If you have been injured at work in Queensland, you can make a workers’ compensation claim to cover:
- Medical costs
- Lost income
This is called a WorkCover claim, a no-fault insurance scheme that covers most Queensland workers.
To start your WorkCover claim, you need:
- A completed claim form
- A medical certificate from your doctor
You have 6 months from the date of your injury to lodge your claim under the Workers’ Compensation and Rehabilitation Act 2003 (Qld).
Understanding Workers' Compensation in Queensland
Workers' compensation in Queensland is a no-fault scheme. That means you can claim whether the injury was your fault, your employer's fault, or nobody's fault.
The scheme is managed by WorkSafe Queensland (formerly WorkCover Queensland).
What does WorkCover cover?
- Medical treatment
- Wage replacement
- Rehabilitation support
- Physical injuries
- Psychological injuries
- Illnesses caused or made worse by work
Who does it cover?
- Most workers in Queensland
- Full-time, part-time, and casual employees
- Anyone classified as a ‘worker’ under the Act
- Injuries must be work-related
How does the insurer decide if your injury qualifies?
The insurer assesses three things:
- Whether you are classified as a ‘worker’ under the legislation
- Whether your injury happened at work or because of your work
- Whether your employment was a significant contributing factor to the injury
For physical injuries, the connection to work is usually straightforward. For psychological injuries (mental health conditions caused by work), the bar is higher. You must show that the work itself contributed significantly.
Additionally, the sole cause cannot be reasonable management actions, such as:
- Normal decisions your manager makes in the course of managing you
- Performance reviews
- Restructuring
- Disciplinary proceedings
What about self-insured employers?
Most employers in Queensland are covered through WorkSafe Queensland. However, some large employers hold a self-insurance licence (approval to manage their own workers' compensation claims instead of going through WorkSafe).
Self-insured employers in Queensland include Woolworths, Wesfarmers (Bunnings, Kmart, Officeworks), Coles, and Brisbane City Council.
If you work for a self-insured employer, the claim process is similar. The difference is that you deal directly with your employer's claims team instead of WorkSafe Queensland.
The same laws and entitlements apply, but disputes can feel harder because you are dealing with your own employer rather than an independent insurer.
Your Rights and Obligations as a Claimant
A successful WorkCover claim gives you access to several types of support while you recover.
What you are entitled to:
- Weekly income payments to replace lost wages: up to 85% of your normal weekly earnings for the first 26 weeks, then 75% from weeks 26 to 104
- Medical and hospital expenses, including surgery, GP visits, medication, and allied health
- Rehabilitation and return-to-work support, including physiotherapy and occupational therapy
- Travel costs for medical appointments
- A lump sum payment if you are left with a permanent impairment of at least 5% whole person impairment (a standard measure of overall impairment across the body)
What you must do:
- Report the injury to your employer as soon as possible, in writing
- See a doctor and get a WorkCover medical certificate
- Lodge your claim within 6 months of the injury date
- Follow your treatment and rehabilitation plan as your treating doctors recommend
- Keep your employer and the insurer updated on your recovery and work capacity
Step-by-Step Process
Step 1: Report the injury to your employer
Tell your employer about the injury as soon as you can. Even if you’ve told them verbally, also do this in writing.
Your employer is legally required to report the injury to their insurer within 8 business days of becoming aware of it. Failing to report is an offence.
Step 2: See your doctor
Visit your doctor and explain that you have been injured at work. Ask for a WorkCover medical certificate (called a 'work capacity certificate'). This describes your injury, your capacity for work, and your treatment needs. This is required as part of your claim.
Step 3: Complete the claim form
Fill out a WorkCover claim form. You can download the form from WorkSafe Queensland or ask your employer for a copy.
The form asks for details about your injury, when and how it happened, and your employer's information.
Step 4: Lodge the claim
Submit the completed form and your medical certificate to your employer's insurer. For most workers, this is WorkSafe Queensland. For self-insured employers, submit it to your employer's claims team.
Critical deadline: You must lodge your claim within 6 months of the date of injury. If you lodge more than 20 business days after the injury, the insurer's liability for back-paying your benefits is limited.
Step 5: Wait for a decision
The insurer aims to decide your claim within 20 business days. According to the WorkCover Queensland Annual Report 2024-25, 61.7% of claims were determined within five days, and 91.3% within 20 days.
If the insurer needs more time, they must contact you and explain why. Common reasons for delay include:
- Waiting for employer records
- Waiting for medical information
- Understanding the circumstances of the injury
Step 6: Start receiving benefits
Once your claim is accepted, your entitlements begin. The insurer will pay your weekly benefits and cover approved medical expenses. You will work with a claims officer who manages your return-to-work plan.
WorkCover vs Common Law: Understanding Your Options
WorkCover is always the starting point. Every injured worker opens a statutory WorkCover claim first. This is the no-fault scheme that covers your wages, medical costs, and rehabilitation during recovery.
If your injury involved negligence by your employer or a third party, you may also be able to pursue a common law claim (a separate legal claim that a solicitor runs on your behalf) on top of your WorkCover benefits. An open WorkCover file is a prerequisite for a common law claim.
You do not choose between them at the start. In most cases, injured workers receive WorkCover benefits during recovery and then pursue a common law settlement after their injury stabilises.
The following table compares the two:
Learn more about the difference between WorkCover and common law claim.
