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WorkCover Payout Examples – Case Studies.
If you’ve been injured at work, looking at WorkCover payout examples can be a good way to understand the claim process and what you might be entitled to. The five examples in this article provide insights that might surprise you and highlight how a lot of injured workers are at risk of missing out on significant lump sum payouts if their claims aren’t handled properly. As you’ll see, some of these claims were initially rejected by insurers, but our lawyers got the insurers’ denials overturned and won significant payouts for our clients.
These examples are just a small sample of the thousands of WorkCover payouts we’ve won for our clients, and they demonstrate how it’s critical that your claim is managed carefully, and isn’t simply ‘processed’.
WorkCover payouts – what you need to know.
What many people don’t realise is that their WorkCover compensation claims may consist of two parts; you might have to submit more than one application to get your full entitlements.
- Most people are aware they can claim benefits to cover lost wages and medical expenses if they’re injured at work
- For more serious injuries, you may also be entitled to a lump sum payout
Lump sum payouts can be significant and applications need to be carefully and thoroughly prepared to make sure you don’t miss out.
Here’s how this works in NSW and Victoria:
If you’ve been injured at work in NSW, you probably know you’re entitled to workers compensation to cover your lost wages and medical expenses. But in NSW around $1.14 billion is paid out in additional lump sum payouts to workers compensation recipients every year.*
| Permanent impairment payout | A lump sum compensation payout to cover a permanent impairment as a result of a work-related injury or illness. |
| Work injury damages payout | Also known as a common law claim, this is a lump sum payout for damages if your injury was caused by your employer’s negligence. |
*According to SIRA Open Data, June 2024
When you make a WorkCover claim in Victoria, if your claim is approved, you’ll begin receiving payments from the WorkCover insurer, who will provide weekly payments while you recover. Weekly payments are capped at $2,800.
However, you may also be entitled to claim the additional lump sum workers compensation payouts listed below:
| Permanent impairment payout | This is payable if you have suffered a permanent impairment of 10% or more. |
| Common law damages payout | This claim is available when you’ve suffered a serious injury that was caused by someone else’s negligence. |
WorkCover payout example 1 – $890k for psychiatric injury claim.
Stephanie, a 25-year-old healthcare worker, was assaulted at work by one of her regular clients. After talking to her employer she agreed to take paid leave from work to recover. However, on her return to work she was assaulted for a second time – incredibly by the same client. This led to a diagnosis of severe stress, anxiety, and depression. Stephanie put in a claim for workers compensation for a psychiatric injury, but this was rejected outright by her employer’s insurer.
This is when Stephanie turned to Law Partners for help.
The insurer had initially rejected the claim, arguing that a certain level of stress and hardship was all part of her job. We set to work, gathering evidence with assessments and reports from psychologists. We got to know Stephanie over many weeks, helping her draft a very comprehensive statement detailing her assaults and the impact they’d had on her life.
We went to the Personal Injury Commission to resolve the dispute with her case, and we were successful in proving her employer’s liability. The commission found Stephanie had indeed experienced a legitimate workers compensation injury, and that her employer had been negligent and breached their duty of care.
Our psychiatrist also assessed Stephanie and found her psychiatric injury were above the threshold to qualify for a work injury damages (WID) claim. This is a lump sum to cover future loss of earnings, and we managed to get Stephanie $600,000 for this part of the claim.
Overall, including her workers compensation payments for wages and medical treatment expenses, we got Stephanie a total WorkCover payout of $890,000.
Click here to read Stephanie’s full story.
Call 13 15 15 or chat to us now for free advice
Chat nowFind out how much you can claim.
Get startedWorkCover payout example 2 – $700K for psychological injuries.
Stephen, a disability support worker for children experienced a debilitating set of psychological injuries in the course of his work. He asked his employer and the care sector for support, but unfortunately didn’t receive it. Feeling traumatised and isolated, he was diagnosed with an acute mix of depression and PTSD.
This is when he called Law Partners for help with workers compensation.
Stephen felt guilty about seeking compensation or support for himself as a disability care worker. But if you’ve been injured physically or psychologically, you’re entitled to support, payments, and wages while you recover. We really got to know Stephen, to fully understand the impact of his injuries on his life, so we could make sure he received all the compensation he was entitled to.
We were able to get Stephen a total WorkCover payout of over $700,000. This covered wages and medical treatment expenses, an initial lump sum of $50,000, and a final Work Injury Damages (WID) payout of approximately $500,000.
The insurance company disputed our findings but we successfully disproved the insurer’s opinion by gathering medical reports and clinical notes from his doctors. Our medical evidence also helped demonstrate a full picture of how Stephen’s psychological injury was affecting him, in all areas of his life.
Click here to read Stephen’s full story.
WorkCover payout example 3 – $572K after workplace fall.
Christian, 44, tripped on a pothole inside his workplace and severely damaged his shoulder as he fell. The injury was debilitating. Christian qualified for workers compensation payments which covered some of his lost wages and medical treatments, but he wasn’t getting better.
This is when Christian got in touch with Law Partners.
We explained Australia’s no-fault workers compensation policy. The policy means that even if Christian had been in the wrong, he would still be covered. His lawyer, Peter, took the time to get to know Christian personally, which allowed him to build a case for a work injury damages (WID) payout.
Peter arranged for a doctor who was experienced with workers compensation patients to review Christian’s injuries. The doctor assessed Christian as having a whole person impairment (WPI) rating of 23% and referred him for a shoulder reconstruction. The workplace insurer denied the request for surgery, stating that it was unnecessary.
