10 tips for successful compensation claims

One of the first questions people often ask after an accident is: “How much compensation could I receive?” There is no fixed amount for a particular injury in Queensland. Two people can suffer apparently similar injuries but have significantly different claims because the impact on their lives, employment, future earning capacity and treatment needs may be very different. For example, an injury that prevents a tradesperson from returning to physical work may have very different financial consequences from the same injury sustained by someone who can continue working without any reduction in income. The value of a personal injury claim therefore depends on the individual circumstances rather than simply the diagnosis. What Does Personal Injury Compensation Cover? Depending on the type of claim and the circumstances, compensation may include several different categories of loss, commonly referred to as heads of damage . These can include: pain and suffering; past loss of income; future economic loss or reduced earning capacity; medical and rehabilitation expenses; future treatment expenses; and in appropriate cases, care and assistance. The rules applying to each category can differ depending on whether the claim involves a motor vehicle accident, public liability accident or workplace injury. Pain and Suffering Compensation for pain and suffering is generally referred to as general damages . It recognises the non-financial consequences of an injury, which can include pain, suffering and loss of quality or enjoyment of life. In Queensland, general damages for many personal injury claims are assessed using an Injury Scale Value (ISV) system. An injury is assigned an ISV within the applicable range according to matters including its nature and severity. The ISV is then used to determine the amount of general damages under the applicable legislation and regulations. For Queensland CTP claims, MAIC confirms that the ISV scale runs from 0 to 100 and that not every injury is sufficiently serious to attract an award of general damages. The amount for pain and suffering therefore cannot reliably be determined simply by looking up the name of an injury. Past Loss of Income If an injury prevents you from working, causes you to reduce your hours or affects the work you are able to perform, compensation may potentially include income you have already lost. Evidence may include: payslips; tax returns; PAYG records; employer records; records of overtime; business financial records for self-employed people; and medical evidence concerning your capacity to work. MAIC confirms that CTP compensation can include wages lost because a person has been unable to work as a result of their injuries. The assessment becomes more complicated for people whose income fluctuates, business owners, self-employed people or those whose career trajectory was expected to change. Future Economic Loss For significant injuries, future economic loss can be one of the largest components of a personal injury claim . The question is not simply whether you are currently working. An injury may leave someone capable of returning to employment but nevertheless reduce their ability to: work the same hours; perform overtime; undertake physically demanding duties; obtain promotions; continue in their existing occupation; compete for other employment; or remain in the workforce for as long as otherwise expected. Queensland legislation specifically permits consideration of matters including a person's age, work history, actual loss of earnings and permanent impairment when future earnings cannot be precisely calculated. This is why a person who has returned to work may still potentially have a claim for future economic loss. Medical and Rehabilitation Expenses A personal injury claim may also include reasonable expenses caused by the injury. Depending upon the circumstances, these might include: GP and specialist appointments; physiotherapy; psychological treatment; medication; surgery; rehabilitation; occupational therapy; medical equipment; and travel associated with treatment. Future treatment can also be relevant where medical evidence establishes that further treatment will probably be required. For CTP claims, MAIC expressly identifies both past and future treatment and rehabilitation as matters that can form part of a claim. Care and Assistance A serious injury may affect a person's ability to perform ordinary activities such as cleaning, cooking, gardening, personal care or looking after children. Depending upon the applicable legislation and whether statutory thresholds are satisfied, compensation may potentially be available for necessary care or assistance. The precise requirements are technical and vary according to the type of claim, so the fact that family or friends have provided assistance does not automatically mean that compensation will be payable for that care. It is nevertheless useful to keep a record of significant assistance required because of an injury. Why Can Two People With the Same Injury Receive Different Compensation? Consider two people who each sustain a significant knee injury. One works primarily at a desk, returns to full-time employment and has relatively limited future treatment requirements. The other works in a physically demanding occupation and can no longer perform the duties required for that work. Although the medical diagnosis may be similar, the second person's injury may produce considerably greater economic loss. Other factors that can affect compensation include: age; occupation; pre-injury income; employment history; severity of the injury; permanent impairment; prognosis; future treatment requirements; capacity to return to work; pre-existing medical conditions; need for care and assistance; and whether the injured person