Injured at Work - Just after Some Advice

LJOCKz on 13/08/2016 - 16:42

Hey guys,

I broke my leg at work a few weeks back, and a few days later fell though the shower door as a result of the injury. Tetanus and some bandages (nothing major). I was contacted by my employers insurance company on Wednesday and basically said they feel its not their responsibility because the fall happened out of work. Not knowing the full story i decided to discuss it with my doctor. He believes they should be covering the cost because the fall happened as a result of my foot injury. I've read the correspondence emails between my employer (HR) and the doctor. To cut the story short HR asked him to amend his examination and remove the home injury from his report. Insult to injury …

The medical cost totals $130 which isnt all that much, but should i ask them to pay or just fork it out myself ?

Education & Work

Comments

  • kima on 13/08/2016 - 17:06
    +29

    They have no right telling your doctor to remove it from the report, they don't have to agree with it and they can argue about it but they can't tell him to change his professional opinion because they don't like it. I would not accept it, if they are going to carry on about this then expect them to be more trouble later. Compo can be long-term and if you pay it and accept responsibility now that can come back to bite you later.

  • altomic on 13/08/2016 - 18:59
    +18

    I was a claims manager for Vic Worksafe for 3 years.

    You're not covered for your shower accident. That occurred outside work despite there being an existing work place accident.

    Fork it out yourself.

    • scrimshaw on 13/08/2016 - 19:45
      +1

      /thread

      Nothing else to be discussed because aforementioned point is undeniably true.

      • davidmwilliams on 14/08/2016 - 11:15
        +4

        It's not the end of the thread. It does depend on whether the alleged home injury was caused by, or exacerbated by, the alleged workplace injury.

        You will note below that Mr Altomic is now backtracking on this unconditional assertion.

        • dazweeja on 14/08/2016 - 18:07
          +1

          I've broken my foot before. If I subsequently fell through a shower, I'd assume I had (profanity) up pretty badly. I didn't though because I was aware my foot was broken and adjusted my behaviour accordingly. I'm not saying I'd never have an accident like that but even with a broken foot, I'd assume the responsibility was all mine.

        • davidmwilliams on 14/08/2016 - 18:25
          +2

          I am not arguing in favour of OP, but the issue is not just black and white. While I personally believe people must take responsibility for many things I can see there is an argument that the second incident would not have occurred if the first one didn't, ergo there is a case that it is directly related to the alleged workplace injury.

          If liability was limited solely to treatment relating to the initial incident solely and nothing further you wouldn't have lawyers for Claimants trying it on for "loss of sexual function" and the many other claimed problems that allegedly result from workplace injuries.

        • Serapis on 15/08/2016 - 22:41

          @davidmwilliams:

          Issue is most definitely not black and white…

          It's a matter of foreseeability… If OP broke their leg as a result of the employer's negligence AND that OP fell through the shower door only a few days later as a result of this injury, then employer may actually be liable for this as well. BUT if OP had been careless and fell through the shower door as a result, they may only have partial liability.

          I mean if the addition of the shower door injury has no effect on this or future claims, why bother asking for the report to be changed at all?

        • Serapis on 15/08/2016 - 22:51

          @dazweeja: I doubt your opinion would be the same if someone else caused your broken foot.

          Say you are a metalworker, your employer failed to maintain their machine which dropped a weight on your foot. That night, as a result of the broken foot, you slipped and fell through the shower door. Would it be reasonable to think that your employer is liable for both the broken foot and the shower accident?

        • sobes on 16/08/2016 - 07:48

          @Serapis:
          What if falling through the shower door injured your hand, then a few days later you dropped a hot frying pan and suffered burns - is your employer on the hook for that, too? At which injury number does personal responsibility start to apply?

        • dazweeja on 16/08/2016 - 09:55

          @Serapis:

          Would it be reasonable to think that your employer is liable for both the broken foot and the shower accident?

          Beyond the original accident - which the employer is responsible for - the employer has not failed in their any way. They have not provided an unsafe home environment, they have not withheld information from me, in short they have not failed to do anything that could be reasonable expected of them. If there was nothing they could do - subsequent to the accident - to prevent the shower accident, how could they conceivably be responsible for it?

          I can assure my opinion would be exactly the same because I am the type of person that takes responsibility for my own mistakes. The work incident would have been their responsibility, the shower incident all mine.

        • Serapis on 16/08/2016 - 12:37

          @dazweeja: Might not be something workcover deals with but can potentially sue in court. Whether you do that or not would be up to the individual.

          In my experience money always speaks louder than principles.

        • Serapis on 16/08/2016 - 12:45

          @sobes: at injury number 'X' (being whatever limits a court would decide to impose on this.) As an employer you can be on the hook for years.

