WorkSafe Victoria

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

 

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:

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

 

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.