If you are injured at work, the first step in claiming a workers compensation is to notify your employer of the injury that you have sustained. You may also notify your employer’s workers compensation insurer as well.
The notification of injury can be submitted via Icare’s online portal or by email or by phone. The notifications can be given to the insurer by the worker or the employer or by some other person on behalf of the worker, for example, the worker’s lawyers, doctors, colleagues, families and so forth.
After the insurer has been notified of the injury, they will contact you to discuss the support available and provide you with a claim number. The benefits you are generally entitled to while on workers compensation include weekly payments for loss of earnings, medical treatment expenses. A lump sum compensation for permanent impairment is available after your injuries have stabilised. Usually, 12 months from date of accident.
The relevant workers compensation insurer is obliged to start provisional payments within 7 calendar days unless there is a reasonable excuse not to. So, if the insurer has not issued you a reasonable excuse notice, you can expect to start receiving provisional weekly payments within 7 days.
If the insurer has issued a reasonable excuse within the 7 days, you then need to complete a claim form. They will explain in the notice as why provisional weekly payments has been delayed and include the details of the reasonable excuse they have applied. A claim form normally comes together with their reasonable excuse notice for you to complete and return, and you will also be advised how to make a claim.
One of the most common reasonable excuses is that they have not received sufficient medical information. If this happens, you just need to provide them with your medical documents such as a workers compensation certificate of capacity or other medical records which can show that a work-related injury has occurred.
There are also other reasonable excuses the insurer is allowed to use for not starting provisional weekly payments. You can find more details of the reasonable excuses through the following link: https://www.sira.nsw.gov.au/workers-compensation-claims-guide/legislation-and-regulatory-instruments/guidelines/workers-compensation-guidelines#part-1
However, please be aware that a reasonable excuse may apply to provisional weekly payments but not to medical payments. What this means is that upon receipt of the injury notifications, the insurer might be able to delay started paying weekly payments by applying reasonable excuses in certain circumstances, but they cannot delay paying for medical and hospital expenses. Once the notification of injury is received by the insurer, they are required to pay up to $10,000 for medical expenses until they make a formal determination on liability of claims.
Once the completed and duly signed claim form is received by the insurer, they have 21 days to either accept provisional liability for weekly payment for up to 12 weeks, or accept liability, or dispute liability.
If the insurer has accepted your claim for weekly payments, they will advise you of your weekly payment amount that you are entitled to. The weekly compensation is a form of insurance and not a wage, and as such the amount does not exactly equate to your pre-injury weekly earnings. The weekly benefits are normally paid at 95% of your pre-injury average weekly earnings (PIAWE) for the first 13 weeks and thereafter at 80% of PIAWE.
If your claim is disputed, you should consider seeking legal advice and assistance. At Alliance Compensation and Litigation Lawyers, we have assisted many injured workers in overturning declined claims at no costs to you. All our fees will be paid by the Independent Review Office (IRO).
Please book in free consultation with one of our Law Society Accredited Worker’s Compensation Specialists to find out how we can help.
一旦工人赔偿索赔被提出，会发生什么？
如果您在工作中受伤，索取工伤赔偿的第一步是通知您的雇主您所受的伤害。您也可以通知您雇主的工人赔偿保险公司。
受伤通知可以通过 Icare 的在线门户或电子邮件或电话提交。通知可以由工人或雇主或代表工人的其他人（例如，工人的律师、医生、同事、家人等）向保险公司发出。
保险公司接到受伤通知后，他们将与您联系以讨论可用的支持并为您提供索赔编号。您在领取工伤赔偿金期间通常有权获得的福利包括每周支付的收入损失、医疗费用。在您的伤势稳定后，您可以获得永久性损伤的一次性赔偿。通常，自事故之日起 12 个月。
Yīdàn gōngrén péicháng suǒpéi bèi tíchū, huì fāshēng shénme?
Rúguǒ nín zài gōngzuò zhōng shòushāng, suǒqǔ gōngshāng péicháng de dì yī bù shì tōngzhī nín de gùzhǔ nín suǒ shòu de shānghài. Nín yě kěyǐ tōngzhī nín gùzhǔ de gōngrén péicháng bǎoxiǎn gōngsī.
