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AustraliaTraumatised police officer takes criminal action after case manager EML dragged out workers' compensation claim

19:17  24 june  2019
19:17  24 june  2019 Source:   abc.net.au

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Learn About Filing Workers Compensation Claims . Free Case Review by a Workers Comp Workers ' compensation laws are set up to cover Why one former cop is going to criminal court over compensation . Traumatised police officer takes criminal action after case manager EML

A former police officer who suffered horrific and graphic traumas after being trapped in a crashed squad car has launched criminal action after being forced to wait more than a year for a workers ' compensation payout.

A former police officer who suffered "horrific and graphic traumas" from being trapped in a crashed squad car has launched criminal action after being forced to wait more than a year for a workers' compensation payout.

Traumatised police officer takes criminal action after case manager EML dragged out workers' compensation claim© AAP: Dean Lewins A former police officer suffered physical and psychological injuries as a result of an on-duty crash. Julie Heise was travelling at high speed in a police vehicle near Newcastle in 2009 when it rolled and she became stuck inside the crumpled wreckage.

She suffered physical and psychological injuries as a result of the crash and was later diagnosed with post-traumatic stress disorder and depression.

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Traumatised police officer takes criminal action after case manager EML dragged out workers ' A former police officer who suffered horrific and graphic traumas after being trapped in a crashed squad car has launched criminal action after being forced to wait more than a year for a

Traumatised police officer takes criminal action after case manager EML dragged out workers ' compensation claim . https I wonder if we can find out from the ombudsman, how many complaints have been submitted with regards to EML and Workcover insurers through freedom of information?!

Ms Heise was discharged by NSW Police in 2015 and lodged a workers' compensation claim in 2017, only to be dragged through a year-long process by the case manager Employers Mutual Limited (EML).

Under New South Wales workers' compensation laws, failure to decide on a claim within two months is a criminal offence and attracts a fine of $5,500.

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A former police officer who suffered "horrific and graphic traumas" after being trapped in a crashed squad car has launched criminal action after being forced to wait more than a year for a workers ' compensation payout. © AAP: Dean Lewins A former police officer suffered physical and

Traumatised police officer takes criminal action after case manager EML dragged out workers ' compensation claim - Such a disgrace and where’s the The Department of Defence faces three new charges over workplace health and safety breaches after an investigation by Comcare, but some

Ms Heise has since taken the extremely rare step of launching a private criminal prosecution against EML.

Cop left traumatised by crash

Traumatised police officer takes criminal action after case manager EML dragged out workers' compensation claim© ABC Former NSW police officer Julie Heise was trapped inside this squad car following a crash. EML declined to comment on the case, but court documents make clear the company does not dispute that Ms Heise's injuries were caused by her employment.

According to a psychiatric assessment carried out as part of her compensation claim, after returning to work following the crash she was exposed to "repeated horrific and graphic traumas … in the course of her subsequent general duties".

EML will not say whether it has made a determination on Ms Heise's claim, and the company has not explained why it delayed the process.

The case is now on track to proceed to trial after the NSW Supreme Court threw out an application from EML to have Ms Heise's prosecution ruled invalid.

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Traumatised police officer takes criminal action after case manager EML dragged out workers ' compensation claim - Such a disgrace and where’s # EML #EmployersMutual in the breach for their recidivist disgraceful behaviour. Can’t wait to hear what the @PoliceAssocNSW have to say! https

Traumatised police officer takes criminal action after case manager EML dragged out workers ' compensation claim - Such a disgrace and where’s the regulator? https Loading seems to be taking a while. Twitter may be over capacity or experiencing a momentary hiccup.

A spokesperson for EML said the company was unable to comment as the matter was still before the courts.

Traumatised police officer takes criminal action after case manager EML dragged out workers' compensation claim© ABC Ms Heise was a passenger in the police vehicle when it crashed in 2009. Neither EML nor the workers' compensation authority, iCare, publish data on the amount of time injured workers have to wait for a determination.

But in just the first two months of this year, the Workers Compensation Independent Review Office (WIRO) received more than 250 complaints about delays in case managers deciding on claims.

EML was among the companies complained about.

David Shoebridge, a Greens member of the NSW Upper House who has pushed for reforms to the workers' compensation system, said Ms Heise's case highlighted the reluctance of the State Insurance Regulatory Authority (SIRA) to prosecute breaches of the act.

"I've had hundreds of injured workers contact my office about failures of insurance companies to comply with the law," he said.

