WorkCover FAQs

Here are some FAQ's on what employers need to do in relation to Workers' Compensation, and where to go for more information.

If you need further assistance with workers' compensation advice, call CCIQ on 1300 365 855 during business hours from 8:30am to 5:00pm (AEST) Monday to Friday and talk with a member of our Workers' Compensation team.

 

Do I need a WorkCover policy?

If you have a business in Queensland and employ workers, you must insure them against work-related injuries.

The type of policy you take out will depend on the workers you employ, the type of business or organisation you run and your own role.

If you’re an employer in Queensland, you’ll be looking to take out an Accident Insurance Policy.

But, depending on your situation, other options might be appropriate. Click here for more information.

 

 

What are my responsibilities as an employer if an employee is injured at work?

It's important to first make sure that people are safe if an incident happens.

As an employer, you must notify Workplace Health and Safety Queensland (WHSQ) immediately if there is a work-related death, a serious injury or illness, or a dangerous incident at your place of work or caused by the running of your business. In an emergency call 000. Head here for more information.

Anyone can notify WHSQ of an incident, but the business owner or employer is legally required to do so and there are penalties if they don't.

Electricity distribution entities must also notify WHSQ when they become aware of a serious electrical incident or dangerous electrical event, in addition to the notification that must be made by the business owner or employer.

If an incident/accident has occurred at work, depending on the severity you may need to notify WHSQ

You have a legal responsibility to notify WorkCover Queensland immediately of an injury for which compensation may be payable. You should contact them and lodge a report as soon as you know the details of your workers injury. It is then the workers decision to make a claim. If a claim is lodged, a WorkCover claims advisor will make contact and get details to ascertain whether the claim will be approved or not. Depending on the injury nature and severity, there may be restricted duties or hours, and your employee and insurer can advise you on what your obligations are. Head here for more information on what happens after a claim is made.

There are also certain rights and responsibilities for all parties. For more information, click here.

 

 

What is the claims process?

When making a claim for worker’s compensation with WorkCover Queensland (or a self-insurer), there are a number of criteria to be considered before WorkCover decides whether to accept it.

WorkCover considers the following questions:

  • Has the claim been made in the right timeframe?
  • Was the person claiming working for the employer when they were injured?
  • Is the person claiming considered to be a worker?
  • Did a work-related incident cause the injury?
  • Was the person’s job a significant contributing factor to their injury (this means a large part of the cause)?

These criteria are set out in the Workers Compensation and Rehabilitation Act 2003 (the Act).

Every claim is different, just as every worker and injury can be different. The type of injury or how it happened can mean more information is needed to decide your claim.

Sometimes different criteria might be applied to your claim. This can be the case with injuries like:

 

For more information on the claims process, visit the WorkSafe website.

 

 

What are my responsibilities if the claim is accepted?

The recovery and return to work process after a work-related injury or illness is a team effort. Working together is key when it comes to getting an employee back to work and back to life as normal.

Many people will be involved in this process, including the employer, work supervisor, the injured employee's doctor (or an allied health professional), and the insurer. Workplace specialists like rehabilitation providers and Rehabilitation and Return to Work Coordinators will also be involved.

Knowing who these people are and what they are responsible for, will ensure the best support is given.

Working as a team means any challenges can be discussed and solved together.

 

As a worker

You should be involved with the planning of your return to work from the start. This increases the likelihood that your recovery and return to work will be a success. As well as focusing on getting better, setting goals for returning to your normal job is an important step.

You should also communicate openly and honestly about your injury and how you are feeling. Your full responsibilities can be found on our Worker commitments page.

 

As an employer

Most importantly, you need to support your worker in returning to work. By understanding their injury and being prepared to be flexible, you can strike a balance between doing what’s right for your worker and what’s good for your business.

You can find your full responsibilities on our Employer obligations page.

 

Who else is involved?