Shòushāng tōngzhī kěyǐ tōngguò Icare de zàixiàn ménhù huò diànzǐ yóujiàn huò diànhuà tíjiāo. Tōngzhī kěyǐ yóu gōngrén huò gùzhǔ huò dàibiǎo gōngrén de qítā rén (lìrú, gōngrén de lǜshī, yīshēng, tóngshì, jiārén děng) xiàng bǎoxiǎn gōngsī fāchū.
Bǎoxiǎn gōngsī jiē dào shòushāng tōngzhī hòu, tāmen jiāng yǔ nín liánxì yǐ tǎolùn kěyòng de zhīchí bìng wèi nín tígōng suǒpéi biānhào. Nín zài lǐngqǔ gōngshāng péicháng jīn qíjiān tōngcháng yǒu quán huòdé de fúlì bāokuò měi zhōu zhīfù de shōurù sǔnshī, yīliáo fèiyòng. Zài nín de shāngshì wěndìng hòu, nín kěyǐ huòdé yǒngjiǔ xìng sǔnshāng de yīcì xìng péicháng. Tōngcháng, zì shìgù zhī rì qǐ 12 gè yuè.
除非有合理的理由不这样做，否则相关的工人赔偿保险公司有义务在 7 个日历日内开始临时支付。因此，如果保险公司没有向您发出合理的免责通知，您可能会在 7 天内开始收到临时每周付款。
如果保险公司在 7 天内给出了合理的理由，那么您需要填写一份索赔表。他们将在通知中解释为什么临时每周付款被延迟，并包括他们申请的合理借口的详细信息。索赔表通常附有合理的辩解通知，供您填写并返回，您还将被告知如何提出索赔。
最常见的合理借口之一是他们没有收到足够的医疗信息。如果发生这种情况，您只需向他们提供您的医疗文件，例如工人赔偿能力证明或其他可以表明发生工伤的医疗记录。
还有其他合理的借口允许保险公司不开始临时每周付款。您可以通过以下链接找到更多合理借口的详细信息：https://www.sira.nsw.gov.au/workers-compensation-claims-guide/legislation-and-regulatory-instruments/guidelines/workers-compensation-指南#part-1
Chúfēi yǒu hélǐ de lǐyóu bu zhèyàng zuò, fǒuzé xiāngguān de gōngrén péicháng bǎoxiǎn gōngsī yǒu yìwù zài 7 gè rìlì rìnèi kāishǐ línshí zhīfù. Yīncǐ, rúguǒ bǎoxiǎn gōngsī méiyǒu xiàng nín fāchū hélǐ de miǎnzé tōngzhī, nín kěnéng huì zài 7 tiānnèi kāishǐ shōu dào línshí měi zhōu fùkuǎn.
Rúguǒ bǎoxiǎn gōngsī zài 7 tiānnèi gěi chūle hélǐ de lǐyóu, nàme nín xūyào tiánxiě yī fèn suǒpéi biǎo. Tāmen jiàng zài tōngzhī zhōng jiěshì wèishéme línshí měi zhōu fùkuǎn bèi yánchí, bìng bāokuò tāmen shēnqǐng de hélǐ jièkǒu de xiángxì xìnxī. Suǒpéi biǎo tōngcháng fù yǒu hélǐ de biànjiě tōngzhī, gōng nín tiánxiě bìng fǎnhuí, nín hái jiāng bèi gàozhī rúhé tíchū suǒpéi.
Zuì chángjiàn de hélǐ jièkǒu zhī yī shì tāmen méiyǒu shōu dào zúgòu de yīliáo xìnxī. Rúguǒ fāshēng zhè zhǒng qíngkuàng, nín zhǐ xū xiàng tāmen tígōng nín de yīliáo wénjiàn, lìrú gōngrén péicháng nénglì zhèngmíng huò qítā kěyǐ biǎomíng fāshēng gōngshāng de yīliáo jìlù.
