Unfair reduction: One injured worker's fight for fair compensation

David* was getting used to life as a near quadriplegic following a workplace accident when he was informed that his weekly payments were about to be drastically reduced by his employer’s WorkCover insurer.

Unfortunately, weekly payment reductions are all too common.

Insurers often reduce or deny payments, leaving injured workers with financial difficulties. This injustice can make the physical and psychological challenges even tougher as it becomes more difficult for injured workers to focus on adapting to their new reality.

David had bought a new house before his injury, and if the reduction in his payments were made, he would no longer be able to afford the mortgage on his home.

Dispute over WorkCover entitlements

David worked as an interstate truck driver.

He had worked for many years without an incident until one day, he slipped and fell two metres backwards out of his truck, suffering a serious spinal cord injury. It left him with very limited use of his arms and legs and adversely affected almost all his bodily functions.

As David was injured at work, he was entitled to WorkCover ‘weekly payments’. Weekly payments are an entitlement that injured workers claim if their injury prevents them from receiving their normal wages.

Following a review of his WorkCover entitlements a year after his injury, David’s insurer informed him that his weekly payments would be reduced by more than half.

The insurer claimed it could reduce his payments because over fifty percent of his pre-injury wage included overtime and allowances, which he was no longer entitled to after 52 weeks. This is a situation we see often, as overtime and allowance payments are not usually considered in long-term disability or injury claims. So, after a year, insurers no longer need to pay them in the claim.

David had worked hard throughout his life to set himself up for retirement. This decision left him in significant financial and emotional distress.

Legal intervention

David felt that the reduction in his payments was wrong, but he was reluctant to dispute it because he was worried that if he lost, he might lose all his entitlements, and he did not want to lose the little money he was still receiving.

Luckily, David was a member of the Transport Workers’ Union (TWU), who was there to support him when he needed it most. David turned to his local delegate, who forwarded his case to our firm – the TWU’s preferred injury lawyers.

We looked into the insurer’s decision. It felt wrong, but at first, it was hard to pinpoint why. The pay slips that David’s employer gave to the insurance company did seem to show significant overtime, but the structure was vague and unclear.

Unfortunately, David no longer had copies of his contract and full pay records, which we needed to assess the insurer’s decision properly. Understandably, David had other things on his mind since his injury.

To assist David, we sought assistance from the TWU. David’s TWU organiser helped us obtain records that clarified his pay structure. The findings revealed that David, like many interstate truck drivers, had been paid on a per-kilometre rate rather than an hourly rate. The concept of ‘overtime’, therefore, did not apply, despite what the payslips said. This meant the insurer had no justification for reducing David’s weekly entitlements.

We disputed the decision and prepared detailed submissions about the matter. The insurer ultimately agreed to reinstate David’s full payment amount without us having to go to court.

This amounted to almost $1,000 extra each week. Given that David will never work again, these payments will likely continue until he reaches retirement age, relieving him of significant financial distress and the capacity to keep his house.

After resolving the weekly payments dispute, we sought lump-sum compensation for David's significant permanent impairment. We successfully resolved the lump-sum claim for the maximum possible figure, further helping David secure his financial position and allowing him to focus more on his health and quality of life.

David’s case is a reminder of why it’s important to seek legal advice about any changes to your WorkCover entitlements, as they might not be justified. With the right support by your side, you can be sure to protect your rights and secure the benefits you are entitled to.

Getting help with a work injury claim

If you've been injured at your workplace or as part of your work, you may be eligible to make a workplace injury claim. Our dedicated workers' compensation lawyers are here to help you get back on track so you can focus on getting better.

Use our free claim check tool to find out if you're eligible for a worker's compensation claim, send us a message or call us on 1800 111 222.

*Client’s name has been changed to protect his privacy.