Making a claim
If a worker experiences a work-related injury or illness at work or travelling to or from work, they may be eligible to make a claim for workers' compensation.
Usually, a worker’s insurer can support them with the costs of treatment, help with returning to safe work and pay some of their wages if they need time off work.
Workers’ compensation insurers
WorkCover Queensland insures most employers. Self-insured employers manage their own workers’ compensation claims. If an employer is licensed as a self-insurer by the Workers’ Compensation Regulator, workers can contact their employer’s workers’ compensation unit for any claim questions.
If a worker is unsure if their employer is insured through WorkCover Queensland or self-insured, they can check the list of self-insured employers or check if their employer has a current accident insurance policy with WorkCover Queensland (an ABN is required to use this link).
How to make a claim
- See your doctor as soon as possible.
- Ask your doctor for a work capacity certificate. This is a type of medical certificate you’ll need to make a claim.
- Your work capacity certificate must clearly state all of the injuries you want to be assessed as part of your claim. This is because only injuries listed on your work capacity certificate will be assessed by your insurer.
- To be a valid claim, you must submit both a work capacity certificate and an application for compensation.
- To make your claim, use WorkCover’s online claim form or contact your employer’s workers’ compensation unit (if your employer is self-insured).
You will need to provide your insurer some personal details including:
- your full name, date of birth and personal contact information, including your email address and mobile phone number
- your employer's name and location
- a work capacity certificate from your initial consultation for this injury (your doctor can give you this)
- your bank details—BSB, account number and account name (for weekly compensation or reimbursement claims)
- a Tax File Number declaration (PDF, 0.08 MB) (for time loss claims)
- information about your injury or illness, including details about how and when it happened.
Your work capacity certificate will tell your insurer:
- all of the injuries that you want the insurer to assess
- the nature of your injury/ies or illness/es
- a clear diagnosis of your work-related injury/ies
- the treatment you need to help you recover
- whether you need time off work
- details about your capacity to work (what you can and cannot do due to your work-related injury)
- if you can stay at work, what support you may need.
Talk to your employer
It is important to let your employer know about your injury or illness. Your insurer will usually contact them to seek information about your work and what they know about the injury, and your wage information if you are unable to work.
Your employer has work health and safety obligations to notify Workplace Health and Safety Queensland or the Electrical Safety Office about WHS incidents.
Your employer also has rehabilitation and return to work obligations to help you recover and get back to work.
If you and your employer and worker lodge a claim together, the process may be faster.
Access mental health treatment while your claim is decided
Getting treatment early puts you on the path to recovery sooner.
If you have a psychological injury, it's important to start getting support to help you recover straight away.
While your psychological injury claim is being assessed, you can access certain mental health treatments funded by your insurer. This may include:
- GP mental health appointments
- counselling or psychology sessions
- psychiatry appointments
- reasonable travel expenses incurred to access and attend treatment
- medication, such as antidepressants.
What is not covered:
- in-patient hospital costs
- costs related to a hospital stay, such as nursing, or medications received in hospital.
If you’re unsure how to access treatment options, your insurer can help you with this after you lodge a claim.
Your insurer can also help with mediation services between you and your employer, to support recovery and getting back to safe work early.
Please note: To access early mental health support, you must have lodged a workers’ compensation claim and have a work capacity certificate from your doctor confirming the diagnosis of a psychological injury.
If your insurer decides not to accept your claim funding of this treatment will stop but you won't have to pay back the costs for treatment already received.
If you have had a previous workers’ compensation claim for a psychological injury caused by the same or a similar circumstance, you should talk to your insurer about whether they’ll pay for this treatment while your claim is assessed.
Returning to work
If you need time off, returning to work is an important part of your recovery process.
Your employer may be able to adjust your duties, hours or days or make changes to your work environment to help you return to safe work sooner. In some cases, you may be able to continue to work while you recover, if your doctor agrees.
It is important that you, your employer and your treating doctor work together to discuss your options and return to work.
How claims are assessed
When reviewing your claim, insurers must consider:
- when you first saw a doctor about your work-related injury/ies or illness/es (there is usually a time limit for lodging a claim, often within 6 months of the date you were first seen by a doctor, unless you have reasonable excuse that is accepted by your insurer)
- your employment status at the time of your injury
- where and how the injury occurred
- whether your employment was a significant contributing factor to your injury.
Additional information may be requested depending on your circumstances. Providing complete details early helps your insurer progress your claim.
Find out more about the claim process.
Public hospital referral
If you go to the hospital with a work-related injury, the hospital may send your work capacity certificate to your insurer directly. If you decide to make a claim, you will need to submit both an application for compensation and your work capacity certificate with all injuries listed. It is important for you to obtain a copy of the work capacity certificate from the hospital for your own records and to provide to your insurer as required.
Should you decide not to lodge a claim, you will be responsible for any costs you have to pay relating to your injury.
If you have a worker’s consent, you can start the claim process on their behalf by lodging a claim with your insurer. If you lodge a claim together with a worker, the process may be faster.
You may need:
- your worker's full name, date of birth, and personal contact information
- your policy number, and/or your business name, ABN or ACN
- details about the type of injury and how and when it happened
- your copy of the worker's work capacity certificate, with all injuries listed
- normal weekly earnings wage figures and working hours for your worker, if they’re taking time off work. You’ll also need the amount payable under your worker’s industrial agreement.
If you do not have the worker’s consent to lodge a claim on their behalf, you may need to report the injury and notify Workplace Health and Safety Queensland of the incident.
Explore the sections below to find what you must do for your individual situation.
Returning to work
If a worker needs time off, returning to work is an important part of the recovery process.
From the time a worker is injured you must consider if you are able to adjust their duties, hours or days or make changes to their work environment to help them return to safe work sooner. In some cases, they may be able to continue to work while they recover, if their doctor agrees.
It is important that you, your worker and your treating doctor work together to discuss your options and return to work.
Notify of an incident and/or make a claim
Learn more about incidents and whether you need to notify of an incident.
Once you’re sure you need to notify, use online services to let Workplace Health and Safety Queensland know about the incident and start the claim process with your insurer.
Report an injury
Report to WorkCover Queensland
As an employer, you must report a work-related injury or illness within eight days of becoming aware of it. Reporting the injury isn’t the same as making a claim for workers’ compensation.
There are several ways to report an injury or illness to WorkCover. You can:
- phone 1300 927 928 to speak to a member of WorkCover’s Customer Service Team, or
- complete the approved form (PDF, 0.14 MB) and
- upload it to WorkCover’s online services, selecting 'New claim' to report an injury
- fax it to 1300 651 387, or
- post it to GPO Box 2459, Brisbane Qld 4001, or
- complete WorkCover’s Report an injury online form.
Report to a self-insurer
If your employer self-insures, you’ll need to complete the approved form (PDF, 0.14 MB) and submit it to your employer. Contact your insurer (Self-insurer) if you have questions on how to report an injury.
Find out if your employer is self-insured.