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Psychological or psychiatric injury claims

At WorkCover, we understand that a psychological/psychiatric injury (PPI) can significantly impact on a worker’s life, both at home and at work. It can also affect the employer’s business.

We look to make decisions on PPI claims in a timely manner so we can assist the worker and employer with a safe and early return to work. Being off work can have a negative effect on a worker and their family, so WorkCover encourages staying and recovering at work.

What is a work-related psychological or psychiatric injury?

When making a decision on a psychological or psychiatric injury, WorkCover will apply criteria and exclusions as outlined in the Workers' Compensation and Rehabilitation Act 2003.

The Act states that ‘an injury is a personal injury arising out of, or in the course of, employment if for a psychiatric or psychological disorder—the employment is the major significant contributing factor to the injury’.

The Act states that ‘an injury does not include a psychiatric or psychological disorder arising out of, or in the course of, any of the following circumstances’:

  • reasonable management action taken in a reasonable way by the employer in connection with a worker's employment 
  • a worker's expectation or perception of reasonable management action being taken against a worker 
  • action by the authority or an insurer in connection with a worker's application for compensation.

Examples of actions that may be reasonable management actions taken in a reasonable way include: 

  • action taken to transfer, demote, discipline, redeploy, retrench or dismiss a worker 
  • a decision not to award or provide promotion, reclassification (or transfer of), leave of absence or benefit in connection with the worker's employment.

How WorkCover decides a psychological or psychiatric injury claim?

We look to make decisions on all claims in a timely manner so we can assist the worker and employer with a safe and early return to work.

We will explain our approach to ensure all parties have a clear understanding of what to expect and what will be required to make a determination on the claim.

We gather information from the worker, employer, doctors, allied health professionals and other people, such as direct witnesses to the event(s) or independent medical examiners, to help us make our decision.

  • We will contact the worker to discuss the details of the injury and event(s) that have contributed to the injury.
  • We will discuss the injury and the event(s) that have caused the need to seek medical treatment with the treating doctor.
  • We will also contact the employer to notify them that a new claim has been lodged on their policy, confirm basic employment details, and gather information on the stated event(s) that have contributed to the injury.
  • We will keep all parties informed and updated throughout the determination of the claim and will ensure that the approach is fair to all parties.
  • Once we've gathered enough information to decide the claim, we will inform both the worker and the employer of the decision, as well as the treating doctor and allied health professional.

Support

WorkCover has developed a Psychological or psychiatric injury claims – frequently asked questions page to support workers and employers in understanding our approach to determining a psychological or psychiatric injury claim and to assist in supplying information to support their claim.

Last updated
15 February 2016

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