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NSW Workers Compensation System: Complete Guide

The worker's compensation guidelines contain information to help you understand the workers compensation system and to manage your claim.

The NSW Workers’ Compensation System is designed to provide support and benefits to workers who have been injured or fallen ill because of their employment. This comprehensive guide delves into the key aspects of the system, including the roles of various parties, coverage details, the claim process, and the responsibilities of general practitioners (GPs) and treating doctors.

What is The Role of SIRA?

SIRA or the State Insurance Regulatory Authority, is a government-run organisation that oversees the workers’ compensation system in New South Wales. As the primary regulatory authority, iCare is responsible for ensuring that employers comply with the system’s requirements and that injured workers receive the necessary support and benefits to aid their recovery.

Key Players in the NSW Workers’ Compensation System

The NSW Workers’ Compensation System involves several key players, each with their specific roles and responsibilities. These include:

  1. Injured Worker: The individual who has sustained a work-related injury or illness and is seeking compensation and support.
  2. Employer: The organisation responsible for providing a safe work environment and taking necessary steps to facilitate the injured worker’s claim and recovery.
  3. Claims Handling Agent: The company that manages workers’ compensation policies for employers, assessing claims and providing financial support to injured workers such as EML, Allianz, QBR and GIO.
  4. SIRA: The government-run organisation that regulates the workers’ compensation system and ensures compliance by all parties.
  5. Icare: the government run workers compensation insurer for all employers in NSW.
  6. WorkSafe NSW: The state’s workplace health and safety regulator, which enforces compliance with occupational health and safety laws and investigates workplace incidents.
  7. General Practitioner (GP): The medical professional who diagnoses and treats the injured worker and plays a key role in their recovery and return to work.
  8. Rehabilitation Provider: The organisation that assists injured workers with their rehabilitation and return-to-work process, offering services such as physiotherapy and occupational therapy.

How does NSW Workers Compensation Work?

Workers’ compensation coverage in NSW is mandatory for all employers in NSW. The system provides financial support and medical benefits to injured workers, including:

  • Weekly benefits for lost wages
  • Medical and rehabilitation expenses
  • Lump-sum payments for permanent impairment
  • Death benefits for dependents

To be eligible for workers’ compensation, the injury or illness must have occurred during employment or be directly related to work activities.

Claim Process and Key Steps in the NSW Workers Compensation System

The claim process in the NSW Workers’ Compensation System involves several key steps:

  1. Report the Injury: The injured worker must report the injury to their employer as soon as possible.
  2. Seek Medical Treatment: The worker should consult a GP for diagnosis and treatment. The GP will issue a certificate of capacity, which outlines the worker’s fitness for work and any required restrictions.
  3. Lodge a Claim: The employer must submit a workers’ compensation claim to their insurance provider within 48 hours of receiving notification of the injury. The claim should include the certificate of capacity and any relevant documentation.
  4. Claim Assessment: The insurance provider reviews the claim, gathering additional information if necessary, and determines whether to accept or decline the claim.
  5. Notification of Decision: The insurance provider notifies the injured worker, employer, and GP of the claim’s outcome, outlining the reasons for their decision if the claim is declined.
  6. Payment of Benefits: If the claim is accepted, the insurance provider commences payment of benefits, covering medical expenses, weekly benefits, and other entitlements as appropriate.
  7. Recovery and Return to Work: The injured worker, employer, GP, and rehabilitation provider collaborate to support the worker’s recovery and facilitate their return to work in a safe and timely manner.

Supporting Injured Workers Through Recovery

The NSW Workers’ Compensation System prioritizes the recovery and return-to-work process for injured workers. This involves: ·

  • Developing an injury management plan tailored to the worker’s needs
  • Regular communication between the worker, employer, GP, and rehabilitation provider
  • Adjusting work tasks and responsibilities to accommodate the worker’s capacity
  • Identifying suitable duties and implementing a return-to-work plan · Monitoring progress and making adjustments as needed Responsibilities of GPs and Treating Doctors GPs and treating doctors play a pivotal role in the NSW Workers’ Compensation System.