Hái yǒu qítā hélǐ de jièkǒu yǔnxǔ bǎoxiǎn gōngsī bù kāishǐ línshí měi zhōu fùkuǎn. Nín kěyǐ tōngguò yǐxià liànjiē zhǎodào gèng duō hélǐ jièkǒu de xiángxì xìnxī: https://www.sira.nsw.gov.au/workers-compensation-claims-guide/legislation-and-regulatory-instruments/guidelines/workers-compensation-guidelines#part-1
但是，请注意，合理的理由可能适用于临时每周付款，但不适用于医疗付款。这意味着，在收到伤害通知后，保险公司可能可以在某些情况下通过合理的借口延迟开始支付每周的付款，但他们不能延迟支付医疗和住院费用。一旦保险公司收到伤害通知，他们需要支付高达 10,000 美元的医疗费用，直到他们对索赔责任做出正式决定。
保险公司收到填写完整并正式签署的索赔表后，他们有 21 天的时间来接受最多 12 周的每周付款临时责任，或接受责任或争议责任。
如果保险公司接受了您的每周付款索赔，他们将告知您您有权获得的每周付款金额。每周赔偿是一种保险形式，而不是工资，因此金额并不完全等同于您受伤前的每周收入。每周福利通常在前 13 周按您受伤前平均每周收入 (PIAWE) 的 95% 支付，之后按 PIAWE 的 80% 支付。
如果您的索赔有争议，您应该考虑寻求法律建议和帮助。在 Alliance Compensation and Litigation Lawyers，我们已帮助许多受伤的工人推翻被拒绝的索赔，无需您承担任何费用。我们所有的费用将由独立审查办公室 (IRO) 支付。
请与我们的一位律师协会认可的工人赔偿专家进行免费咨询，以了解我们如何提供帮助。
Dànshì, qǐng zhùyì, hélǐ de lǐyóu kěnéng shìyòng yú línshí měi zhōu fùkuǎn, dàn bùshìyòng yú yīliáo fùkuǎn. Zhè yìwèizhe, zài shōu dào shānghài tōngzhīhòu, bǎoxiǎn gōngsī kěnéng kěyǐ zài mǒu xiē qíngkuàng xià tōngguò hélǐ de jièkǒu yánchí kāishǐ zhīfù měi zhōu de fùkuǎn, dàn tāmen bùnéng yánchí zhīfù yīliáo hé zhùyuàn fèiyòng. Yīdàn bǎoxiǎn gōngsī shōu dào shānghài tōngzhī, tāmen xūyào zhīfù gāodá 10,000 měiyuán de yīliáo fèiyòng, zhídào tāmen duì suǒpéi zérèn zuò chū zhèngshì juédìng.
Bǎoxiǎn gōngsī shōu dào tiánxiě wánzhěng bìng zhèngshì qiānshǔ de suǒpéi biǎo hòu, tāmen yǒu 21 tiān de shíjiān lái jiēshòu zuìduō 12 zhōu de měi zhōu fùkuǎn línshí zérèn, huò jiēshòu zérèn huò zhēngyì zérèn.
Rúguǒ bǎoxiǎn gōngsī jiēshòule nín de měi zhōu fùkuǎn suǒpéi, tāmen jiāng gàozhī nín nín yǒu quán huòdé de měi zhōu fùkuǎn jīn’é. Měi zhōu péicháng shì yī zhǒng bǎoxiǎn xíngshì, ér bù shì gōngzī, yīncǐ jīn’é bìng bù wánquán děngtóng yú nín shòushāng qián de měi zhōu shōurù. Měi zhōu fúlì tōngcháng zài qián 13 zhōu àn nín shòushāng qián píngjūn měi zhōu shōurù (PIAWE) de 95% zhīfù, zhī hòu àn PIAWE de 80% zhīfù.
Rúguǒ nín de suǒpéi yǒu zhēngyì, nín yīnggāi kǎolǜ xúnqiú fǎlǜ jiànyì hé bāngzhù. Zài Alliance Compensation and Litigation Lawyers, wǒmen yǐ bāngzhù xǔduō shòushāng de gōngrén tuīfān bèi jùjué de suǒpéi, wúxū nín chéngdān rènhé fèiyòng. Wǒmen suǒyǒu de fèiyòng jiāngyóu dúlì shěnchá bàngōngshì (IRO) zhīfù.
Qǐng yǔ wǒmen de yī wèi lǜshī xiéhuì rènkě de gōngrén péicháng zhuānjiā jìnxíng miǎnfèi zīxún, yǐ liǎojiě wǒmen rúhé tígōng bāngzhù.
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