WorkCover
Has an injury, illness, or dangerous incident occurred at your workplace?
Depending on the seriousness, an employer may need to notify Workplace Health and Safety Queensland (WHSQ) of the incident.
To find out more about what to do if you are a worker injured at work click here.
To find out more about what to do if you are a worker injured at work click here.
Claims and return to work
Workers injured at work, or because of work, may be eligible to claim workers’ compensation benefits from their workers’ compensation insurer. If a worker is employed by a self-insured employer then the worker must submit their application to the self-insurer, otherwise applications must be made to WorkCover Queensland (WorkCover).
A 'no fault' workers' compensation scheme means that Queensland workers have the right to apply for statutory benefits, no matter who or what caused their workplace injury.
WorkCover is here to help a worker through their recovery from injury and support their return to work as soon as safely possible.
WorkCover may provide:
A 'no fault' workers' compensation scheme means that Queensland workers have the right to apply for statutory benefits, no matter who or what caused their workplace injury.
WorkCover is here to help a worker through their recovery from injury and support their return to work as soon as safely possible.
WorkCover may provide:
- weekly compensation (for lost wages)
- return to work support
- medical and rehabilitation expenses
- travel and other allowances
- death benefits and funeral expenses.
Claim process
When deciding a physical claim, an insurer will apply criteria from the Workers' Compensation and Rehabilitation Act 2003 (the Act).
Criteria can include considering whether:
To find out more about the making a claim click here.
Criteria can include considering whether:
- the claim was made within the time limits
- the person was employed at the time of the injury by the employer
- the person is considered to be a worker
- the injury was caused by a work-related event, and
- the person was injured out of, or in the course of, employment, if the employment is a significant contributing factor to injury.
To find out more about the making a claim click here.
How a WorkCover claim is processed
Once a claim has been made, it is allocated to a WorkCover Queensland claims representative to be determined.
WorkCover determines claims as quickly as possible and will generally contact both the worker and employer within three business days of the claim being made.
Workers have the opportunity to give details of the injury and event before we make our decision. We'll also speak to their employer to get further information (such as confirmation of employment and wage details) and to notify them that a new claim has been lodged on their policy.
To find out more about the process of making a WorkCover claim click here.
How long does it take to decide a claim?
When workers and employers provide true and accurate information about the claim, WorkCover is able to make a decision very quickly.
A decision on a claim can take up to 20 business days, especially if we have difficulty getting the information we need such as information from the employer, the work capacity certificate or information from doctors.
If we can't determine the claim within this timeframe, we will contact the worker verbally and in writing to let them know why a decision hasn't been made.
The worker can request to have the insurer’s failure to decide the claim within 20 business days reviewed by the Workers' Compensation Regulator if unhappy with the reasons provided.
To find out more about how long it may take for WorkCover to decide a claim click here.
Information needed to decide a claim
WorkCover gathers information from the worker, employer, doctors and other people, such as witnesses to the event or independent medical examiners, to help us make our decision.
Once we've gathered enough information to decide the claim, both the worker and the employer will be informed of the decision.
To find out more about the information needed by WorkCover to decide a claim click here.
Once a claim has been made, it is allocated to a WorkCover Queensland claims representative to be determined.
WorkCover determines claims as quickly as possible and will generally contact both the worker and employer within three business days of the claim being made.
Workers have the opportunity to give details of the injury and event before we make our decision. We'll also speak to their employer to get further information (such as confirmation of employment and wage details) and to notify them that a new claim has been lodged on their policy.
To find out more about the process of making a WorkCover claim click here.
How long does it take to decide a claim?
When workers and employers provide true and accurate information about the claim, WorkCover is able to make a decision very quickly.
A decision on a claim can take up to 20 business days, especially if we have difficulty getting the information we need such as information from the employer, the work capacity certificate or information from doctors.
If we can't determine the claim within this timeframe, we will contact the worker verbally and in writing to let them know why a decision hasn't been made.
The worker can request to have the insurer’s failure to decide the claim within 20 business days reviewed by the Workers' Compensation Regulator if unhappy with the reasons provided.
To find out more about how long it may take for WorkCover to decide a claim click here.
Information needed to decide a claim
WorkCover gathers information from the worker, employer, doctors and other people, such as witnesses to the event or independent medical examiners, to help us make our decision.
Once we've gathered enough information to decide the claim, both the worker and the employer will be informed of the decision.
To find out more about the information needed by WorkCover to decide a claim click here.
What happens if the claim is approved?
If a claim is accepted and a worker receives weekly compensation, their employer will be required to pay the first payment of weekly compensation (this is the employer’s excess).
WorkCover will confirm the worker’s bank details and manage all further weekly compensation payments. If a claim requires ongoing management or assistance with return to work, it will be case managed by one of our customer advisors.
Find out more about the types of payments and support available.
To find out more about what happens if the claim is approved click here.
If a claim is accepted and a worker receives weekly compensation, their employer will be required to pay the first payment of weekly compensation (this is the employer’s excess).
WorkCover will confirm the worker’s bank details and manage all further weekly compensation payments. If a claim requires ongoing management or assistance with return to work, it will be case managed by one of our customer advisors.
Find out more about the types of payments and support available.
To find out more about what happens if the claim is approved click here.
What happens if the claim is not accepted?
If an application is not accepted, our claims representative will speak to the worker and explain the decision that has been made. A letter will be sent explaining the information considered and the reason why the application was not accepted. Find out more about what happens if a claim is not accepted.
To find out more about what happens if the claim is not accepted click here.
I’m confused about a claim. Who can I talk to?
If an application is not accepted, our claims representative will speak to the worker and explain the decision that has been made. A letter will be sent explaining the information considered and the reason why the application was not accepted. Find out more about what happens if a claim is not accepted.
To find out more about what happens if the claim is not accepted click here.
I’m confused about a claim. Who can I talk to?
- Call WorkCover Queensland on 1300 362 128
- If your employer self-insures, you can contact the relevant claims department
- Employers can contact CCIQ’s Workers’ Compensation Helpline
- Workers can contact the Queensland Council of Unions’ Workers’ Compensation Advisory Service
