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Rights and responsibilities

Workers' rights and responsibilities

As a worker in Queensland, you have both rights and responsibilities during the claims process with WorkCover.

It's important when you apply for compensation that you understand what is required during the application and rehabilitation process.

Making a claim

Under the Act, workers are required to cooperate with WorkCover, their employer and their doctors. This helps us make a decision on the claim and also helps workers receive appropriate medical treatment and rehabilitation as quickly as possible.

To make sure a claim is made efficiently, as a worker you must:

  • complete and sign all necessary forms
  • let WorkCover know if your condition or treatment changes
  • make sure WorkCover has all current workers' compensation medical certificates.

You can only receive workers' compensation benefits if we have a copy of these.

During the claim

Under the Act, you must ensure that:

  • all information provided to WorkCover is true and not misleading. For example you must inform us if you're receiving Centrelink payments.
  • you participate in rehabilitation programs if required to.
  • you tell WorkCover if you are returning to work of any kind. This includes self-employment or working for another person. This applies whether or not you are paid for performing the activity.

Penalties can apply if you don't comply with these requirements. We can suspend a worker's compensation benefits or prosecute for an offence under the Act if these requirements are not fulfilled. Of course, penalties do not apply if you satisfactorily participate in rehabilitation or provide a reasonable excuse for not participating.

If the claim is not accepted

WorkCover carefully considers the facts presented when making decisions to either accept or reject an application for compensation. We must consider if you are:

  • a Queensland worker
  • whether your application has been lodged in time
  • whether a work-related event caused your injury.

Based on the facts presented, we determine if we will accept or reject your claim. If your application is not accepted, your claims representative will speak to you and explain the decision that has been made. A letter will be sent to you explaining the information considered and the reason why your application was not accepted.  

If the claim has ceased

WorkCover carefully considers the facts presented when making a decision to stop payments for treatment or compensation. We consider if the necessary and reasonable treatment has been provided and whether you are able to work due to the accepted work related injury.

A claim may be ceased and payments stopped for different reasons. For example, if you have received all appropriate treatment for your work-related injury, however require additional treatment for a pre-existing or non work-related condition or injury, WorkCover Queensland will be unable to pay for the additional treatment. This will be determined on medical evidence.

Rights

If you are unhappy about decisions made by WorkCover Queensland, these issues can be addressed through our internal complaints process or through the Workers' Compensation Regulator's review process.

Call 1300 362 128, or speak to your WorkCover claims representative or customer advisor directly if you have any questions about your rights and responsibilities in Queensland.

Employer rights and responsibilities

As an employer of Queensland workers, you have both rights and responsibilities during the claims process with WorkCover.

Injuries at work

It is your responsibility to notify us immediately of any injury for which compensation may be payable. You should contact us as soon as you know the details of your worker's injury. It's then the worker's decision to claim for compensation.

During the claim

If the claim is accepted, you should take every reasonable step to cooperate and participate with rehabilitation and suitable duties and keep us informed about your worker's progress in returning to work. This assists us to get your worker back to work as quickly and safely as possible.

You will need to pay an excess on any accepted claim if your worker has taken time off from work due to their injury. This excess will be the lesser of:

  • 100% of Queensland full-time adult's ordinary time earnings (QOTE), or
  • the injured worker's weekly compensation rate.

You should also notify us if you pay any claim expenses, so we can reimburse you for them.

Rights

It's your right to raise any concerns with your claims representative or customer advisor throughout the duration of the claim. This may include disputing the claim, or any decisions we make about the claim. If we have made a decision or taken action that you don't understand, please discuss these with us so we can help you with your concerns.

If you feel your dispute, or any other issues you've raised with us have not been resolved to your satisfaction, you can make an official complaint.

If you disagree with a decision that we've made, you can seek a review with the Workers' Compensation Regulator.

Call 1300 362 128, or speak to your WorkCover customer advisor directly if you have any questions about your rights and responsibilities in Queensland.

Last updated
15 February 2016

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