Workers Compensation Guide (Qld)
The following is our workers compensation guide to claims in Queensland.
What is workers compensation?
The Queensland workers’ compensation scheme, often known as “workers comp” or workplace injury insurance, offers financial and medical benefits to employees who suffer a work-related injury. Both physical injuries and psychological injuries are covered. The Workers’ Compensation and Rehabilitation Act 2003 and the Workers Compensation and Rehabilitation Regulation 2014 governs the workers’ compensation scheme in Queensland, Australia.
WorkCover Queensland is the primary provider of workers compensation insurance in Queensland. WorkCover Queensland carries out all workers’ compensation insurance functions, including underwriting, claims management, and regulation. Some larger employers (for example, Woolworths, Coles, Wesfarmers etc) are self-insured. This means they manage their own workers’ compensation claims. The same process applies to a workers’ compensation claim regardless of whether it is with WorkCover or a self-insured employer.
In Queensland, workers’ compensation is intended to cover workers who are injured or become ill on the job or while performing work-related responsibilities. This covers injuries or illnesses that occur on the job site, travelling to/from/between job sites, and those that may be caused by prolonged exposure to workplace dangers. Slips, stumbles, and falls; repetitive strain injuries; manual handling and exposure to dangerous substances or chemicals are prominent examples of the types of injuries and diseases covered by workers’ compensation in Queensland.
If you are a Queensland employee who sustains an injury or illness due to your job activities, you may be entitled to workers’ compensation. Employees who work for a Queensland-based employer but sustain an injury outside of Queensland can, in certain situations, still claim workers’ compensation benefits from the Queensland scheme.
These benefits include funding for medical treatment, rehabilitation, and other expenses, in addition to wages.
If you are injured or fall ill at work in Queensland, you must complete the following procedures to lodge a claim for workers’ compensation:
- Notify your employer immediately of the injury or illness, and fill out a workers’ compensation claim form.
- Seek medical treatment and ask your treating to complete a workers’ compensation medical certificate.
- Submit the claim form, workers’ compensation medical certificate and any supporting evidence, such as medical records, to WorkCover (or the self-insured employer). The claim can be lodged online, over the phone or your treating GP can lodge it on your behalf.
In Queensland, workers compensation claims are subject to time limits. Generally, you must lodge a WorkCover claim within six months after the date of the injury or illness. If the injury occurred over a period of time, you have six months from when you first saw a doctor about the injury. This six month time frame can be waived if you lodge a claim within 20 business days of assessed with an incapacity for work for the first time by a doctor. Otherwise, there are limited situations where the six month time frame can be extended.
You can seek a review of the decision if your workers’ compensation claim is denied. That is done by lodging an Application for Review with the Workers’ Compensation Regulator through the Queensland Office of Industrial Relations. An Application for Review must be lodged within three months of receiving WorkCover’s decision.
As the workers’ compensation scheme in Queensland is a state-based scheme, it is different to workers’compensation schemes that operate in other Australian states. It is crucial to be informed of your state’s individual laws, processses and time frames.
If you have issues concerning workers compensation or require assistance with submitting a claim, you can contact the Queensland Office of Industrial Relations or consult with an expert workers’ compensation lawyer, such as Travis Schultz & Partners – we have offices in Brisbane, Sunshine Coast, Cairns and on the Gold Coast.
How do I make a WorkCover claim in Queensland?
WorkCover is a government-owned insurance company that provides coverage for work-related injuries, including medical and rehabilitation expenses and lost wages.
All Queensland employers must hold a WorkCover policy unless they are self-insured. This means that all Queensland workers are covered by a workers’ compensation policy, which is usually through WorkCover. The workers’ compensation policy covers employees who sustain a physical or psychological injury at work, while travelling to/from/between work, and while performing work-related duties outside of their usual work site.
If you are injured in a workplace accident in Queensland, here are the steps you should follow to make a claim.
Step #1: Medical treatment
- Get immediate medical attention
- Inform your supervisor of the injury (if physically able to do so)
- Fill out an incident report, if requested
- Remember that all medical costs will be covered in the WorkCover claim process
Step #2: Lodge Your WorkCover claim
- Obtain a Work Capacity Certificate from your doctor
- Submit a Claim Form to WorkCover (online, over the phone or on paper)
- If your employer is self-insured, contact their self-insurance department for details
- Your employer must assist you in preparing the claim form, but you have the option to deal with WorkCover directly
- The claim must be lodged within six months of the date of injury, or you may lose your rights altogether.
Step #3: WorkCover decision
- WorkCover has 20 business days to decide whether to accept your claim
- WorkCover will contact you and your employer to ask questions about the injury and your employment
- Be truthful in your responses, as everything you say will be recorded
Step #4: After WorkCover accepts your claim
- WorkCover will begin paying your weekly wages, also known as weekly compensation payments
- WorkCover will cover medical and rehabilitation expenses, including GP consultations, surgery costs, and physical therapy sessions
- If your claim is denied, you have the option to seek a review of the decision within three months by lodging an Application for Review with the Workers’ Compensation Regulator
- It is recommended to seek legal assistance when making a WorkCover claim to ensure you receive the maximum benefits you are entitled to from WorkCover
WorkCover and work injuries – frequently asked questions
How much workers compensation am I able to claim?
