Taking on Compensation Insurers

Posted 10-05-2021
Written by admin 101
Category Compensation

If you have suffered an injury which is disputed by a workers compensation insurer, you have the right to challenge their decision. The RMB Compensationn division explains.

RMB Lawyers recently acted for a client, for confidentiality reasons let’s call him John*, who suffered a slip and fall at work. His arm became caught in nearby equipment, and he suffered a significant shoulder injury including dislocations and torn muscles.

John suffered some general aches and pains in his neck, but thought it was due to the shoulder injury. He lodged a workers compensation claim for his shoulder and his treatment was paid by the insurer.

John had several surgeries for his shoulder injury but his neck pain worsened.

He saw his doctor who believed that John had also suffered a neck injury in the initial incident. This had been made worse by repeated surgery.

The workers compensation insurer disputed John’s claim that the neck injury had arisen in the original workplace incident. They claimed that there were insufficient medical records for the 18 months after the incident to prove that the neck injury was work-related.

RMB Lawyers, working hard to protect John’s rights to compensation, found records from other doctors whom John had seen. Those records showed that within three weeks of the incident, he had been complaining of ongoing neck pain.

After finding that information, RMB Lawyers engaged an expert medicolegal doctor to help prove that the neck injury was indeed caused by the original fall, and also made worse by the work-related surgery to his shoulders.

The insurer refused to accept this evidence, and so RMB Lawyers applied to the Personal Injury Commission to have the insurer’s decision overturned.

A hearing was held at the Personal Injury Commission, and it was determined that the type of injury sustained to John’s neck was clearly consistent with the mechanism of his injury, and the neck injury was found to be related to the workplace incident.

John will now be able to claim further compensation for his neck. He will be entitled to receive further treatment, and claim weekly benefits for lost wages due to that injury.

If you have suffered an injury which is disputed by a workers compensation insurer, you have the right to dispute their decision. RMB Lawyers can help. Furthermore, you may be entitled to access funding from the Independent Review Office, meaning that you will not need to pay for our legal costs and fees. Your first step should be to contact our office to arrange a free consultation. You can contact us by by phone or our 'Ask a Question' tool on our website.