Workers: The Claims Process
Follow the steps to find out what you need to do if you have a work-related injury or illness.
Are you an employer? Follow the employer journey
Step Two: Making a claim
If you are injured at work, you may wish to make a compensation claim for loss of income or treatment costs. If you wish to claim other benefits, more information is available on impairment benefits or suing for damages.
- Plan with your employer about returning to work
- Obtain a ‘Certificate of Capacity’
- If a motor vehicle was involved, report it to the police
- Complete the Worker’s Injury Claim Form
- Submit the claim form to your employer
- You may be required to attend an examination
- You may be asked to provide a statement
- You will receive a decision within 28 days
Plan with your employer about returning to work
If you need time away from work it is important to stay in touch with your employer about the progress of your recovery. You should also talk with your employer about any assistance you need to return to safe work, which might include modifications to your duties or work area or reduced hours.
Obtain a Certificate of Capacity
If you cannot do your normal job or hours because of your work-related injury or illness and you want to claim for loss of income (weekly payments), you will need to give your employer a Certificate of Capacity. You can view an example Certificate of Capacity here.
The first certificate can cover up to the first 14 days of work capacity and should be provided with your claim form. Later certificates can cover up to 28 days of work capacity.
You must sign the back (or second page) of each Certificate of Capacity for it to be valid.
You should continue to get Certificates of Capacity if your claim for loss of income from your work-related injury or illness is ongoing.
If a motor vehicle was involved, report it to the police
If your injury is the result of a motor vehicle accident, you must also report the accident to the police.
Complete the Worker’s Injury Claim Form
Once you have a Certificate of Capacity, the next step is to complete the Worker's Injury Claim Form. You can get this form:
- via download
- from an Australia Post outlet
- from your employer’s WorkSafe Agent
- by contacting the WorkSafe Advisory Service on 1800 136 089 or (03) 9641 1444 or email@example.com
When you complete a claim form, ensure that you list all the injuries or illnesses related to your claim for compensation. You can view an example Worker’s Injury Claim form here.
Are you a firefighter? Check out this information sheet for firefighters.
Submit the claim form to your employer
Once you have completed and signed the claim form, give it to your employer, along with your Certificate of Capacity.You can hand deliver the form to your employer, or post it. You may want to use Registered Post so you know that your employer has received the form.
Your employer will need to complete the ‘Employer Lodgement Details’ section of the claim form and give you a copy. They must then submit your claim to their WorkSafe Agent within 10 calendar days of receiving it.
You may be required to attend an examination
Independent medical examinations are conducted to provide impartial information to help your WorkSafe Agent make decisions about your entitlement to weekly payments and treatment and to support your recovery, rehabilitation and return to safe work.
You may be asked to provide a statement
In the interests of making a fair and accurate assessment of your claim, a Circumstance Investigator may be appointed to obtain information and statements from witnesses about your claimed injury. This is your opportunity to give the WorkSafe Agent details about your injury and the events that took place.
You will receive a decision within 28 days
WorkSafe Agents are required to notify you in writing about the decision/s made on your claim within 28 days from the date they received your claim from your employer.
Have you received a phone call or letter advising that your claim has been rejected or accepted? Check out Step Three: what to do after the claim has been assessed.
Tips and tools to help you through this stage
- Download and complete the Worker's Injury Claim Form. Don’t forget to sign it! You can view an example of a completed form here.
- You should keep copies of anything you send to your employer or WorkSafe Agent, such as the claim form, invoices and receipts.
- Who is the Eligibility Officer at the Agent? Find out more about who’s involved in the claims process
- Give your doctor a helping hand – talk to your employer about the activities you can safely do at work while you recover and pass this information on to your doctor
- Find out more about Independent Medical Examinations
- Take a look at our comprehensive guide: Introducing WorkSafe, a guide for injured workers
What your employer should be doing
Your employer should:
- Acknowledge that they have received your injury claim form in writing and give you a copy of the completed claim form
- Complete an Employer Injury Claim Report
- Lodge the claim and report with their WorkSafe Agent within 10 calendar days
- Cooperate with a Circumstance Investigator if appointed
- Appoint a Return to Work Coordinator (if one is not already appointed)
- Plan your return to work in consultation with you, your treating health practitioner, the occupational rehabilitation provider (if one is appointed) and the WorkSafe Agent
- Stay in regular contact with you while you are off work.
What the WorkSafe Agent should be doing
The WorkSafe Agent:
- will review the claim documentation and may contact you for further information
- may contact your treating health practitioners to obtain further information
- may arrange an Independent Medical Examination for you to attend
- may obtain further information about the circumstances of your injury or condition
- will notify you within 28 days about the outcome of your claim.