Step by Step Guide
If you have been injured at work in Queensland, including if you are in a car accident on your way to or from work or whilst on a break, understanding how to make a WorkCover claim correctly, and on time, can make the difference between a smooth claim process and a rejected application.
The following details the process from notifying your employer, lodging the application, through to receiving statutory compensation.
This is, however, just a superficial overview of the application process and does not take into consideration the complexities of the claim process and the nuances that can have a significant adverse impact on your entitlement to statutory compensation or, thereafter, you ability to successful pursue a claim for damages.
Additionally, everything in the claim process is relevant, as such, the contents of even the first document produced in respect to the application for WorkCover compensation can have significant ramifications on the ultimate outcome.
Getting it right, both factually and strategically from the outset is of the greatest importance.
As such, whilst the following information details the process, it is recommended professional legal advice be obtained from workers compensation lawyers from the outset, as going it alone could have real consequences on the amount of compensation you receive.
What Is a WorkCover Claim?
A WorkCover claim is an application for statutory compensation lodged with WorkCover Queensland under the Workers’ Compensation and Rehabilitation Act 2003.
If the application is accepted, It covers medical expenses, a percentage of your lost wages, and rehabilitation support for workers injured or made ill because of their job.
Step 1: Notify Your Employer Immediately
Report your injury to your employer as soon as possible after it happens. This is a statutory requirement in Queensland, and delays can complicate your claim later.
However, the contents of what is reported to your employer is of the utmost importance as any discrepancy or inconsistency in your reporting of what occurred and how the injury was suffered will almost certainly be of the highest relevance to any claim for damages you may wish to pursue at the end of the statutory compensation phase, which is why many people injured at work choose to speak with workplace injury lawyers early in the process.
Step 2: Get a WorkCover Medical Certificate
Make an appoint and see your doctor as soon as possible. Then, when attending upon your doctor, be very clear about what occurred and all of the injuries you believe you have suffered. Your doctor will also be required to complete a Workers’ Compensation Medical Certificate. When completing WorkCover’s certificate, your doctor should outline your diagnosis for each injury, your capacity for work, and any recommended treatment.
Step 3: Lodge Your WorkCover Claim
You can lodge your claim with WorkCover Queensland:
- Online via the WorkCover Queensland portal;
- By phone; and
- By paper form.
Importantly, claims must generally be lodged within 6 months of the injury.
Late claims may still be accepted if you have a reasonable excuse for the delay in lodging your claim.
Again, it is recommended professional legal advice be obtained from lawyers for workplace injury claims, as the information you represent to WorkCover in respect to any delay can have a significant impact on whether your claim is accepted or rejected.
Step 4: WorkCover Assesses Your Claim
WorkCover aims to make a decision within 20 business days of receiving your claim.
This timeframe can extend if they request further medical evidence or information.
For strategic reasons, careful consideration of whatever information and further evidence is provided to WorkCover must be carefully considered.
Step 5: What Happens If Your Claim Is Accepted
Accepted claims typically include:
- Rehabilitation and return-to-work support.
- Weekly compensation payments, calculated based on your normal weekly earnings (the calculation method changes after the first 26 weeks);
- Medical and treatment expenses;
Step 6: What Happens If Your Claim Is Rejected
If WorkCover rejects your claim, you have the right to request a review by the Regulator within 3 months of WorkCover’s decision.
Obviously, if the claim is rejected by WorkCover and an appeal to the Regulator is necessary, the stakes get higher as, in the event the claim is also rejected by the Regulator, you will then be required to appeal the Regulator’s decision to the Queensland Industrial Relations Commission (QIRC).
The stakes obviously get higher the further along in the appeal process you get and, again, what is conveyed to the Regulator or the QIRC, both in respect to the factual circumstances and any supportive evidence in respect to you claim requires careful consideration, ideally with input being provided by a solicitor who specialises in WorkCover claims, such as experienced workplace compensation lawyers.
Common Mistakes to Avoid
- Missing the 6-month notification window, even with reasonable excuse provisions, early action is safer and reduces the risk of your claim being rejected;
- Using the wrong medical certificate, a GP letter or generic medical certificate is not substitute for the WorkCover claim;
- Assuming a rejected claim is the end of the road, review and appeal rights exist;
- Providing too much or too little information, of the utmost importance is having careful and strategic regard to what information is conveyed to WorkCover, the Regulator and the QIRC. Obtaining professional advice from workplace compensation lawyers as soon as possible helps to mitigate the risk that your claim is rejected on the basis of the information you provide;
- Confusing a WorkCover claim with a common law claim — these are separate but highly interrelated processes. A common law claim for damages claim requires you to prove your employer was negligent and that the negligence caused your injuries. Information provided in the earlier, statutory compensation process, is relevant to the assessment of the claim for damages. However, you generally cannot proceed to pursue a claim for damages unless and until your statutory WorkCover claim has reached a Notice of Assessment stage.
Do You Need a Lawyer for a WorkCover Claim?
You are re not required to have a lawyer to lodge a WorkCover claim, but legal advice from workers compensation lawyers is particularly valuable if you think your employer has been negligent and there is a possibility you may wish to pursue a claim for damages for future losses you may incur as a result of the injuries or your initial application has been rejected.
Getting it right, from the start, is critical in any WorkCover claim and whilst it is possible to commence the claim process on your own, the risks of whatever steps taken having an impact on the amount of damages (money) you ultimately receive it high.
Get Help With Your WorkCover Claim
Fisher Dore Lawyers’ compensation team, our workplace injury lawyers, is highly experienced in assisting injured workers with their claim for compensation and claim for damages that follow.
If you have been injured at work in Queensland and need advice on your WorkCover claim or a potential common law claim, please contact our workplace compensation lawyers to discuss how we can provide you with strategic advice and assistance to make the claim process as smooth as possible, whilst also maximizing the amount of damages you receive at the end of the claim process.
Click here to arrange a no obligation free consultation with one of our WorkCover compensation solicitors.
Frequently Asked Questions About TPD Claims in Queensland
How long do I have to make a WorkCover claim in Queensland? Generally 6 months from the date of injury, though late claims may be accepted with a reasonable excuse.
How long does WorkCover Queensland take to decide a claim? WorkCover aims to decide within 20 business days, though this can extend if more information is needed.
Can I make a common law claim as well as a WorkCover claim? Potentially, yes — but a common law damages claim generally cannot proceed until your statutory claim reaches certain milestones. Legal advice from lawyers for workplace injury matters is recommended.
What happens if my WorkCover claim is rejected? You can request a review by the Regulator within 3 months, and appeal to the QIRC if that review is unsuccessful. Legal advice is recommended.
Fisher Dore Lawyers is a Queensland based law firm specialising in all areas of compensation and criminal law. Specifically in respect to our compensation team, we can assist with complex claims involving workplace injuries, medical negligence, motor vehicle accidents, public liability, assaults and battery and the like.
Whether your injuries are relatively minor or catastrophic in nature, it is important you obtain professional advice about your rights to ensure you receive the compensation you deserve.
Should you have suffered personal injuries in a motor vehicle accident and you wish to discuss your rights in respect to a claim for damages, please call our team of professional personal injury lawyers on 3236 1800.
Compiled by Michael Biscak | Special Counsel
