If you’ve been injured at work and have to deal with medical bills and lost income, you may want to seek workers compensation. But what’s the first step, and how much could you be entitled to, in terms of benefits?

What are your options?

An experienced workers compensation lawyer can consider your situation and advise you on the best course of action. Getting legal advice is the best first step, because a number of different factors can influence how much compensation you receive, and the complications of the legal process can be daunting. Your eligibility for the various types of compensation benefits depends on the nature of your claim and the date, type and severity of your injury. Among other things, you may be worried about having to deal with insurance companies that might try to delay you or make offers that are too low.

Types and amounts of workers compensation benefits

The following list sets out the types and levels of workers compensation benefits you may be entitled to after a work-related injury or illness – depending on your circumstances.

Upfront payments

Your employer’s workers compensation insurer can pay you weekly benefits and medical expenses up to $7,500 for up to 12 weeks without admitting or incurring liability.

Weekly payments

Weekly payments partly cover lost earnings due to a work-related injury or illness. Claims for injuries during work breaks and some work-related journeys may be possible, if there is a real and substantial connection between your employment and the incident that resulted in your injury.

Payments are currently capped at $2,016.10 a week. They vary depending on your pre-injury average weekly earnings and whether you’re:

• still able to work in suitable employment, or
• not able to work, or
• suitable employment is not available, or
• you’ve retired within the last 12 months but you still have some injury-related medical expenses.

Generally, weekly payments will decline in time and stop altogether after five years or when you reach retirement age.

Medical, hospital and rehabilitation expenses

This can include:

• the cost of reasonably necessary treatment by doctors, physiotherapists and other allied health professionals. Many treatments require prior approval for payment. Travel expenses to attend medical, hospital and rehabilitation appointments are also covered
• artificial aids, domestic help, and nursing, medical or medicine supplies
• the cost of treatment at public and private hospitals and/or rehabilitation centres, as well as some ambulance transfers
• costs to do with your return to work, such as job analysis and modification, identification of suitable employment, and retraining and placement in suitable employment.
• reasonable costs in relation to the repair or replacement of artificial aids such as false teeth or spectacles, or clothing damaged in the accident.

Lump sum payments for permanent impairment injuries

If you have a permanent impairment of more than 10 percent for a physical injury (including hearing loss) and you’ve reached maximum medical improvement since your injury, you may be eligible for a lump sum payment, in addition to weekly payments and medical and related expenses.

Payments are based on an assessment by an accredited specialist of your degree of permanent impairment, expressed as a percentage. The maximum lump sum payment for an injury on or after 5 August 2015 resulting in a permanent impairment of 75 percent or more is $577,050 (plus an additional five percent for permanent impairment of the back).

To be entitled to a lump sum for a primary psychiatric or psychological impairment, you must be assessed as having at least a 15 percent permanent impairment.

Lump sum payments can also be made for pain and suffering arising from the impairment.

Payments to your dependants in the event of your death

Family support and funeral expenses are also available under the workers compensation scheme.

Work injury damages claims

If your work injury was caused by someone’s negligence, you’ve been assessed as having at least 15 percent permanent impairment and this is accepted by the insurer or determined by the Workers Compensation Commission, you may be able to file a claim for damages under common law.

In New South Wales this is mostly limited to past loss of earnings and future loss of earning capacity. In most cases the claim will referred for mediation before starting court proceedings. If it goes to court, you must be able to prove your claim of negligence.