If you work for a large employer in Queensland, such as Coles, Woolworths, or a government department, your workers’ compensation claim will probably be managed by your employer as a self-insurer rather than through WorkCover Queensland.
Key takeaway: Your legal entitlements are identical under both systems.
The main difference is simply who manages your claim:
- WorkCover Queensland handles claims as an independent government insurer.
- Self-insured employers manage claims internally but must follow the same laws and provide the same benefits.
- Both systems are overseen by the Workers’ Compensation Regulator to protect your rights.
This guide explains what these differences mean in practice, how claims and appeals work under each system, and when to seek legal advice to protect your entitlements. Let’s get started.
Quick Answer Box
Whether your claim relates to a self-insurer or WorkCover Queensland, your entitlements are the same.
Key facts:
- Self-insurers are only available to employers with 2,000+ employees
- Both the self-insurer and WorkCover Queensland have the same statutory benefits, common law rights, and appeal process
- To review a decision, the timeframe is the same for both systems: 3 months from when the decision was made
- If the review was unsuccessful, you can appeal to the Queensland Industrial Relations Committee (QIRC), but this must be lodged within 20 business days of the review outcome
Important steps to consider:
- Check if your employer is self-insured or covered by WorkCover Queensland
- Report your injury immediately and seek medical treatment
- Submit your claim with the proper documentation
- Seek legal advice if your claim is disputed or rejected
Understanding Self-Insurance and WorkCover Queensland
So, what’s the difference between a self-insurer and WorkCover Queensland?
Put simply, WorkCover Queensland is the main provider of workers' compensation insurance to Queensland employers. The majority of businesses get their coverage through this system, and WorkCover is then expected to manage the claim if a worker is injured.
Self-insurers are large organisations (2000+ employees) that have been licensed to manage and fund their own workers' compensation claims. Instead of paying premiums to WorkCover Queensland, these employers take direct financial responsibility for workplace injuries.
In practice, this might mean:
- A retail worker injured at a small local shop has their claim managed by WorkCover Queensland. That’s to say, they assess the claim, approve benefits, and pay the compensation.
- A Coles employee, on the other hand, who injures their back lifting stock would submit their claim to Coles' self-insurance division, which handles the assessment and compensation payments directly.
Who are the major self-insured employers in Queensland?
Retail sector:
- Coles supermarkets
- Woolworths supermarkets
Government sector:
- Various Queensland government departments and agencies
- Public sector organisations with 2000+ employees
Other large employers:
- Major healthcare providers
- Large manufacturing companies
- The mining sector
- Banking and financial institutions
If you're unsure whether your employer is self-insured or uses WorkCover Queensland, the simplest thing is to check your employment contract or ask someone in the HR department. You can also contact the Workers' Compensation Regulator.
Your Entitlements and Responsibilities
What am I entitled to claim through the self-insurer or WorkCover Queensland schemes?
- You’re entitled to the same benefits for medical expenses, rehabilitation, and wage replacement. The Workers’ Compensation Regulator makes sure both systems deliver the same entitlements.
- You can also access common law claims if your injury was caused by employer negligence, which means you could claim compensation for pain and suffering, future lost income, and reduced earning capacity on top of your regular weekly benefits.
- The Workers’ Compensation Regulator provides independent oversight, monitoring both WorkCover Queensland and self-insurers to make sure they follow the same rules and protect your rights.
What must I do to ensure the process runs smoothly?
- Report your injury immediately to your employer or supervisor as soon as the injury occurs or when you become aware of a work-related illness. Delays in reporting can reduce the likelihood of a successful outcome.
- Seek medical treatment promptly and ensure your doctor provides detailed documentation linking your injury or illness to your work. Keep copies of all medical reports and certificates.
- Submit your claim with complete documentation within the required timeframes (usually 6 months), including medical evidence, incident reports, and witness statements.
- Request a review within 3 months if your claim is rejected or you disagree with a decision that’s been made. Missing this deadline may prevent you from challenging the decision.
Common Scenarios and FAQs
My employer is self-insured. Will I receive less compensation because they’re not covered by WorkCover Queensland?
No. Your entitlements are legally identical under both systems.
What you need to know:
- Self-insurers must comply with the same Workers’ Compensation and Rehabilitation Act 2003 that governs WorkCover Queensland.
- The Workers’ Compensation Regulator monitors self-insurers to ensure equivalent benefits, access to common law claims, and fair claim management.
