Impact of recent WorkCover changes – what to know

On 31 March 2024, important new WorkCover legislation came into effect which impacts mental injury claims and weekly payments for WorkCover claimants. 

Mental injury claims

In order to be eligible for compensation for a ‘mental injury’ a worker must now demonstrate that they have an injury which causes a ‘significant behavioural, cognitive or psychological dysfunction’ and which is diagnosed by a medical practitioner under the current Diagnostic and Statistical Manual of Mental Disorders (DSM).

This is a significant change and means that workers will no longer be entitled to lodge WorkCover claims for conditions such as ‘stress’, ‘anxiety and depression’ or ‘mental health’.  Instead, they must have proof from a GP or psychiatrist of an eligible diagnosis as defined by the DSM, for example, Post-traumatic Stress Disorder, Generalised Anxiety Disorder, Major Depressive Disorder and so on.

In addition, a worker must now demonstrate that their diagnosed mental injury is predominantly caused by their employment, which is stronger than the previous requirement of employment being ‘a cause’ of injury.

Further, injured workers no longer have an entitlement to compensation where a mental injury predominantly caused by work relates to stress or burnout which is usual or typical and reasonably expected to occur in the course of the worker’s duties.

This means that for instance a professional or a manager with a position of responsibility or seniority would be prevented from making a claim if the demands of their job caused them to have a mental breakdown resulting in a diagnosis.  It might also mean that workers in busy hospital and aged care environments who suffer overwork might not be entitled to claim.

The amendments maintain a worker’s entitlement to claim compensation for a diagnosed mental injury predominantly caused by traumatic events that may be usual or typical and reasonably expected to occur.  This means that emergency and justice services workers will still be able to claim.

Weekly payments

From 31 March 2024, any worker who reaches 130 weeks of weekly payments will have their payments ceased at the 130-week mark unless:

·         They have no current work capacity and this is likely to continue indefinitely and

·         They have a whole person impairment of more than 20%.

For workers who are already beyond their 130-week mark as at 31 March 2024, their entitlements will remain in place, subject to the usual insurer reviews. However, for workers approaching their 130-week mark, the insurer will arrange an independent medical assessment seeking assessment of work capacity and whole person impairment.

In cases where an insurer makes a determination that a worker is not entitled to weekly payments beyond the 130-week mark, they must provide 13 weeks’ notice to the worker terminating their entitlement.

If you have a WorkCover claim and believe you may be impacted by the legislative changes, contact Grainger Legal to speak with one of our expert lawyers about your entitlements.

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