Worker’s compensation – what is actually claimable?
Workers compensation claims are a form of insurance available to employees if they become sick or injured due to their work.
They cover an employee's wages while they're not fit for work, and medical and rehabilitation expenses.
Employers in each state or territory must take out workers compensation insurance to cover themselves and their employees.
Who is covered?
CCIWA Safety and Risk consultant Matt Butterworth says it is important for employers to understand who should fall under their workers’ compensation schemes.
“The legislation really provides a very broad definition of a worker," he explains.
-full-time workers on a wage or salary;
-part-time, casual or seasonal workers;
-workers on commission;
-contractors and subcontractors may also be defined as workers depending on the circumstances of the working arrangement.
Businesses are advised to contact their insurer to clarify these definitions.
When it comes to a workers’ compensation claim, a decision on whether an injury is compensable comes down to either insurers or the court, based on information provided by an employer.
The decision comes down to whether the duties being undertaken at the time of injury were part of their usual duties in their job description, Butterworth explains.
He adds that when employees are travelling for work, there are some exceptions as to whether a claim will be accepted.
“If a worker is travelling from their place of residence to their normal workplace or from their from their place of work to their place of residence and they suffer an injury as a part of that journey, that injury is generally deemed to be not compensable,” Butterworth says.
“However, if the worker was to deviate from that journey to carry out duties related to the employment so they were to go to another workplace, for example, on their way to their normal place of work and an injury was sustained, there certainly is case for a that particular injury to be deemed compensable.”
Fly-in-fly-out workers who sustain injuries on site, whether they be working or not, are generally deemed compensable.
Workers’ compensation claims in WA are based on the no-fault principle, meaning workers do not have to prove their employer was negligent or at fault.
As Butterworth explains, there are some exceptions to the no fault rule.
“If a worker is not connected with WA or if they're working interstate or internationally, there is cause potentially for that claim to be denied,” he says.
“There is also…serious and wilful misconduct by a worker - that can relate to events such as the voluntary consumption of alcohol or drugs, both of which have the potential to alter or impair the function of their of their facilities or the ability to carry out work.
“Or there is failure without reasonable excuse, of which the proof is on the worker to use protective equipment, clothing or accessories provided by his worker or the workers use, or any other serious and wilful misconduct.”