- The only real difference is who pays your compensation, not how much you receive.
Important note: If you believe your self-insured employer is not providing the amount you deserve, you have the same right to review and appeal as workers covered by WorkCover Queensland.
My self-insurer rejected my claim. Is the appeals process different?
No. The appeals process is similar for both WorkCover Queensland and self-insurer decisions.
What to do:
- Request a review from the Workers’ Compensation Regulator within 3 months of the decision using their online form or a written submission. For WorkCover Queensland, the review is first made internally and can then be appealed
- Provide supporting evidence such as medical reports, witness statements, and employment records.
- The Regulator issues a decision within 25 business days of receiving your application.
- If you disagree, appeal to the Queensland Industrial Relations Commission (QIRC) within 20 business days using Form 9 WCR Notice of Appeal.
Important note: The QIRC’s review process essentially starts from scratch, meaning they can consider new evidence.
I work for Woolworths and injured my shoulder. Do I submit my claim to WorkCover Queensland or my employer?
Submit your claim to Woolworths’ self-insurance division, not WorkCover Queensland.
What to do:
- Report the injury immediately to your manager and ensure it is recorded in Woolworths’ reporting system.
- See a doctor for assessment and obtain a medical certificate outlining your work capacity.
- Submit your claim through Woolworths’ workers’ compensation process (check with HR or your manager for details).
- Keep copies of all reports, medical certificates, correspondence, and claim forms.
Important note: Even though Woolworths manages the claim internally, the company must follow the same rules as WorkCover Queensland. If you experience difficulties, you have the same right to an independent review and appeal.
Can I still make a common law claim if my employer is self-insured?
Yes. Self-insured workers have the same common law rights to pursue compensation for employer negligence.
What you need to know:
- Legal entitlements are identical whether your employer is self-insured or claims go through WorkCover Queensland.
- Common law claims cover more than just weekly payments. They can include pain and suffering, future income loss, and reduced earning capacity.
- You must prove your employer was negligent, such as failing to provide a safe workplace or adequate training.
Important note: Common law claims have strict limitation periods and complex requirements. Early legal advice greatly improves your chances of maximising compensation.
Does having a self-insured employer mean faster claim processing?
It can, but experiences vary depending on what resources the employer has available to handle the claim.
What affects processing times:
- Self-insurers handle claims internally, which can speed up decisions for straightforward cases.
- Some have experienced claims and rehabilitation teams, while others may take longer when it comes to complex injuries.
- WorkCover Queensland has specialist staff, but may have more formal procedures, lengthening proceedings.
What to do:
- Submit complete documentation with your claim to avoid delays.
- Respond promptly to requests for more information or medical assessments.
- Keep records of all communication and follow up if responses are delayed.
Important note: Both systems must provide the same benefits within the same legal timeframes. Delays do not affect your entitlements.
I’m concerned my self-insured employer isn’t taking my claim seriously enough. What can I do?
You have independent review rights and regulatory oversight to ensure fair treatment.
What protections exist:
- The Workers’ Compensation Regulator monitors self-insurers to ensure compliance with the same standards as WorkCover Queensland.
- You can request an independent review within 3 months if you believe a decision is unfair or incorrect.
- Legal representation ensures your employer follows required procedures and your claim is properly assessed. This should always be considered an option.
What to do:
- Document everything, including emails, letters, and conversations about your claim, adding dates and times.
- Request written reasons for any decisions you disagree with.
- Seek legal advice if you feel your employer is not handling your claim fairly or if you are being pressured to return to work earlier than what you deem to be acceptable.
Important note: Although your self-insured employer manages the claim, the regulatory framework and appeal rights are there to protect you. Do not let concerns about employer relationships stop you from pursuing your full entitlements.
Step-by-Step Process: Making a Claim
For both WorkCover Queensland and self-insurers:
- Report the injury immediately to your employer or supervisor, providing details about what happened, when, where, and any witnesses. Ask for an incident report number or written confirmation that the incident has been recorded.
- Seek medical treatment as soon as possible, making sure that your doctor understands the injury is work-related. Request a medical certificate detailing your diagnosis, treatment plan, and capacity to work.
- Gather supporting evidence, including photos of the injury site, witness statements, equipment or task logs, and any other documentation showing unsafe working conditions or inadequate training.
- Submit your claim with complete documentation:
- WorkCover Queensland: Your employer typically lodges the claim, but you should get confirmation that this has been done and make a note of your claim number.
