A primary psychological injury is a mental health condition that’s directly caused by trauma, bullying or harassment suffered in the workplace, while a secondary psychological injury is depression or anxiety that develops as a consequence of an accepted physical workplace injury.
If you have been subject to either of these, it is crucial that you fully understand this distinction because it affects the compensation you can receive and how your claim is assessed.
Secondary psychological injury claims in Queensland have doubled since 2012, but acceptance rates have lagged behind at just 45.6%. Workers with primary psychological injuries may be able to claim lump sum compensation, while those with secondary injuries generally only receive weekly payments and reimbursement of medical expenses.
This guide will explain the key differences between these injuries, the compensation you’re entitled to, the claim process and how to protect your rights under Queensland's workers' compensation system.
Understanding Primary vs. Secondary Psychological Injuries
What is a primary psychological injury?
A primary psychological injury is a diagnosable mental health condition that’s the direct result of a workplace event or the circumstances of your employment. This includes conditions like PTSD, depression or anxiety caused by workplace trauma, ongoing bullying or harassment and/or cumulative workplace stress. Recent changes to Queensland legislation now requires insurers to provide early intervention mental health support.
Common examples include:
- Acute trauma: witnessing a workplace death or serious accident which results in PTSD. For example, a paramedic who develops anxiety and depression stemming from attending multiple traumatic incidents would have a primary psychological injury.
- Cumulative stressors: experiencing prolonged workplace bullying, harassment and/or discriminatory treatment that leads to diagnosed depression or anxiety disorders.
- Work pressure injuries: the development of a mental health condition due to unreasonable workloads. However, these types of claims generally face challenges under the "reasonable management action" exclusion.
For these types of compensation claims to succeed, the workplace events or circumstances must be a significant contributing factor to the injury, not just a minor or trivial cause.
What is a secondary psychological injury?
A secondary psychological injury is a mental health condition that develops as a direct consequence of a physical workplace injury, not from direct workplace factors. This represents the psychological deterioration that arises from having to deal with chronic pain, disability, financial stress and loss of identity following a physical injury suffered in the workplace.
Common examples, but are not limited to, include:
- Depression from chronic pain: a worker who suffered a serious injury develops depression due to constant pain, inability to work, loss of physical capacity for family activities and dependence on others for household tasks.
- Anxiety from financial stress: after a workplace injury prevents a worker from returning to work, they develop anxiety about financial security and their ability to support their family.
- Loss of identity: a tradesperson who can no longer work in their profession develops depressive symptoms stemming from loss of purpose and social isolation.
The critical difference here is that secondary psychological injuries are reactive conditions which arise from how the physical injury has impacted the worker's life, rather than being directly caused by workplace events.
Your WorkCover Rights and Entitlements
What you're entitled to:
- Weekly compensation payments: this will typically be 85% of your normal weekly earnings while unable to work due to your psychological injury, and applies to both primary and secondary injuries.
- Medical treatment costs: payment for reasonable and necessary psychological or psychiatric treatment, counselling sessions, medications and GP consultations related to your mental health injury.
- Rehabilitation services: access to mental health support services, return-to-work programs and vocational rehabilitation to help you recover and return to suitable employment.
- Lump sum compensation (primary injuries only): if you have suffered a primary psychological injury which results in permanent impairment, you may be entitled to a lump sum payment. However, it’s important to keep in mind that this entitlement does not apply to workers who only have secondary psychological injuries.
- Protection from dismissal: Queensland law prevents unfair dismissal linked to compensation absence, but does not guarantee protection from termination for unrelated reasons, and cessation of benefits may trigger lawful dismissal in some cases.
What you must do:
- Report symptoms immediately: notify your treating doctor and WorkCover insurer the moment psychological symptoms begin to develop. Delayed reporting can jeopardise the success of your claim.
- Ensure proper documentation: your psychological injury must appear on your Work Capacity Certificates in Part B (diagnoses section) alongside any physical injuries you may have.
- Attend medical appointments: it is vital that you undergo all the required assessments, including independent psychiatric examinations arranged by WorkCover or your employer's insurer.
- Participate in rehabilitation: engage with return-to-work planning and reasonable rehabilitation activities to the best of your ability given your condition.
