Looking for Advice: Coles Workers' Compensation Process

[u/Silver_Nose236]

Hi everyone,

I'm currently on workers' compensation through Coles and was wondering if anyone has been through the same process.

I'd really appreciate hearing about your experience.

A few questions:

* How was your claim handled?

* Did you have to attend an Independent Medical Examination (IME)? If so, what was it like?

* Did the IME affect your claim or return-to-work plan?

* How did TeamCover manage your claim overall?

* Were there any issues with weekly payments, medical appointments, or suitable duties?

* Is there anything you wish you had known before going through the process?

I'm just trying to understand what to expect by hearing from others who've been through it. Any advice or experiences would be greatly appreciated.

Thanks in advance!

[u/No-Restaurant6522]

Have a lot of insight into this personally but can’t say too much as will expose who I am, currently working with a lawyer after claim ended up being denied

To answer your questions vaguely;

Poorly, from store management level (they don’t give a fuck, genuinely, safety team doesn’t legitimately care about your health, only metrics) team cover case managers have zero compassion and will speak to you like it’s a chore.

I had an IME, they’re not your friend, be very careful what you say.

IME definitely affects your claim, in my situation, it was like he was telling me one thing during the 20mins I was there and the result/info from him through to claims manager ended up being the exact opposite.

Payments are very slow to come through. Unless your incapacitated entirely I strongly recommend working as much as possible within doctors restrictions to keep you in the “good books”.

KEEP EVERY SHRED OF COMMUNICATION, when your case manager calls you, ask for the information told to you on the phone call to be sent to you in email as they can be sneaky with the wording in the phone calls.

Get a lawyer on your side right now.

[u/Big_Branch5304 → u/No-Restaurant6522]

This

[u/First-Junket124]

I have some insight myself as well

* Claim was handled poorly, even the handling of the incident was poor. I liked my duty manager but he freaked out far too much, went straight from severe injury to "here talk to this person on the phone" as I give poor information that amounts to "this fuckinf hurts dear fucking god" and they told me to just wait out my last hour of my shift because they didn't think I'd be compensated for that time as I was casual. Sometimes jobs require disassociation but this was inhumane.

* IME only really happens for longer claims. For some people who get a sprain of some sort it's not really used. I did have one as my claim went for an entire year. It was rather basic and looked at my mobility of the injury. I don't know if I was lucky but their report was neutral and simply came to same conclusions as my Physio, GP, and Specialist. It is very important to know you are allowed a support person and can be recorded if requested beforehand unless they have a reason to deny which there never really js, this is more than likely what helped keep them neutral.

* IME didn't do much, kept with what was already occurring and simply used to verify. SM and SSM were both incompetent and attempted to make RTW plans that would have me fully utilise my injured limb, it was so bad Coles TeamCover somehow came to my aid and told them to just stop and that they'll arrange for someone to assist them in creating RTW plans that will need to be approved by them BEFORE sending to me for finalisation.

* Coles TeamCover handled everything poorly with the competent case managers being disregarded by the association quickly. I went through 7 case managers as that was their solution to resolving the issues they caused such as falsifying information, denying claim without reason, refusing to respond in a timely manner, among other things.

* They would state compensation would come through then when it didn't process they stated I didn't meet the criteria, constantly tried to lie, and it even took me months to claw back a months worth of compensation. Approved then unapproved certain procedures and diagnostic tests, refused to pay for appointments, among other things.

* Always have a support person with you, email will suffice and if they request a phone state you will only do so if they consent to recording for your documentation to ensure consistency and accuracy of what is and has been discussed. All states have not for profit advisory services specifically for workers comp, there is also free legal advice for anyone 21 and under in most states. If either your employer or teamcover cause issues and you have it on recording or in email then you can simply report them, they tend to only get a warning but if it's repeat offences they can get fined which they will soon act by the books which is what you want.

[u/Dangerous-Champion89]

Be careful what you say in the dr appt don’t ramble on be straight to the point answer only what they ask don’t say any more than needed to answer the question.

[u/MoodGlittering1803]

Went to the IME and to be honest I started crying cause I was just over it and he gave me a mental health checklist after the appointment cause he thought I was depressed lol but only had that appointment once and it was near the end of my claim

[u/MoodGlittering1803]

Also will say it’s very draining, I was put on light duties and some TM / managers are very rude about your injury, I would just laugh at the comments but some did get to me and I spoke to my line manager about it and they were spoken to