Worker's compensation payments reinstated

Summary

A WorkSafe agent terminated an injured worker's weekly payments. It was unclear how the available medical evidence supported the termination.

We raised this with WorkSafe and the agent. WorkSafe overturned the agent's decision. The injured worker was back-paid over $20,000.

What was the case?

Steve was working as a labourer when he injured his neck at work in 2014. He made a WorkCover claim, and the agent Gallagher Bassett accepted it.

Steve made a few attempts to return to work over the following years. In early 2017, he had to stop work completely due to his injury. He also developed a secondary mental injury and chronic pain syndrome.

He received weekly payments for loss of injury, until in late 2018 Gallagher Basset stopped his payments. They said he had or would have capacity to work in the foreseeable future. They relied on the opinions of three Independent Medical Examiners (IMEs). This was despite the IMEs being unclear about when and if Steve would have capacity to work.

Steve disputed the decision at conciliation, but it was not resolved. Steve made a complaint to us.

Our enquiries

We reviewed Steve's claim file. We could not see how the available medical evidence supported stopping Steve's payments.

We asked WorkSafe and Gallaher Bassett to review the decision. WorkSafe reviewed all the evidence and over-turned Gallagher Bassett's decision.

Outcome

Steve's entitlement to weekly compensation payments was reinstated. He was back-paid over $20,000.

Complaint handling WorkSafe