Key deadlines:
- Immediate notification: report any and all psychological symptoms to your doctor and insurer as soon as they develop
- Independent examinations: attend all scheduled psychiatric assessments within the required timeframes (typically 2-4 weeks' notice)
- Review decisions: if your claim is rejected, you have limited time to seek internal review or lodge an appeal, which is why seeking professional legal advice as early as possible is crucial
WorkCover Rights: Common Questions
Can I claim for depression that developed after my back injury at work?
Quick answer: yes, this counts as a secondary psychological injury claim. You're entitled to weekly payments and treatment costs, but not lump sum compensation for the psychological component of the injury.
What to do:
- Ask your treating doctor to add the psychological diagnosis (e.g., "Major Depressive Disorder") to Part B of your next Work Capacity Certificate alongside the diagnosis of your back injury.
- Request the treatment for your psychological injury be listed in Part C of the certificate. This may include sessions with a psychologist or psychiatrist or any other therapy or medication.
- Notify your WorkCover insurer in writing that your doctor has diagnosed you with a secondary psychological injury, and request confirmation that it's been accepted as part of your claim.
- Document the connection between the impact of your physical injury impact (chronic pain, inability to work, financial stress, loss of activities, etc.) and your psychological symptoms.
Important note: it’s likely that you’ll be required to attend an independent psychiatric examination as part of your claim. The psychiatrist will assess whether your depression is causally connected to your physical workplace injury or if it stems from other factors.
My claim was rejected because of "reasonable management action." What does this mean?
Quick answer: this will happen in cases concerning primary psychological injuries, not secondary injuries. If your mental health condition is the result of reasonable management decisions made in a reasonable way, you will not be eligible to receive compensation.
What to do:
- Understand what's excluded: reasonable management action includes performance reviews, disciplinary processes, restructures and changes to duties conducted appropriately.
- Review the specifics: the rejection should explain exactly what management action was deemed to be reasonable. It’s important to determine whether the action itself was reasonable AND if it was taken in a reasonable manner.
- Gather contrary evidence: if actions taken by management were unreasonable (bullying disguised as performance management, discriminatory treatment, unfair processes, etc.), it’s important to collect relevant documentation, emails and witness statements.
Important note: this is a complex area of law where legal advice is essential. Many rejected claims can be successfully challenged on the grounds that actions weren't truly reasonable or weren't conducted in a reasonable fashion, so you should always seek legal advice at the earliest opportunity.
I'm seeing a psychologist for my injury. How do I get WorkCover to accept and pay for this?
Quick answer: your treating doctor will have to list the psychological injury and any treatment you require because of it on your Work Capacity Certificate, and then formally notify WorkCover.
What to do:
- Discuss with your GP or specialist: explain your psychological symptoms and how they relate to your workplace injury (whether primary trauma or secondary to physical injury).
- Request proper certification: ask your doctor to complete the Work Capacity Certificate with your psychological diagnosis in Part B and counselling/psychiatric treatment in Part C.
- Submit to WorkCover: present the certificate to your WorkCover insurer along with a cover letter that specifically requests acceptance of the psychological injury and approval for psychological treatment.
- Keep detailed records: document all your psychological symptoms, how they affect your daily life and work capacity and any treatment you've already received thus far.
Important note: WorkCover will typically approve a limited number of psychology sessions initially (often 10-20 sessions), but will require evidence of their benefit before approving any further treatment.
Can I get both WorkCover and TPD superannuation for my psychological injury?
Quick answer: you may be entitled to pursue both, but WorkCover payments can affect the amount of your TPD benefit.
What to do:
- Check your super fund's TPD definition: certain policies cover "own occupation" (unable to work in your pre-injury job), while others require "any occupation" (unable to work in any job you're suited for by training, education or experience).
- Gather comprehensive evidence: TPD claims require extensive medical evidence demonstrating that your combined physical and psychological injuries prevent you from working, including impact on capacity, restrictions and permanency.
- Consider timing: you can lodge a TPD claim while receiving WorkCover, but keep in mind that the insurer will take your WorkCover weekly payments into consideration when calculating any lump sum TPD benefits.
Important note: TPD claims for psychological injuries will undergo stringent scrutiny. Secondary psychological injuries can support a TPD claim when considered alongside physical injuries, even though they won't get you lump sum WorkCover compensation.
WorkCover wants me to see their psychiatrist. Do I have to go?
