How to Make a WorkCover Claim QLD for a Work Accident

If you want to do an accident at work claim by yourself, here’s a simple guide on how to do it through WorkCover in Queensland. Follow it and let us know if you need any extra support along the way. 

How to Make a WorkCover Claim

To make a WorkCover claim, follow these basic steps: 

• First, ensure your immediate safety and medical care. 
• Take photos of your injuries and the accident scene if possible. 
• Report the incident to your employer promptly. 
• Get a work capacity certificate from your doctor, outlining your injuries and treatment. 

File your WorkCover claim through an online application, a physical form submission, or by phone.

The full process of filing an injury at work claim with WorkCover starts from the moment your injury happens. This can be confusing and stressful, so we’ve detailed what to do to make sure your workers compensation claim application process goes smoothly. 

Step 1: Get Immediate Medical Attention 

Before you even consider making your claim, put your safety and medical care first. It’s essential to get medical attention as soon as possible to minimise complications. While you’re waiting to be treated, you should take photos of your injuries to use as evidence in your claim. 

Ask a coworker to take photos of the accident scene immediately, even if you leave to get medical care. It’s a good idea to discuss this upfront with a coworker you trust, so you know that if you’re injured at work, you have someone to get evidence for you. 

Step 2: Report Your Work-Related Incident to Your Employer 

Before you can make a workplace injury claim, you need to report the incident to your employer. File an incident report as soon as possible, because it’s your employer’s responsibility to report it to WorkCover QLD (WorkSafe) within 8 days of the accident. 

If you make a claim and discover that your employer has not reported the accident, your rights as an employee have been violated. Get in touch with us, and we can guide you through the claims process. 

Step 3: Get a Work Capacity Certificate 

Once you’ve been treated for your injuries, your doctor will provide you with a work capacity certificate. This medical certificate explains your injuries and your treatment, and indicates if you need time off work to recover. 

Gather other supporting evidence, including all medical expenses and documentation, medical-related travel expenses, the accident report (recorded by your employer), all photos of the scene and your injuries, and witness statements about what happened. 

Step 4: Make a WorkCover Claim QLD for a Work Accident

Once you have all the evidence, it’s time to file your formal workers compensation claim with WorkCover. Here’s how to make a WorkCover claim in Queensland:  

• Lodge an online claim: This is the fastest way to submit your claim. Apply here – the WorkSafe claim form will guide you through the process step by step. 
• Fill in a physical form: You can download the WorkCover claim form, fill it out, and re-upload it, or send it in by mail or fax. 
• By phone: Call WorkCover QLD on 1300 362 128, and they will be able to help you make your claim over the phone instead of filling out a compensation claim form. 

Note that if you are unable to make a WorkCover QLD claim because you’re in the hospital, your medical practitioner will send your certificate of capacity directly to WorkCover. WorkSafe will contact you via SMS to ask if you would like to submit a claim for workers compensation. 

Step 5: WorkCover Claim Assessment Process

WorkCover will get back to you within 20 working days of receiving your workers compensation claim. Before a decision is made on claims, WorkCover will do a thorough investigation, which will include speaking to you about the accident, speaking to your employer, and possibly speaking to witnesses. 

What questions will WorkCover ask after an injury? The investigator will want to hear how your injury happened, where you were, and what you were doing at the time. They may also ask about the injuries you sustained. Be honest – everything is recorded and will likely be used as evidence. 

WorkCover will contact your employer and verify your employment details and wages. The investigator will also ask your employer to confirm how the accident happened. Witnesses may also be asked to explain the incident, to back up your version of events. 

Once WorkCover has made its decision, an agent will inform you if your work injury claim was successful or not.

Are You Eligible for a WorkCover Claim?

WorkCover Queensland will consider the Workers Compensation and Rehabilitation Act 2003 for every claim. Understanding the criteria is essential for knowing how to make a WorkCover claim in QLD successfully. You will be eligible for workers compensation claims if you: 

• Lodged the claim within the time limits 
• Were working for the employer at the time of the accident 
• Meet the definition of being a “worker” 
• Had the workplace accident as a result of doing your job.

