When we’re at our workplace, regardless if it’s in a field or office, no one wishes to have accidents in the area. Unfortunately, uncertainties can happen in any workplace, and sometimes, they result in serious injuries, including damage to the teeth, jaw, or mouth.
If you’ve suffered a dental injury at work, you may be wondering: Does workers’ compensation cover dental injuries?
The good news is that, in many cases, dental workers’ compensation benefits can help cover the costs of your treatment and even daily allowances as you recover.
Let us explain how workers’ compensation claims apply to dental injuries, how to claim workers’compensation, and what steps you should take if you need to make a dental injury claim.
Understanding Workers’ Compensation and Dental Injuries
How Does Workers’ Compensation Work?
Workers’ compensation is a government-mandated insurance scheme, which employers must take out, that provides financial assistance and rehabilitation costs to employees who suffer injuries or illnesses due to their jobs. It helps cover medical expenses, lost wages, and rehabilitation costs to ensure that injured workers receive the necessary care without facing financial hardship.
When it comes to dental injuries, workers’ compensation claim coverage depends on how and where the injury occurred. It is likely covered if your dental injury happened while performing work-related duties.
When Does Workers’ Compensation Cover Dental Injuries?
There can be three incidents that can make sure your dental injuries are covered by your workers’ compensation insurance. You should either experience:
1. Work-Related Accidents
If you suffered a dental injury while performing your job, you may be eligible for compensation. Common work-related dental injuries include:
- Being struck in the face by an object – Falling tools, equipment, or accidental impacts can cause broken, chipped, or knocked-out teeth.
- Falls that result in broken or knocked-out teeth – Slips, trips, and falls at work can lead to dental trauma, including fractures or lost teeth.
- Workplace violence or physical altercations – Assaults or accidental collisions with coworkers can cause significant oral injuries.
- Accidents involving machinery or equipment – Getting caught in or struck by work machinery can lead to severe jaw injuries or facial fractures.
In case you get caught in any of these accidents, you may be able to claim for your workers’ compensation benefits and get treated for your dental injuries. Some of these may include:
- Emergency dental care – Immediate pain relief and stabilisation of dental injuries.
- Dental extractions – Removal of damaged or severely broken teeth.
- Dental crowns and bridges – Restoration of cracked or broken teeth to restore function and appearance.
- Root canal treatment – Repair of deep dental injuries affecting the nerves.
- Dental implants – Permanent tooth replacement for knocked-out teeth.
- Orthodontic treatment for misalignment – If the injury has caused jaw or bite misalignment, orthodontic care may be necessary.
- TMJ treatment – If the accident results in jaw pain, joint issues, or limited jaw movement, WorkCover may cover treatment for temporomandibular joint disorders, like splints or nightguards.
2. Occupational Hazards
Some workers are more prone to dental injuries due to the nature of their job. For example:
- Construction workers may get hit by falling debris.
- Healthcare workers could suffer facial injuries from patient interactions.
- Athletes or security personnel may experience trauma due to physical contact.
If your job increases your risk of a dental injury, workers’ compensation can be your safety net in case you get injured during your work. Aside from the medical expenses, you may also be able to file a dental workers’ compensation claim for lost wages due to your injury.
3. Work-Related Stress Injuries (Bruxism and TMJ Disorders)
Stress-related dental conditions such as bruxism (teeth grinding) or temporomandibular joint (TMJ) disorders may also be covered under workers’ compensation if they can be directly linked to work-related stress or repetitive strain.
Some may even be diagnosed with cavities because of poor oral hygiene due to workplace-related depression and anxiety. Because of these, patients may be recommended to get splints to control their teeth grinding, or crowns for those who experienced cracked teeth at work.
How to Claim Workers’ Compensation for Dental Injuries
When you’re faced with a dental injury that is job-related, remember to stay calm and don’t panic. Remember these steps when you are currently in a dental injury:
Step 1: Report the Injury
As soon as the injury occurs, report it to your employer. Delaying your report could impact your ability to file a successful workers’ compensation claim.
Step 2: Seek Medical and Dental Treatment
Check with a GP first to ensure that your injury does need help from a dental professional. Inform them that your injury is work-related to give you proper documentation for your concern, like a GP referral, insurance approval, and a valid claim number.
If it’s for immediate dental treatment and you have to see the dentist right away, the treatments may need to be paid out of pocket and claimed back later via your insurance.
Step 3: Complete a Workers’ Compensation Claim Form
Once you’re given medical and dental treatment and are conscious enough to proceed with your claim, you’ll need to fill out a workers’ compensation claim form. This is usually available from your employer or GP. Provide detailed information about how the injury occurred and the treatment required.
Step 4: Submit Supporting Documentation
Aside from the form, the most beneficial evidence to claim your workers’ compensation is to prove that your injuries are work-related. To strengthen your claim, gather the following:
- Medical and dental reports
- Accident reports from your employer
- Witness statements (if applicable)
- Photos of the injury (if relevant)
Step 5: Wait for the Claim Decision
Once your claim is submitted, it will be reviewed by your employer’s workers’ compensation insurer. They will determine whether your injury is covered and what benefits you are entitled to receive.
Step 6: Use Claim Number for Dental Work
Once your claim decision is approved, you will also receive a claim number that you can use when getting an appointment for your dental work. Bring your GP referral proving that you need to see a dentist and your claim number to the dental clinic you will have your dental work done.
You may also call them and provide your claim number to let them know you’re covered by WorkCover. With Dentist Near Me Merrylands, you can just easily call our landline so we know your claim is valid and good to undergo dental treatments
Disclaimer: This is just a general guide on how to claim your workers’ compensation when you’re faced with dental injuries. Every state has their own different eligibility and requirements, so make sure you check with Safe Work Australia.
What Workers’ Compensation Covers for Dental Injuries
If your claim is approved, workers compensation may cover:
- Emergency dental treatment
- Restorative procedures (e.g., crowns, bridges, fillings)
- Oral surgery (e.g., tooth extractions, jaw surgery, nightguards or splints)
- Missing teeth (implants)
- Physical therapy for jaw-related injuries
- Lost wages if you need time off work for recovery
What If Your Claim Is Denied?
Sometimes, dental injury claims are denied due to a lack of evidence or disputes about whether the injury was work-related. If this happens:
- Request a written explanation for the denial.
- Gather additional evidence, such as medical opinions or witness statements.
- Seek legal advice or contact a workers’ compensation specialist for guidance. Contact Andy from Spinak Lawyers who offers no-win, no-fee service, and 99% win rates. You can email him at office@spinaksolicitors.com.
Getting the Support You Need
Suffering a dental injury at work can be painful and stressful, but workers’ compensation claim benefits may help cover the cost of treatment and lost wages. If you’ve been injured, make sure to follow the necessary steps on how to claim workers’ compensation to ensure you receive the support you need.
If you require professional dental care following a workplace injury, you can ask for assistance with treatments and the help of our no out-of-pocket lawyer from Dentist Near Me Merrylands. Our experienced team can provide the necessary treatment and assist with your dental workers’ compensation claims.Contact us immediately at (02) 9718 9469 in case you’re faced with dental injuries in your workplace.