Quick answer: attending independent medical examinations is mandatory under Queensland workers' compensation law. Failure to do so may result in your benefits being suspended.
What to do:
- Attend the appointment at the scheduled time. Failing to attend without a reasonable excuse can result in the suspension of your weekly payments.
- Bring all relevant information: take a list of your current medications, treating practitioners, symptom history and how your injuries affect daily activities.
- Request a copy: you're entitled to receive a copy of the independent psychiatrist’s report. Ensure you request this from WorkCover after the examination.
Important note: the independent psychiatrist's job is to provide an objective assessment of your injury and its effect on you, not to advocate for you. Their report will heavily influence whether your psychological injury claim is accepted or rejected.
My psychological injury developed months after my physical injury, is it too late to claim?
Quick answer: no. It’s common for secondary psychological injuries to develop weeks or even months after the initial physical injury as the full life impact becomes apparent.
What to do:
- Report symptoms immediately: notify your doctor and WorkCover insurer as soon as you recognise the development of psychological symptoms. Don't wait for these symptoms to worsen before taking action.
- Establish the timeline: document when symptoms first appeared and clearly show the connection to the impact of your physical injury (e.g., "depression developed three months after surgery when it became clear I couldn't return to my trade").
- Update your medical certificate: make sure that your next Work Capacity Certificate includes both your ongoing physical injury and the new psychological diagnosis.
- Provide causal evidence: explain to your doctor and WorkCover how the consequences of your physical injury (chronic pain, inability to work, financial pressure, loss of activities, etc.) led to your psychological symptoms.
Important note: although you are able to claim for psychological symptoms that develop later, early identification and reporting significantly improves outcomes and helps you get faster access to treatment.
Step-by-Step Process for Primary or Secondary Psychological Compensation Claims
- Recognise and report symptoms. As soon as you notice the signs of depression, anxiety and/or other psychological symptoms developing after suffering a physical injury, discuss them with your treating doctor. Explain to them how the impact of your physical injury (pain, disability, financial stress, loss of activities, etc.) is affecting your mental health.
- Update your Work Capacity Certificate. Ask your doctor to complete your next Work Capacity Certificate with your psychological diagnosis listed in Part B ("The patient is/was suffering from") alongside your physical injuries. Part C should clearly state your psychological treatment needs and Part D should note any work restrictions arising from your psychological symptoms.
- Formally notify WorkCover. Submit your updated Work Capacity Certificate to your WorkCover insurer along with a cover letter which specifically requests confirmation that the secondary psychological injury has been accepted as part of your workers' compensation claim. Never assume it will be automatically covered under your physical injury claim.
- Attend your independent psychiatric examination. WorkCover will generally organise an assessment with an independent psychiatrist (not your treating psychologist). This psychiatrist will determine whether you have a diagnosable psychiatric condition and if it's causally connected to your physical workplace injury.
- Await decision. Either WorkCover or the self-insurer will make a decision about accepting your secondary psychological injury based on the independent psychiatric report and the other medical evidence you submit. This process typically takes 4-8 weeks from the date of the examination.
- Access treatment if accepted. Once your request is accepted, you will be able to access psychological or psychiatric treatment covered by WorkCover. You might have to request approval for specific treatment (number of psychology sessions, psychiatric consultations, medications, etc.).
- Challenge rejection if necessary. In the event that your claim is rejected, you can request an internal review, seek an assessment by the Medical Assessment Tribunal or appeal the decision. Proper legal advice is essential for this process.
Documents you'll need:
- Updated Work Capacity Certificates. These must clearly list your psychological diagnosis in Part B alongside your physical injuries, and also identify your psychological treatment needs in Part C. Your doctor's certificate creates the formal basis for your secondary injury claim.
- Treatment records. Collect all the records you have from your psychologist, psychiatrist or counsellor which document your psychological symptoms, their onset timing and the treatment you received. These records should demonstrate the connection between the impact your physical injury had on you and your psychological symptoms.
- Evidence of life impact. Collect documentation which demonstrates how your physical injury affected your life. This could be medical records detailing chronic pain or disability, financial statements showing income loss, statements from family members about changed relationships and activities and your own personal diary or journal entries tracking symptoms.
Timeline documentation. Create a clear timeline showing when your physical injury occurred, when your psychological symptoms first appeared and how these symptoms developed. This will establish the causal sequence between your physical injury and the onset of your secondary psychological condition.
