Rejected Claims

The WorkCover scheme primarily provides for entitlements to “workers” who sustain injury or illness ”arising out of or in the course of employment”.

These tests form part of what are known as the entitling provisions and in most cases, the circumstances of a work injury are clear and there is no dispute about whether or not a claim should be accepted at first instance.

However, the law is complex and, in some circumstances, a person who is injured and has lodged a WorkCover claim, may have that claim rejected on what could be considered technical grounds.  The reasons given for a rejection might include that:

  • You are not a worker;
  • You have not sustained an injury;
  • Where a heart attack or stroke has occurred, that employment was not a significant contributing factor; or
  • In stress related claims that the injury occurred as a result of reasonable action taken in a reasonable manner.

It is important that you obtain prompt legal advice should your claim be rejected for the above reasons, or any other reason as there may be legal argument which can be raised to support your claim, and have it accepted.

Our team have on numerous occasions challenged insurer decisions to reject claims and our clients have gone on to receive the compensation they deserve.

The scheme surrounding workers compensation and your entitlements is complex and there are strict time limits that apply.  It is important that you get appropriate legal advice from the outset to ensure that your rights are protected.

We can help you navigate the scheme, maximise your entitlements and make the decisions that are right for your future.

If you have a query, please do not hesitate to contact our expert Workers Compensation Team for a no obligation chat.