Navigating your workers compensation claim in New South Wales – The essentials
Published on July 19, 2023 by Robert Algie
In NSW, the process of filing a workers compensation claim involves specific steps to ensure you as an injured worker receive the necessary support and benefits. It’s often a difficult and stressful time, and you may receive a lot of information from your employer, your doctor, and the insurer which can itself be overwhelming. This article outlines the essential steps you should take when you start a workers compensation claim.
What am I entitled to?
If you have been injured at work, you may be entitled to:
- Medical expenses;
- Loss of income (paid in the form of a weekly compensation benefit);
- Rehabilitation services;
- Lump-sum compensation;
- Legal costs.
What steps should I take?
- Report the injury or illness to your employer
The first step is to report your work-related injury or illness to your employer as soon as possible. You can notify them verbally and in writing or by email, providing details about the incident, the date and time it took place, as well as the nature of your injury. By law, every employer should have an injury book or accident register for you to fill in. Keep a copy of all your reporting for your own records. Prompt reporting helps establish a record of the incident and ensures that you meet the statutory notification requirements. If you do not notify your employer within 30 days of becoming aware of your injury, your claim may be rejected.
- Seek medical attention from your doctor
After reporting the injury, you should seek medical attention from your doctor also as soon as possible. It is important to see your doctor even if you think your injury might be minor. Sometimes, it takes some time for the extent of your injury to present itself and it’s important to see your doctor to ensure you have explained everything that happened to you around the time that it occurred.
- Get a ‘certificate of capacity’ from your doctor
When you visit your doctor, they will assess your condition, provide you with appropriate treatment, and most importantly, issue to you a certificate of capacity. This medical certificate is essential for supporting your workers compensation claim. You must ensure you communicate the details of your injury accurately to your doctor, including the circumstances, symptoms, and any limitations it imposes on your ability to work. You should also keep a record of all medical reports, receipts, and invoices related to your injury, as they will be required during the claims process.
- Notify the insurer and lodge a claim form
To initiate the formal workers compensation claim process, you must notify the insurer of your injury and lodge a claim form. Your employer should provide you with the necessary forms and guide you through the process. Alternatively, you can directly contact the insurer or access the claim forms from their website.
Complete the claim form accurately, providing detailed information about the incident, your injuries, and any medical treatment received. You should also attach supporting documents, including medical certificates, invoices, and witness statements if there are any available.
What happens next?
Once your claim is lodged, the insurer will assess the validity and eligibility of your claim. They may request additional information or documents to support your case.
As part of the claims process, the insurer may also arrange for you to undergo an independent medical examination (IME). You should attend these medical assessments as scheduled, as they help assess your condition, determine the extent of your injuries, and evaluate your work capacity.
Throughout the claims process, the insurer and employer also have a legal obligation to facilitate your return to work, either in your pre-injury role or suitable alternative duties. You should engage in the return-to-work planning process and collaborate with your employer, doctors, and rehabilitation providers to develop a suitable plan tailored to your capabilities and limitations. You should participate actively in any rehabilitation programs or treatment prescribed by your doctor. This may include physiotherapy, counselling, or vocational retraining. You can regularly communicate with your employer and the insurer regarding your progress, any changes in your condition, or adjustments needed to your return-to-work plan.
You can contact us at Carroll & O’Dea Lawyers on 1800 059 278 or via our Contact Page if you have been injured in a workplace accident and one of our lawyers will assist you. You can also complete our Personal Injury Claim Check here.