Workers’ Compensation
If you’ve experienced a physical or psychological injury at work, you may be eligible to receive fair compensation. Understanding which compensation scheme applies to your situation helps you take the right steps and access the right support.
Workers' Compensation Options in South Australia
If you’ve suffered a work-related injury or illness in South Australia, there are three main legal pathways through which you may be able to claim compensation. The right pathway depends on your type of employment, who or what caused your injury, and whether negligence was involved.
- Return to Work SA (Statutory State Scheme): This is South Australia’s no-fault workers' compensation scheme under the Return to Work Act 2014 (SA). It applies to most employees in South Australia and covers injuries that arise out of or in the course of employment, regardless of who was at fault.
- Comcare (Federal Scheme): This scheme applies to employees of Australian Government agencies and certain licensed national employers. It operates under the Safety, Rehabilitation and Compensation Act 1988 (SRC ACT) and covers injuries with a sufficient connection to the worker’s employment.
- Common Law Claims: In some cases, an injured worker may be able to bring a separate claim for damages if their injury was caused by negligence. This could involve the employer or a third party, such as another company or contractor. If the claim is against the employer, the worker must first be assessed as a seriously injured worker, which generally means having a whole person impairment of 35% or more.
Each scheme has its own rules, entitlements, and legal thresholds. Some claims focus only on the connection between your work and your injury. Others require evidence that someone was legally at fault. Understanding which option applies to your situation can be complex. At Grope Hamilton Lawyers, we’ll help you find the right path and pursue the fair compensation you should receive.
Comparsion of Workers' Compensation Scheme in SA
Scheme | Eligibility criteria | Negligence required | Available entitlements | Legal eligibility threshold |
---|---|---|---|---|
Return to Work SA | Workers who usually work in South Australia or are based in South Australia, including full-time, part-time and casual employees, labour hire workers, certain independent contractors in prescribed industries, and recognised emergency service volunteers. | No | Weekly income support, medical expenses, rehabilitation services, and lump sum compensation for permanent impairment. | Injury must arise out of or in the course of employment in South Australia. |
Comcare | Employees working for Australian Government departments or agencies, statutory authorities, or national employers holding a self-insurance licence under the federal SRC Act. | No | Income support, medical and allied health treatment, rehabilitation, attendant care, travel costs, and lump sum for permanent impairment. | Injury or illness must be sufficiently connected to employment under the SRC Act. |
Common Law Claim | Workers whose injury was caused by negligence. To claim against an employer, the worker must be assessed as seriously injured under the Return to Work Act. No impairment threshold applies for third-party negligence claims. | Yes | Damages for pain and suffering, past and future economic loss, superannuation loss, and future care expenses. | 35% WPI (physical) or 30% WPI (psychiatric) required for employer claims; no threshold for third-party negligence claims. |
Return to Work SA
It’s not always clear what to do after a workplace injury, especially if you’re still recovering or unsure how serious it is. But it's important to inform your employer about a work-related injury as early as possible. In most cases, workers' compensation claims in South Australia should be made within six months of when the injury happens or is diagnosed.
Psychological injuries may be covered under the Return to Work scheme in South Australia, but certain legal criteria must be met. To qualify, the psychological harm must have been caused by your employment, and the law requires that your work was the most significant contributing cause of the condition. This means it must be more than just a contributing factor. It needs to be the main reason the injury occurred.
Examples of work-related psychological injuries can include the effects of ongoing stress, exposure to traumatic incidents, or harm caused by workplace bullying or harassment. However, compensation is not available if the injury arose entirely or mostly from your employer taking reasonable management action. This can include a lawful dismissal, a performance review, or a workplace restructure, provided it was carried out in a proper manner.
The injury does not need to be formally diagnosed as a psychiatric illness, but it must involve a recognised impact on your mental functioning and be supported by appropriate medical evidence. These matters can be complex and often involve multiple contributing factors, which is why it’s important to seek advice if you’re unsure about your entitlements.
If you are off work or working reduced hours because of a work-related injury, weekly income payments may help cover the gap in your earnings. Under South Australia's Return to Work scheme, these payments are designed to support injured workers while they recover.
Your entitlement is generally based on your Average Weekly Earnings calculated over the 12 months before the injury. This includes base wages and may also account for overtime, allowances, second job income, and salary-sacrificed superannuation. If you have not been employed for a full 12 months, a comparable worker in a similar role may be used to determine your earnings.