Peter was not only able to overturn the denied surgery costs, but also pursue a Work Injury Damages (WID) claim. The fact that Christian’s company had warned employees about the pothole proved that they knew it was an issue and hadn’t fixed it, which is workplace negligence.
Combined with Christian’s WPI being over the required minimum of 15%, they were able to claim a WID lump sum payout to cover Christian’s future medical expenses and lost wages. The matter went to mediation where Peter was able to reach an extremely favourable settlement for Christian, totalling $572,000.
Read Christian’s full story here.
Workcover payout example 4 – over $500K for workplace bullying claim.
Colin, 51, was bullied by a colleague while he was working as a high school teacher. Colin reported the bullying to his principal on two separate occasions but no action was taken to prevent the behaviour or reprimand the teacher. As a result of this Colin was diagnosed with severe anxiety and PTSD and was forced to step away from his job on medical advice.
This is when Colin contacted Law Partners after his concerned wife discovered our website.
Colin spoke with Law Partners solicitor Natalie, a workers compensation specialist, who advised that he could be eligible for compensation and potentially a lump sum payout. Natalie took the time to get to know Colin and understand how the situation had impacted his life.
Natalie immediately got the ball rolling on the claim by making contact with the school’s workers compensation insurer and arranged for Colin to be assessed by an independent medical expert.
Natalie always made herself available to answer any of Colin’s questions throughout the claims process. She explained the purpose of an independent medical assessment was to determine whether the bullying was the primary contributing factor to his injury, along with its severity, to qualify for a permanent impairment lump sum payout.
As suspected, the independent medical expert determined that Colin’s psychological injury was caused by the bullying and his whole person impairment (WPI) was assessed at 22% – enough to qualify for a lump sum. But Natalie was determined to secure Colin all the compensation he was entitled to, and given the fact that his WPI was assessed as over 15% and his principal was made aware of the bullying on a number of occasions and failed to act – Natalie decided to pursue a work injury damages claim.
After extensive investigating, evidence gathering and four rounds of negotiating, the insurer agreed to meet Natalie’s proposed payout figure – bringing Colin’s total WorkCover payout to well over $500,000.
To read the full story of Colin’s journey click here.
Workcover payout example 5 – $350K for falling object accident at work.
Callum, 42, a fitness store worker was injured when a pull-up bar pack fell from a stack onto the back of his knee. Callum sought medical treatment and had three weeks off work. He then returned to light duties, but following pressure from his employer and financial needs he soon resumed full-time work. This caused further injury to his leg. He sought further medical treatment and was told he needed surgery but his employer’s insurance doctor denied his claim for this. He was pressured to continue work and just have physio and steroid injections.
After finding the Law Partners ‘Guide to Workers Compensation Claims’ online he contacted us.
Natalie, a workers compensation specialist, listened to Callum’s situation and advised he had a legitimate claim and could dispute the insurer’s surgery decision. Natalie contacted the insurer to dispute the decision and arranged for an independent orthopaedic specialist to assess Callum’s injuries. He agreed with Callum’s doctor’s recommendation for surgery. With this report and the medical evidence from when Callum was injured, Natalie managed to successfully overturn the insurer’s decision.
Callum’s surgery was a success but he still had ongoing mobility issues. Because Natalie had spent time getting to know Callum she noticed he’d become a little hunched over in the shoulder and there was swelling in his other knee. She suspected, based on her experience, this could be the result of using a cane and overcompensating for the injured leg.
Natalie arranged for another assessment to determine the extent of all Callum’s injuries and level of permanent impairment. As suspected, Callum had developed joint damage in both his shoulder and other knee and his total permanent impairment was determined to be at 19 percent.
As a result, Natalie was able to claim Callum a lump sum for permanent impairment and given that his permanent impairment was assessed as over 15 percent, she quickly turned her attention to pursuing a damages claim.
Natalie and her team proved the employer’s negligence after discovering that the packing of the pullup bar packs had been an issue for quite some time before the accident and the management knew the shelving wasn’t safe but continued to use it. At this point the employer’s insurer made a settlement offer. After discussing it with Callum, Natalie advised that the offer wasn’t fair and decided to pursue mediation. Natalie settled the claim for significantly more than the original offer and including his lump sum for permanent impairment, his WorkCover compensation payout amounted to $350,000.
Call 13 15 15 or chat to us now for free advice
Chat nowFind out how much you can claim.
Get startedHow much will I get for my WorkCover payout?
Workers compensation lump sum payments can be substantial. In the 12 months to February 2024, around $1.14 billion was paid to injured workers in NSW alone in common law payments and permanent impairment lump sums*. Lump sum payouts for permanent impairment in NSW range from $22,480 up to a maximum of $740,550**, and if you’re entitled to a common law damages settlement, it’s paid on top of this amount. So for more serious injuries that were caused by employer negligence, payout amounts can be substantial.
For more information on WorkCover payouts in NSW and Victoria, refer to the following guides:
Guide to WorkCover payouts in NSW
Guide to WorkCover payouts in Victoria
How can I get help claiming my WorkCover payout in NSW or Victoria?
Our NSW and Victorian teams of WorkCover no win,no fee lawyers have extensive experience with lump sum claims and a strong track record of winning payouts for our clients. Whether you’re looking to engage a lawyer or just get some free legal advice, you’re welcome to call us on 13 15 15 or chat with us online.
Chantille Khoury
Principal
A Doyle’s Guide listed personal injury law professional and one of the country’s preeminent workers compensation specialists, with over 15 years’ experience in delivering optimal outcomes to injured Australians.
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