From making a claim to lodging an appeal

Explaining the process of making a claim and, if required, lodging an appeal.

Injured worker lodges Application for Workers’ Compensation form with relevant insurer (WorkCover or self-insurer)

Lodge application with Q-COMP Medical Certificate (copy to employer) and other relevant supporting documentation eg medical report

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The insurer (WorkCover or self-insurer) assesses the application in accordance with the legislation, for example

  • does the injured worker meet the definition of a worker under the Act?
  • did the injury arise out of, or in the course of, employment and was employment a significant contributing factor?
  • are there other issues relevant to the claim that should be considered?

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When assessing the application, the insurer may -

  • Talk to the worker, employer, treating doctor, nominated witnesses
  • Ask worker to attend a medical examination for assessment of injury (not for treatment)
  • Ask worker and/or employer, treating doctor for further information
  • It can be beneficial in some instances for the injured worker to provide the insurer with written medical opinion that stated mechanism is consistent with the injury rather than relying on the insurer seeking the relevant medical information

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Application is accepted

Insurer notifies the worker and the employer

Injured worker to request decision in writing

 

Application not accepted

Insurer notifies the worker and the employer

Injured worker to request decision in writing

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Injured worker receives compensation benefits relevant to the claimeg weekly compensation, payment of medical treatment

 

Injured worker can lodge an application for a review of the decision with Q-COMP, the independent regulatory authority

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Claim continues until injury has resolved or reached maximum medical improvement and is stable & stationary

 

If review is unsuccessful injured worker can lodge an Appeal with Queensland Industrial Relations Commission

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