Information on your rights to appeal work compensation related decision by WorkCover Queensland.
There are a variety of reasons why WorkCover may choose to decline your claim. For example, your application may not have been lodged on time, or WorkCover may decide that your injury was not substantially caused by a work-related event.
If your claim is rejected, first speak with your claims representative. If you are not happy with their response, you can appeal the decision through the Workers’ Compensation Regulator’s review process. The Workers’ Compensation Regulator is not part of WorkCover so its decisions are independent and the appeal is free.
Appeals to WorkCover Queensland (and self-insurer) decisions are handled by a third party, QCOMP. QCOMP (part of Workers' Compensation and Policy Services, Office of Industrial Relations, Department of Justice and Attorney-General) can make decisions independently to the workers compensation insurer.
You have 20 days from the date of decision to request a 'decision document' from WorkCover. They should provide this you within five business days. The document should outline how they made the decision. If you feel the reasons provided are valid then you choose to take no further action. If you still wish to appeal then you have 90 days from the date of the decision document letter to apply for a review by the regulator, QCOMP.
You may appeal an unfavourable decision made by WorkCover by applying for an independent review by the Workers’ Compensation Regulator.
We recommend reviewing the latest information available on the Worksafe website or calling the QCOMP Reviews & Appeals Unit on 1300 739 021.
You will need details of your claim available including:
The Workers’ Compensation Regulator will make their review decision within 25 business days. You will have the right to appear before the Regulator, either in person or over the phone to discuss your side of the matter.
Although you are not required to have a lawyer it is recommended that you get a lawyer to assist you to prepare your appeal to give you the best prospects of winning.
The laws and regulations regarding workers compensation are very complicated & information provided by the regulators can be difficult to understand.
There are a number of avenues available to help you understand your rights including:
Queensland Council of Unions (QCU) - 1800 102 166
It’s important to get advice for your specific situation. Check if you can make a risk-free compensation claim and get free initial advice from our Principal lawyer, Greg Smith.
Have you had a WorkCover claim that has been closed, only to have your injury return or get worse? Check your rights to reopen a previously closed claim.
Are you covered by WorkCover Queensland and/or able to make a work injury compensation claim if a contractor or sub-contractor?