What if WorkCover doesn’t cover my mental health claim?

In today's work environment, mental health is of greater concern than ever. Yet, recent legislative changes in Victoria and proposed changes in New South Wales could leave workers with mental health conditions without the support they need.

These reforms may significantly reduce the number of psychological/psychiatric injury claims that can be brought by workers suffering from burnout, stress, bullying, or harassment.

This is concerning given that according to the ABS National Study of Mental Health and Wellbeing for the period 2020-2022, 42.9% of people aged 16 to 85 years had experienced a mental disorder at some time in their life and 39% of young people aged 16-24 experienced a mental disorder in the last 12 months.

A mental disorder is ‘characterised by a clinically significant disturbance in an individual’s cognition, emotional regulation, or behaviour’. The term covers a range of conditions, including:

• anxiety disorders such as social anxiety disorder, panic disorder and post-traumatic stress disorder (PTSD)
• affective disorders such as depression and bipolar disorder
• substance use disorders.

This means that many workers might be forced to continue working in unhealthy conditions or forgo necessary treatment because they can't afford it.

However, another option is insurance within superannuation - an often-overlooked entitlement – that can help fill this gap.

Understanding these legislative changes and knowing your insurance entitlements can make a world of difference in ensuring you get the support you need.

What are your WorkCover rights, if you suffer from a mental health condition?

Usually, if a worker has an approved WorkCover claim for a mental health condition, they will receive weekly income payments while they are medically unfit to work and funding for medical & like expenses. This support is crucial, as psychological or psychiatric treatment can be life-changing but prohibitively expensive, while weekly income payments enable people to maintain their living expenses and live a dignified life while they can’t work and earn an income. 

Victoria updates to mental health injury claims

In Victoria, for claims arising on or after 31 March 2024, stress or burnout are no longer eligible for compensation, except for bullying or harassment if a worker experiences an unexpected traumatic incident and when a worker’s normal duties expose them to traumatic events. Up to 13 weeks of provisional payments are available for all mental injury claims to help cover mental health treatment and support services, even if the claim is rejected. However, they will not be paid beyond this time.

New South Wales proposed changes

The proposed legislative reform of the workers’ compensation scheme in NSW, aimed at prevention rather than compensation for psychiatric/psychological conditions arising out of the course of employment, may significantly reduce the number of psychological injury claims that can be brought by workers who suffer a mental health condition such as burnout, stress, bullying or harassment at work.

Therefore, workers suffering from mental health conditions may need to consider other forms of income support if they can’t work or afford medical treatment.

Insurance within superannuation may fill the gap

Most people don’t realise that your super includes default insurance that covers you for mental health conditions. You receive cover simply by being a member of a default super fund called a MySuper product. This type of insurance isn't underwritten in the same way as direct insurance policies. It can even cover claims for conditions that existed before you joined the super fund.

The three main types of insurance offered through your superannuation are:

• Income protection
• Total and permanent disability (TPD)
• Terminal illness/death cover

Simply put - if your mental health means you can’t work, then you may have a mental health claim.

Your condition doesn’t have to be work-related, but if it is, you don’t need an accepted WorkCover claim to pursue your insurance within super. Our team will handle the paperwork to maximise your entitlements. 

Read more: Latest mental health data highlights the importance of seeking help

Your super insurance and mental health

Just like it is important to seek help for mental health issues, it’s important to be aware of the insurance our super funds have in them to help us out during hard times.

We’ve helped thousands of Australians successfully claim their insurance benefits when they became unable to work due to their poor mental health. Importantly, these insurance payments are separate from your super balance.

Casey’s Story

We acted for Casey, who experienced bullying and harassment at work, causing her stress, anxiety and depression, which ultimately caused her to be unable to continue working as a disability support worker.

Her WorkCover claim was rejected, so she withdrew her super account balance and was told she no longer had any insurance on her account. We did a Superannuation Free Claim Check for her and confirmed that on the date she stopped work a few years earlier, she did have insurance for TPD on two superannuation accounts.

We made two TPD claims on her behalf, gathering all the necessary information and medical evidence, and we successfully obtained about $300,000.00 in insurance entitlements for Casey. Casey was overwhelmed with the outcome, especially as she wasn’t aware she had the insurance and could claim for her mental health. Casey was delighted that she had a solution for her financial instability, enabling her to pay her mortgage and access psychiatric treatment she previously couldn’t afford.

Help with navigating superannuation insurance claims for mental health conditions

Your claim does not have to be work-related, but insurance within super may be an important safety net if it is. You could be suffering from depression, anxiety, an eating disorder, or a substance abuse issue; if your mental health is preventing you from being able to work in your usual occupation, you will likely have a super insurance claim.

In many cases, disability insurance benefits for mental health conditions can be received in addition to other compensation benefits for work and road-related accidents.

A successful insurance claim can ease the financial burden of unemployment caused by mental health issues and can provide the funds needed to access additional mental health treatment.

The claims process can be complicated, and insurers are often challenging to deal with. And when you’re unwell, it might be the last thing you feel like doing. That’s why our experienced and dedicated super insurance legal team is here to help.

Call us for an obligation-free and confidential discussion where our expert lawyers can get started on a free super claim check to find out your entitlements and discuss your options for making a claim.