My workers compensation claim has been denied, now what?
Upset, anxious, uncertain, these are just a few of the many emotions that thousands of Australians who lodge a workers compensation claim experience every year.
It’s bad enough that you’re unable to work and potentially do the things you love, but to be forced to put your trust in a system that you don’t fully understand can significantly compound an already stressful situation.
All of a sudden your medical bills pile up, your physical pain isn’t disappearing and just when you think things couldn’t get any worse, you’re hit with the dreaded Section 78 notice – informing you that your employer’s insurer isn’t accepting liability for your workplace injuries.
Unfortunately, this is a common scenario for many injured workers but it’s important to realise that if you receive a Section 74 notice, it’s not the end of the line, you certainly do have options.
Exactly what is a section 78?
An insurer does not have to accept and pay for your claimed injuries without question, but by the same token, if it denies liability, the insurer must issue you with a Section 78 notice that outlines the exact reasons why your claim has been denied or why you’re not entitled to compensation payments arising from your injury.
Every section 78 notice that goes out must provide:
- A clear explanation why it has disputed liability and the factors that brought the insurer to that decision
- Identification of all documents available to the insurer at the time it made its decision (including copies of those documents if you don’t already have them)
- A clear pathway or guidelines outlining how you can go about requesting a review of the decision
What can I do?
If you receive a section 78 notice detailing the insurer’s intention to dispute liability, you can:
- Request a review of the decision by the insurer
- Request a review of the decision by the Workers Compensation Commission
However, if you’re hoping to be successful in overturning the insurer’s decision on liability, you need to make sure you thoroughly review all the evidence gathered by the insurer that led to its decision and present a strong case as to why you believe they are liable.
Responding to a section 78 notice without help or advice can be a very daunting and overwhelming, particularly when you’re dealing with a serious injury. That’s why it’s important to obtain legal advice.
At Law Partners our specialist workers compensation solicitors have overturned many denied claims. We’ll review all the materials the insurer used to come to its decision, assess if their denial of liability is valid and provide advice on your next steps – including potentially requesting a review by the Workers Compensation Commission.
You may be eligible for lost income, medical expenses, travel expenses, domestic assistance, pain and suffering and permanent impairment.