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Workers Compensation & Personal Injury Insurance Disputes
Have you been injures at work or as the result of someone else’s negligence? Are you involved in a dispute with your Insurance Company?
Is your Insurance Company not honouring your Policy? We guarantee they will listen to us.
If you have been injured because of the actions or negligence of someone else, then you may be able to make a claim for personal injury compensation. At Bale Boshev we can help you with your compensation claim and our expert personal injury lawyers will guide you through the process.
We act only for Plaintiffs. We do not act for Insurance Companies.
You should never forget that Insurance Companies have their own team of Lawyers who are usually pretty very experienced in their field.
We will assess your case for FREE.
Important Information About Your Rights in a Workers Compensation case
You may have seen our Television Advertisements claiming to have won over 99% of Litigation cases conducted by us. Incredible as it seems, it is true. The vast majority of those wins were in Personal Injury cases for injuries sustained:-
In a motor vehicle accident
In a public place or shop
Due to medical negligence
We will assess your case and your chances of success quickly and free of charge. If we then take on your case we will in most instances do so on the basis of a no win/no fee arrangement.
It goes without saying that if we act for you on a no win/no fee basis your chances of success must be very good indeed.
Workers Compensation Claims
Any employee injured whilst in the course of their employment, performing usual duties, including accidents which occur off the premises or during the course of a journey to and from work, may be entitled to make a workers compensation claim. This includes employees who are employed on a permanent or casual basis.
Q. What can I make a claim for?
A. There are a number of things you can make a claim for but the main claims are for medical expenses for treatment, wages and lump sum compensation for your injury.
Q. How do I make a claim?
A. If you are injured you should notify your employer of the accident and ask that the accident be recorded in the employer’s register of injuries. A medical certificate in the appropriate form should then be obtained from your treating doctor. Your employer should then provide you with a Workers Compensation Claim Form to be completed in part by you and the employer. The employer should then forward the claim form to the Workers Compensation Insurer. A claim number will then be provided to you. Medical expenses and/or wages may be paid to you.
Q. What if the employer or insurer refuses to make payments for medical expenses and wages?
A. We are able to assist in any dispute with your employer and insurer. An Application can be made with the Workers Compensation Commission to resolve a dispute.
Q. What is the Workers Compensation Commission?
A. Following legislative changes to the Workers Compensation System implemented by the Carr Government in 2002, Workers Compensation cases are now handled and determined in the Workers Compensation Commission and no longer in the Compensation Court.
The Workers Compensation Commission is an independent Statutory Tribunal within the Justice System of New South Wales.
Q. What can the Commission do?
A. The Commission can make decisions on:
(a) Interim payment directions – The Commission can order interim weekly compensation payments and payment of medical and related expenses (up to $5,000.00).
(b) Weekly benefits paid as compensation for loss of earnings.
(c) Permanent impairment / pain and suffering.
(d) Payment for damages to personal property.
(e) Compensation for the death of a worker.
(f) Management of a worker’s injury or illness in the workplace including rehabilitation or suitable duties.
Q. What is the procedure?
A. An Application Form is prepared by Bale Boashev and sent to the Commission with supporting documentation including medical reports obtained on your behalf. The Application will be stamped and returned to your solicitor with a case or “Matter” Number. The Application is formally registered. The Application is then forwarded to the Respondents (i.e. the Insurer and/or employer).
Q. How does an Application at the Commission work?
A. Once a claim is registered the parties exchange information. A teleconference is held with all parties within 6 weeks. The Arbitrator will decide:
(a) The readiness of the parties.
(b) The prospects of settlement.
(c) Whether there is an agreed statement of facts or issues.
(d) Any legal or threshold issues.
(e) Any recent development toward the resolution which may not be reflected in the documents.
(f) In the case of a claim for lump sum compensation, the referral to an Approved Medical Specialist.
Q. What are the types of claims?
A. Interim Payment Direction.
There is a direction made by the Commission for weekly payments or medical expenses. Such an Order can only be made when an Insurer has been notified about an injury and has failed to commence payment within the required time or to explain why this has not happened.
Interim Payment Directions can be made while the Insurer is deciding liability to allow for payment of weekly compensation (wages) for up to 12 weeks or if payments have not been made before the direction for up to 10 weeks or medical expenses up to $5,000.00.
The Insurers role is to make a decision about provisional liability within seven (7) days of being notified of the injury (or up to 21 days if the injury is not significant).
Medical Expenses (S60 expenses)
Lump sum compensation for permanent impairment.
The amount of compensation you may receive depends on the date of the accident with the relevant date being 1 January 2002 which determines on what basis Section 66 of the Workers Compensation Act is assessed.
There are various types of wage claims that can be made under Section 36 to 40 of the Workers Compensation Act. Please talk to a lawyer from Bale Boshev Lawyers about the different types.
Q. What is an Approved Medical Specialist (AMS) and why should there be a referral to one if I have already been examined by my own specialist and another for the insurer?
A. An AMS is a Senior specialist who assesses medical disputes for the Commission. Before the Commission can decide on the issue of lump sum compensation, you must be examined by an AMS otherwise the Commission cannot make a determination on lump sum compensation.
Q. What happens after taking the above steps?
A. If at the time of the teleconference the Arbitrator believes the case is ready to be determined on the materials provided he may make a decision called a “Determination on the Papers”. This is a decision based on the documents without the need for a hearing.
Q. Does this always occur?
A. No, the Arbitrator may direct a face to face meeting involving a period of time for discussion between the parties in an attempt to settle the matter. The discussion begins with an outline of the dispute, identification and explanation of the issues and potential outcomes and negotiations.
Q. What happens if the parties do not settle at the face to face meeting?
A. If the dispute does not settle it moves to a more formal phase called the Arbitration Hearing. Essentially this is like a hearing in a Court without the formalities associated with Courts. The emphasis is on informality and a non-adversarial procedure. Then the Arbitrator makes a decision on the issues in the claim on the spot or within 2 weeks with a reason for the Award. A decision can be appealed within 28 days.
Q What is an Arbitrator?
An arbitrator is a legally qualified and/or highly experienced person in Workplace Injury Management. Under the law, they have a responsibility to try to bring the parties to an agreed resolution of the dispute.
At Bale Boshev we offer a service of the first consultation free to ascertain details of your claim & explain our services that only require payment if the action we undertake on your behalf is successful. Contact us today for an appointment. We have Workers Compensation lawyers in Newcastle, Maitland and Tornoto.