With so much information out there about Workers Compensation and how it works, the practical steps you need to take to make a Workers Compensation claim can be complicated.
It can be even more confusing during the process as the injured worker is dealing with their injuries and receiving information from their employer, insurers (who manage workers compensation claims) and medical practitioners. At the moment, it can be overwhelming – especially if you are in a situation where you don’t feel that your workplace or others involved are being cooperative.
In simple terms, there are five steps to take when making a workers’ compensation claim for a work-related injury.
Making a Workers Compensation Claim
All employers are required to have Workers Compensation Insurance and each state has their own workers compensation schemes to support injured workers. In NSW the workers compensation regulator is SIRA, which covers all types of employees, except for employees of an Australian Government agency or statutory authority.
To make a workers compensation claim, you will first need to know if you’re eligible for workers compensation arrangements with your employer and follow the application steps.
I've been injured at work. Am I Eligible for Workers Compensation?
You are entitled to Workers Compensation if you have been injured at work in NSW – this could be a physical injury or an illness that has developed over time. This compensation is designed to cover your lost wages and treatment expenses. However, you may also be entitled to a lump sum compensation, which is why it’s worth getting legal advice before your workers comp claim is simply ‘processed’.
How to apply for workers compensation NSW
If you’ve been injured at work or an illness occurred as a result of your work and you believe you are eligible for Workers Compensation, you will need to submit a formal claim for compensation. However, before you submit this claim, there are some steps you’ll need to take first so you have all the required documentation to go with your application. The following are the five steps to making a Workers Compensation claim:
Report Your Injury to Your Employer
The first thing you need to do when you discover you’ve been injured as a result of work or while at work is to report the injury to your employer. This is important, as your claim may be rejected if your employer is not notified within 30 days of you becoming aware of the injury. By law, every employer is required to have an injury book or accident register for you to fill in. If your workplace doesn’t have one, you can give your employer written details of your injury (i.e. write it down or send an email). Make sure you keep a copy of this written notice for your own records.
Seek Treatment: Visit A Doctor
As soon as you realise you are injured or ill, you should seek medical treatment, even if you think your injury is only minor. Sometimes you won’t know the true extent of an injury until you have spoken to a medical professional. During this appointment, it’s important to explain everything that happened to you and how you believe this injury occurred as a result of your workplace or the work you do.
Get a ‘Certificate of Capacity’
Sometimes called a ‘work capacity certificate’, this document is an official statement from a medical practitioner that your capacity to work is impacted by your injury or illness, how long it is expected to be impacted for and the expected treatment for the injury or illness.
Request a Workers Compensation Claim Form
Your employer should give you a Workers Compensation claim form when you report your injury, if they have not, you will need to request one. If they do not have one, you can also get one from your doctor or from the WorkCover authority in your state or territory.
Complete and Submit the Claim Form
The last step in the claims process is to complete the workers compensation claim form, with your certificate of capacity attached to the form, and submit it to your employer.
Be sure to keep a copy of the completed form and certificate for your own records, and start keeping track of all medical bills, as well as any time you need to take off work as a result of your injury. Your employer’s workers compensation insurance should cover your medical expenses and provide you with a portion of your wages while you’re unable to work.
Insurer (or employer) Obligations After Receiving the Claim
There are a number of obligations an insurer/employer have throughout the claims process and afterwards. These obligations are clearly outlined in the SIRA (State Insurance Regulatory Authority) – the NSW Workers Compensation insurer – guide to Workers Compensation Claims.
Under NSW workers compensation legislation every employer is required to have certain policies and documentation in place to assist workers if they suffer a work injury, including:
- workers compensation insurance
- display of the ‘If You Get Injured at Work’ poster
- documented return to work program describing the steps you will take if a worker is injured
When it comes to assisting injured workers, employers are obligated to:
- maintain a record of work-related injuries
- notify their insurer of all workplace injuries within 48 hours
Following the success of a claim, your insurer is obligated to work with your employer to develop the workers injury management plan, which will outline and manage your recovery at work. Your employer also has a number of obligations following a claim, including
- participating in the development of the workers injury management plan with the insurer and complying with the obligations outlined in the plan.
- provide suitable work (as far as reasonably practicable) when a worker is able to return to work (whether full-time or part-time).
- provide suitable work that is (as far as reasonably practicable) the same as or equivalent to the work being performed at the time of the injury..
- must not dismiss a worker because of a work-related injury within six months from when the worker first became unfit as a result of the injury.
Need Assistance with Making Your Workers Compensation Claim?
If you’ve been injured at work, it’s important to know that you may be entitled to workers compensation benefits.
To make a workers compensation claim, you’ll need to report your injury to your employer as soon as possible. Your employer should provide you with the necessary paperwork to fill out, and you’ll need to provide detailed information about the circumstances of your injury. It’s also important to seek medical attention right away, as a doctor’s report can be crucial in determining the severity of your injury and the amount of compensation you may be entitled to.
If your claim is denied or you feel that you’re not receiving the benefits you’re entitled to, you may want to seek the advice of an experienced workers’ compensation attorney – contact BurkeMead Lawyers to discuss your unique circumstances and potential compensation outcomes.
Call 1300 292 700 or email [email protected]
About the Author
Sean is a member of the personal injury team with extensive experience in representing injured clients at the Personal Injury Commission as well as in the District and Supreme Courts of NSW.