It’s essential for all organisations to understand how the workers’ compensation system works in their state or territory before they have a claim.
This is the second article in a three-part series that explores how the workers’ compensation system operates and what employers and employees need to do in the event of an injury, illness and subsequent claim. In the first article, we explored what is workers’ compensation. Here, we look at how the claim process works.
“Both the employer and employee have responsibilities in the claim process.”
Steps to follow after a claim
Once a report of injury has been notified to the workers’ compensation insurer, the insurer will provide the employer with an injury notification number, also known as a claim number.
Employers then need to provide detailed information to the insurer so they can get the claim up and running. This includes providing details to the appropriate body about the worker, such as the name and address of the worker, the employer’s contact details, the name of the treating doctors and, if applicable, the hospital at which the worker received treatment.
Each state and territory has a different approach to workers’ compensation. See the list below for further information regarding workers’ compensation in your state or territory:
- In NSW, go to icare or SIRA.
- In Victoria, go to WorkSafe Victoria.
- In South Australia, go to ReturnToWorkSA.
- In Western Australia, go to WorkCover WA.
- In Tasmania, go to WorkSafe Tasmania.
- In Queensland, go to WorkCover Queensland.
- In the Northern Territory, go to NT WorkSafe.
- In the ACT, go to Access Canberra.
Workers’ compensation and your responsibilities, a three-part series. Part one – what is workers’ compensation?
When a claim is made, the insurer will require details of the injury, how it happened, details of a contact person at the employer and their relationship to the worker, as well as the date when the worker stopped working.
The insurer will also want to know if the worker has had time off work and how long they have had off as well as any medical treatment.The insurer will also require documentation such as a certificate of capacity completed by a treating doctor, which provides evidence of the injury and the illness the worker has sustained as a result of the employment.
In New South Wales, the employer must also provide wage information such as wage slips and details of their pre-accident wages, submitted through a pre-injury average weekly earnings (PIAWE) form.
It’s essential to complete this form so the worker can start receiving reimbursement for their wages when they're off sick if the claim is accepted and is work-related. The worker must also provide details of practitioners such as physiotherapists.
If the claim is accepted, the insurer will liaise with the worker’s treating doctors and other providers. The insurer will also engage the services of a rehab provider to assist the worker to get back to work. The insurer will then request the employer to prepare and certify a return to work plan. The worker must also submit any invoices related to their post-injury care to the insurer so they can be paid.
As you can see, both the employer and employee have responsibilities in the claim process.In the next article, we’ll look at what to do to support an injured worker coming back to work.
Important note - the information provided here is general advice only and has been prepared without taking in account your objectives, financial situation or needs. Steadfast Group Ltd (ABN 98 073 659 677, AFSL 254928)
Important notice - Steadfast Group Limited ABN 98 073 659 677 and Steadfast Network Brokers
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