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By Tom Maling

Commonwealth and ACT public servants are covered under the Comcare system for workplace injuries. At Elringtons, we have the expertise and experience to assist people with Comcare claims, including:

  1. Initial claims
  2. Psychological injury claims
  3. Reconsiderations when Comcare denies a claim
  4. Reconsiderations when Comcare ceases entitlements
  5. Merits reviews at the Administrative Appeals Tribunal
  6. Comcare debts
  7. Federal Court Appeals

Please see the below tabs for more information on Comcare claims or feel free to contact us to speak to Tom Maling.

Injuries and Diseases

You can claim for a frank injury or if your work has made a pre-existing injury or disease worse. The basic qualification is that your work must cause your injury or disease. However, there are slightly different causation requirements for an injury and a disease:

  1. An injury must arise out of your work
  2. A disease must have been contributed to, to a significant degree, by your work

As you will have noticed, the causation test for a disease is more stringent.

The claims process

  1. A worker must notify their employer that they are injured as soon as possible after becoming injured.
  2. A worker must complete a Comcare claim form with a medical certificate. The form is given to your employer, who must then give it to Comcare.
  3. Comcare will consider your claim. They may require you to provide specific information. send you to be examined by an independent medical expert
  4. Comcare must accept or reject your claim. Please note, there are no specific timeframes under the Safety, Rehabilitation and Compensation Act 1988 (‘the Act’) requiring Comcare to determine your claim within a specific timeframe. Absent a specific timeframe, they must determine your claim within a reasonable timeframe.
  5. If Comcare reject your claim, you have 30 days from the day you were notified of the decision to submit a reconsideration request. You may ask Comcare to extend this, but it is up to Comcare whether or not to extend the time.
  6. Comcare must affirm or set aside the initial decision. There is no mandated timeframe, but it is their policy to aim for 30 days.
  7. If you disagree with the reconsideration decision, you have 60 days to submit a merits review request at the Administrative Appeals Tribunal.

Entitlements

Under the Act, injured workers may be entitled to:

  1. Weekly payments
  2. Medical treatment expenses
  3.  Lump sum permanent impairment and pain and suffering payments
  4.  Payments for household and care services
  5.  Death benefits

Comcare Overpayments or Comcare Debts

There has been recent media attention about Comcare issuing debt notices claiming people have been overpaid. Just because Comcare has sent you a debt letter claiming for an overpayment does not necessarily mean you have been overpaid and owe them money.

Elringtons is looking for people who have been sent overpayment letters for a new type of Federal Court claim. We want to help people who, through no fault of their own, have been burdened with a debt claim by Comcare in unfair circumstances. For more information see Comcare Overpayments or Comcare Debts.

Psychological Injuries

There are special laws in the Comcare system limiting the circumstances when an employer is liable to pay you compensation for a psychological injury.  If you think you may have received a psychological injury from work, it’s very important you understand the law prior to making a claim.

People who receive a frank psychological injury and those who already have a diagnosis of a mental illness may be eligible for compensation where work has made their illness worse.  These types of claims can be quite complex. For more information see our article Comcare and Psychological Injuries.

Tips for workers

We see many workers who have made Comcare claims. Some have done well while others, inadvertently, have dug themselves into a hole. Here are a few tips from our experience to those contemplating a claim:

  1. Comcare is a no fault system, so you don’t need to show that your workplace did something wrong. They may have, but trying to show that work did something wrong may only provide Comcare with more opportunities to deny your claim.
  2. Show that your work caused your injury. If something other than work has impacted on your injury, you must be honest. However, make sure you do not overstate the impact of a non-work event.
  3. Be careful what you put in writing, especially with psychological injury claims. See our article Comcare and Psychological Injuries for more information.
  4. Make a very good record as soon as possible about what happened when you were injured.

Specialist Comcare Lawyers

Comcare claims are different to other workers compensation claims. This is not just because it involves a different piece of legislation. As Comcare is a government body, their decisions come under a branch of law call ‘administrative law’. This differs from ACT and NSW workers compensation systems where decisions are made by private insurance companies. Therefore you need lawyers with knowledge and experience in administrative law. We understand administrative decision making and use this to seek remedies for our clients where:

  • Comcare has failed to take into account relevant information when making a decision
  • Comcare takes into account irrelevant information when making a decision
  • Comcare makes a decision which is not based on evidence
  • Comcare incorrectly applies law when making a decision
  • Comcare makes a decision which is not the correct or preferable decision
  • Comcare fails to make a decision when they are required to

We understand the impact a workplace injury has on your life: physically, emotionally, and financially.  Matt Bridger’s experience enables him to provide expert and timely advice to assist injured workers.  He is assisted on Comcare matters by Tom Maling, who trained as a Registered Nurse and has worked in the ACT Government. Tom uses his health knowledge to understand your injury experience and government experience gives him particular insight on administrative law issues.

For more information or to make an obligation free appointment, please do not hesitate to contact Matt Bridger or Tom Maling.

For ACT Government Workers, see our dedicated page on ACT Government Workers Compensation.

Further reading

p: +61 2 6206 1300 | e: Info@elringtons.com.au


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