Comcare Workers' Compensation Claims

Comcare is the body responsible for safety, rehabilitation and workers’ compensation matters for Commonwealth employees. Comcare claims and workers’ compensation are administered under the Safety, Rehabilitation and Compensation Act 1988 (Cth) and various other legislations and regulations. When a worker covered by the Comcare system is injured, they can lodge a Comcare claim for benefits and compensation.

Who is covered by Comcare?

Comcare covers all employees of the Commonwealth (federal Australian) government.

Some examples of employees Commonwealth government are Australian Federal Police Officers, public servants in various federal departments and customs officers. Some exceptions apply for employees of the defence force. Members of the defence force are generally covered by the Department of Veteran Affairs military compensation scheme.

Comcare also covers some employees of private companies who ‘self-insure’ using the Comcare scheme. Some examples include many of the large banks (e.g ANZ, Commonwealth Bank, National Australia Bank (NAB)), Virgin Australia Airlines, Australia Post and Telstra.

If you are unsure whether you are covered by the Comcare scheme (or a different workers’ compensation scheme in your State), our lawyers will be able to assist you to review your employment information and advise you which scheme is applicable to your situation.

Contact us for FREE advice:  1800 001 339

Who is eligible for Comcare benefits?

If an employee who is covered by the Comcare scheme is injured in the course of their employment, then they may be eligible for benefits through Comcare.

Notably, some scenarios which may be outside of the employee’s usual workplace may still be considered in the course of their employment. These could include, for example:

1. Travelling to and from work in some circumstances;
2. During a training course; and
3. When undertaking work outside of the usual workplace.

It is important to note that a reference to an ‘injury’ may also include a ‘condition’ such as asbestos-related conditions and psychiatric or mental health conditions (e.g anxiety, depression, and PTSD).

What benefits are available through Comcare?

Some of the benefits available through the Comcare scheme include the following:

1. Medical expenses – payment or reimbursement for reasonable treatment of the injury or condition;
2. Weekly payments - if the employee is unable to work, then they are entitled to weekly payments to cover their income. This is paid at the employee’s ‘normal weekly earnings’ for the first 45 weeks and then at 75% of the employee’s ‘normal weekly earnings’ while the worker remains incapacitated for work until they reach retirement age; and
3. Permanent impairment claim (lump sum compensation) - if the worker has sustained a permanent impairment, they may be eligible to receive a lump sum payment.

How do I make a Comcare claim?

Initially, you should report your injury to your employer. Your employer may have a particular form for you to fill in or a process for you to follow, to do this.

As part of the application process, you will be required to provide a medical certificate. Therefore, you should visit a medical practitioner to seek treatment and for them to complete a medical certificate for you to lodge with your claim.

To begin a Comcare claim, you can fill in a Comcare claim form and lodge it online through the Comcare website or you can lodge your claim through your employer. Once your claim form is lodged, Comcare will decide whether they will accept liability for your injury or condition.

Can I do anything if I am unhappy with a Comcare decision?

Comcare will make several decisions, called ‘determinations’, throughout the course of a person’s claim including:

1. Accepting or denying an application;
2. Decisions regarding access to benefits;
3. Decisions about a person’s normal weekly earnings;
4. Decisions about treatment for a person’s injury or condition;
5. Making ‘reconsiderations on own motions’; and
6. Decisions regarding permanent impairment

Generally, there are two stages of appeals that you can go through if you are unhappy with a Comcare determination regarding your claim.

Request for reconsideration of decision

Initially, you can apply to Comcare to have the determination reconsidered. An application for reconsideration must be made within 30 days of the determination.

IM Lawyers can assist you with drafting this application to articulate the reasons why Comcare should reconsider its determination. We can assist in reviewing and highlighting the appropriate evidence to the person who will reconsider the Comcare determination.

Contact us for FREE advice:  1800 001 339

After receiving the application for reconsideration, Comcare will either:

1. 1. affirm the determination, which means the determination does not change;
   2. vary the determination, which means the original decision is changed in some way following the reconsideration; or
   3. revoke the determination, which mean the original decision is revoked and replaced with a new decision.

The decision to affirm, vary or revoke is called a ‘reviewable decision’.

AAT appeal

If you are unhappy with the reviewable decision (as outlined above), you may apply to the Australian Administrative Appeals Tribunal (AAT) for a review of the decision within 60 of the reviewable decision.

IM Lawyers are experienced in assisting clients throughout this AAT process by drafting your appeal, gathering evidence and representing you in conferences and hearings.