In Queensland, the amount of workers compensation you can claim through WorkCover depends on the specifics of your injury and your employment situation. Generally, WorkCover will cover your medical expenses and a portion of your lost wages while you are unable to work due to the injury. Your weekly compensation payments will be based on your average normal weekly earnings over the 12 months before the injury occurred.
In addition to covering your medical expenses and lost wages, WorkCover may also provide rehabilitation and retraining benefits if you cannot return to your previous job due to the injury. These benefits can include funding for education or training programs, assistance with finding alternative employment, and support for any necessary adaptations or modifications to your home or workplace.
It is important to note that there are limits on the compensation you can receive through WorkCover. For example, the maximum weekly benefit payment for an injury that occurred in 2021 is $5,527.40 per week, and the maximum amount of time you can receive benefits is 5 years. It is also possible that WorkCover may find that your injury is an aggravation of a pre-existing condition, which will limit the benefits you may be entitled to. If you have questions about the amount of workers’ compensation you can claim through WorkCover, it is recommended to seek legal assistance.
How long does WorkCover take to accept or reject a workers compensation claim?
The length of time it takes to process a workers’ compensation claim through WorkCover in Queensland can vary depending on the specifics of your case. Generally, WorkCover is required to make a decision on your claim within 20 business days of receiving your Claim Form. However, the process may take longer if your claim is complex or if additional information is needed to make a decision.
Once your lawyer knows all of the facts, they can give you a more accurate idea of how long your claim will take.
Are there time limits for making a workers’ compensation claim in Queensland?
In Queensland, workers compensation claims are subject to time limits. Generally, you must lodge a WorkCover claim within six months after the date of the injury or illness. If the injury occurred over a period of time, you have six months from when you first saw a doctor about the injury. This six month time frame can be waived if you lodge a claim within 20 business days of assessed with an incapacity for work for the first time by a doctor. Otherwise, there are limited situations where the six month time frame can be extended.
If you cannot file your claim within the required time limits due to extenuating circumstances, you may be able to request an extension. However, you will need to provide a valid reason for the delay and demonstrate that you have a genuine claim for compensation. It is recommended to seek legal assistance if you need to request an extension or have any questions about the time limits for making a workers’ compensation claim in Queensland.
What is the cost of making a workers compensation claim in Queensland?
There is no cost to making a workers’ compensation claim through WorkCover in Queensland. WorkCover is responsible for covering the costs of your medical treatment and any necessary rehabilitation for your work-related injury, as well as a portion of your lost wages while you are unable to work due to the injury.
If your claim is accepted, you will not need to pay for any of these expenses out of pocket. WorkCover will generally pay for your medical bills directly, and your weekly compensation payments will be deposited into your bank account.
There may be some exceptions to this rule. For example, if you seek treatment from a medical provider who is not approved by WorkCover, you may be required to pay for those expenses yourself. If you’re seeking legal support, Travis Schultz & Partners work on a No Win, No Fee basis, there will be no upfront legal fees or out-of-pocket expenses associated with your claim.
Is it up to me to prove the accident happened while I was at work?
When you make a workers’ compensation claim through WorkCover in Queensland, you will need to provide evidence that the injury is related to your work. This may include documentation such as incident reports, witness statements, and medical records.
It is essential to gather as much evidence as possible to support your claim. This may include photographs of the accident scene, any equipment or materials involved, and any visible injuries you sustained. It is also helpful to have a clear and detailed account of what happened, including the date and time of the accident, the location, and any witnesses present.
It is not necessarily up to you alone to prove that the injury occurred while you were at work. WorkCover will also conduct its investigation and may request information from your employer and other relevant parties. However, it is important to be proactive in gathering evidence and providing it to WorkCover in a timely manner to support your claim. If you have questions about the evidence required to support a workers’ compensation claim in Queensland, it is recommended to seek legal assistance.
If I make a WorkCover claim, will my employer sack me?
It is illegal for an employer to dismiss an employee or take adverse action against them for making a workers’ compensation claim in Queensland. This includes firing, demoting, or reducing pay or hours. If an employer takes such action against an employee in retaliation for making a claim, the employee may have grounds to pursue legal action.
If you are concerned about making a workers’ compensation claim because you fear retribution from your employer, it is essential to know that you have rights and protections under the law. You should inform your employer of the injury and your intention to file a claim as soon as possible and be prepared to provide any necessary documentation or information to support your claim. If you feel that your employer is not acting in good faith or is taking adverse action against you, it is recommended to seek legal assistance.
