Key takeaways
- Speak to a lawyer as soon as your payments stop, treatment is refused, or your claim is rejected. Those are decisions, and decisions can be reviewed.
- The 130-week mark changes your entitlement to weekly payments. It is a point to get advice before, not after.
- A permanent injury may support an impairment benefit, and separately a common law damages claim if someone was negligent.
- You can still get advice while the insurer is paying you. Being paid now does not mean the claim is being run properly.
- You can change lawyers at any stage of a WorkCover claim, and it does not send you back to the start.
If you have been injured at work, the WorkCover process can feel confusing very quickly.
At first, it might seem simple enough. You report the injury, lodge a claim, see your doctor and wait for the insurer to make a decision. But for many injured workers, the process does not stay simple for long.
Payments can stop. Treatment can be rejected. The insurer may ask for more medical reports. You may be sent to an independent medical examiner. Your employer may be pressuring you to return to work before you feel ready. Or you may simply feel like nobody is properly explaining what is happening.
That is often the point where speaking to a WorkCover lawyer can make a real difference.
At Hotchin Gupta Lawyers, we help injured workers across Melbourne and Victoria understand their rights, protect their entitlements and make informed decisions about their WorkCover claim.
What is WorkCover?
WorkCover is Victoria’s workers compensation scheme. It provides support to eligible workers who are injured because of their work.
Depending on the circumstances, a WorkCover claim may involve:
- weekly payments if you cannot work or cannot return to your full pre-injury duties
- payment or reimbursement of medical and like expenses
- support with return to work
- lump sum compensation for permanent impairment
- in some cases, a common law damages claim if your injury is serious and caused by negligence
Every claim is different. Some claims move smoothly. Others become disputed, delayed or much more complicated than the injured worker expected.
When should you speak to a WorkCover lawyer?
You do not need to wait until everything has gone wrong before getting legal advice.
In fact, early advice can often help you avoid problems later.
You should consider speaking to a WorkCover lawyer if:
- your claim has been rejected
- your weekly payments have stopped or reduced
- treatment has been denied
- you have been told to return to work before you feel ready
- you are approaching 130 weeks on weekly payments
- you have received a notice from the insurer that you do not understand
- you are being sent to an independent medical examination
- your injury is serious or may be permanent
- you feel pressured by your employer, insurer or return to work coordinator
- you are not sure whether you may have a lump sum or common law claim
Even if you are not ready to take action, getting advice can help you understand where you stand.
What if my WorkCover claim has been rejected?
If your WorkCover claim is rejected, it does not necessarily mean the matter is over.
In Victoria, injured workers may be able to dispute certain WorkCover decisions through the Workplace Injury Commission. This process is called conciliation.
Conciliation is designed to give injured workers and insurers an opportunity to resolve a dispute without going straight to court. It may involve the injured worker, the insurer, the employer and any representatives.
Common disputes include:
- rejected claims
- rejected treatment
- unpaid weekly payments
- termination or reduction of weekly payments
- disputes about capacity for work
- disputes about whether an injury is work-related
The timeframes can be important, so it is sensible to seek advice quickly after receiving an insurer decision.
What happens after 130 weeks on WorkCover?
The 130-week mark is one of the most important points in many WorkCover claims.
For some injured workers, weekly payments may come under review around this time. The insurer may look closely at your capacity for work, your medical evidence and whether you meet the requirements for ongoing weekly payments.
This can be a stressful stage of the claim, especially if you are still injured, still receiving treatment, or unable to return to your pre-injury work.
If you are approaching 130 weeks, or you have received correspondence from the insurer about your ongoing entitlement, it is worth getting legal advice before responding. We explain the notice and the 130-week test in more detail in our guide on WorkCover payments being stopped.
A lawyer can help you understand:
- what the insurer is reviewing
- what medical evidence may be needed
- whether the decision can be challenged
- whether you may have other entitlements available, including a superannuation TPD claim if you are unlikely to return to work
- whether your injury may support a serious injury or common law claim
Can I claim compensation if my injury is permanent?
If your work injury has caused permanent impairment, you may be entitled to make an impairment benefit claim.
This is sometimes called a lump sum claim.
An impairment benefit claim is separate from weekly payments and medical expenses. It involves an assessment of your permanent impairment, usually after your injury has stabilised.
In some cases, an injured worker may also have a common law damages claim. This is different from an impairment benefit claim.
A common law claim may be available where:
- the worker has suffered a serious injury, and
- the injury was caused by negligence
Common law claims can include compensation for pain and suffering and, in some cases, loss of earnings.
These claims are more complex and usually require careful medical and legal assessment.
Do I need a lawyer if the insurer is already paying me?
Sometimes, yes.
Just because your claim has been accepted does not mean every future issue will be straightforward.
You may still need advice if:
- treatment is being questioned
- the insurer wants updated medical reports
- your work capacity is being reviewed
- your payments are changing
- you are being pushed into unsuitable duties
- you are unsure whether to make a lump sum claim
- you want to know whether you have a serious injury claim
The best time to get advice is often before a major decision is made, not after.
Why injured workers can feel lost in the WorkCover system
WorkCover claims involve doctors, employers, insurers, case managers, return to work coordinators, independent medical examiners and sometimes multiple lawyers.
For an injured worker, it can feel like everyone else understands the process except you.
That can be especially difficult when you are also dealing with pain, financial pressure, surgery, psychological stress, family responsibilities or uncertainty about whether you will ever get back to your normal work.
Good legal advice should make the process clearer.
You should understand:
- what stage your claim is at
- what decisions are being made
- what evidence matters
- what options you have
- what time limits may apply
- what you should avoid doing
- what the next step is
You should not feel like your own claim is happening around you.
How Hotchin Gupta Lawyers can help
Hotchin Gupta Lawyers helps injured workers with WorkCover claims across Melbourne and Victoria.
We can assist with:
- rejected WorkCover claims
- weekly payment disputes
- medical treatment disputes
- conciliation
- 130-week reviews
- impairment benefit claims
- serious injury applications
- common law damages claims
- second opinions on existing claims
Our approach is simple: you deal directly with your lawyer.
That means you do not have to keep retelling your story to a new person every time you call. You get consistent advice from someone who understands your claim, your injury and what matters to you.
Can I switch WorkCover lawyers?
Yes, you can usually change lawyers if you are unhappy with the way your current claim is being handled.
Many injured workers seek a second opinion because they feel:
- their lawyer does not return calls
- they do not know what is happening
- their claim has stalled
- they are being passed between different people
- they do not feel listened to
- they are unsure whether they are getting the right advice
A second opinion does not mean you have to change lawyers. It simply helps you understand whether your claim is on the right track.
At Hotchin Gupta Lawyers, second opinions are confidential.
Speak to a WorkCover lawyer in Melbourne
If you have been injured at work, or if your WorkCover claim has become difficult, you do not have to work it out alone.
Getting advice early can help you understand your rights, avoid mistakes and make better decisions about your future.
Hotchin Gupta Lawyers offers clear, practical advice for injured workers across Melbourne and Victoria. We also publish what a WorkCover claim actually costs, stage by stage, so you can decide with the numbers in front of you.
If you would like to speak with a WorkCover lawyer, contact Hotchin Gupta Lawyers for a confidential discussion, or start with a free claim check.
This article is general information only and is not legal advice. Every WorkCover claim is different. You should seek advice about your own circumstances.