Other people who will be / are likely to be involved in the rehabilitation and recovery process are:

  • Worker’s supervisor
  • Rehabilitation and return to work coordinator
  • Insurer: WorkCover Queensland or a self-insured employer
  • Health providers
  • Injury management coordinator

To see what these people are required to do, click here.

 

For more information visit: https://www.worksafe.qld.gov.au/rehabilitation-and-return-to-work/recovering-from-injury-or-illness/rehabilitation-roles-and-responsibilities

 

 

Do I need to contact Workplace Health and Safety Queensland (WHSQ)?

If an incident has occurred at work, depending on the severity you may need to notify WHSQ.

For more information visit: https://www.worksafe.qld.gov.au/injury-prevention-safety/incidents-and-notifications/notify-of-an-incident

 

 

What is a journey claim?

Not all work-related injuries happen in your main place of work. Depending on the situation, you may still be eligible for compensation.

You might experience an injury:

  • travelling between your home and place of work
  • on your way to or from training relating to your work
  • travelling to or from medical or rehabilitation treatment that is part of an existing WorkCover claim
  • travelling between jobs with separate employers
  • while travelling for work-related reasons (i.e. a work conference or meeting) locally, interstate or internationally.

For more information visit: https://www.worksafe.qld.gov.au/claims-and-insurance/work-related-injuries/injury-travelling-to-from-or-for-work

 

 

What is a suitable duties plan?

Some injuries might mean it’s not safe or possible for an employee to do the tasks that are part of their normal job. In such cases, the employer needs to find other work for the employee to do, if they can. This is called ’suitable duties’ or is sometimes also called ’alternative duties’.

Employers should understand that when an employee is injured, there are still ways they can contribute positively to the workplace. As such, employers should look at skills and experience when it comes to finding other tasks for the injured employee.

If an employee is not provided with suitable duties at work, they may need to stay away from work longer in order to get better. 

Suitable duties have a variety of benefits, for both the injured employee and the employer.

For more information visit:  https://www.worksafe.qld.gov.au/rehabilitation-and-return-to-work/getting-back-to-work/suitable-duties.

 

 

What if I can’t provide suitable duties for my injured employee?

There might be some cases where the employer can’t offer suitable duties for safety or practical reasons. This doesn’t mean the injured employee is required to stay at home until fully recovered.

Recover at Work is a temporary program that allows injured employees to work for a host employer while they recover. The program is supported by WorkCover, or the employer if they are self-insured, and means the injured employeee can make use of their skills and abilities, whilst maintaining an income until they are able to go back to their normal job.

For more information visit: https://www.worksafe.qld.gov.au/rehab-and-claims/stay-at-work-return-to-work/how-to-return-to-work/suitable-duties-plan

 

 

Can I get a review conducted of a decision or appeal a decision?

The Workers' Compensation Regulator is responsible for undertaking reviews of insurer decisions under Chapter 13 of the Workers' Compensation and Rehabilitation Act 2003. This function is delegated to and undertaken by the Office of Industrial Relations, which aims to provide independent, prompt, non-adversarial review of certain decisions made by insurers.

If a worker, claimant or employer is unhappy with a decision made by WorkCover Queensland or a self-insurer they may be able to ask the insurer for a reasons for decision document within 20 business days of being advised of the decision.

A worker, claimant or an employer is then able to lodge an application for review with the Office of Industrial Relations within 3 months of receiving the insurer's written decision.

Whoever lodges an application for review is known as an Applicant.

The other party to a review will either be the worker or employer depending on who lodges the review.

The review process is not a court process. It involves a review by a Review Officer of all the documentation available in relation to a worker's application for compensation. The Review Officer does not re-investigate an application for compensation and will not request further information from the applicant or the other party.

For more information visit: https://www.worksafe.qld.gov.au/rehab-and-claims/reviews-and-appeals

 

 

What are grounds for review?

Not all insurer decisions can be reviewed.