Injured travelling to or from work? See our guide to WorkCover journey claims in Queensland.

What Happens When WorkCover Accepts Your Claim?

If your WorkCover compensation claim is accepted, a representative will reach out to you with detailed information about what you will get. Depending on your case, they may offer you a lump sum payment or weekly payments. 

WorkCover may require you to see one of its preferred doctors to determine when you may be able to return to work. Alternatively, WorkCover may help you find a new role which is more suited to your ability level, or help you arrange to work “suitable duties” with your employer – a lower-capacity version of your job that you are medically cleared to perform. 

If you cannot work within an adjusted duty allowance at your workplace, you may be able to join a “Recover at Work” program. You’ll be placed with a host employer who will provide you with suitable duties during your recovery, to help you stay active and working. 

What Do WorkCover Claims in QLD Cover? 

Depending on the severity of your injury or illness, and whether you file a statutory claim or common law claim, your payment may cover: 

• Loss of income (past and future earnings) 

• Medical treatment costs, including rehabilitation expenses
• Medical expenses related to travel
• Paid care or help around the house 

• Prescription medication
• Home/car modifications to accommodate your injury 
• Pain and suffering 

It’s worth noting that pain and suffering as well as loss of past and future income are only covered if you make a common law claim, which can be filed when someone was negligent or at fault. 

When Do Your Payments End? 

Your WorkCover payments will end when you: 

• Go back to work
• Have recovered significantly from your injuries 
• Reach the maximum agreed-upon value of your payout 
• Retire from work (if this comes before the others). 

More Questions About Making a WorkCover Claim

Do you have to disclose a WorkCover claim?

The Workers’ Compensation and Rehabilitation Act deals with pre-existing injuries and conditions, not with past claims as such. If a prospective employer asks in writing, a prospective worker must disclose a pre-existing injury or medical condition they suspect would be aggravated by the duties, and a knowingly false or misleading answer means the worker will not be entitled to compensation or damages for any event that aggravates that condition (s 571B). It is also an offence to obtain or use a workers’ compensation document about a worker to decide whether to employ or keep them, with an exception for documents needed for rehabilitation or early return to work (s 572A, 100 penalty units). When you make a claim, knowingly stating anything false or misleading to the insurer is an offence (s 534).

What is an employer excess?

An employer excess is an amount the employer pays directly to an injured worker as the worker’s first weekly compensation payment, when the worker has time off work because of the injury and WorkCover Queensland accepts the claim. WorkCover Queensland does not pay the worker for that period. The excess is the lower of the worker’s weekly compensation amount and 100% of Queensland full-time adult ordinary time earnings. The employer must pay it within 10 business days of being notified; if it does not, WorkCover Queensland pays the worker and recovers the cost from the employer.

What Do You Do If Your WorkCover Claim Is Rejected in QLD?

You have the right to appeal a rejection by requesting a review of the claim decision. Our team at WT Compensation Lawyers understands how frustrating dealing with a rejected claim can be, which is why we’re here to help. WorkCover will provide you with instructions for appealing the decision, along with your other documentation. Once you’ve submitted your appeal, the workers compensation regulator will review the decision. 

Even if your WorkCover statutory claim outcome was positive, you may still have the option to file a common law claim against your employer for damages. Ask us about pursuing this legal process if your work-related injury or illness was caused by someone else’s negligence. 

When Should You Get Legal Help?

If you feel that your case has been unfairly rejected, seek legal advice. Our team is here to assist you through every stage of the process, whether you’re struggling with how to make a WorkCover claim in QLD or appealing a decision.

Our compassionate Queensland compensation lawyers have a “No Win, No Pay” policy, which means you only pay if we get a result. Call us on 07 3924 9544, email info@wtlaw.com.au, or use our FREE case review.

Contact us

WT Compensation Lawyers
Address: Level 6, 10 Eagle Street, Brisbane QLD 4000
Phone: (07) 3924 9544
Email: info@wtlaw.com.au
Hours: Monday to Friday, 8:30 a.m. to 5:00 p.m.

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