For the first 52 weeks following your injury, you may receive up to 100% of the difference between your pre-injury average and any amount you are currently earning. From week 53 to week 104, this typically reduces to 80%. After two years, income maintenance payments stop unless you have been assessed as a seriously injured worker.
If you are assessed as a seriously injured worker, weekly payments can continue beyond the initial two-year period. This applies where a formal medical assessment confirms a whole person impairment of at least 35% for physical injuries or 30% for psychiatric injuries. In many cases, these payments are made at up to 80% of your pre-injury average and may continue until retirement age.
If your work-related injury is accepted under the Return to Work scheme, you can claim reasonable medical expenses related to your recovery. This includes costs for treatment by doctors and specialists, hospital care, prescribed medication, physiotherapy, psychological support, and therapeutic aids.
Travel costs to attend medical appointments may also be reimbursed. In some cases, additional support such as home modifications or domestic assistance can be approved if they are part of your recovery or return to work plan.
For most injured workers in South Australia, these expenses are covered for up to one year after weekly income payments stop or after returning to work. However, this time limit does not apply if you are assessed as a seriously injured worker, or if the costs relate to medical equipment needed to maintain your capacity.
If you are planning future treatment, such as surgery or rehabilitation, it’s possible to request pre-approval. A written recommendation from your treating doctor is generally required, and a decision should be made within one month.
If your work-related injury has left you with a permanent physical impairment, you may be eligible for a one-off lump sum payment through the Return to Work scheme in South Australia. This is in addition to other forms of compensation, such as weekly income support and medical expenses.
There are usually two types of lump sum payments available. One is for non-economic loss, which relates to the long-term impact of the injury on your quality of life. The other is for 5% or more. The amount you receive depends on several factors, including your age and the hours you were working at the time of the injury.
Under South Australia's Return to Work scheme, you may only be entitled to one formal assessment of permanent impairment. It is important to approach this step with care and proper advice. Grope Hamilton Lawyers can assist you in navigating this process with clarity and confidence.
If your workers' compensation claim has been rejected, this is often the most important time to seek legal advice. A rejection does not necessarily mean the end of your case. In South Australia, you have the right to challenge the decision through the South Australian Employment Tribunal (SAET). The process can be complex, which is why it’s important to have the right legal guidance from the start.
When a claim is rejected, you should receive a letter explaining the reasons behind the decision. These often involve questions about whether the injury is genuinely work-related, whether the claim was made within the required time frame, or whether the medical evidence was considered sufficient. If you disagree with the determination, you can lodge an application to have the decision reviewed. This generally needs to be done within one month of being notified. At Grope Hamilton Lawyers, we can assist you in understanding the reasons for the rejection and help determine whether the decision can be challenged based on the facts of your situation.
During the review process, additional evidence can be submitted to strengthen your claim. This might include updated medical reports, witness statements, or clarification of the work-related circumstances surrounding the injury. Our legal team can help prepare and present these materials in a way that supports your case and meets the Tribunal’s requirements. We also ensure you are aware of what to expect at each stage, from conciliation to a potential hearing, and help you navigate the procedure with confidence.
Comcare
If you are a Commonwealth employee and suffer a work-related injury that prevents you from working, you may be entitled to weekly income support through the Comcare scheme.
For the first 45 weeks of incapacity, Comcare typically pays up to 100% of your usual pre-injury wage. If you remain unable to return to work beyond that time, the weekly rate usually reduces to 75% of your normal earnings. However, if you have dependants, this may increase to up to 90%, depending on your circumstances. To receive these payments, your claim must be accepted and you must provide relevant medical evidence showing your incapacity for work. Payments may be reviewed over time, particularly if your condition improves or if you're able to return to some form of work, even on reduced hours.
A permanent impairment claim under Comcare is a lump sum compensation available to Commonwealth employees who have sustained a lasting work-related injury or illness. To be eligible, the impairment must be stable, assessed as permanent, and meet a minimum threshold of 10% whole person impairement.
Both physical and psychological conditions may qualify, provided they are accepted under the Comcare scheme. The process involves an assessment by an accredited medical professional, who determines the degree of impairment using the relevant guidelines. In some cases, an additional payment may be available for non-economic loss, which recognises the broader impact the injury has had on your quality of life.
