When notified of an injury, the Scheme Agent or insurer must: 

• contact the worker and the employer within three days, and consult with all relevant parties including the treating doctor, to ensure that the worker receives necessary assistance to recover and return to work 
• provide information regarding the claims process
• within seven days, decide whether to approve provisional weekly payments for up to a maximum of twelve weeks, and commence these payments (unless a reasonable excuse exists)
• decide whether to approve provisional medical expenses for up to $7500 and commence these payments
• decide whether they or the employer will pay the worker
• notify the injured worker and employer, in writing, about the amount and time period of the provisional payments
• develop an injury management plan for a worker with a significant injury and comply with their obligations under the injury management plan. 

In relation to claims the Scheme Agent or insurer must:

• decide whether the injured worker needs to complete a claim form, and assist the worker to complete the form
• inform the employer, within seven days, if a claim has been made and make a decision about the ongoing liability of the claim within 21 days or before the end of the period of provisional liability
• provide the worker with contact details of the WorkCover Assistance Service, to facilitate communication of accurate information and prevent disputes
• provide the worker with a written explanation of a decision to decline the claim or any aspect of the claim, attaching all relevant reports and documents and contact details of the Workers Compensation Commission.

www.workcover.nsw.gov.au

Last updated on February 24, 2011 by Galen & Gray