    • spackbace on 13/08/2016 - 20:35
      +3

      And even if it was covered, worst question on job applications - have you had any worksafe claims? If so, briefly explain

      Do you really wanna explain the shower incident to the next employer over $130?

      • altomic on 13/08/2016 - 21:48
        +5

        companies aren't actually allowed to ask if you have ever had a worksafe claim.

        • rowenaduncan on 14/08/2016 - 07:53
          +5

          They all do in my experience…

        • davidmwilliams on 14/08/2016 - 11:08

          They all do. Can you cite legislation to substantiate your assertion?

        • altomic on 14/08/2016 - 13:12

          @davidmwilliams: pre-existing injuries - yes, an employer can ask about any pre-existing injuries that may impact upon a worker to perform his duties. failure to provide provide details of preexisting injuries that may hamper/be aggravated by work place duties can make any future claim invalid.

          previous work cover claims -no (especially if any previous work cover claims will impact upon their decision to employ the prospective employee

          https://www.worksafe.qld.gov.au/insurance/rights-and-respons…

        • davidmwilliams on 14/08/2016 - 18:26
          +1

          That page says an employer may ask about existing and open injuries but does not say anything about closed cases.

        • altomic on 14/08/2016 - 18:47

          @davidmwilliams: you're right.

    • chumlee on 13/08/2016 - 20:40
      +1

      Have worksafe had any of their claim denials overturned?

      So OP should give up because an ex worker says you can't?

      • altomic on 13/08/2016 - 21:50

        they have had claims overturned. but this……seriously.

        "I had a broken leg from a workplace injury and because of it when I was moving my Van Gogh I tripped and destroyed it…..so I want to claim for that."

        • chumlee on 13/08/2016 - 22:00

          Wonder if Josh Gibson got workcover payments when he slipped in the shower and hit his head (although he never did clarify which head was hit)

    • davidmwilliams on 14/08/2016 - 09:12
      +1

      So, according to you, the workplace injury can never possibly cause or exacerbate anything else which may happen outside the workplace eh?

      • altomic on 14/08/2016 - 10:48
        -2

        not at all. that is a ridiculous conclusion to draw.

        • davidmwilliams on 14/08/2016 - 11:05
          +1

          That is what you are saying however. You stated very explicitly that the alleged injury had no relationship whatsoever to the alleged workplace accident/

          You dismissed it entirely, even without suggesting more detail would be needed.

          Now you are backtracking.

          NOTE: I see you have changed your comment. For posterity, what you originally said was "if there was a trophy for moronic comment then you would win." - charming ! So not only are you giving inaccurate advice but you are a hotheaded one!

        • altomic on 14/08/2016 - 12:37
          -1

          @davidmwilliams: I'll just pander to your perspective and say "yes, you are correct."

          the OP was asking if his employer should be paying for his medical costs associated with his shower incident due to his work place injury. I stated "no". The employer/worksafe insurer is not liable for any costs associated with further incidences that occur outside the workplace unless it is directly related to treatment for the for the workplace injury from the work place incident.

          If a client had requested reimbursement for this medical cost when I was their case manager then I would have refused it. The worker has the right to appeal that decision. I'd say with a high degree of certainty that the appeals officer would refuse the appeal

  • LakeVostok on 13/08/2016 - 22:11

    have a read of this:
    https://www.fairwork.gov.au/leave/workers-compensation

  • davidmwilliams on 14/08/2016 - 07:55

    Surely you have an open worker's compensation claim from the broken leg, right? Can you confirm that?

    If not, well, claiming for falling through the shower is like the tail wagging the dog.

    • JOCKz on 14/08/2016 - 11:52

      Well yes, i initially broke my leg at work on Friday. The following monday i was to return to the doctors for x-ray results which was when i fell through the shower.

      • davidmwilliams on 14/08/2016 - 11:54
        +2

        Report it to the insurer's claims officer who you are dealing with in relation to your workplace injury along with proof of the expenses.

        • JOCKz on 14/08/2016 - 12:05

          I received a call from the claims officer and he said they were not going to cover it (Allianz). That is why im asking here. All the paperwork was submitted through work and passed on to their insurer as it happened or days after.

          Do you mean i should call Work Cover ?

        • CandyMan on 14/08/2016 - 18:44
          +1

          @JOCKz: Yes call them

  • wayacos on 14/08/2016 - 08:45
    +6

    Talk to your Union.

  • murrystores on 14/08/2016 - 09:26

    Depending on what state your in you can always ring workcover assist for help with your questions as well as mentioned your union.
    Believe it would make up part of your claim.
    Compo 15 years.

