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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.

Understanding Workers’ Compensation Coverage

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...
Kimberly B.
23:14 14 Feb 24
Mathew is very knowledgable and has been of great assistance to me. All the staff are friendly and helpful. I'm so happy I found this firm.Thank you Mathew and team for your great work in my case.... I am 100% happy with what you achieved for me.read more
Julie M.
10:16 16 Jan 24
My last stage of Workers compensation claim was managed by Emma Perkins, Natasha Stojanovic, Rebecca Dunshea and Kelli Robinson at Garling and Co. Lawyers who went the extra mile with their service... from the beginning to the end of 3 years of my case. I have become very anxious with almost everything after a workplace injury and a lot of times I probably ask more questions than I need to, but Emma Perkins always finds clear answers to my questions in a short time and explains to me patiently even using her mealtime or between her meeting and make me feel that I have been very well take care and supported. I am so grateful and extremely satisfied. The excellent service, attitude, and culture of Metthew Garling and his team are second to none with a very high success rate. If you going to battle with your workplace injury for a short or long period, you are better off with Garling and Co. lawyers who are able back you up every step of the way. I strongly recommend it to anybody who needs their service like me. Julieread more
patrick P.
01:46 19 Dec 23
I like to say that I had a very wonderful experience,And the support, and also understanding with all my requests,I could not ask for a better team!Thank you Emma and also her assistant Rebecca... thank youread more
Kazi H.
13:38 13 Dec 23
Work cover fund is GOVT’S money but insurer think that it is from their 14th generation. So only they can have it. Not only that, people from the work, IME doctor from insurer, back to work... coordinator from work, Rehab provider from any side push the worker as hard as possible that the worker (doesn’t matter how the workers mental or psychical condition) either go back to his pre injury duty or leave the job.More over on that very bumpy any difficult journey some of them only treat the worker as a MONEY MAKING MECHINE .in some point worker feels like, no rooms to breath. On that moment need someone to support legally, someone to care, someone to relive.On my case I believe that, somehow, I manage to make my God happy. That’s why God sends me to Matthew Gerling and his team Allison, Rebecca and Nathan, and all of GARLING & co Lawyers.I am not good enough in English, can’t express my gratitude.Matthew, Allison, Rebecca and Nathan, please accept my appreciation and pass it to others.read more
Carol L.
01:32 29 Nov 23
Professional, understanding and friendly
Sean G.
23:21 14 Nov 23
Matthew Garling and everyone I spoke to at Garling and Co were kind, caring and compassionate. They were sensitive to my psychological condition and were patient in explaining everything to me, so... that I clearly understood the legal process. I am exceptionally grateful for the settlement outcome that Garling and Co obtained for me. Many thanks.read more
waqas A.
08:33 13 Nov 23
Great Experience with Garling & Co. Matthew explained everything in detail during the first appointment. Allison, Nathan, Rebecca and the staff have been extremely helpful. Thank You to the team and... lawyers at Garling & Co. for making the long process easy for me and getting an excellent outcome for my compensation claim.I would highly recommend Garling & Co. Lawyersread more
Saskia L.
21:42 08 Nov 23
The world of workers compensation is long, hard and confusing, but Emma and Rebecca at Garling & Co always treated my case with kindness, respect and understanding. No question was ever silly and... they always had time to make sure I knew what would happen next and how we could best prepare. I am so thankful for their expertise and could not have chosen anyone better to represent me.read more
Antonio P.
08:46 06 Nov 23
Thank you Matthew and his team for taking care of my case couldn’t ask for a better results and couldn’t have better team to do that thank you
Julie M.
00:40 06 Nov 23
Garlic & Co Lawyers have been wonderful, supporting me through some difficult times. With their assistance, positive outcomes were achieved. Many thanks to the Team.Julie
READ ALL TESTIMONIALS

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Kimberly B.
23:14 14 Feb 24
Mathew is very knowledgable and has been of great assistance to me. All the staff are friendly and helpful. I'm so happy I found this firm.Thank you Mathew and team for your great work in my case.... I am 100% happy with what you achieved for me.read more
Julie M.
10:16 16 Jan 24
My last stage of Workers compensation claim was managed by Emma Perkins, Natasha Stojanovic, Rebecca Dunshea and Kelli Robinson at Garling and Co. Lawyers who went the extra mile with their service... from the beginning to the end of 3 years of my case. I have become very anxious with almost everything after a workplace injury and a lot of times I probably ask more questions than I need to, but Emma Perkins always finds clear answers to my questions in a short time and explains to me patiently even using her mealtime or between her meeting and make me feel that I have been very well take care and supported. I am so grateful and extremely satisfied. The excellent service, attitude, and culture of Metthew Garling and his team are second to none with a very high success rate. If you going to battle with your workplace injury for a short or long period, you are better off with Garling and Co. lawyers who are able back you up every step of the way. I strongly recommend it to anybody who needs their service like me. Julieread more
patrick P.
01:46 19 Dec 23
I like to say that I had a very wonderful experience,And the support, and also understanding with all my requests,I could not ask for a better team!Thank you Emma and also her assistant Rebecca... thank youread more
Kazi H.
13:38 13 Dec 23
Work cover fund is GOVT’S money but insurer think that it is from their 14th generation. So only they can have it. Not only that, people from the work, IME doctor from insurer, back to work... coordinator from work, Rehab provider from any side push the worker as hard as possible that the worker (doesn’t matter how the workers mental or psychical condition) either go back to his pre injury duty or leave the job.More over on that very bumpy any difficult journey some of them only treat the worker as a MONEY MAKING MECHINE .in some point worker feels like, no rooms to breath. On that moment need someone to support legally, someone to care, someone to relive.On my case I believe that, somehow, I manage to make my God happy. That’s why God sends me to Matthew Gerling and his team Allison, Rebecca and Nathan, and all of GARLING & co Lawyers.I am not good enough in English, can’t express my gratitude.Matthew, Allison, Rebecca and Nathan, please accept my appreciation and pass it to others.read more
Carol L.
01:32 29 Nov 23
Professional, understanding and friendly
Sean G.
23:21 14 Nov 23
Matthew Garling and everyone I spoke to at Garling and Co were kind, caring and compassionate. They were sensitive to my psychological condition and were patient in explaining everything to me, so... that I clearly understood the legal process. I am exceptionally grateful for the settlement outcome that Garling and Co obtained for me. Many thanks.read more
waqas A.
08:33 13 Nov 23
Great Experience with Garling & Co. Matthew explained everything in detail during the first appointment. Allison, Nathan, Rebecca and the staff have been extremely helpful. Thank You to the team and... lawyers at Garling & Co. for making the long process easy for me and getting an excellent outcome for my compensation claim.I would highly recommend Garling & Co. Lawyersread more
Saskia L.
21:42 08 Nov 23
The world of workers compensation is long, hard and confusing, but Emma and Rebecca at Garling & Co always treated my case with kindness, respect and understanding. No question was ever silly and... they always had time to make sure I knew what would happen next and how we could best prepare. I am so thankful for their expertise and could not have chosen anyone better to represent me.read more
Antonio P.
08:46 06 Nov 23
Thank you Matthew and his team for taking care of my case couldn’t ask for a better results and couldn’t have better team to do that thank you
Julie M.
00:40 06 Nov 23
Garlic & Co Lawyers have been wonderful, supporting me through some difficult times. With their assistance, positive outcomes were achieved. Many thanks to the Team.Julie
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.
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