How to Make a Worker's Compensation Claim

In Queensland, workers' compensation is a type of insurance that provides financial support and medical benefits to employees who suffer from work-related injuries or illnesses. The primary provider of this insurance is WorkCover Queensland, although some large employers may be self-insured. 

This article will guide you through the process of making a statutory workers' compensation claim with WorkCover Queensland and provide information for those whose employers are self-insured. It will also touch on the option of making common law claims in cases of employer negligence.

Step-by-Step Guide to Making a WorkCover Claim

1. Seek Medical Treatment

The first step after sustaining a work-related injury or illness is to seek immediate medical treatment. Visit a doctor or hospital to get the necessary care and obtain a Work Capacity Certificate. This certificate is crucial as it details your injury, the required treatment, and whether you need time off work.

2. Report the Injury to Your Employer

Notify your employer about your injury as soon as possible. Give them a copy of your Work Capacity Certificate. Employers are legally required to report the injury to WorkCover within eight days of becoming aware of it.

3. Lodge Your Claim with WorkCover Queensland

You can lodge your claim with WorkCover Queensland in several ways:

• Online: The fastest and easiest method is to complete and submit an online claim form on the WorkCover Queensland website.
• Phone: Call WorkCover Queensland at 1300 362 128 to lodge your claim over the phone.
• Mail: Download and complete a claim form, then mail it to WorkCover Queensland.

Ensure you provide all necessary information, including personal details, employment information, and details about your injury or illness. Attach your Work Capacity Certificate to your claim.

4. Keep Records

Maintain copies of all documents related to your injury and claim, including medical certificates, receipts for medical expenses, and any correspondence with WorkCover Queensland or your employer.

5. Claim Assessment

WorkCover Queensland will assess your claim based on several criteria:

• Whether the claim was lodged within the appropriate time frame.
• Whether you are considered a worker under Queensland law.
• Whether the injury or illness is work-related.
• Whether your job significantly contributed to the injury or illness.

WorkCover generally aims to make a decision within 20 business days, provided all required information is submitted.

6. Decision and Benefits

If your claim is accepted, you will receive benefits such as:

• Weekly payments to replace lost wages.
• Coverage for medical and rehabilitation expenses.
• Lump sum payments for permanent impairment.

If your claim is denied, WorkCover will provide reasons for the decision and information on how to appeal.

For Employees of Self-Insured Employers

Some major employers, such as Woolworths and Bunnings, are self-insured. This means they manage and fund their own workers' compensation claims. The process for making a claim with a self-insured employer is similar to that with WorkCover Queensland:

1. Seek Medical Treatment: Obtain a Work Capacity Certificate from your doctor.
2. Report the Injury: Notify your employer and provide them with your Work Capacity Certificate.
3. Lodge Your Claim: Submit your claim directly to your employer's workers' compensation unit. Contact details for self-insured employers can be found on the WorkSafe Queensland website.

Self-insured employers are bound by the same legislation as WorkCover Queensland, so your rights and benefits should be similar.

Common Law Claims

In addition to statutory claims through WorkCover Queensland, you may also have the option to pursue a common law claim if your employer's negligence contributed to your injury. Common law claims involve suing your employer for damages, which can include compensation for pain and suffering, loss of income, and medical expenses.

When to Consider a Common Law Claim

You can consider a common law claim if:

• Your statutory claim has ended.
• You have received a Notice of Assessment (NOA) from WorkCover Queensland.
• You can prove that your employer breached their duty of care, leading to your injury.

Steps to Make a Common Law Claim

1. Consult a Lawyer: Common law claims are complex and require legal expertise. Consult a personal injury lawyer to assess your case and guide you through the process.
2. Notice of Claim for Damages: Your lawyer will help you submit a Notice of Claim for Damages, detailing the negligence and the resulting injury.
3. Pre-Proceeding Phase: WorkCover will investigate the claim and attempt to resolve it before court proceedings. If necessary, the case may proceed to litigation.

Navigating the Claim Process and Seeking Legal Help

Making a workers' compensation claim in Queensland involves several critical steps, from seeking medical treatment to lodging your claim with WorkCover Queensland or a self-insured employer. Understanding the process and your rights can help ensure you receive the benefits you are entitled to. Additionally, if your injury resulted from employer negligence, you might have grounds for a common law claim.

For those injured in a workplace accident, navigating the claims process and pursuing a full legal claim can be challenging. Consulting with a lawyer can provide the expertise needed to maximise your compensation and ensure your rights are protected.

If you have any questions or need assistance with your claim, consider seeking legal advice from experienced professionals. Smith's Lawyers run workers' compensation and common law claims with no upfront costs. Contact us at 1800 960 482 or request a free case review online.