Traumatised police officer takes criminal action after case manager EML dragged out workers' compensation claim© AAP: Dean Lewins NSW Greens MP David Shoebridge has pushed for reforms to the workers' compensation system. "I find it astounding that there hasn't been a single instance where SIRA has stepped up and prosecuted for these obvious breaches of the law.

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Traumatised police officer takes criminal action after case manager EML dragged out workers ' compensation claim - ABC News (Australian Loading seems to be taking a while. Twitter may be over capacity or experiencing a momentary hiccup. Try again or visit Twitter Status for more information.

Traumatised police officer takes criminal action after case manager EML dragged out workers ' compensation claim | PTSD First Responder #PTSDFirstResponder # Traumatised #Epidemic #Crisis # WorkersCompensation #LeadershipMatters https

"Instead, we have an individual, in the middle of their case, having to deal with the trauma of being injured, also having to deal with the additional stress of prosecuting the insurance company."

In a statement, SIRA said while it has never prosecuted a case manager for a criminal breach, it has issued warnings and penalty notices.

The impact of delay can worsen the injury already suffered by claimants, according to Unions NSW.

"The system's not actually being geared towards getting workers back to work. It's being very geared to challenging injured workers' claims [and] dragging them out," Unions NSW secretary Mark Morey said.

Insurer has monopoly on compensation claims

EML is among Australia's biggest workers' compensation insurers, operating in New South Wales, Victoria and South Australia.

Traumatised police officer takes criminal action after case manager EML dragged out workers' compensation claim© ABC EML chief executive Mark Coyne (right) hands over a donation to mental health advocacy group Beyond Blue in 2016. In NSW, employers pay insurance premiums into a central fund administered by the state government.

Management of compensation claims is outsourced to private insurance companies. These have included EML, Allianz and GIO.

But in 2017, the New South Wales Government named EML the monopoly case manager for new claims from the start of 2018.

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While the criminal justice system may take a matter first and then a civil claim will commence, there are times when this is in reverse. With the assistance of law enforcement officers , the The civil case has no bearing on the criminal trial, but the information garnered may help in prosecuting the

Want to find out the difference between a personal injury case and workers compensation claim ? Worker ’s comp usually covers very specific injuries or conditions that are clearly listed by law or under contract. Some main differences between personal injury lawsuits and worker ’s compensation

The EML arrangement has had a rocky start.

According to the latest WIRO annual report, employers have been frustrated by delays in EML approving medical expenses for injured workers.

"On many occasions, employers have found it necessary to schedule medical treatment for injured workers to assist them to return to work in a timely manner, as EML has not decided whether that treatment is reasonably necessary," the WIRO report said.

"A significant number of NSW employers have complained to WIRO about difficulties in communicating with EML by telephone … an unacceptable time that they are required to spend 'on hold'; and difficulties arising from improperly trained and/or overworked staff members answering their phone calls."

Incentives given for limiting compensation

Last month, SIRA announced a review of the NSW workers' compensation scheme, to be headed by former Victorian Traffic Accident Commission CEO Janet Dore.

The review will examine how well the scheme is helping injured workers return to employment, as well as its case management performance.

The review comes at a time of intense scrutiny of workers' compensation schemes around the country, and the private insurers that operate within them.

The Victorian Ombudsman is working on her second investigation into the Victorian WorkSafe authority in less than three years.

In a scathing 2016 report, the ombudsman found that financial incentives WorkSafe paid to claims managers, including Allianz, QBE, Gallagher Bassett and Xchanging, were having a negative impact on the lives of injured workers.

Under WorkSafe's model, insurers received reward payments for limiting the number of weeks workers were on compensation, and for reducing the growth in medical expenses paid to injured workers.

The investigation found staff at some insurers were manipulating claims data in order to attract higher financial rewards.

It also uncovered internal email to QBE staff offering prizes to case managers who terminated the most work claims within a month.

The ombudsman recommended WorkSafe change its financial incentives to "ensure there is a sufficient focus on good quality and sustainable decision-making".

The Victorian Government and WorkSafe accepted all of the report's recommendations, but last July a follow-up investigation was announced.

"Given the distressing nature of what we found in 2016, it is incumbent upon me to examine whether the situation has improved for workers with complex injuries and conditions," Victorian Ombudsman Deborah Glass said at the time.

The ombudsman received more than 600 complaints about WorkSafe and its agents last financial year.

If you or anyone you know is suffering from depression, call Lifeline on 13 11 14, Beyondblue on 1300 22 4636, or Kids Helpline on 1800 55 1800.

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