Section 540 of the Workers' Compensation and Rehabilitation Act 2003 sets out a list of decisions that can be reviewed. A few of these include:

  • A decision to allow or reject an application for compensation
  • A decision to terminate or suspend payment of compensation
  • A decision to increase or decrease weekly payment of compensation
  • The failure of the insurer to make a decision on an application for compensation
  • A decision about the time to apply for compensation.

Examples of decisions that are not reviewable include:

  • A decision by an insurer regarding ongoing management of the application for compensation
  • A decision not to fund a particular medical procedure.

For more information visit: https://www.worksafe.qld.gov.au/claims-and-insurance/compensation-claims/independent-review-of-a-claim-decision

 

 

What happens if I am unhappy with a review decision?

Some of these decisions may however be appealable to an Industrial Magistrate. For more information on appeals, click here.

If a worker, claimant or employer is unhappy with the insurer's approach in determining an application for compensation, this is not something that can be reviewed. However a complaint can be lodged directly with the insurer.

If a worker, claimant or employer is not sure if a decision is reviewable, an application for review can still be lodged, however it will need to be assessed to determine if it is a reviewable decision.

 

 

How do I lodge an appeal?

When preparing a Notice of Appeal to the Queensland Industrial Relations Commission (QIRC), a worker, claimant or employer will need to use the form located on their website under the Forms tab – Form 9 WCR Notice of Appeal.

The correct respondent to the appeal is the Workers’ Compensation Regulator.

Do not attach any documents to the notice of appeal other than the review decision which is being appealed. You will have an opportunity in the course of the appeal to provide any documents or additional evidence you wish to be considered to the respondent.

When completing the notice of appeal, please refer to the QIRC's Workers' Compensation information on their website, including the Workers’ Compensation Appeal Guide.

If a worker, claimant or employer has any questions about completing the Form 9 notice of appeal they may contact the QIRC registry on 1300 592 987.

For more information visit: https://www.worksafe.qld.gov.au/claims-and-insurance/compensation-claims/appealing-a-review-decision/guide-to-appealing-a-review-decision

 

 

Who do I need to speak to about a claim?

You should speak with WorkCover Queensland as your insurer about the specifics of your particular claim.

 

 

What is a common law claim?

Under the Queensland workers’ compensation scheme, if an employee feels their employer contributed to their injury through negligence, the employee has a right to sue their employer.  This process is called a common law claim.

 

For more information visit: https://www.worksafe.qld.gov.au/rehab-and-claims/injuries-at-work/common-law-claims

 

 

Do I need to appoint a rehabilitation and return to work coordinator (RRTWC)?

Employers who pay annual wages of more than $8,368,360 (5200 times QOTE) for the preceding financial year, or are in a high risk industry with wages of more than $4,184,180 (2600 times QOTE), must appoint a rehabilitation and return to work coordinator (RRTWC). 

If you're an employer and you have a worker who’s experienced a work-related injury or illness, you must help them return to work if you can. There are a number of things you should do to make this happen.

For more information visit: https://www.worksafe.qld.gov.au/rehabilitation-and-return-to-work/recovering-from-injury-or-illness/rehabilitation-roles-and-responsibilities/employer-obligations

 

What will WorkCover pay in a claim?

Workers’ compensation may provide payments for:

What is not paid for?

WorkCover isn’t able to provide payments for:

  • damage to clothing or jewellery
  • damage to your car if your injury happened while travelling to or from work
  • any hospital costs that aren’t approved.

For more information visit: https://www.worksafe.qld.gov.au/claims-and-insurance/compensation-claims/payments-and-support

 

 

What are Medical Assessment Tribunals and what are they used for?

Medical assessment tribunals (tribunals) provide independent, expert medical decisions about injury and impairment sustained by Queensland workers. The tribunals consist of a panel of specialist doctors.

A worker may be required to attend a tribunal if there are conflicting medical opinions in relation to:

  1. whether employment has been a significant contributing factor to the worker's injury; or
  2. whether there is an ongoing incapacity for work as a result of a work injury.

