Bullying by the Insurer in Workers Compensation Claims

Friday, June 24, 2016

The insurers’ main interest is to get you, the injured worker, back to work as soon as possible. It is very common for the insurer to pressure and bully the injured worker to return to work as soon as possible and sometimes before they are ready.

Often the Insurer claims officer will pressure the injured worker by saying that they have to go back to work or their payments will be suspended. Sometimes they say that they are just being lazy and milking their injuries. Workers who are truly injured often feel humiliated by such conduct.

In many cases the worker is pressured to return to work when their injuries have not healed and this can often exacerbate the injuries making for a delayed recovery.

Macquarie University recently published a report into allegations of bullying in the Workers Compensation system. One injured worker reported that her return to work coordinator called her every day after she had major surgery to ask her when she would return to work. Her coordinator belittled her, telling her she was taking too long to recover, which was against advice provided by her surgeon.

It is also very common for the claims officer to contact and pressure the injured workers nominated treating doctor into upgrading the WorkCover Certificate of Capacity to say that the worker is fit to return to work. Often claims officers will have a case conference with the injured worker and the doctor to discuss the return to work plan and try and pressure the Doctor into upgrading the hours of work.

Unfortunately, time and time again doctors’ change their patients certificate to say that they can return to work because they fear if they don’t the insurer will reduce or cease their patients’ payments.

WHAT SHOULD I DO IF I AM BEING BULLIED?

  • Tell your insurer that you don’t want to speak to them on the phone and you want them to put it all in writing. This way if they are bullying you or making you feel guilty about not returning to work it is documented. If you ask for written correspondence opposed to verbal correspondence they are less likely to bully and belittle you.

  • Always meet with your doctor before a conference with the case officer. You have the right as a patient to speak to the doctor alone. If the case officer tries to come in with you you can tell them to wait. When you speak with your doctor alone you should discuss your WorkCover Certificate of Capacity. You should also tell your doctor if the insurer has been bullying you, and that they may try to do the same to the doctor.

  • If the insurer continues the bullying behaviour you should make a complaint to the claim officers’ supervisor. It is important that the complaint is made in writing. An email or letter will do.

  • If your complaint is not addressed and the claims officer continues to bully you then you should make a complaint to the WorkCover Independent Review Officer (WIRO) on 13 94 76 or a complaint can be submitted online at www.wiro.nsw.gov.au. WIROs' role is to assist injured workers with any disputes, complaints or issues that they have with workers compensation insurers.

  • If WIRO is unable to assist further with your complaint then you should contact an experienced accredited specialist in personal injury law who may be able to assist you with lodging an Anti-Discrimination Act claim or such similar proceedings.

 

Garling and Co Lawyers 2016

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