Code of claimants’ rights

This Code details how WorkSafe, self-insurers and agents will work with claimants to make sure they are treated with dignity and respect. A complaint can be made under this Code from 1 February 2027.

How to access the code

The Code comprises 5 parts:

Part 1: Introduction
Part 2: Rights and obligations
Part 3: Concerns and complaints
Part 4: Remedies available
Part 5: Reporting.

You can access the code in digital form below or download a printable PDF.

Download code

Part 1: Introduction

Background

The Minister for WorkSafe and the TAC approves this Code of claimants’ rights (Code) under sections 12A to 12D of the Workplace Injury Rehabilitation and Compensation Act 2013 (WIRC Act).

Purpose of the Code

In accordance with sections 12A and 12C of the WIRC Act, the purpose of this Code is to:

ensure claimants are treated with dignity and respect by WorkSafe Victoria, its agents and self-insurers
set service standards for WorkSafe, its agents and self-insurers in the operation of Victoria’s WorkCover compensation scheme.

This includes:

the rights of claimants under the Code
obligations of WorkSafe, its agents and self-insurers in providing services to claimants to ensure their rights are promoted and upheld
explaining who has obligations under the Code
a procedure for lodging and dealing with complaints about WorkSafe, its agents or self-insurers if they fail to comply with the Code
remedies that apply if any complaints are substantiated.

This Code encourages positive relationships between WorkSafe, self-insurers, agents and claimants. It details how WorkSafe, self-insurers and agents will work with claimants to make sure they are treated with dignity and respect.

Commencement of the Code

This Code comes into effect on 1 February 2027. A complaint can be made under this Code from that date. A complaint cannot be made under this Code about any dealings WorkSafe, its agents and self-insurers had with a claimant before 1 February 2027.

Application of the Code

The obligations in this Code apply to:

WorkSafe
authorised agents
self-insurers
independent medical examiners (IMEs)
occupational rehabilitation providers
private investigators.

The Code applies broadly across a wide range of circumstances, interactions and parties involved in the WorkCover compensation scheme. The rights set out in the Code are framed to guide conduct across diverse situations.

The application of each right will depend on the specific context in which it arises. This includes the:

role and responsibilities of the relevant party
nature of their interaction with the claimant.

Investigations of complaints made under this Code will consider how the relevant rights apply in the circumstances when determining if a claimant’s rights have not been upheld.

Complaints made under the Code are limited to complaints about the rights and obligations set out in the Code, to the extent that they relate to the manner and conduct of the person the claimant is dealing with.

What the Code does not cover

Section 12D of the WIRC Act clarifies that any rights or obligations specified in this Code do not:

affect any entitlements or responsibilities of claimants under the WIRC Act or any other Act, or at common law
create a legal right in any person
give rise to any civil cause of action because of a contravention of a right or obligation specified in the Code. No damages may be awarded in respect of any such contravention .

This means that the obligations, responsibilities and entitlements of claimants do not change from how they are set out in the WIRC Act or Accident Compensation Act 1985 (AC Act).

This Code does not cover disputes about decisions relating to compensation and entitlement, including treatment. Such disputes need to be addressed by the dispute mechanisms under the WIRC Act or AC Act.

The Code does not cover complaints about:

professional medical services
clinical opinions
medical treatment.

In addition, claimants retain the rights and responsibilities they have under any other enactment or the general law. This includes:

the Charter of Human Rights and Responsibilities Act 2006
the Privacy and Data Protection Act 2004
the Health Records Act 2001
any other enactments or general laws that apply.

Definitions

The following definitions apply in this Code:

‘WorkSafe’ means the ‘Authority’ as defined in section 3 of the WIRC Act.
‘Authorised agent’ means ‘authorised agent’ as defined in section 3 of the WIRC Act.
‘Self-insurer’ means ‘self-insurer’ as defined in section 3 of the WIRC Act.
‘Independent medical examiner’ (IME) means any of the following—
1. a medical practitioner;
2. a registered dentist;
3. a registered physiotherapist;
4. a registered chiropractor;
5. a registered osteopath;
6. a registered psychologist
— approved by the Authority for the purposes of section 27 of the WIRC Act.
‘Occupational rehabilitation provider’ means a person approved by WorkSafe as a provider of an ‘occupational rehabilitation service’ as defined in section 3 of the WIRC Act.
‘Private investigator’ means a person engaged by a registered WorkSafe private investigation service to conduct investigations.
‘We’ and ‘us’ mean WorkSafe, authorised agents, self-insurers, IMEs, private investigators and occupational rehabilitation providers, as defined in these Definitions.
‘You’ and ‘claimants’ mean every person who has an entitlement to compensation or provisional payments under the WIRC Act and AC Act. This includes where a decision is pending.

Part 2: Rights and obligations under this Code

You have the right to be treated with dignity and respect.

We will treat you with dignity and respect.

We will treat you with honesty and courtesy.

We acknowledge and understand that you may be under physical, emotional, social or financial strain from the workplace injury.
You have the right to be treated fairly and to have your views considered.

We will treat you fairly.

We will listen to you and consider your views.

Where you choose to share your individual needs, we will be respectful and sensitive. These may relate to:

your age

your sex or gender identity

any disability or impairment.

We will take reasonable steps to consider and respond to your individual needs.
You have the right to have your culture, values and beliefs respected.

Where you choose to share your cultural needs, we will be respectful and sensitive.

We will take reasonable steps to consider and respond to your cultural needs.
You have the right to seek support from others. A support person or persons may be someone that provides help, emotional support or guidance. A support person is different from a person you appoint to represent you, such as a legal or union representative.

