Making a claim for workers' compensation

Under the Queensland Scheme, if you sustain a work-related physical or psychological injury you are entitled to lodge a claim for workers’ compensation. A claim must be lodged within 6 months of incurring the injury

A claim will be assessed by the relevant insurer i.e. WorkCover Qld or a self-insurer before a decision is made on whether the claim is accepted or not.

A claim will be assessed in accordance with the Workers’ Compensation & Rehabilitation Act 2003.

WHAT TO DO IF YOU ARE INJURED

If you are injured at work or have a work-related injury or illness you should seek medical attention as soon as possible. You have the right to attend your own treating doctor.

Report the incident to your employer as soon as possible and complete an incident report if you are able to.

When attending your doctor be sure to:

  • explain the circumstances of how you were injured; and
  • the connection with your work.

If the doctor diagnoses a workplace injury or illness, the doctor should issue a Workers' Compensation Regulator Medical Certificate.

The doctor should note his opinion of the relationship between your employment and your injury on the certificate.

If your doctor thinks your injury has happened over a period of time from a specific task you perform, this should be recorded on the certificate.

LODGING AN APPLICATION FOR WORKERS' COMPENSATION

If the insurer is WorkCover, you can lodge your application, a medical certificate from the Regulator and all additional information direct to WorkCover from most doctor surgeries.

Alternatively you can download an application from WorkCover and send by fax or email, or lodge your claim online.

If your employer is a self-insurer you will need to complete the appropriate application form available from the self-insurer.

The Workers' Compensation Regualtor Medical Certificate issued by the doctor is in quadruplicate, with a copy for the employer, the insurer, the medical/dental practitioner and you.

You must provide your employer and the relevant insurer, with the copy of the medical certificate.

PROVIDE ADDITIONAL INFORMATION WITH YOUR APPLICATION

One of the most important aspects of a claim for workers’ compensation is establishing the link between the injury or illness and work.

Sometimes the doctor provides a clear opinion of the link between your work and your injury or illness and there may be no need to provide additional information.

However in some instances how a work-related injury or illness occurred is not so straight forward. You may need to write a statement outlining how the injury or illness occurred and seek additional evidence such as a letter or report from the doctor linking the injury to work, provide witness statements if an event was witnessed that is relevant to your claim.

TIME FOR APPLYING

It is best to lodge an application for workers’ compensation as soon as possible to the time the injury was sustained and you attended a doctor in relation to the injury.

Legislation determines that an application for workers’ compensation must be lodged within six months of incurring a workplace injury or illness.

However a delay in lodging an application may mean benefits are not paid from the date the injury is sustained.

So it is in your best interest to lodge a claim as soon as the injury or illness has been sustained and you have attended a doctor in relation to the injury.

KEEP COPIES OF EVERYTHING YOU PROVIDE

Keep a copy for your own records of any forms, medical certificates and additional information you provide to WorkCover or the self-insurer.

IF YOUR CLAIM IS ACCEPTED

Current legislation determines the insurer must make a decision on an application within 20 business days of the application being lodged.

Once the insurer has assessed an application they will make a decision whether to accept or reject the application.

If your application is accepted you will be notified by the relevant insurer ie WorkCover or the self-insurer.

For the duration of your work-related injury or illness you must provide up to date Workers' Compensation Regulator medical certificates to your employer and to WorkCover (or self-insurer).

IF YOUR CLAIM IS REJECTED

If the insurer advises they are rejecting your claim, request they provide you with their reasons for the decision in writing and a copy of your claim file.

You may wish to have the insurer’s decision reviewed. A review is conducted by Q-COMP, the regulatory authority, and an Application for Review must be lodged with the Workers' Compensation Regulator within 3 months of receiving the insurer’s decision.

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