Being injured at work is disorienting. You are dealing with pain, uncertainty about your job, and a system that seems built for insurers rather than people. In 2026, on top of all that, the NSW scheme is being reshaped by significant reforms. This guide walks you through a NSW Workers Compensation Claim step by step, in plain English, so you know what to do — and when — from the day of your injury through to resolution.
Step 1: Get medical attention, and tell the doctor everything
Your first priority is your health. Go to a doctor or hospital the same day if you can. Tell the treating practitioner everything that hurts, feels wrong, or is bothering you — even if some symptoms seem minor. Ask them to make note of it by way of record.
This is the most important document in your entire claim. Insurers and the Personal Injury Commission rely heavily on the first medical entry. An incomplete early record is nearly impossible to fix later. If your injury is psychological, describe the workplace circumstances clearly and ask for a referral to a psychologist or psychiatrist.
Make sure your doctor issues a WorkCover Certificate of Capacity — this is the formal certificate that records your injury, your capacity for work, and the treatment plan. You will need fresh certificates regularly throughout your claim.
Step 2: Report the injury to your employer
NSW law requires you to notify your employer of a workplace injury as soon as practicable. Do it in writing where possible — an email, a text, a message through your workplace system. Even a brief note helps: “I was injured at work on [date] doing [task]. I have seen a GP and will provide a certificate.”
Your employer is required to keep a register of injuries and to record your notification. If your employer refuses to record it, that refusal is itself relevant and should be documented.
Step 3: Lodge your claim with the insurer
Most NSW employers are insured through icare (the Nominal Insurer). Some are self-insured. Either way, a claim is lodged with the relevant insurer, typically through your employer’s notification or directly by you.
You will usually need to provide:
- Your completed WorkCover Certificate of Capacity;
- Details of the incident;
- Identification;
- Bank details for payments; and
- Authority forms for medical and employment information.
If you cannot get your employer to lodge on your behalf, you can lodge directly with iCare. Do not delay. Late lodgement is one of the most common reasons claims become contested.
Step 4: Receive the insurer’s initial decision
Within a set number of days of receiving your claim, the insurer must make a provisional liability decision — either accepting the claim (wholly or partly), declining it, or deferring pending further information. Provisional liability usually means the insurer will fund reasonable and necessary treatment and some weekly payments while it investigates.
If the insurer denies liability, or disputes a particular head of claim, the decision should come to you in writing with reasons. Don’t accept a denial at face value — you have review rights and, in many cases, access to free legal assistance through the Independent Legal Assistance and Review Service (ILARS) administered by the Independent Review Office (IRO).
Step 5: Weekly payments and medical treatment while you recover
Once your claim is accepted, you are entitled to:
- Weekly payments to replace part of your pre-injury earnings, calculated on formulas that vary depending on how long you have been off work.
- Medical and related treatment that meets the new “reasonable and necessary” test introduced by the 2026 reforms (once commenced).
- Hospital expenses.
- Rehabilitation services and return-to-work support.
Weekly payments are not flat. They reduce at specific milestones — after the first 13 weeks, and again after 130 weeks, subject to a range of rules. For primary psychological injuries, weekly payments are now capped at 130 weeks unless the worker meets the new WPI thresholds for extended benefits.
Step 6: Return to work — or not
Return to work is a major focus of the NSW scheme, even more so after the 2026 reforms. You and your employer are expected to engage in a return-to-work plan suited to your injury and capacity. Suitable duties might mean reduced hours, modified tasks, a different workstation or equipment, or a different role for a period.
If your employer will not offer suitable duties, or the duties offered are genuinely unsuitable, that is something to raise with the insurer and, if needed, with a lawyer. A return to work pushed too early can cause re-injury. Delayed too long, it can be treated as a lack of engagement.
Under the 2026 reforms, a new Return to Work intensive program has been introduced. Workers with primary psychological injuries assessed at 21% WPI or above (but below the prevailing upper threshold for extended benefits) may be eligible for an additional 52 weeks of weekly and medical entitlements — up to 182 weeks total — at 60% of PIAWE or the maximum weekly compensation amount, whichever is less.
Step 7: Permanent impairment assessment
If your injury is not going to fully resolve, you may be assessed for whole person impairment (WPI). Under the 2026 reforms, there will now generally be a single principal WPI assessment by an approved medical assessor. The WPI percentage determines whether you are entitled to permanent impairment compensation (a lump sum) and, for psychological injury claims, whether you can access weekly payments beyond 130 weeks or pursue a work injury damages claim.
Thresholds matter:
- Permanent impairment compensation (lump sum). For physical injuries, the threshold remains at least 11% WPI for most workers. For primary psychological injuries, the threshold is at least 15% WPI.
- Work injury damages for primary psychological injury. For injuries notified on or after 1 July 2026, the threshold is at least 25% WPI, rising progressively to more than 26% WPI from 1 July 2027 and at least 28% WPI from 1 July 2029.
Step 8: Work injury damages — the common law claim
For the most seriously injured workers, a work injury damages (WID) claim may be available. This is a common law damages claim against the employer, typically requiring negligence to be established and requiring the relevant WPI threshold to be met. A WID claim is a one-off payment covering past and future economic loss.
Once you accept WID damages, your statutory entitlements for that injury effectively end. That is a significant decision and one that should always be made with full information and independent advice — not under pressure from an insurer’s deadline or a mediator’s time limit.
Common pitfalls to avoid
- Not notifying your GP early. An early entry matters more than most people realise.
- Downplaying symptoms. The GP note is the record. If you tell them “I’m fine, just a bit sore,” that’s what will be on the page.
- Accepting the first insurer decision without review. Review rights exist for a reason. Use them.
- Missing time limits. For notification, lodgement, permanent impairment claims, and WID claims — every stage has deadlines.
Practical takeaways
- See a doctor the same day and tell them everything.
- Notify your employer in writing and keep a copy.
- Lodge your claim directly with icare if your employer delays.
- Request fresh WorkCover Certificates of Capacity as needed.
- Engage with return-to-work planning but not beyond your genuine capacity.
- Keep a running file of certificates, payslips, receipts, and correspondence.
- Get legal advice before WPI assessment, before settlement, and before accepting WID damages.
How Gajic Lawyers helps injured NSW workers
Our team has been running NSW workers compensation claims for 30-plus years. We run claims on a No Win No Fee basis. Our fully paperless, technology-driven process means you can run your entire claim from anywhere in NSW.
If you have been injured at work in NSW and you are uncertain about the process, call us for a free, obligation-free consultation on (02) 9890 5885, or visit our workers compensation page to begin.