We will welcome you and your support person, as long as this can be done safely.

Where possible, your support person can attend meetings with you and help you communicate with us.

There may be circumstances where a support person is not able to be present; for example, during an independent medical examination.

If your support person cannot be present, we will explain this to you and tell you why. In these circumstances, they can still accompany you to provide support before and after the examination.

Where there is a valid reason that a support person cannot be present, this will not represent a failure to uphold this Code.
You have the right to receive effective communication.

We will communicate with you openly, honestly and effectively.

We will respond to your questions and requests.

We will ask about your preferred method of communication.

We will provide you with an interpreter where possible. If we cannot provide you with an interpreter, we will explain this to you and tell you why.
Obligations of WorkSafe, authorised agents and self-insurers

We will explain how to make an application for compensation.

We will provide you with information about your:

claim

entitlements

obligations and responsibilities

review rights.

We will give you information about how we fund services and how to access them.

We will discuss expected timeframes with you.

We will inform you if your entitlements change.

Obligations of IMEs, private investigators and occupational rehabilitation providers

We will give you information about our role and how we will interact with you.
You have the right to make a complaint if you do not believe your rights have been met.

We will work with you to address your problem or concern.

We will inform you about the options available to resolve your complaint.

We will inform you about the complaints process and expected timeframes.

Part 3: Concerns and complaints

Overview

This Code supports a positive relationship between you and:

WorkSafe
self-insurers
authorised agents
IMEs
occupational rehabilitation providers
private investigators.

It acknowledges that we need to work together to achieve the best outcome.

But you can take action if you feel the rights outlined in the Code are not being upheld.

This section outlines:

how you can raise a concern
how you can make a complaint under the Code
how a complaint will be managed
the outcomes you can expect if you make a complaint.

How to raise a concern or lodge a complaint

If you think your rights under this Code have not been upheld, you have 2 options.

You can raise your concerns directly with:
- the person you have been working with
- their manager
- the agent or self-insurer.
They will work with you to try to address your concerns.
You can lodge a formal complaint at any time. You can do this verbally or in writing.

Where to lodge a complaint

Subject of complaint	Lodge with WorkSafe	Lodge with relevant agent or self-insurer
WorkSafe	Yes	No
Authorised agent	Yes	Yes
Self-insurer	Yes	Yes
Occupational rehabilitation provider	Yes	No
Private investigator	Yes	No
IME	Yes	No

Your complaint will be handled by the party you choose to lodge it with.

WorkSafe, the authorised agent or the self-insurer will do the following:

Work with you to try to resolve your complaint.
Act in a fair and impartial manner, and consider the evidence and views of all parties, including you.

WorkSafe, the authorised agent or the self-insurer may decline to investigate where a complaint is more correctly dealt with by another agency, such as the:

Victorian Equal Opportunity and Human Rights Commission
Disability Services Commission
Victorian Disability Worker Commission
Australian Health Practitioner Regulation Agency
Office of the Victorian Information Commissioner
Mental Health and Wellbeing Commission.

In these circumstances, you will be told about appropriate agencies that may be able to help.

Procedure for dealing with a complaint

In dealing with a complaint, WorkSafe, the authorised agent or the self-insurer will do the following.

Acknowledge receipt of the complaint in writing.
Advise you about the complaints process and estimated timeframes.
Comply with all the other relevant rights in this Code.
Investigate the complaint to be able to determine the outcome.
Advise you of any issues, such as entitlements, that are not matters for this Code. Tell you who to contact about these issues.

Outcomes following a complaint

You will be advised of the outcome of your complaint. This decision will be in writing and include the following.

Whether the complaint against a party subject to this Code was substantiated.
The reasons for that outcome.
What, if any, of the remedies or actions identified in Part 4 are appropriate.

If there is another body who is better placed to manage your complaint, we will give you this information.

Making a complaint to the Victorian Ombudsman

The Victorian Ombudsman also considers complaints about WorkSafe, its agents and self-insurers. When considering such complaints, the Ombudsman will consider whether these organisations acted in a way that was lawful, reasonable and fair. You have the right to lodge a complaint with the Ombudsman if you are dissatisfied with the management of your complaint under this Code.

Making a complaint to the Ombudsman will not affect your claim or entitlements. More details on the Ombudsman's role in relation to WorkSafe can be found on their website at ombudsman.vic.gov.au.

More information

Complaints about contraventions of the Code or decisions made under it are not dealt with by the:

Workplace Injury Commission (formerly the Accident Compensation Conciliation Service)
Victorian Civil and Administrative Tribunal.

Part 4: Remedies available

If a complaint investigation identifies that there was a failure to uphold the rights in this Code, WorkSafe, the authorised agent or self-insurer may do any or all of the following.

Provide a written or oral apology.
Provide information, advice or an explanation of what happened and why, in an appropriate and accessible form.
Meet with the claimant to consider their views and achieve resolution.
Confirm steps to remedy the failure and/or adhere to the Code into the future.

Part 5: Reporting

WorkSafe will report on activity under this Code on its website at least once per year. This will include information on the:

total number of complaints received
total number of complaints substantiated
number of complaints received and substantiated for each type of party subject to this Code.

Code of claimants’ rights

How to access the code

Download code

Part 1: Introduction

Background

Purpose of the Code

Commencement of the Code

Application of the Code

What the Code does not cover

Definitions

Part 2: Rights and obligations under this Code

Dignity and respect

Fair treatment

Cultural values

Support person

Communication

Information

Obligations of WorkSafe, authorised agents and self-insurers

Obligations of IMEs, private investigators and occupational rehabilitation providers

Complaints