In most cases, you can only make one permanent impairment claim for each accepted injury. If you have more than one accepted injury affecting different parts of the body, separate claims may be available. That’s why it’s crucial to ensure each injury is properly assessed and supported by thorough medical documentation from the beginning.
Under the Comcare scheme, workers with accepted claims may be eligible for reimbursement or direct payment of a broad range of medical and therapeutic expenses. These can include consultations with general practitioners and specialists, diagnostic testing, surgery, prescribed medication, and allied health services such as physiotherapy, psychology, or occupational therapy. Travel costs to and from medical appointments are often covered as well.
In more serious or ongoing cases, additional support may extend to rehabilitation programs, assistive aids and appliances, home or vehicle modifications, domestic help, or personal care services, provided they are reasonably required due to the injury.
Once your Comcare claim is rejected, it is important to seek legal advice promptly. The decision can be challenged through a two-stage review process.
The first stage is to request a reconsideration. This must be lodged within 30 days of receiving the decision. At this point, you may submit additional material, such as updated medical reports or clarification from your treating doctor. At Grope Hamilton Lawyers, we review the initial determination, identify any weaknesses or missing evidence, and help prepare a clear and well-supported reconsideration request.
If the claim is still denied after reconsideration, the matter can be referred to the Administrative Review Tribunal (the Tribunal) for independent review. You have 60 days to lodge an application. This process may involve case conferences, further medical documentation, and potentially a formal hearing. Our team guides clients through each stage, from preparing submissions and briefing medical experts to providing representation at the Tribunal.
Common Law Claims
In most cases, a common law damages claim must be commenced within three years from the date of the injury or when the injury was diagnosed.
If you are considering a claim against your employer, there are certain requirements that generally need to be met before legal action can be taken. This includes having an accepted workers' compensation claim under the Return to Work SA scheme and being assessed as a seriously injured worker within that system.
Where the injury was caused by someone other than your employer, such as a contractor or another company’s worker, those additional steps may not apply. However, the same time limit still applies.
To bring a successful common law claim, it’s not enough to show that you were injured at work. The key is proving that someone else, such as your employer or a third party, was legally at fault. This is what’s known as negligence.
For employers, the law recognises a duty of care to provide a safe and healthy work environment. This responsibility includes physical safety and psychological wellbeing. It covers areas such as providing proper training, maintaining equipment, managing known risks, and addressing workplace issues like bullying or prolonged stress. If an employer fails to take reasonable care and you are injured as a result, whether physically or psychologically, it may amount to negligence. Negligence can also arise where someone outside your direct employment, such as a contractor, site operator or another business, fails to meet their duty of care. Injuries caused by third parties can also give rise to a valid claim for compensation under common law.
In any common law claim, you generally need to prove four elements: that a duty of care existed, that it was breached, that the breach caused your injury, and whether your own actions contributed to the harm. This last point is known as contributory negligence, and it may reduce the amount of compensation you receive.
Common law claims can be complex, and each situation is different. At Grope Hamilton Lawyers, our experienced team can help you understand your rights, assess whether negligence can be established, and guide you through the process to ensure your claim is handled properly. If you’ve been injured and believe someone else was at fault, we encourage you to get in touch for clear, practical advice.
In South Australia, you may be eligible to pursue a common law damages claim in addition to the statutory benefits you have already received, but only under specific circumstances. To qualify for a common law claim, you must first be classified as a seriously injured worker. This requires undergoing a formal permanent impairment assessment, where your whole person impairment (WPI) needs to be assessed at 35% or higher for physical injuries, or 30% or higher for psychological injuries.
Deciding to pursue a common law claim involves careful consideration. Accepting damages under common law usually means you will no longer receive ongoing statutory entitlements, such as weekly income payments or medical expense coverage. Additionally, you may need to repay some or all statutory benefits you've previously received.
The potential advantage of a common law claim is the possibility of receiving compensation for losses beyond what statutory benefits offer. This could include compensation for future economic losses, pain and suffering, reduced quality of life, and other non-economic impacts not typically covered by statutory payments.
At Grope Hamilton Lawyers, we understand how significant this decision can be. Our experienced personal injury lawyers can thoroughly review your situation, including your current impairment assessment and statutory entitlements, to determine if pursuing a common law claim could benefit you. We guide you through each step, clearly explain your options and their implications, and help you decide on the best course of action to protect and maximise your entitlements.
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