- Self-insurer: Submit through your employer's designated workers' compensation process (often via HR or a specific claims team, depending on the organisation).
- Attend medical assessments as required, keeping copies of all reports and maintaining regular communication with your doctors about your recovery and ability to return to work.
- Participate in return-to-work planning if suitable duties are available, but never agree to tasks that could worsen your injury or that your doctor has advised against.
Documents you'll need:
- Medical evidence such as treatment notes, specialist reports, imaging results, and medical certificates showing your injury, treatment, and work capacity limits.
- Employment records, including incident reports, position descriptions, rosters, pay slips, and any written communication about your injury or work conditions.
- Witness statements from co-workers who saw the incident or can confirm the circumstances, safety concerns, or working conditions related to your injury.
- Correspondence records covering all emails, letters, and text messages with your employer, WorkCover Queensland, or the self-insurer about your claim.
- Financial documentation showing lost wages, medical expenses, and other injury-related costs. Top tip: Keep receipts and invoices for everything.
Key deadlines:
- Straight away: Report the injury to your employer and seek medical treatment
- Within 6 months of the injury: Ensure that the claim has been sent to either WorkCover Queensland or is being managed through the internal self-insurer
- Within 3 months of receiving the decision: Request a review by the Workers' Compensation Regulator if the claim is rejected
- A further 25 business days: Timeframe for the Regulator to complete their review
- A further 20 business days: Appeal to QIRC after receiving the review decision
- A further 10 business days: Send a copy of the QIRC appeal to Workers' Compensation Regulatory Services
Legal Framework
The Workers' Compensation and Rehabilitation Act 2003 governs both WorkCover Queensland and self-insurance arrangements, ensuring consistent worker protections across both systems.
What this means for your self-insurer or WorkCover Queensland claim:
- Self-insurers must comply with identical statutory benefit requirements as WorkCover Queensland, providing the same medical coverage, wage replacement, and rehabilitation support.
- Both systems are subject to oversight by the Workers' Compensation Regulator, which complies with legislative requirements and investigates complaints about claim handling.
- Your appeal rights and access to independent review are protected by the same legislation regardless of who manages your claim.
When to Seek Legal Advice
Seek legal advice early, especially if:
- Your workers’ compensation claim has been rejected, or your payments fall short of what you were expecting to receive.
- You’ve suffered a serious or permanent injury affecting your ability to work and earn money.
- Employer negligence, such as unsafe practices, poor training, faulty equipment or ignored hazards, contributed to your injury.
- You’re nearing or have missed appeal deadlines and need urgent help to protect your rights.
- WorkCover Queensland or a self-insurer is pushing a settlement, and you’re unsure if it’s fair and seek guidance.
- You’re struggling with a self-insured employer’s claims team or feel your case isn’t being handled properly or promptly.
Why early advice matters:
- Know your full entitlements under both statutory and common law claims so you don’t settle for less than you deserve.
- Access rehabilitation and support services sooner with guidance from an expert who understands the workers’ compensation system.
- Avoid common pitfalls such as weak medical evidence, missed deadlines or undervalued settlement offers.
Protect your rights and keep appeal options open before critical time limits expire.
Key Takeaways
- Your legal entitlements under workers' compensation are identical whether your employer is covered by WorkCover Queensland or is a self-insurer.
- Self-insurance is only available to large employers with more than 2,000 employees, and it includes major retailers like Coles and Woolworths, government departments, and other large organisations.
- The Workers' Compensation Regulator oversees both systems to ensure self-insurers provide the same statutory benefits, common law access, and claim management standards as WorkCover Queensland.
- You must request a review within 3 months of a claim decision and appeal to the QIRC within 20 business days of receiving the review outcome.
- Common law claims for employer negligence are available under both systems and can provide significantly more compensation than statutory benefits alone.
- Early legal advice protects your rights, ensures you receive all entitled benefits, and maximises your potential compensation for workplace injuries.
Get Help Now
If you’re struggling to make sense of your claim or your claim has been rejected, you suffered a serious injury, you wish to appeal, or there was negligence, getting early legal advice can help protect your rights and make sure that you get the compensation you deserve.
Contact Smith’s Lawyers for a free, no-obligation consultation. We operate on a No Win, No Fee, No Catch® basis and can guide you every step of the way, from your initial claim to potential escalation with the Regulatory Services and the QIRC. Call us on 1800 960 482 or request a call back using the form below.