Tribunals can also assess the degree of permanent impairment resulting from a worker's injury. Degree of permanent impairment may also be assessed for disfigurement or scarring as a result of a worker's injury.

For more information visit: https://www.worksafe.qld.gov.au/rehab-and-claims/medical-assessment-tribunals

 

 

How are my WorkCover premiums calculated?

Premiums are calculated differently depending on whether your wages are higher or lower than $1.5 million.

How much your accident insurance policy costs will depend on several things:

  • the amount your business pays in wages
  • your claims experience (the cost of any injury claims against your business)
  • your industry.

You’ll pay your premium ’provisionally’, which means you’ll pay it at the start of the financial year and we’ll adjust it at the end if needed.

 

What do I need to tell you?

WHSQ will work out your policy based on several figures, depending on whether you’re taking out a new policy or renewing an existing policy.

To work out how much you need to pay, we’ll simply ask you to declare your estimated wages for the current financial year.

If you’re renewing your policy, we’ll need to know:

  • your actual wages for the previous financial year
  • your estimated wages for the current financial year.

We also consider your estimated wages for the previous financial year (you’ll have already told us this at your last renewal).

If you under or overestimated your wages for the previous year, we’ll work out the difference and adjust your current premium.

Learn more about Policy renewal and declaring wages.

For more information visit: https://www.worksafe.qld.gov.au/claims-and-insurance/workcover-insurance/premium-calculation

 

 

What Legislation applies in Queensland?

The legislation that applies is the:

 

 

What are some ways I can reduce my premium?

There are several ways you can lower your premium costs, ranging from improving safety in your workplace to employing apprentices. You can learn more by visiting the WorkSafe how to reduce your premium page.

 

 

Small business specific information?

The Small Business Program provides free, easy to use services to help manage health and safety in your business. The program is suited to Queensland small businesses that have limited or no safety systems in place. Better health and safety can improve your business through:

  • increased productivity
  • lower running costs
  • reduced down time
  • better worker morale
  • staff retention
  • improved customer perception

For more information visit: https://www.worksafe.qld.gov.au/__data/assets/pdf_file/0024/16368/smallbusinessprgrm.pdf

 

 

Contact numbers and websites

WorkCover Queensland - 1300 362 128. ht

Workers' Compensation Regulatory Services – Reviews and Appeals unit, phone 1300 739 021

Workplace Health and Safety Queensland – reporting incidents (ask for inspector), 1300 362 128. 

Office of Industrial Relations – 1300 362 128

 

 

Timelines

To lodge claim 
Within 6 months from date of injury (if lodged more than 20 days after injury, may be approved from date of lodgement)

To approve/deny claim
Within 20 business days from receipt of claim

To request review
3 months of receiving an insurers decision

 

 

Who is Who?

WorkCover Queensland is the main provider of workers’ compensation insurance to Queensland employers and manages the claims of those employees. They are your insurer and should be your first point of contact in relation to a workplace injury or illness. 

Licensed self-insurers are Queensland employers who have met legislative requirements and obtained a self-insurance licence. These employers are referred to as a self-insurer and the self-insurer manages their own workers’ compensation claims. 

The Workers' Compensation Regulatory Services oversees the Queensland workers’ compensation system and runs the review and appeals unit, administers medical assessment tribunals and monitors compliance and licensing issues. The Workers’ Compensation Regulator is also committed to supporting Return to Work Coordinators and employers through a range of education initiatives including webinars and conferences. The Workers’ Compensation Regulator is part of the Queensland Government Office of Industrial Relations which also oversees work health and safety and electrical safety in Queensland. 

 

 

What are high risk industries?

Industries are categorised in this schedule using a system known as the Australian and New Zealand Industrial Classification (ANZSIC).  

For more information visit: https://www.worksafe.qld.gov.au/laws-and-compliance/workers-compensation-laws/guidance-materials/high-risk-industries