Before making a workers compensation claim, an injured worker or their representative must advise their employer that an injury has occurred, and provide medical information. 

Step 1: notify the employer as soon as possible
Step 2: record the injury/illness in the employer’s Register of Injuries
Step 3: obtain a WorkCover medical certificate from the injured worker’s nominated treating doctor or hospital
Step 4: notify the Scheme Agent or insurer of the injury (the Scheme Agent or insurer can be notified by the employer, the worker or a third party)
Step 5: ensure that the medical certificate and any associated bills or expenses are given to the worker’s employer.

Generally, once the Scheme Agent or insurer has been notified of an injury, the following will occur:

• the Scheme Agent or insurer will contact the worker, employer, and if necessary, the worker’s nominated treating doctor
• provisional liability payments will start within seven days of the insurer receiving notification of the injury
• if the Scheme Agent or insurer has a reasonable excuse to not commence provisional liability payments, the Scheme Agent or insurer will notify the worker within seven days of receiving notification of the injury.

In most cases, an injured worker does not need to complete a claim form if the Scheme Agent or insurer has sufficient information about the injury. 

A claim form is only required if:

• the Scheme Agent or insurer has a reasonable excuse to not commence provisional liability payments and has notified the worker
• weekly payments exceed the 12 week provisional liability period or medical expenses exceed $7500 and there is insufficient information to determine ongoing liability
• the injury has been notified but there is insufficient information to determine liability.

www.workcover.nsw.gov.au

Last updated on February 24, 2011 by Galen & Gray