Their responsibilities include:   

  • Diagnosing and treating the injured worker’s condition
  • Issuing certificates of capacity outlining the worker’s fitness for work
  • Collaborating with the employer and rehabilitation provider to develop an injury management plan
  • Providing ongoing medical support and monitoring the worker’s progress · Advising on suitable duties and return-to-work strategies

What are the legal costs in a workers compensation claim?

There are no legal costs payable by you in Workers compensation claims. The legal costs are payable by the WorkCover Independent Review Officer (WIRO).

WIRO is a body set up by the NSW government to fund payment of workers compensation claims much like Legal Aid. When your matter is ready to proceed we will apply on your behalf to WIRO to approve funding for payment of our legal costs and disbursements (such as the cost of obtaining a medical report).

WIRO will review the Application and approve funding. Your lawyer will tell you if funding has been approved or not and proceed with your claim. If funding is approved at no time will you be responsible for our legal costs and disbursements.

Should your claim be unsuccessful the Workers Compensation Commission can make an order for you to pay the insurers legal costs. This is very rare and usually only if there was no proper justification for making the claim or if the claim was fraudulent. We are required by the Legal Profession Act of NSW to enter into with all clients a costs agreement which we will provide to you to sign before we can commence your claim. The agreement is straight forward and confirms no legal costs are payable by you.

Conclusion

The NSW Workers’ Compensation System is a vital support mechanism for injured workers, providing financial assistance and medical benefits to help them recover and return to work. By understanding the roles and responsibilities of all parties involved, including iCare, employers, insurance providers, GPs, and rehabilitation providers, we can ensure a smooth and effective process for workers navigating this system.

If you have been injured at work and need the assistance of an expert in person injury law, contact Garling and Co lawyers. Our lawyers are accredited specialists in personal injury law and available to assist you with your claim. Should you have any further questions, please contact our office at (02) 8329 9500 or complete a free case assessment here.

Garling & Co Lawyers

Matthew Garling

Matthew Garling is an Accredited Specialist in Personal Injury Law approved by New South Wales Law Society. He is admitted to practice in the Supreme Court of NSW and the High Court of Australia. Matthew is also a member of...
Lisa L.
05:18 13 Jul 24
Outstanding service and commitment to my case was delivered from the first point of contact right until the end of my successful case.Highest recommendations to the team at Garling and Co. Matthew... got me an excellent result and was available and informative throughout the entire foreign process of legal proceedings. He was wonderful and so was his team.If i could rate higher than 5 stars i would!read more
J B
07:12 02 Jul 24
Matthew Garling and all of the team were extremely professional and supportive throughout what was a very long and arduous CTP battle. I am happy with the result and feel that their fees were fair... and well deserved.read more
Nelson B.
02:11 30 Jun 24
Professional, prompt & honest service
Brad M.
02:19 28 Jun 24
I worked with Garling & Co for 3+ years, the team has been incredible and I could not have been happier with Kerry's support and the results produced!I highly recommend choosing them as your... representatives!!read more
Ray H.
07:33 13 Jun 24
Matthew Garling and Team are kind, patient, polite, professional, empathetic and efficient. I was treated terribly by the at fault insurer. Garling and Co. had my back. Matthew gently and patiently... kept me up to speed on all the steps to go through. From my personal experience I recommend these guys. They are safe hands. Thank you team.read more
Jo L.
05:58 07 May 24
So very impressed with the professional team who looked after me throughout the last 4 and 1/2 years. A special mention to Kerry and Nathan who navigated each request to fight for my right to gain... access to further treatments and physio and to ensure medical treatment would be covered moving forward. I was so grateful I could hand it all over to you and not have to go through this very challenging time without your support.I thank you for the compassion you have provided to me, from the first contact with Matthew and Natasha, to finalisation with Kerry and Nathan.I highly recommend the team at Garling and Co for any third party compensation claims. You are in good hands with them all.read more
Linda O.
21:53 06 May 24
Emma, Rebecca and the team at Garling and Co have worked diligently throughout my workers compensation claim. The level of professionalism, support and communication has been faultless. Of particular... note has been the sensitivity displayed to me throughout the lengthy process. Worker’s compensation claims are complex and not easy to navigate, particularly when you are unwell. I do not hesitate to recommend Garling and Co to help you find a way through this otherwise unfathomable system.read more
Keith H.
20:51 23 Apr 24
After my case stalled with another firm, I decided to give Matthew Garling a call. He took my case and not only won, but achieved an outcome that far exceeded my expectations. This firm is the best... in the business in my opinion and I wouldn't hesitate to recommend them to anyone.read more
Anthony T.
00:50 16 Apr 24
Thank you Matthew and his team who guided me through the legal process, a truly positive experience with total professionalism.
Mikaele N.
03:01 15 Apr 24
Garling &Co Lawyers were awesome, I called every compensation law firm and was told that I couldn't claim for compensation.The whole experience and process was simple and stress free.Mr Matthew... Garling and Allison deserve an accolades for the very best in client service. I would highly recommend their service to anyone.read more
READ ALL TESTIMONIALS