The DPI assessment choice
After your injury stabilises, you may be assessed for permanent impairment (lasting physical or psychological damage from your injury). This is measured as a percentage called the Degree of Permanent Impairment (DPI).
If your DPI is below 20%, you must choose: accept the statutory lump sum payment, or give it up to pursue a common law claim. You cannot have both. If your DPI is 20% or above, you can accept the statutory lump sum and still pursue a common law claim.
This is a major decision for most people and many prefer to seek legal advice before they make the choice.
Common Scenarios and FAQs
Can I still claim WorkCover if I was a casual?
Yes. Casual workers are covered by WorkCover in Queensland. What matters is that you were performing work for your employer when the injury occurred.
The type of employment contract does not determine your eligibility.
What happens if my employer says my injury did not happen at work?
You can still lodge your claim. The insurer investigates independently and does not rely solely on your employer's version of events.
Provide your own account, any witness details, and your medical records. If the insurer sides with your employer, you can dispute the decision.
What should I do if my claim was rejected?
If your claim was rejected, you can apply for a review within 3 months of receiving the rejection decision. The review is handled by the Workers' Compensation Regulator, which is independent of WorkSafe Queensland. If the review does not go in your favour, you can appeal to the Queensland Industrial Relations Commission (QIRC).
Can I claim for a mental health condition caused by work?
Yes, but psychological injury claims have a higher rejection rate than physical claims. According to WorkSafe Queensland data (2023-24), 49.9% of psychological injury claims were rejected, compared to just 4.9% for physical injury.
Your employment must be a significant contributing factor to the condition, and the insurer will check whether the injury was caused by reasonable management action (the day-to-day activities your manager does to manage you).
What if my injury happened over time, not in one event?
You can claim for gradual onset injuries. Conditions like repetitive strain injuries, hearing loss from noise exposure, or back injuries from years of manual labour are covered if your work was a significant contributing factor.
The 6-month time limit runs from when you first became aware of the injury and its connection to work.
Does WorkCover still pay my wages if I get fired?
Your WorkCover entitlements continue even if your employment ends. Being dismissed does not cancel your claim. You remain entitled to weekly payments, medical expenses, and rehabilitation support for as long as you meet the eligibility criteria.
Red Flags and Warning Signs
Watch for these signs that something may be going wrong with your claim:
- The insurer requests an Independent Medical Examination (IME) with a doctor you did not choose, and the report contradicts your treating doctor
- Your weekly payments are reduced or stopped without a clear explanation
- The insurer pressures you to return to work early, before your doctor says you are ready
- Your employer discourages you from lodging a claim or suggests it will affect your job
- A self-insured employer’s claims team acts in the employer’s interest rather than assessing your claim fairly
- You are asked to sign documents you do not fully understand
Common mistakes to avoid:
- Waiting too long to report the injury to your employer
- Not getting a medical certificate on the same day or as close to the injury as possible
- Accepting a verbal 'no' from your employer instead of lodging a formal claim
- Not keeping copies of every document you submit
- Returning to full duties before your doctor clears you, which can affect your claim
When to Get Legal Advice
You do not need a solicitor to lodge a WorkCover claim. But certain situations call for the extra knowledge and experience that only legal representation can offer:
- Your claim has been rejected or only partially accepted
- Your psychological injury claim was denied based on “reasonable management action”
- The insurer’s medical examiner disagrees with your treating doctor
- You have been assessed with permanent impairment and need to decide between a statutory lump sum and a common law claim
- Your employer is self-insured and the process feels unfair
- Your weekly payments have been reduced or cut off
- You are being pressured to return to work before you are ready
Why legal representation matters
Insurers are well-resourced organisations that handle thousands of claims every year. They know that a worker without legal representation is unlikely to take a claim to court, so they may offer less with a limited risk of being challenged.
That changes when a solicitor is involved.
With legal representation, the insurer knows your workers’ compensation claim can proceed to court if negotiations are not fair. This shifts the balance and often leads to more realistic settlement offers because:
Very few cases end up in court. Therefore, it’s not about seeking legal representation to take the negligent party to court; it’s about having leverage in the negotiation.
Key Takeaways
- You generally have 6 months to lodge a statutory WorkCover claim from the date of your injury. Missing this deadline can limit or prevent access to your entitlements.
- WorkCover is a no-fault scheme. You can claim whether the injury was your fault, your employer's fault, or an accident with no clear cause.
- Your employer should report your injury within 8 business days. Do not rely on them to do this. Report it in writing yourself as well.
- Common law is an additional option, not a replacement for WorkCover. If negligence was involved and your permanent impairment is at least 5% (WPI), you may be able to pursue a common law claim on top of your WorkCover benefits.
- Get legal advice before making the DPI choice. If your permanent impairment is assessed below 20%, you must choose between the statutory lump sum and a common law claim. This decision is irreversible and the amounts involved are significant.
Get Help Now
If you’re concerned about making a workers’ compensation claim, are feeling pressured to accept an offer, or feel that your injuries have been wrongly assessed, Smith's Lawyers offers a no-obligation review of your situation with no upfront cost.
A member of the team will assess your rights, explain your options and let you know the best course of action.
Contact Smith's Lawyers today:
- Call 1800 960 482 for a free, no-obligation consultation about your situation
- No upfront costs: We operate on a No Win, No Fee, No Catch® basis; you only pay if we secure compensation for you
- Or request a call back: Use the form below to have our experienced team get in touch at a time that’s convenient for you.
