are able to assume compliance.
Of course, we aim for first-time compliance! We will work with you to ensure your Notice of Claim is comprehensively completed at lodgement time.
What does Deeming mean?
Once we have lodged your Notice of Claim for Damages form (Notice of Claim), the Workers' Compensation Insurer has a certain time period to respond to confirm that we have met the requirements of the legislation in providing sufficient detail and materials. If the Workers' Compensation Insurer does not respond within the required timeframe, we can write to the them and “deem” the notice compliant. We can then proceed with the next steps of the claim as though they had issued their compliance response.
What is a liability response?
The Workers' Compensation Insurer (or their Representatives) has 6 months from compliance to investigate the accident and tell us whether they admit, partially admit or deny liability (fault). Shine Lawyers will assist and advise you during this process, including asking for an early liability response, so your claim can progress.
The Workers' Compensation Insurer (or their Representatives) can claim Contributory Negligence if they believe that you are partly responsible for the accident and/or injuries. Common examples of Contributory Negligence include failure to take care of your own safety. If the Workers' Compensation Insurer alleges Contributory Negligence, they are required to express what percentage of responsibility they believe you should wear. They will argue that your claim valuation should be reduced to reflect this percentage.