  • staunts on 14/08/2016 - 20:21
    +4

    Hmmmm. All this for $130. No matter who is at fault , do you really think it's worth the hassle? And would any action you take upset your employer? If the answer is yes, then I'm guessing it ain't worth the $130.

    • Seraphin7 on 15/08/2016 - 10:52
      +4

      My thoughts exactly. At first I thought this was a case of falling through the shower doors, cutting yourself to ribbons and looking at months off work, if not long term issues.

      It appears this is all about the $130 bill for a consultation, an injection and a few bandages. If that's the case, then just pay the $130 and move on with your life.

  • Ayanami on 14/08/2016 - 20:58

    Get some legal advice about your entire claim. Many will provide advice on a 'deferred fee' basis for workers' comp (e.g. payment at settlement or termination of retainer).

    For what its worth, as a practising solicitor in working in the field (maybe a different state though), off the cuff I think you'd have a fair argument for a causative link and coverage, though it does depend on the details. You may as well ask when getting advice about your claim generally (in my experience, self represented claimants get lower settlements even in straightforward claims). Insurers will do almost anything to reduce liability, even by a small amount.

    And that business about asking your doctor to amend the report is rubbish, though not uncommon. Hold on to those emails and show your lawyer.

    • lasertip on 16/08/2016 - 23:53

      Agreed. Sounds like it's reasonably foreseeable that a person could sustain a fall in the bathroom resulting from a broken leg and you have a fair argument.

      BUT note that instructing a lawyer, has costs beyond lawyer's fees. Time, stress, employment relationships, etc.
      Some battles just aren't worth being fought. You should consider your costs vs benefits before taking your next step.

  • badg3rz on 14/08/2016 - 21:40

    Claim Income Protection through your superannuation…

    • Cyphar on 15/08/2016 - 17:53
      +1

      They often have a wait period of 30 - 60 days so this would not be claimable

  • one man clan on 15/08/2016 - 13:41
    +2

    Contact a lawyer/ your union. There's some terrible advice in this thread.

    • StewBalls on 16/08/2016 - 11:45
      -1

      This. Don't ever listen to the bush lawyers of OzBargain or WP.

  • [Deactivated] on 15/08/2016 - 14:17
    -2

    Time to lawyer up pal ! It's pay day !
    Or just play victim, chicks dig that.

  • MrFrugalSpend on 15/08/2016 - 19:01

    I'm not sure I agree with a lot of the advice here. Depends on the specifics of the injury at work and liability etc. I'm not a lawyer so I may be wrong, I've only studied enough to be dangerous, however I believe there are two different areas of law to consider - worker's compensation / return to work legislation, and common law liability.

    If there is liability in common law / tort for the original injury (e.g. negligence or the likes on the part of your employer), there should be liability for damages reasonably foreseeable which follow from that trauma, depending on whether there is a foreseeable manner of harm. There are rules like the chain of causation rule / proximate cause to consider.

    However at common law damages could be reduced by the extent your own negligence played a part in not ensuring your safety when the subsequent accident occurred, the 'degree of negligence' comes into play. Therefore, if your damages are limited to $130, probably not worth pursuing.

    If the injury is serious enough, perhaps you could maybe even argue that temporary home modifications to ensure your shower was safe should have been a foreseeable part of the recovery / return to work plan.

    Not worth it for $130, however if you get an infection and end up really sick or the injury doesn't heal (permanent physical impairment), then see a lawyer - some practice no win no fee. One thing to know about the law is it is NEVER black and white, there are always grey areas, lawyers can argue anything to get compensation.

  • Sethenon on 15/08/2016 - 21:24

    Here's something else to consider for the OP

    Is your employer a large or small company?
    And what industry are you in?

    If you work in a small company that doesn't make much money and in an industry that is struggling. Is the $130 claim worth your job?
    In these tough times difficult employees are the first to go… Whilst they may not say it was due to your claim if they are struggling and need to lay people off you may be top of the list..
    Not sure exactly how it works but assumptions would be you broke your leg at work. Your company would need to have work safe come out and do an audit. Their insurance premiums would increase and there's a lot of paperwork to be completed.

    If you industry isn't laying anybody off and the company is large enough then this wouldn't be as relevant.

  • Bnjam3 on 16/08/2016 - 08:50

    Maybe we should setup up $130 gofundme page for you. Models is no better than you.

    • JOCKz on 17/08/2016 - 13:43

      If we are going through the trouble of setting up a gofundme, why not bump it up to 30k ? I could sit on a beach in Vietnam for a couple months !

      • StewBalls on 18/08/2016 - 08:16
        -1

        I'd actually consider contributing to that therapeutic option. ;)

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