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Workers Compensation & Comcare - ComCare Frequently Asked Questions - National Compensation Lawyers

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What is Comcare?

Comcare was established under the Safety Rehabilitation and Compensation Act 1988.

Comcare is a national system of occupational health and safety and provides worker’s compensation to those employed by the Commonwealth, an ACT Government employee or an employee of a company licensed to operate under the Comcare Scheme.

Who can claim compensation?

If you are a Commonwealth or ACT Government employee or an employee of a company licensed to operate under the Comcare Scheme and you have sustained an injury or illness due to your work or during your work, you may be entitled to a range of benefits and compensation under the Comcare Scheme.

What are the first steps?

To claim compensation from Comcare, there are a number of important steps you should undertake:

  • You should initially report your injury to your employer and as soon as possible complete an incident report form.
  • It is important to seek the appropriate medical treatment and get a medical certificate from your medical provider. This Certificate should detail the precise injuries or condition which you have suffered. Further, it should clearly detail the date of injury and your fitness to return to work.
  • After the injury is reported, you should lodge a Claim Form for your time off work and medical expenses. This Claim Form can be obtained from National Compensation Lawyers 1300 FEARLESS (1300 332 753), your employer or alternatively can be downloaded from the Comcare website.
  • Once you have completed your Claim Form, you must give the completed Claim Form to your employer together with the medical certificate obtained from the doctor. Where it is not possible to give the Claim Form to your employer, the form can be sent direct to Comcare.
  • You should always keep a copy of the documents relevant to your claim, including copies of your incident report, Claim Form, Medical Certificate and any medical expenses which you have paid.
  • There is a time limit for a response. However, a response is usually received within 4-8 weeks. If your claim is rejected and you want to appeal the written decision, you must request reconsideration within 30 days. We encourage you to contact National Compensation Lawyers on 1300 FEARLESS (1300 332 753) immediately to discuss this process and the steps to be taken.
What benefits and compensation can I receive?

Under the Safety Rehabilitation and Compensation Act 1988 you have two separate sets of rights and entitlements, these are:

  • your no fault benefits; and
  • a Common Law damages claim against the at fault party.

Under the no fault scheme, you have three sets of rights and entitlements which include:

  • your entitlement to weekly payments of compensation;
  • payment of medical, rehabilitation and like expenses; and
  • lump sum compensation for permanent injuries suffered.

When pursuing a claim for permanent injuries, you are required to establish a greater than 10% impairment when assessed in accordance with the relevant Guides before compensation will be awarded.

What are my rights if Comcare makes a decision I disagree with?

The decision made by Comcare or their insurer takes the form of a determination. If you disagree with the determination made, you must request a reconsideration within 30 days.

A request for reconsideration is made in writing, forwarded to Comcare/their insurer.

Comcare will then reconsider its decision and will provide you with a written decision called a reviewable decision. If you are dissatisfied with that reviewable decision you then have 60 days in which to have an Appeal lodged to the Administrative Appeals Tribunal.

The steps are complex and the time periods are crucial. We encourage you to contact National Compensation Lawyers should you receive a decision from Comcare/their insurers which you disagree with.

Can I sue the at fault party?

If your injuries or illness have been caused through the fault or negligence of your employer, you may wish to sue your employer for damages. In Comcare matters, those damages are restricted to what is known as general damages for your pain and suffering and loss of enjoyment of life. As it presently stands, that amount is capped at $110,000.

The Comcare Scheme requires that you choose between either a Common Law claim, suing the at fault party or alternatively a lump sum Permanent Impairment Benefit.

In bringing a Common Law claim against your employer, it is necessary for you to:

  • proceed with an Impairment Benefit Application and obtain an assessment of greater than 10% pursuant to the relevant Guides;
  • make an irrevocable election to proceed with a Common Law claim for damages. This means that you will not receive whatever Impairment Benefit entitlement you may otherwise have had;
  • prove that your injuries were due to the negligence of your employer.

It is important to note, should your injuries have been caused by the negligence of a third party, you are able to bring a claim against that negligent party without the restrictions imposed by the Comcare Scheme.

Are there any important time periods I need to be aware of?

There are a number of key time limits that you need to be aware of. These include:

  • When you suffer injury, you should immediately notify your employer and complete an incident report form.
  • Should you receive a decision from Comcare/their insurer which you disagree with, reconsideration is to be made within 30 days from the date you receive the determination.
  • Should you disagree with the reviewable decision made by Comcare/their insurer, you have 60 days from the date you receive the reviewable decision to make an Application to the Administrative Appeals Tribunal.
  • A Common Law damages claim suing the at fault employer needs to be made within 3 years from the date of your injury.
  • There are no time limits to bring a permanent impairment claim, however, such a claim should be made after your injury has stabilised. This usually takes 12 months from the date you suffered injury.