Workers involved in a Personal Injury Claim in a work related accident have an entitlement to various benefits upon acceptance of their application for workers compensation benefits.
These entitlements are regulated by the provisions of the Workers’ Compensation and Rehabilitation Act 2003 (the WCRA).
All entitlements are dependant upon the worker being in receipt of current medical certification in the approved form. This certificate will certify for a specific period of time:
(a) Total incapacity;
(b) Partial incapacity allowing for a return to suitable duties; or
(c) Partial incapacity allowing full duties but requiring ongoing medical treatment.
These medical certificates are a prerequisite for payments under the WCRA. If your medical certification lapses, your claim and benefits will cease.
Wages. If totally incapacitated, you will be entitled to payment of wages at 85% of your NEW (Normal Weekly Earnings). After 26 weeks, if still totally incapacitated, your entitlement will reduce to 65% of NEW.
Further reduction in the payable compensation occurs after 2 years, unless you can show that the injury could result in a WRI (work-related impairment) of more than 15%.
Medical Expenses. The workers compensation insurer must pay the costs of medical treatment or hospitalization that they consider reasonable.
There exists a table of costs, and the insurer will have regard to this table, in considering a particular expense. Quite often the insurer may only fund part of an expense and accordingly it is advisable to seek pre-approval for the expense.
Again, current medical certification is essential. The insurer will not pay for any expenses incurred where a worker was not in possession of a medical certificate.
Travelling Expenses. Ambulance travel is generally paid, provided it occurs immediately after the injury and the injured worker is taken to a place where appropriate medical treatment is available, or in the event that subsequent travel is required and certified by a doctor.
You are entitled to seek reimbursement for travel expenses incurred from a work related accident if the requirement for travel exceeds 20km one way.