contributed to the accident. This is why meaningful assessment requires considerably more information than the name of the injury. Does Permanent Impairment Determine How Much Your Claim Is Worth? Permanent impairment can be important, but it is not necessarily the same thing as the overall value of a common law claim . An impairment assessment measures the permanent medical effect of an injury according to prescribed criteria. A damages claim considers broader consequences, particularly the person's financial loss and future circumstances. This distinction is particularly important in workers’ compensation matters. WorkSafe Queensland explains that common law damages can include pain and suffering, past and future economic loss and past and future medical costs. The assessment can take account of factors including the worker's age, remaining working years, impairment, income and employment prospects. Related article: Workers’ Compensation Claims in Queensland: What Injured Workers Need to Know Does Being Partly at Fault Reduce Compensation? It can. If an injured person contributed to the accident through their own negligence, compensation may be reduced to reflect their share of responsibility. For example, MAIC confirms that a person who was partly responsible for a motor vehicle accident may still make a CTP claim, but their compensation may be reduced. Similar principles concerning contributory negligence can arise in other common law personal injury claims. The effect depends on the circumstances of the particular accident. Are Motor Vehicle Accident Claims Calculated Differently? Motor vehicle accident claims in Queensland are made through the CTP scheme where another driver was wholly or partly responsible. Compensation may potentially include: treatment and rehabilitation; past and future loss of income; general damages for qualifying injuries; and certain legal costs and disbursements. Each claim is individually assessed according to the injury and the claimant's circumstances. Related article: What to Do After a Motor Vehicle Accident in Queensland What About Public Liability Claims? Public liability claims can arise where an injury was caused by another party's negligence in a place such as a shopping centre, restaurant, business premises, private property or public area. The value of the claim depends not only on the injuries and resulting loss but also on liability. If liability is disputed or the claimant is found partly responsible for the accident, this can affect the amount ultimately recovered. Related article: Public Liability Claims in Queensland: What You Need to Know What About Workplace Injuries? Workers’ compensation requires an important distinction between statutory compensation and common law damages . Statutory benefits can include weekly compensation, medical and rehabilitation expenses and, where applicable, lump-sum compensation for permanent impairment. A common law claim is different. It requires the worker to establish that the employer breached its duty of care and that the breach caused the injury and loss. Where a common law claim succeeds, damages may include past and future economic loss, pain and suffering and medical expenses. Can an Online Compensation Calculator Tell You What Your Claim Is Worth? Online compensation calculators should be treated cautiously. A calculator cannot properly assess matters such as: whether another party is legally liable; competing medical evidence; the likelihood of future surgery; whether you will return to your previous occupation; your future career progression; the effect of an injury on a business owner's income; pre-existing conditions; contributory negligence; or the strength of the available evidence. At best, an online calculator may illustrate certain components of a claim. It should not be treated as a reliable valuation of an individual personal injury matter. When Can the Value of a Claim Be Properly Assessed? It is often difficult to accurately assess a personal injury claim immediately after an accident. The medical position may still be developing. Further treatment or surgery may be required. It may not yet be known whether the person will return to their previous employment or whether the injury will cause permanent restrictions. MAIC advises CTP claimants that they do not need to rush to settle and should consider how their injuries may affect them in the future. This is important because a settlement ordinarily represents the final resolution of the claim. Once the longer-term medical and financial consequences are reasonably clear, the claim can generally be assessed more meaningfully. Evidence Is Important When Assessing Compensation The value of a personal injury claim needs to be supported by evidence. Depending upon the claim, this may include: medical records; specialist reports; independent medical assessments; tax returns; payslips; employment records; business financial statements; receipts for expenses; treatment records; and evidence concerning future employment capacity. Keeping appropriate records from an early stage can therefore be important. There Is No “Average” Personal Injury Payout It can be tempting to compare a claim with another person's settlement or an amount reported online. Those comparisons can be misleading. A settlement involving a particular injury does not establish what another person with the same diagnosis should receive. The proper question is not simply: “What is this injury worth?” It is: “What losses has this injury caused this particular person, and what losses is it likely to cause in the future?” That distinction is central to understanding personal injury compensation. 

Injured at work in Queensland? Learn how workers’ compensation claims work, what benefits may be available and the difference between statutory and common law claims.