If you’re suffering from a work-related psychological injury, getting on the road to recovery as soon as possible can make all the difference. For immediate mental health support services, call Lifeline on 12 11 14 or Beyond Blue on 1300 224 636. We’ve written this short guide to give you an overview of the steps involved in making a compensation claim for a psychological injury at work.
In Queensland, mental health conditions account for 11% of all serious claims. When compared to physical illness or injury, mental health conditions are one of the costliest forms of workplace injury. They can result in significant time off and higher compensation than other types of claims.
What is a psychological injury?
Psychological or mental health injuries may include depression, anxiety, or post-traumatic stress disorder. These injuries can have a significant impact on how you feel, interact, behave or think. To prevent a psychological injury from developing or getting worse, it’s important for employers to provide support and address workplace issues at the early signs of mental health issues as a result of job stress or other trauma in the workplace.
If you’re suffering from a psychological injury, you may be eligible for compensation if your workplace has been a major contributing factor. In general, a psychological injury claim is often not accepted if it is the result of reasonable action taken by an employer (such as dismissal, performance appraisal, or disciplinary action) provided it was taken in a reasonable way.
What is the criteria for a psychological injury claim?
While every psychological injury claim is different, they all need to meet certain criteria to be accepted by WorkCover Queensland. Information will be gathered from you, your doctor, fellow employees and your employer during the assessment process.
WorkCover Queensland won’t accept an application for compensation if:
- medical opinion determines you don’t have a diagnosed psychological injury
- your doctor has stated that work is not a significant contributing factor in causing your injury
- there’s not enough information to support and prove your description of events and that those events gave rise to your injury
- the claim lodgement timeframe hasn’t been met (you usually have 6 months to lodge your claim from the date you first saw your doctor for the injury)
- if the injury was caused by management action that is determined as reasonable taken in a reasonable way.
What is reasonable management action?
In Queensland, if a mental health injury is caused by reasonable management action taken in a reasonable way, it is excluded from worker’s compensation. According to WorkSafe Queensland, provided the action is taken in a lawful and reasonable way, it may include:
- giving performance feedback in a fair and constructive way
- investigating complaints and misconduct
- changing a worker’s role
- taking disciplinary action (such as dismissing a worker).
Even if a psychological claim is not accepted by WorkCover Queensland, it’s important to address any mental health issues that are occurring. Visit the WorkSafe website for further information on the support and treatment services available to you.
How to make a workplace psychological injury claim
If you are suffering from a mental health condition, it is important to get the professional and personal support you need. Pursuing a claim involves the following steps:
- Report your developing symptoms, and the cause of those symptoms to your employer
- See a doctor
- Lodge an application with WorkCover Queensland or the workplace insurer
- Your claim is accepted
- Receive treatment, and if time off work is required be compensated for lost wages by WorkCover Queensland
- If your injury is ongoing, preventing, or limiting you from returning to usual work you may consider taking legal advice as to your ability to pursue a damages claim
Reporting your injury
A common disqualifying factor when it comes to making a successful damages claim for injuries sustained at work is that the employer didn’t know you were likely to sustain a mental health injury, and therefore couldn’t do anything to prevent it. If you have been encountering difficulties at work, due to fatigue, workplace pressure, trauma or other stressors that have resulted in mental health symptoms, make a complaint so that your employer is aware, and the fact it is causing you mental health issues.
It’s important that they are aware you are suffering, or likely to suffer, from mental health symptoms due to the workplace factor/s. Even if you have a bad experience over a period of time, if you don’t mention to your employer that you are suffering and they don’t have the opportunity to fix it, this can seriously impact your prospects of success in a damages claim.
Many people may not be comfortable notifying an employer directly depending on the circumstances. If this is the case, you can submit your complaint through human resources or another manager.
Seeing a doctor
The next step is to see a doctor to receive treatment and get a Work Capacity Certificate. You will need to report to them clearly about what your problems are at work and that the symptoms you are suffering from have been caused by those issues in the workplace. Your doctor will then determine whether you have a medical condition, as a result of the workplace contributing factors.
Lodging an application with WorkCover Queensland
Once your doctor confirms you are suffering from a psychological injury and that work is a significant contributing factor, lodge an application with WorkCover Queensland or the workers compensation insurer of your employer. WorkCover (or the insurer) will talk to you and your doctor to work out what caused the injury and may also talk to the employer during this time. They will provide the employer with a summary of the claim.
The employer must then respond with any requested information in the given timeframe. According to legislation, WorkCover must decide claims within 20 business days. The employer’s response may include the employee’s role and events that could have caused the injury. You will be able to see your employer’s response, and you will both be notified of the claim outcome.
What happens while I’m waiting for my claim outcome?
To begin your road to recovery, it’s important you get the help and support you need as soon as possible. While WorkCover is deciding whether you have a successful claim or not, you should seek to access treatment through a mental health plan from your GP and seek a referral to an appropriate treatment provider. If your claim is accepted, the insurer will then take over funding and assist with payment of your wages while you are away from work.
Treatment funded by WorkCover during this time may include:
- GP appointments
- counselling or psychology sessions
- psychiatry appointments
- medication (such as antidepressants).
They may cover the following if recommended by your treating Psychiatrist:
- in-patient hospital costs
- costs for hospital stays.
For questions about how to access treatment, you should liaise with your GP, or you can call WorkSafe Queensland on 1300 362 128.
What is covered if your claim is accepted
If your claim is accepted, benefits covered by workers’ compensation may include:
- medical expenses
- income replacement payments
- rehabilitation costs
- costs for retraining for other employment or duties
- lump sum payment for permanent injury or disability.
Pursuing a damages claim
Your workers compensation claim will have a period of time where you receive compensation, payment of medical expenses and other rehabilitation costs through the no-fault statutory scheme (under the Workers’ Compensation and Rehabilitation Act 2003). At the end of this statutory scheme, you will either recover and go back to work, or you may still be affected by the injury and not yet able to return to work at all or in the same capacity as before your injury.
If your injury is not allowing you to return to work, and if your condition is assessed by a medical practitioner as being stable and stationary, WorkCover or the insurer will arrange for you to be assessed for permanent impairment. This will be done before the Medical Assessment Tribunal, with a view to ceasing your claim, and offering a lump sum compensation settlement to prevent you from pursuing a damages claim.
If you receive ANY offer from WorkCover or an insurer, you should NOT accept it without taking legal advice. Acceptance of this offer will preclude you from making any damages claim for the injuries sustained and the future impact the symptoms will have on you and on your ability to earn a living.
Our lawyers can help you to take the right legal action. We will:
- speak to you about the circumstances of your injuries
- consider the factual circumstances giving rise to the injury
- assess whether in the circumstances you are able to prove that your employer was negligent for allowing/causing your injuries
- provide you with advice as to whether acceptance of the lump sum offer should be considered, or if commencing a damages claim for compensation is advised.
Any decision about the lump sum offer is a final decision and should not be made without taking legal advice. If you have any questions or would like to discuss your situation with our lawyers, please get in touch.
Mental health support services
Please find a list of mental health support services on the WorkSafe Queensland website.