Eligibility to claim

If a worker suffers an injury, disease or illness arising out of or in the course of employment, and if the employment was a significant contributing factor to the claimed injury, the worker shall be entitled to (WorkCover) compensation.

What you need to do

As soon as practicable after the injury, disease or illness arises you should attend, and be medically examined by, your treating medical practitioner. If your treating medical practitioner decides to give you time off work, he/she will issue a "certificate of work capacity" form. The first certificate for work capacity issued can provide time off work up to, but not exceeding, 14 days. Subsequent certificates of work capacity can provide time off work for up to 28 days. The treating medical practitioner is able to issue retrospective certificates of work capacity forms up to 90 days, but must have a valid reason for doing so. Those reasons must be included in the comments section of the certificate.

Notifying your employer

It is required by law that you must notify your employer within 30 days of becoming aware of the injury, disease or illness. You must enter the particulars of the injury, disease or illness in the "Employer's Register of Injuries" book. If you are unable to do this personally, you can have a representative complete the register of injuries book on your behalf within the 30-day time limit. If you fail to enter the particulars in this time frame, you will not be able to claim workers compensation for that particular injury.

The claim form

You are required to complete a "Workers Claim for Compensation" form. A claim for compensation can not be considered unless this is done. Claim forms can be obtained from any Australian Post Office, or from the Victorian WorkCover Authority (03 9641 1347). Prior to completing the claim form, you are encouraged to get advice and assistance from CPSU WorkCover Services (03 9639 1822). If your time off work does not exceed 10 days, or your medical and like expenses do not exceed $682, your employer is able to accept the claim as a "minor claim". If the employer rejects the minor claim, or you have been off work for more than 10 days, or have medical expenses in excess of $682, the employer must forward the claim to the insurer for assessment and decision. This must occur within 10 days of the employer receiving the claim form and certificate of capacity.

Claims

Time off work & medical expenses

The insurer has 28 days from the date the insurer receives the claim form and certificate of capacity to make a decision on whether to accept the claim or not. The insurer must notify you in writing as to the decision they have reached.

Medical & like expenses

The insurer will make a decision normally within 60 days of receiving the claim form. You must be advised of the decision in writing.

Rejected claims

If the claim is rejected, reasons for the rejection must be contained in the writing notification sent to you.

Claim check list

• Notify your employer of your injury by completing the "Employers Register of Injuries" book. This must be done within 30 days of you becoming aware of your injury, disease or illness.
• Complete and sign your claim form. You must also have a witness to your signature sign the claim form.
• Give the claim form together with any certificate of work capacity to your employer.
• Keep copies of all the documentation provided to the employer.
• If your claim is rejected, obtain advice on your rights before you do anything.