People can be injured in a variety of situations. Most commonly, the injuries people suffer are physical but injuries can also be psychological in nature. There are laws in SA which provide certain entitlements and compensate people who have been injured in a variety of situations or different settings. The instances in which you might have an entitlement to benefits or compensation in SA include:
You may be asking yourself whether or not you have a claim for compensation given your individual circumstances. You may believe that someone else was to blame for your injuries. If this is the case, you should seek legal advice from a lawyer who specialises in personal injuries law. A lawyer will be able to assess whether you have rights or entitlements under the various South Australian compensation schemes, particularly if your injuries were caused by someone else-s actions or neglect.
The most import thing to remember however is do not delay. Strict time limits apply in respect of accessing potential entitlements and claiming compensation and you should seek legal advice as early as possible after you sustain injury.
Don-t wait too long to contact a lawyer to find out about your compensation rights. Time limits apply to all types of claims! And the time limits are not the same for each type of accident.
If the claim is not lodged within that time, then eligibility to entitlements may be lost. A lawyer who is a specialist in the area of personal injury law can talk to you about the time limits which are relevant to your particular matter. It is important to not delay and seek some preliminary advice as soon as you are able to do so.
In some instances, if you have missed a deadline, there is the ability to seek an extension of time through the Courts. It is not automatic that the Courts will extend time, but in certain circumstances it is possible. Often, an application to extend time is costly and very involved. Nevertheless, a lawyer who specialises in this area will be able to advise you of the relevant considerations and assist to steer your in the right direction.
Quite apart from being injured in a transport accident or at work, you may have sustained injury in a variety of other circumstances as outlined above - for example, as a result of medical treatment, in a private or public place, etc.
Depending upon the circumstances of how you sustained injury, you might have other rights or entitlements, particularly if the injury/injuries you sustained are likely to cause ongoing, permanent impairments or conditions. Often, the right to claim compensation for your actual injuries, as compared to out-of-pocket expenses associated with your injury/injuries, such as medical and treatment expenses and income loss, is reliant upon showing that the injury/injuries sustained satisfy a certain threshold level. The thresholds change depending on the type of claim and the nature of the injury, e.g. physical vs psychological.
Often, to be eligible to make a claim, the first pre-requisite is to show that someone else was at fault or negligent in causing your injury/injuries. Fault or negligence is fundamental to any medical negligence claim or public/occupiers liability claim. However, in other instances, the concept of fault is not a pre-requisite, for example, product liability claims and Victims of Crime Applications. Because the particular circumstances surrounding your injury will have a bearing on the type of claim you might be entitled to make, it is always advisable that you seek advice from a lawyer specialising in personal injuries law at first instance, to clarify your rights and provide you with an understanding of what to expect moving forward.
There are special laws that apply to injury or damage caused by animals, injuries to animals and injuries sustained in sport, on private property or on public property. Sometimes the common principles do not apply in these circumstances.
Financial Ombudsman Service is an independent service that assists consumers to resolve their disputes with insurance companies.
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The laws about compensation for motor vehicle accidents are currently being reviewed and may be changed very shortly.
In the meantime you should consider whether you should promptly notify the Motor Accidents Commission if you have been injured in an accident or seek legal advice as to how these changes may affect you.
Q Even though I remain in pain six months after my car accident, my neighbour told me that I am not entitled to claim because I did not take any time off work. Is this correct?
A You need only to meet the threshold that "your ability to lead a normal life was significantly impaired by the injury for a period of at least 7 days" and/or that you incurred medical expenses up to a regulated amount. Whether or not you attended work may be relevant but is not the whole answer. You should not rely on the experiences of people who are not legally qualified. If you want to know your rights, consult a lawyer who specialises in motor vehicle injury claims.
Q My family helped me a lot to get back on my feet after my injury. My wife took a month off work to help. Can we claim for the help my family gave me?
A Compensation is payable for gratuitous services provided to you by some family members during your recovery. The amount depends on who helped you and what they did. Each matter is assessed on its merits.
Q I have received an offer to settle my claim but the amount was reduced because I was not wearing a seatbelt. Is this right?
A Some fixed percentage deductions apply under the Motor Vehicles Act. This is the case when you fail to wear a seatbelt. Deductions can also be made for other contributing factors on your part. Each case depends on the particular facts and you should seek legal advice to be sure of your rights.
Q Before I received my claim number, some of my doctors put my bills through Medicare. Will I have to pay this back?
A Medicare Australia enquires into every claim when it is settled to find out if Medicare has paid for any treatment for your injuries. If so, Medicare will seek a charge against your settlement. Medicare will advise you in writing what you are required to do to identify the accounts which will be in the Notice of Charge. This process can be done before the settlement of your claim so that any charge can be taken into account before you settle.
Q I lodged my claim form some weeks ago but have not received a determination. Is there anything I can do to speed it up?
A Lodging an Application for Expedited Decision with the Workers Compensation Tribunal enables an officer of the Tribunal to enquire into the reasons for the delay and assist you to access a determination. The forms are available on the Tribunal's web site but you can seek help from a lawyer who practices in this area if you need help.
Q I disagree with comments made by an independent medical expert about my disability. Can I request a second opinion?
A You may wish to discuss the medical evidence with your treating doctors. You are entitled to provide further medical evidence from your treating doctors or another independent expert. A lawyer can assist you by ensuring that any further report deals with the questions relevant to your claim.
Q My claim manager suggested I seek legal advice about a Common Law claim for my work injury. I thought there was no right to sue my employer so what is he talking about?
A The Workers Rehabilitation and Compensation Act prevents you from suing your employer if you are entitled to benefits under that Act. There are times however when a third party may also have contributed to your injury. Examples include being injured in a work journey or in some labour hire situations. To properly understand whether you will benefit from investigating any possible Common Law rights, you should consult a lawyer who specialises in these types of claims.
Q I have been offered a redemption of future weekly payments and medical expenses but told I must see a lawyer to sign the papers. Why do I need a lawyer?
A A redemption agreement is a legal contract between you and the compensating authority. Money paid under this contract has Taxation, Centrelink, Medicare, private health and other consequences which you need to understand before signing. Funds cannot be paid under the agreement until you have provided certificates to be attached to the agreement. One of those certificates covers the legal advice you must receive. The lawyer assisting you can advise you of the steps you need to take to secure the redemption agreement.
When you go along to see your lawyer, save time (and money) by bringing along the following:
Freecall: 1800 195 202
Level 10, 30 Currie Street
Adelaide SA 5000
Telephone: (08) 8463 6593
Facsimile: (08) 8204 2169
The WorkCover Ombudsman is an independent statutory officer whose role is to promote the fair and effective administration of the Workers Rehabilitation and Compensation Act 1986.
Complaint forms and answers to common concerns are available from the web site. The Ombudsman can investigate and seek to resolve complaints from workers and employers.