How to Make a Workcover Claim

Workers Compensation Claim Form Insurance Concept

No one wants to suffer a workplace injury or illness.

However, with more than 100,000 serious claims compensated in Safe Work Australia’s last report, it’s something that could affect any Australian – regardless of what industry you work in.

If you have been injured or fallen sick as a result of your work, you may be entitled to worker’s compensation. To be eligible, the injury or illness must be new or an aggravation of a pre-existing one.  Whether you’re a full time, part time, permanent or casual worker you are still able to make a workcover claim. This includes being employed by your place of work or through an employment agency.

Claim benefits help with weekly payments when workplace injury or illness is preventing you from working. It also offers support for medical and rehabilitation expenses, including specialist appointments, treatment and medication expenses.

Here’s what you need to consider before you make a workcover claim:

Keep Your Employer and GP in the Loop

Even if you’re unsure whether you’re going to make a claim, it’s important to inform your employer and doctor.

By reporting the injury immediately (in writing if possible), you minimise the risk of losing any legal rights you may have to receive workers compensation benefits.  Be cautious of time constraints however, as work-related injury or illness must be reported within 30 days of becoming aware of it.

If your workplace has a Register of Injuries, make sure the incident is recorded there, as well as the written notification to your GP and employer. Some claims may not be processed without  a ‘first medical certificate’, which can be obtained from your doctor.

As an employee in Australia, you have the right to visit your own doctor for workplace claims and treatment. Once your employer and GP are notified, a doctor’s report will be written within 30 days of your workplace injury or illness exam.

Your workplace injury report must contain your name, address, the date when injury/illness first occurred and the nature of the case to be processed properly.

Check if Your Employer is Insured

It’s mandatory all employers have workplace compensation in Australia, but it’s still recommended to ensure they’re properly insured.

Self-insured employers will need to manage the claim and return to work assistance themselves.

Tip: Workcover claims are a no-fault scheme. This means that by you making a claim, you’re not ‘blaming’ the workplace incident on your employer, you’re simply saying you have been injured at work and you need time off work or to cover medical expenses. With workers compensation, medical expenses and wages for your time off work will be covered from their insurance, not their pocket, so the business’s bottom line will not be affected.

Seek Legal Advice

It’s recommended to seek independent legal advice when making a claim, as well as engaging with your employer and GP.

This gives you a clear understanding of your entitlements and whether you’re entitled to other rights as part of your compensation. Even if the claim has been accepted by WorkCover, seeking legal advice is strongly encouraged.

Complete a Claim Form

If you need time off work or medical treatment because of your workplace injury, you must complete a WorkCover Worker’s Claim Form.

If the injury or illness is permanent, you’ll need to fill out the Worker’s Claim for Impairment Benefits Form.

Claim forms should be completed by you and your employer together. Not only will this keep the lines of communication open, but it’ll give you both the opportunity to discuss support options to help you return to work as soon as possible.

To make a workplace claim for payment benefits, it must be within 12 months of the date your injury or illness occurred in Western Australia. However, it’s important to note that each state varies with its claim time.

Your claim form must also include:

  • As many details of the incident as possible, including when you first noticed and when it was recorded with your GP and/or employer.
  • All symptoms listed which are associated with the work-related injury or illness. Different industries may not cover certain things, so it’s a good idea to check your claims will be covered.
  • Ensure the claim form is signed and dated, with a copy kept for your records too.

Accepted Claims vs. Not Accepted Claims

Claims that have been accepted mean you will receive weekly compensation (income entitlements) for loss of wages and any medical expenses.

If your claim is disputed, no payments will be made. The insurer will advise you of the reason for the disapproved claim. If you feel your case you should be reassessed, you can approach the insurer or lodge an application here.

Tip: Whilst you’re waiting for your claim to be processed, discuss access to sick or annual leave with your employer. You may wish to apply to Centrelink for financial help too. However, they will need to confirm with your workplace the claim is still waiting to be accepted.

Understand all Obligations

You, your employer and your workplace’s insurer all have obligations when making a workplace claim.

Employers are obligated to allow you to visit a doctor, make a workcover claim and prepare a Return to Work program. Following your obligations to report the injury or illness, your employer has a duty of care to act as soon as possible, complete the register of injuries and assist you in making a claim. Once the form has been filled out, your workplace is required to forward it to their insurer within three working days.

You can find out more about you or your employer’s obligations here.

Returning to Work

Workcover claims are designed to get you back working as soon as possible, as well as protecting your place of work.

If it has been indicated on your report by your doctor that you have the capacity to return to work, it’s likely your previous position can still be held for you. To return back to work safely and quickly, you’ll need to consult with your employer and GP to implement a Return to Work Program.

Making a workcover claim doesn’t have to be stressful or challenging. With the right information and support, you can have compensation for your workplace injury or illness.

Author Bio:

This article is written by Jayde Ferguson, who recommends Perth City Legal – a specialised workers’ compensation law firm.

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