How Do You Know if You Are Entitled to a WorkCover Claim?

By 29 December 2017 August 28th, 2020 WorkCover Claims
how do you know if you are entitled to a workcover claim

WorkCover Claims in New South Wales

In January, the Australian Workers’ Compensation Statistics Report 2015-16 was published. It reported that there were over 100,000 serious Australian worker’s compensation claims during that time period and the median amount of time lost for a serious claim increased by 33%. With so many Australians missing an average of 5.6 weeks of work for serious workplace injuries, it’s no surprise that many want to know whether they are eligible to file a WorkCover claim. If this describes you or a loved one, read through our brief guide and contact a lawyer as soon as possible.


WorkCover in New South Wales provides statutory benefits to those injured in the course of their employment and file a successful compensation claim. In New South Wales, WorkCover is made up of three parts: Insurance and Care NSW (icare), the State Insurance Regulatory Authority (SIRA), and SafeWork NSW. The purpose of this regulatory scheme is to promote workplace health and safety and administer relevant laws, such as the Work Health and Safety Act of 2011, the Workplace Injury Management Act of 1998, and the Workers Compensation Act of 1987.

If you are injured in the workplace, WorkCover provides an affordable compensation scheme that will provide medical and financial support for injured workers.

Types of Claims

The three schemes of worker’s compensation in New South Wales are:

  1. Coalminers: These claims are determined by the District Court and are covered by a separate compensation scheme which includes legal costs.
  2. Emergency services (police, firefighters, ambulance personnel, emergency service volunteers, and bushfire fighters): The benefits offered to this category of persons tend to be more generous than the others and are paid out by the by the worker’s compensation insurer.
  3. All other types of employee: The majority of workers in New South Wales, whose potential claim benefit scheme is outlined below.

Types of Benefits

The largest group of employees in New South Wales fall into the third category of employees. For this category, there are generally 5 categories of benefit available to injured workers in NSW:

  1. Weekly payments: These are based on a formula outlined in the Act and their duration is connected to the amount received for permanent impairment. In order to receive weekly payments, you will need to send a “Certificate of Capacity” filled out by your general practitioner to your employer and the insurer. Weekly payments can last up to two and a half years after the date of the accident, depending upon the discretion of the Workers Compensation Commission.
  2. Medical expenses: Pre-approved and reasonably necessary medical expenses will be paid to the injured party by the insurer. These can include, pharmaceutical expenses, physiotherapy expenses, and travel expenses (to and from treatment for $0.55/km).
  3. Lumps sums for permanent impairment: Once you have established your medical condition, you might be able to receive one lump sum payment after being assessed by a specialist doctor who will determine the amount of whole person impairment. You are required to have at least a 10% whole person impairment in order to receive a lump sum claim.
  4. Death benefits: These exist to aid the surviving family members in the event that someone dies from an accident at work. The lump sum payable when a worker receives fatal injuries is calculated on the first of April and October each year, and will be apportioned between the surviving dependents in accordance with their level of need.
  5. Common law claims (work injury damages claims): If you are able to demonstrate both that you have suffered a 15% or more whole person impairment and that your employer was negligent, you might be able to make a work injury damages claim. This can be calculated through to retirement age and includes net wage loss (past and future wage loss) and loss of superannuation. Non-economic losses (pain and suffering, medical expenses, domestic care, etc.) are not included in a work injury damages claim.

Are you Eligible to Make a Work Injury Damages Claim?

As mentioned above, in order to make a common law claim, you need to demonstrate that your employer was negligent, and your whole person impairment has been determine dot be 15% or more. However, before a work injury damages claim can be settled, you must have received all the statutory lump sum settlements that you are entitled to.

Contact a Lawyer

If you or a family member has been injured in the workplace, in the course of your job, or due to the negligence of an employer, you may be able to file a compensation claim under WorkCover. Suffering an injury caused by your job is painful, stressful, and frightening because of the uncertainty caused by the inability to work. Contact our Parramatta personal injury lawyer today so they can help you receive the benefits and peace of mind you so deserve.

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