I knew there was something deeply wrong with the workers compensation system when a lawyer told me not to hire her for my hearing with QBE. The insurance company had disputed my claim for post traumatic stress disorder (PTSD)-related medical expenses.
The lawyer said insurers almost always won this stage. Don’t waste your money.
The Tasmanian Workers Rehabilitation and Compensation Tribunal had convened a telephone hearing on June 5, 2018 to decide whether QBE had a “reasonably arguable case” to put my claim into dispute.
QBE provided workers compensation insurance to Reuters, the international news agency and my employer at the time.
An invitation from the commission for me to attend the hearing was blunt: “If the tribunal is satisfied that there is a ‘reasonably arguable case’ your compensation payments will stop.”
Australia’s $60 billion workers’ compensation system is under the microscope today after a joint investigation by The Age, The Sydney Morning Herald and ABC’s Four Corners uncovered mismanagement of the state government-run scheme in NSW and “unethical” conduct in Victoria.
Insurers successfully disputed claims to make wage payments and other benefits for mental and physical injury in 97.2% of cases at Tasmania’s tribunal in 2018/2019.
This is my story.
My PTSD resulted from cumulative trauma. I first covered an earthquake in Indonesia in 1994 that killed 200 people.
The 2002 Bali nightclub bombings was the first time I saw what a bomb could do to a human being. I was in Indonesia’s Aceh province after the 2004 Boxing Day tsunami. Death toll 165,000.
I was Reuters bureau chief in Baghdad from 2007 to 2008. In July 2007, three of my staff were killed, two by a U.S. Apache gunship. WikiLeaks co-founder Julian Assange released classified footage of that event in 2010. He called the tape “Collateral Murder”. It’s been viewed tens of millions of times.
A psychiatrist in Hobart needed only 45 minutes to diagnose me with PTSD in early 2016.
The tribunal’s chief commissioner chaired the hearing. Also present was a lawyer for QBE and my QBE case manager.
In insurance jargon, QBE was representing Reuters, even though HR had asked me to file the claim for PTSD-related medical expenses, which I’d been happy to do.
The lawyer representing QBE, from Page Seager in Hobart, spoke for about 20 minutes. He began by saying, “it’s not contended in any way from the employer that Mr Yates is suffering from a significant disease”.
But he said I’d failed what’s known as the employment connection test under the Tasmanian Workers Rehabilitation and Compensation Act (1988) because I wasn’t in Tasmania when exposed to trauma.
There was “significant doubt” as to whether Tasmania or any state was connected to my employment when I was exposed to trauma. My claim had also been filed too late, he said.
The commissioner called the lawyer’s arguments “quite technical”, then asked if I understood what had been said. The lawyer had spoken quickly, but I had the act in front of me and had a fair idea what would be said following emails I’d received from both the insurer and Page Seager.
I read aloud the following paragraph: “The fact that a worker is outside this state when injured does not prevent compensation being payable under this act.”
I said to the commissioner, “doesn’t that open possibility that…”. The commissioner cut me off, saying I might be right, that I might come to a final hearing and say I satisfy the connection test. On the delay in lodging the claim, I’d been advised leeway could be granted. That’s correct, the commissioner said. I’d need to provide evidence, but not in this hearing.
I was angry by now.
“OK … What you are referring to here (commissioner) — and you use these words yourself — are technical grounds, that my case, my claim, is being disputed on technical grounds,” I said.
“Frankly, I find it ethically and morally reprehensible that my case is being disputed on a couple of technicalities when the evidence that I have PTSD is absolutely iron-clad. QBE has had five months to rake through my extensive medical history, send an investigator to interview me, speak to the multitude of doctors, psychologists and psychiatrists who have treated me and the various Reuters managers I’ve had since 2009. How any reasonable person would regard this as being fair and reasonable just beggars belief.”
The commissioner replied that the lawyer said there was no dispute that I had PTSD.
I cut him off.
“I don’t think that’s the point. This is what QBE tries to say. It’s hiding behind a couple of technicalities to dispute what is just absolutely iron-clad. I just find that unbelievable.”
The commissioner then said there was “a reasonably arguable case concerning the employer’s liability to pay weekly compensation and cost of benefits under the act and I therefore order that compensation by way of weekly payments and the cost of any benefits in respect of the injury not be paid by the employer.”
The hearing was over.
With those words, he instantly cut my access to medical payments from QBE, such as out-patient costs for therapy and medication. (Reuters continued to pay them.)
The insurance industry will squeal that in Tasmania in 2018/2019 it paid nearly 91% of workers compensation claims without dispute.
But I see no fairness in a system that cuts wages and other benefits to workers so easily when insurers decide to dispute a claim. The onus is then on the worker to take the matter back to the tribunal or give up.
I explored my legal options. Reuters paid the fees.
A barrister with decades of workers compensation experience said he was confident I could successfully challenge QBE on the two points.
On the employment connection test, precedents had been set with fly-in-fly-out workers injured in other states. However, he advised against doing so because of the relatively small amounts of money involved and the stress it would cause me.
He advised me to “park” the claim, which I did.
Reuters continued to pay all my PTSD-related expenses until I left the company in 2020.
Dean Yates was a journalist, bureau chief and senior editor at Reuters for 23 years until he was diagnosed with PTSD in early 2016. He was head of mental health and wellbeing strategy at Reuters for nearly three years until January 2020.
Similar experience with Worksafe and bullying within the Victorian education system: accepted that the injury occurred but straight out lie about the date the injury was first reported used as an excuse to reject claim. Since I had sick leave anyway it wasn’t worth it to me to take it further but the stress of going through the assessment system and the barefaced mendacity of the insurance firm involved was disgusting.
Please delete comment above.
Dean, I suspect you are a victim of the ‘red tape’ that business cannot possibly survive until it is taken away.
When Jennifer Westacott claims we need to get rid of red tape, I just wish one brave journalist wouldn’t ask what red tape specifically she wants cut. Would it be worker’s compensation, health and safety, having to be paid, being on call at all times with no allowance for it, stripping back wages, having to comply with awards that sometimes run to pages, yes pages?
Where is the first comment?