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Lisa L.
05:18 13 Jul 24
Outstanding service and commitment to my case was delivered from the first point of contact right until the end of my successful case.Highest recommendations to the team at Garling and Co. Matthew... got me an excellent result and was available and informative throughout the entire foreign process of legal proceedings. He was wonderful and so was his team.If i could rate higher than 5 stars i would!read more
J B
07:12 02 Jul 24
Matthew Garling and all of the team were extremely professional and supportive throughout what was a very long and arduous CTP battle. I am happy with the result and feel that their fees were fair... and well deserved.read more
Nelson B.
02:11 30 Jun 24
Professional, prompt & honest service
Brad M.
02:19 28 Jun 24
I worked with Garling & Co for 3+ years, the team has been incredible and I could not have been happier with Kerry's support and the results produced!I highly recommend choosing them as your... representatives!!read more
Ray H.
07:33 13 Jun 24
Matthew Garling and Team are kind, patient, polite, professional, empathetic and efficient. I was treated terribly by the at fault insurer. Garling and Co. had my back. Matthew gently and patiently... kept me up to speed on all the steps to go through. From my personal experience I recommend these guys. They are safe hands. Thank you team.read more
Jo L.
05:58 07 May 24
So very impressed with the professional team who looked after me throughout the last 4 and 1/2 years. A special mention to Kerry and Nathan who navigated each request to fight for my right to gain... access to further treatments and physio and to ensure medical treatment would be covered moving forward. I was so grateful I could hand it all over to you and not have to go through this very challenging time without your support.I thank you for the compassion you have provided to me, from the first contact with Matthew and Natasha, to finalisation with Kerry and Nathan.I highly recommend the team at Garling and Co for any third party compensation claims. You are in good hands with them all.read more
Linda O.
21:53 06 May 24
Emma, Rebecca and the team at Garling and Co have worked diligently throughout my workers compensation claim. The level of professionalism, support and communication has been faultless. Of particular... note has been the sensitivity displayed to me throughout the lengthy process. Worker’s compensation claims are complex and not easy to navigate, particularly when you are unwell. I do not hesitate to recommend Garling and Co to help you find a way through this otherwise unfathomable system.read more
Keith H.
20:51 23 Apr 24
After my case stalled with another firm, I decided to give Matthew Garling a call. He took my case and not only won, but achieved an outcome that far exceeded my expectations. This firm is the best... in the business in my opinion and I wouldn't hesitate to recommend them to anyone.read more
Anthony T.
00:50 16 Apr 24
Thank you Matthew and his team who guided me through the legal process, a truly positive experience with total professionalism.
Mikaele N.
03:01 15 Apr 24
Garling &Co Lawyers were awesome, I called every compensation law firm and was told that I couldn't claim for compensation.The whole experience and process was simple and stress free.Mr Matthew... Garling and Allison deserve an accolades for the very best in client service. I would highly recommend their service to anyone.read more
University of Technology, Sydney
Member of Law Society of New South Wales
Law Society of NSW Specialist Accreditation
University of Sydney
Legal Profession Admission Board of New South Wales
The law society of nsw professional standards scheme logo.
University of Technology, Sydney
Member of Law Society of New South Wales
Law Society of NSW Specialist Accreditation
University of Sydney
Legal Profession Admission Board of New South Wales
The law society of nsw professional standards scheme logo.
Google Rating
4.9