I filed a WorkCover statutory compensation claim, what next?

Once you file your WorkCover statutory compensation claim, it is allocated to a WorkCover Queensland claims representative to be determined. Your representative will likely contact both you and your employer within three business days of the claim being made at which point you will have the opportunity to give further details of the injury and event. They will also gather information from doctors, witnesses to the event or independent medical examiners to help make a decision on your claim.

In the interim, WorkCover will always work with you and your employer to try and return you to the workplace as soon as possible. This might include encouraging workers and employers to look at what alternative duties are available in the early stages.

Assessing your statutory compensation claim

There are several criteria found in the Workers’ Compensation and Rehabilitation Act 2003 that your representative will need to address in determining your statutory compensation claim. The criteria will include the consideration of the following five factors:

  • Whether your claim was made within legislative time limits;
  • Whether you were employed at the time of the injury by an employer who is self-insured;
  • Whether you are considered to be a worker;
  • Whether the injury was caused by a work related event; and
  • Whether the injury arouse out of, or in the course of, employment if the employment is a significant contributing factor to the injury.

Considering what type of injury you sustained…

Most of the representatives’ questions or investigations will be for the purpose of determining these five factors and the onus will be on you to prove the validity of your claim. However, there are some specific types of injuries that may cause your claim to be viewed under slightly different criteria. These include:

  • Psychological and psychiatric injuries;
  • Industrial deafness;
  • Continuation or aggravation of an injury;
  • Injuries sustained on journeys to and from work or on breaks such as morning and afternoon tea and lunch;
  • Asbestos related disease;
  • Diseases contracted in the course of employment such as Q-fever; or
  • Fatalities caused by a work related event.

The WorkCover process

The individual nature of your WorkCover claim will also determine the depth of investigation that your representative will carry out, as well as how long it will take. While some WorkCover claims will require more in depth investigation than others, the sources of information that WorkCover will explore are often the same.

If all the information contained in your statutory compensation claim is accurate and complete, then it is usually pretty quick for WorkCover to assess the claim. If there is any difficulty in obtaining necessary information such as information from you, your employer, or relevant doctors, then this may delay the determination of your WorkCover claim. WorkCover Queensland state that claims take “up to 20 days” to be decided. If a WorkCover claim cannot be decided in this time frame, then WorkCover will contact you to let you know why it hasn’t been decided yet.

Once enough of the relevant information is gathered by your representative, both you and your employer will be informed about the outcome. At this stage, if your claim is approved, WorkCover will ask for your bank details to be able to make payments to you.

In circumstances where your WorkCover claim is decided as requiring ongoing management or assistance with a return to work process, you will be assigned a customer advisor who will manage your case.

If you are concerned about your safety at work, or have sustained an injury, we strongly advise that you have a free consultation with one of our Brisbane personal injury lawyers. You can contact our office on (07) 3252 0011 or through our general enquiries page.

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