Worker’s Compensation Claim

Do I Have A Claim?

In New South Wales, if you are injured during the course of your employment, you can make an injury claim with your employer. Your employer will notify its workers compensation insurer of the injury and lodge an injury claim at the same time.

Once your claim is lodged, the insurer and treatment provider have the responsibilities to assist you to recover and return to the workplace as quickly as possible.

When your injury claim is accepted by the insurer, you may have an entitlement to the following:

  1. Weekly benefits
  2. Medical expenses
  3. Lump sums compensation for permanent impairment

The insurer will provide you relevant information regarding rehabilitation. The insurer aims to assist you in your recovery and to return to work as soon as possible.

However, they do not necessarily advise claimants that they are able to claim for lump sum compensation for permanent impairment. A 'lump sum' claim can be in thousands of dollars and this entitlement is set out in sections 66 and 67 of the Workers Compensation Act 1987.

To properly prepare your claim for lump sum compensation, we will collate all medical information relating to your injuries and disabilities before we arranged for you to be assessed by reputable medico-legal doctors who will assess your injuries and provide a Whole Person Impairment rating in accordance with AMA 5 Guides.

Your legal fees and disbursements will be fully paid by the insurer. You do not need to incur any expenses at any time.

What Do I Do When I’m Injured at Work?

If you are injured at work, you must report the incident and injury to your employer as soon as possible.The incident details must be entered in the company's injury register. Your employer has a legal obligation to notify the insurer within 48 hours of the injury being notified.

Your employer has a legal obligation to notify the Scheme Agent or insurer within 48 hours of the injury being notified.

If your employer fails to lodge an injury claim, you must contact WorkCover Assistance Service on 13 10 50 or our office for immediate advice.

When contacting WorkCover Authority, you must provide the following information:

  1. Your full contact details
  2. Your employer's details
  3. Your doctor's and treatment details
  4. The date of injury and description of the incident
  5. Name of the person who notified the insurer and your relationship to that person

If the employer fails to notify the Scheme Agent or insurer within the 48 hours timeframe, you must contact WorkCover Assistance Service for advice on 13 10 50.

Provisional Liability

Once a claim is made with an insurer, your claim may be accepted provisionally so that you can start receiving weekly benefits and medical expenses. This allows you to claim weekly payments for a maximum of 12 weeks and payment of medical expenses up to $7500.

Your weekly benefits start within 7 days after notification of injury is made with the insurer unless the insurer has a reasonable excuse not to pay weekly benefits.

The insurer must then notify you in writing and provide further advice on resolving dispute.

The reasonable excuse can be any of the following:
  1. You do not have insufficient medical evidence
  2. You are unlikely to be a 'worker'
  3. The insurer is unable to contact you
  4. You refuse to cooperate with the insurer
  5. Your injury is not work-related
  6. You reported your injury after 2 months
  7. Your injury is not a significant injury

Time Limits

It is very important that you lodge a Workers compensation claim within 6 months of the date of injury. You can still bring a late claim if it is the result of ignorance, mistake or absence from NSW.

If you wish to make a claim outside the 6 month period, please contact our office as soon as possible.


WorkCover NSW Medical Certificate

Where possible, you must immediately consult a doctor regarding the injury and request the doctor to complete a WorkerCover NSW Medical Certificate. You must nominate your doctor as a nominating doctor who has your permission to release relevant information to the insurer. An injury management and return to work plan can then be devised for you.

You should promptly give the completed medical certificate to the employer or insurer and include any receipts for medical treatment. You should remember to keep a copy of the receipts and documents relating to treatment.

You must also agree to participate and cooperate with tment and implementation of an injury management plan and return to work plan.

When attending treatment providers such as physiotherapist, you must provide them with claim number. Your treatment provider will then request pre-approval from the insurer. This will ensure that you are not out of pocket.

Mitigation of Loss

You must be seen to mitigate your loss by making all reasonable efforts to return to work. If you are unable to perform pre-injury duties at work, you must inform the doctor and the employer of your disability and other suitable duties.