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Workcover Claims

Since September 1 2015, WorkCover functions have been assumed by three new organisations:

  • SafeWork NSW – NSW’s primary regulator for workplace health and safety.
  • SIRA – SIRA (State Insurance Regulatory Authority) is the body involved with regulating CTP insurance as a result of a motor accident, workers compensation and home building insurance.
  • icare – icare (Insurance and Care NSW) offers insurance and care services in NSW.
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Notify your employer

The first step for a work-related injury is to notify the employer and insurer of that injury.

A worker must tell their employer as soon as possible after the injury happens that they have sustained an injury in the course of employment. A worker can notify their employer verbally or in writing.

The employer must keep a register of injuries in the workplace for the injured worker to complete. When an employer becomes aware of the work-related injury, they must notify the insurer within 48 hours.

If the employer does not notify the insurer, this notification can be made by the worker. Notification to the insurer of the injury can be by email or by phone.

If the employer does not tell the insurer about the injury, then the worker should ask the employer for the insurer’s name and details. If the employer will not give you the name of the worker’s compensation insurer, the worker can phone the SIRA Customer Service Centre on 13 10 50 to discuss their claim.

Give to your employer a Certificate of Capacity

At the same time of notifying the employer of the injury, a worker should provide to the employer (and the insurer) a Certificate of Capacity. This certificate is obtained from your general practitioner and outlines your fitness for work and what treatment a worker needs for their injury.

What happens next?

Once the insurer receives a notification of injury and the Certificate they must either:

  • Start provisional weekly payments within 7 days; or
  • “Reasonably excuse” paying provisional weekly payments on the basis that insufficient information has been provided about the injury and claim.

If the insurer “reasonably excuses” the claim, then the insurer has 21 days to make a decision as to whether they accept or decline liability from the date that a worker’s compensation claim form is completed and sent to the insurer.

Once provisional weekly payments/medical expenses have commenced, the insurer will then investigate the claim and decide as to whether they will formally accept the claim or decline liability.

If the insurer intends to decline liability for a claim, they must do so in accordance with Section 74 of the Workers Compensation Act. This requires the insurer to provide written notice of the reasons and evidence which the insurance company relies upon to decline the claim.

If you need assistance with your claim, please do not hesitate to contact us as follows;

  1. Complete our FREE case assessment form HERE
  2. Email us at info@garlingandco.com.au
  3. Give us a call on (02) 8518 1120 and talk to our specialised lawyers

Would you like assistance with your claim?

Complete our free, no obligation confidential case assessment form and we’ll get back to you within 24 hours.

Alternatively, we are available to talk through phone and email. Please contact our experienced workers compensation lawyers to find out how we can help.

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