If you’ve suffered adverse side effects from a Covid-19 vaccination and are considering making a claim via the government compensation scheme, this guide can help you gather the required proof of injury. Gathering proof is a critical step to make a Covid vaccine claim.
What evidence do I need to prove my Out of Pocket Expenses claim?
You need to provide:
- evidence of the out of pocket expenses incurred (such as receipts or records of treatment): Clause 18(2)(a) of the Scheme Policy.
- evidence that those costs were most likely incurred as a result of your vaccine-related condition Clause 18(2)(b) of the Scheme Policy.
- Evidence of any payments received from others (such as insurance companies, workers’ compensation insurers etc): Clause 18(2)(c) of the Scheme Policy.
- Any other evidence you think is relevant : Clause 18(5) of the Scheme Policy.
What evidence do I need to prove my Future Out of Pocket Expenses claim?
For future costs, you need to provide:
- evidence of the fact you will most likely incur costs in the future: Clause 18(3)(a) of the Scheme Policy. That would typically be in the form of expert medical evidence.
- Proof of what those costs will be (eg getting a quote): Clause 18(4)(a) of the Scheme Policy
- evidence of the fact that such costs are most likely required because of your vaccine-related condition: Clause 18(4)(b) of the Scheme Policy.
- proof of any entitlement to payments from others (such as insurance companies, workers’ compensation insurers etc): Clause 18(4)(c) of the Scheme Policy.
- any other evidence you think is relevant : Clause 18(5) of the Scheme Policy
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What evidence do I need to prove my Past Lost Earnings claim?
It is important to get strong evidence to support your claim for lost earnings. If insufficient evidence is provided, that part of the claim is likely to be rejected (regardless of the merits of the rest of the claim).
The Scheme policy notes what it is expected you will need to have to prove your past lost earnings (see Clause 19(2) of the Scheme Policy).
That evidence should typically include:
- records confirming your job (example: letter of offer of employment or employment contract)
- records showing the source of your income (example: PAYG and payslips)
- records establishing your earnings over a period of time prior to the vaccine reaction and the period since (examples: tax returns for say three years, pay history, PAYG’s and payslips)
- records showing the time you have taken off (examples: a letter from your employer, payslips or leave histories)
- records of any other benefits received before and after the vaccine reaction (examples: documents which show social security payments, COVID-19 Disaster payments, workers compensation etc) or a statement from you that no such payments have been made (or that they have already been deducted from the claim you are making)
- a medical report form from you doctor. Note that that form specifically asks your doctor to give an opinion on various things, such as:
- how much time you’ve had off (and when)
- an explanation why you couldn’t work
- the impact the vaccine reaction has on past and future work restrictions
What evidence do I need to prove my Future Lost Earnings claim?
As with the claim for Past Loss of Earnings claim (see above) you need to provide sufficient financial and other documents to establish your work history, level of earnings, need for time off etc.
In addition though, for the claim for future loss of earnings the Scheme also requires you to provide evidence of:
- your intended retirement age (if beyond 65 years). That is not easily provable. Some examples might be documents which you have previously filled out for others (e.g. financial planners, accountants or lawyers) where that issue was canvassed. Or a letter from your employer (if that was raised with them) or a statement from yourself or others.
- any expected increase in the level of earnings into the future (through promotions or other job opportunities). That might take the form of statements or letters from a current or proposed employer, records of offers of employment and so on.
- how the condition might continue to affect you into the future. That will usually be in the form of expert medical opinion/reports.
These requirements are detailed further in Clause 19(4) of the Scheme Policy.
What evidence do I need to prove my Pain & Suffering claim?
You need to provide ‘satisfactory evidence’ demonstrating the pain and suffering you have and/or will suffer.
The supporting evidence you need to submit must include:
- a medical opinion from an appropriately qualified doctor (it can be but does not need to be a treating doctor) that your pain and suffering is most likely caused by the vaccine-caused condition;
- evidence of any payments already made by another party (eg another insurer, workers’ compensation insurer etc) or a statement to the effect nothing has been received; and
- for a claim under $20,000 (a Tier 1 claim) – a short statement from the affected person about the impact on their pre-vaccination circumstances and their ability to lead a normal life; or
- for a claim over $20,000 (a Tier 2 claim) – a comprehensive statement from the affected person about the impact on their pre-vaccination circumstances and their ability to lead a normal life as well as any other relevant matter.
These requirements are detailed further in Clause 20 of the Scheme Policy.
What evidence do I need to prove my Unpaid Domestic Services claim?
To successfully claim compensation for unpaid domestic services which were provided to you because of your vaccine-related injury you would likely need to submit:
- a report from a doctor confirming there was a need for the services and that the need was greater than 6 hrs per week for more than 6 months – the standard Scheme medical report form asks the doctor to address that;
- a statement from yourself and the care providers of the type of services provided and their duration (this is not specifically stated to be required but is in keeping with the balance of the Scheme requirements);
- a record of any payments you have received from other parties (eg insurers or workers compensation authorities) for those type of services – any such services/payments will be excluded from the assessable amount; or
- a statement from you confirming you have received no such payments.
These requirements are detailed further in Clause 21 of the Scheme Policy.
