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Workers' Frequently Asked Questions
Am I covered for workers' compensation? In the NT, the definition for workers' compensation purposes provides that a worker is a person who provides work or service for another person and does not provide that other person with their Australian Business Number (ABN) in writing. Working directors of companies are only covered if their personal details are disclosed to the insurer. Family members of businesses are covered only if their personal details are disclosed to the insurer. When is a worker covered for workers' compensation? A worker is entitled to compensation for any personal injury or disease or an aggravation of an injury or disease that occurs:
If you believe you have suffered a work related injury or disease tell your employer or supervisor as soon as you can. This can be done either verbally or in writing. You have up to six (6) months to lodge a claim for workers' compensation from the date of the injury or when first becoming aware of the injury or disease. You must complete the first 2 pages of the NT WorkSafe approved claim form and submit the form to your employer. If the claim is for lost time two copies of the approved workers' compensation medical certificate must be attached. If this certificate is not attached, the claim is not valid. If the claim is for medical expenses only, the approved workers' compensation medical certificate is not required. A worker is entitled to receive their normal weekly earnings for the first twenty-six (26) weeks of total or partial incapacity, less any amount they actually earn. If after the first 26 weeks you are still incapacited you will normally be paid at 75% of your loss of earning capacity. Minimum and maximum provisions may apply. Will my weekly benefits reduce at any time? Weekly benefits automatically reduce after 26 weeks to 75% of your loss of earning capacity. What are my other workers' compensation entitlements?
The above list is not complete as the needs of each worker are different and your insurer will consider each request for service on its merits. For more information refer to Information Bulletin 13.01.16. Are employer contributions to my superannuation included in the calculation for my workers' compensation entitlement? Employer contributions to superannuation are NOT included in the calculations of normal weekly earnings with regards to workers' compensation benefits. For more information refer to Information Bulletin 13.01.16. What happens when a decision on a claim gets deferred? A claim can be deferred for up to 56 days to allow the insurer to gather further information on the claim. When the claim is deferred the employer must commence payments of weekly benefits within three working days of the decision to defer. No other benefits are paid during the period of the deferral. What can I do if my claim is rejected, or my benefits are cancelled or reduced? If the claim is rejected or benefits cancelled or reduced, you will be notified formally by the Insurer with a "Notice of Decision and Rights of Appeal" form. You can appeal the decision by applying to NT WorkSafe for mediation. If the matter is not resolved at mediation you can also apply to the Work Health Court for resolution of the dispute. What do I do if I disagree with a decision made on my claim? Should you disagree with the insurer's decision you may request mediation. Mediation may help solve disputes by sharing information, identifying the issues in dispute, discussing them and trying to reach a mutually acceptable agreement. It is fair, informal, quick and is a free service. Can I make an application directly to the Work Health Court? Before a worker can make an application to the Work Health Court, they must first apply for and complete the mediation process. Upon completion a mediation certificate is issued and this is required to be lodged together with an application to the Work Health Court. A worker has 28 days from the date he or she receives a certificate of mediation to make application to the Court. If outside the 28 days, the worker may apply to the Court to extend the time for making application. The granting of such extension is at the discretion of the Court. What happens if I suffer a recurrence or an aggravation of an injury or disease when I am back at work? If the recurrence is a progression of the original injury with no new causative incident or aggravation, then it will form part of the original claim. If the recurrence or aggravation is caused by a new work related incident you will need to submit a new claim. Both you and your employer have an obligation to ensure that you do not undertake duties, which may cause a recurrence or aggravation of your compensable condition. Can I claim for a stress related condition under workers' compensation? Psychological injuries are compensable if there is medical evidence to support that your employment was a substantial contributing factor. A person is not entitled to compensation, if the psychological injury was made as a result of reasonable administrative action taken in connection with the worker's employment, failure by the worker to gain a promotion, transfer or benefit, or as a result of reasonable disciplinary action. How do I make a claim for a permanent impairment? If a worker is left with a permanent impairment as a result of a work related injury or illness there is provision under the Workers Rehabilitation and Compensation Act for payment in respect of that permanent impairment, subject to medical assessment about the level of impact upon loss of body function. If you believe that you have a permanent impairment and your condition is stable, you can ask your insurance company to have you assessed. The insurer will arrange for you to be examined by a medical practitioner, who will assess your impairment in accordance with prescribed guidelines. Alternatively you could ask your own medical practitioner or specialist to do the assessment, but you would have to ensure that they did the assessment in accordance with the prescribed guidelines. If the level of permanent impairment assessment by the medical practitioner dissatisfies either party, they may apply to NT WorkSafe for a permanent impairment reassessment. The cost incurred in carrying out a permanent impairment assessment or reassessment is paid by the employer (insurer). NB: The prescribed guidelines are American Medical Association Guides to the Evaluation of Permanent Impairment (Fourth Edition). I had a vehicle accident on my way to work, am I covered by workers' compensation? Journey claims to and from work involving motor vehicles are excluded from the Workers Rehabilitation and Compensation Act. However they are covered under the Motor Accidents Compensation Act. Journey claims not involving a motor vehicle are still covered. Refer to Information Bulletin 13.01.18. What steps do I need to take to return to work? If rehabilitation is recommended, you must co-operate with reasonable treatment, rehabilitation and return to work programs. If your employer is unable to provide suitable duties you must actively assist in gaining suitable alternative employment. The worker is also required to inform their employer if they commence employment elsewhere, or circumstances change in a way which may affect their entitlements. Can I visit my family doctor or do I have to go to the doctor specified by my employer? You are entitled to be treated by the doctor of your choice, however your employer or insurer is entitled to have you examined by a doctor of their choice. If a work related injury results in the death of a worker, the dependants will be entitled to receive a single lump sum payment, funeral expenses and other benefits in accordance with the Act. Is there Common Law under the Work Health Act? No. Northern Territory Workers’ Compensation Scheme is a no fault scheme. Under the Northern Territory Workers Rehabilitation and Compensation Act there is no provision for common law. That is a worker, for the purposes of the workers’ compensation provision of the Workers Rehabilitation and Compensation Act, cannot sue their employer or fellow worker for negligence. If an employee is not a worker for the purposes of the workers’ compensation provisions of the Workers Rehabilitation and Compensation Act then such an exclusion would not apply and hence the employer could be sued at common law if negligence could be established. Where a partially incapacitated worker is receiving weekly benefits as a top up of his or her loss of earnings, this benefit can, in certain circumstances, be commuted to a once only lump sum payment. Entitlements to weekly benefits may be commuted to a lump sum upon application to the Work Health Court by the employer/insurer or worker, where because of the small amount of the regular payment, the administration cost in making the payments is disproportionate to the benefit received; or otherwise, a worker may apply to the court for a commutation of his or her weekly benefits. In this case the Court must be satisfied that:
The maximum commutation to be linked to the worker’s Normal Weekly Earnings (NEW) or Average Weekly Earnings (AWE), whichever, in the case of a particular worker, is the greater. |
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