Red Flags and Warning Signs
When to act immediately:
- Your doctor identifies psychological symptoms but hasn't listed them on your Work Capacity Certificate. If this happens, you must request that they correct the problem immediately. This is because unlisted conditions won't be accepted or treated under your claim.
- WorkCover questions whether your psychological injury is "really" connected to your physical injury. This is a clear signal of potential rejection. In this case, gather detailed evidence of how your physical injury caused your psychological symptoms.
- You're told secondary psychological injuries can't be claimed. This is incorrect. Secondary injuries are absolutely valid for compensation, they simply don't result in lump sum payments like primary injuries.
- Your weekly payments are suddenly reduced or stopped. Determine whether this is related to your psychological injury claim status. If WorkCover hasn't properly accepted your psychological injury, they may incorrectly assess your work capacity.
- The independent psychiatrist's report contradicts the opinions of your treating specialists. This often leads to claim rejection and requires urgent legal advice in order to challenge the assessment.
Common mistakes to avoid:
- Downplaying symptoms to appear strong. A lot of workers underreport psychological symptoms to independent examiners because they're worried about appearing weak. Be completely honest about your struggles as downplaying symptoms can cause your claim to be rejected.
- Assuming psychological symptoms are automatically covered under your physical injury claim. Secondary psychological injuries must be specifically identified, documented on medical certificates and formally accepted by WorkCover in order for you to be compensated.
- Delaying psychological treatment until claim acceptance. It’s important to seek treatment either from your GP or private health insurance while waiting for WorkCover acceptance as any gaps in treatment can be used to question severity.
When to Seek Legal Advice
In cases such as these, it is almost always recommended that you seek professional legal advice at the earliest opportunity, especially if:
- Your psychological injury claim has been rejected. If your claim is rejected, the decision can be challenged but you must act within strict timeframes. Legal advice will help you determine whether you have grounds for appeal and how best to strengthen your case.
- WorkCover disputes the causal connection between your physical injury and your psychological symptoms. This is a complex area which requires deep medical and legal expertise in order to properly establish causation.
- Your psychological injury prevents you from returning to work. In the event your condition (whether primary or secondary) means you can't return to any suitable employment, you may be entitled to common law claims or TPD beyond standard WorkCover compensation.
Seeking early advice is so important as it will help you:
- Understand your full rights and entitlements, including lump sum compensation for primary injuries, whether you can make a common law claim, as well as TPD superannuation claims if you can't return to work
- Protect your compensation claim from common pitfalls such as insufficient medical evidence, improper Work Capacity Certificate documentation and failure to establish causal connections.
- Get expert guidance before time limits expire for internal reviews, Medical Assessment Tribunal applications and appeals of rejected claims. Missing deadlines can permanently bar your entitlements so it’s important to stay informed and seek representation.
Key Takeaways
Remember these essential points:
- Primary psychological injuries are caused directly by workplace trauma, bullying and/or harassment and can earn lump sum compensation. Secondary psychological injuries develop as a consequence of physical workplace injuries and typically only result in weekly payments and treatment costs.
- Only around 50% of psychological injury claims are accepted in Queensland, so proper documentation and evidence from the outset is critical. Secondary injury claims have doubled in recent years, demonstrating that these conditions are increasingly recognised but still face acceptance challenges.
- Your Work Capacity Certificate must specifically list your psychological diagnosis in Part B alongside any physical injuries. If the psychological injury isn't documented on your certificate, WorkCover won't accept or treat it.
- Early identification and reporting significantly improves outcomes for both claim acceptance and treatment effectiveness. Don't wait for psychological symptoms to become severe before seeking help and notifying WorkCover.
Get Help Now
If you’ve suffered a psychological injury at work, whether from direct workplace trauma or as a consequence of a physical injury, seeking early legal advice helps you understand your rights, identify whether you have a primary or secondaary psychological injury and protect your entitlements to compensation.
Contact Smith's Lawyers today for a free, no-obligation consultation with lawyers experienced in both primary and secondary psychological injury claims under our No Win, No Fee, No Catch® promise.
You don't pay unless your claim succeeds, so call us on 1800 960 482 or use the form below to have our team contact you at a convenient time, and we'll assess your situation and guide you through the claims process.
