Workers Compensation - How to Make a Claim

Workers Compensation - How to Make a Claim

30 June 2020

Insurer’s place estimates on Workers' Compensation claims based on the information made available to them. Information such as the nature of the injury, medical certification, a diagnosis, expected time frames for recovery, return to work and medical treatment required are all important. 

When making a workers' compensation claim you should provide the following documentation

  • Workers Compensation First Medical Certificate and any subsequent progress certificates.
  • Completed Claim Form with authorities signed and signatures witnessed. Completion of the Employer box section at the top of the Claim Form should also be encouraged especially if there is a delay between the Claim Form being signed by the injured worker and the Employer receiving this which is to prevent assumptions that the Employer has delayed submission of the claim.
  • Completed Employer Report Form with supporting pay history if time lost and wages are intended to be claimed.
  • Incident Report Forms.
  • Invoices to assist with estimating.

Please note - A claim can be submitted with just a Claim Form and First Medical Certificate with the other paperwork sent through later but it’s good practice to try and send everything together so the claim can be assessed based on all information known and available to the Insurer.

Additional useful information for the Insurer

Certification of Incapacity / Partial Incapacity

  • There are quite a number of factors to consider with incapacity. These are as follows.
    If certified incapacity has resulted in loss of earnings by the injured worker, please confirm that wages will be claimed and provide additional details such as hours/shifts lost until a return to work was made or is expected to occur.
  • If a worker is certified fit for restricted duties, please confirm whether duties have been provided and if there’s any loss of wages due to reduced hours being worked or perhaps a change in roster to accommodate the restrictions which has impacted the injured worker’s regular penalties.
  • On occasion an injured worker may be certified unfit but they don’t lose time given when they’re next rostered to work. Please ensure updated certification supporting a capacity for work is obtained prior to commencement of work and we are notified that despite certified period of incapacity there was no lost time.
  • If an injured worker has not been financially disadvantaged by their injury in regard to their normal hours and pattern of work there should be no need to pay or claim weekly compensation and this should be confirmed with us. 

As you can see, obtaining the correct Workers' Compensation can be confusing however our team are specialists and are here to help. Speak with our team today.

Please check our Client Tools / Claims Management for useful claims reference material for our clients.