If you sustain a workplace injury in Queensland, in the midst of undertaking medical treatment and rehabilitation, there is the added stress of navigating the world of worker's compensation claims. This blog is a guide for injured workers. We explore:

  • who is covered for worker's compensation in Queensland;
  • lodging your worker's compensation claim;
  • what benefits are available;
  • relevant timeframes for the worker to lodge a claim and the insurer to respond; and
  • options to appeal a denied worker's compensation claim.

Who is covered by the Queensland worker's compensation scheme?

To determine your eligibility for worker's compensation in Queensland, you are required to meet the following criteria:

  • You are a worker in Queensland;
  • You have sustained an injury;
  • You were injured during the course of your employment; and
  • Your employment was a significant contributing factor to your injury.

Please note that some workers who work in Queensland are covered under the Commonwealth worker's compensation scheme, Comcare. You can read information about the Comcare scheme here.

Lodging your Queensland worker's compensation claim

You should notify your employer of a workplace injury or illness as soon as possible after the accident or after any diagnosis of a work-related illness. You should complete an incident report and attend on your doctor or a hospital.

To lodge a worker's compensation claim, you will need a "work capacity certificate". This is a type of medical certificate specifically for worker's compensation claims. It should be completed by your treating doctor.

Once you've notified your employer and obtained your work capacity certificate, you can lodge a worker's compensation claim with WorkCover Queensland, either online here, or by calling them on 1300 362 128. If your employer is self-insured, you can lodge your claim directly with them.

Tips before lodging your claim

  • To claim worker's compensation in Queensland, you need to be able to prove that an incident has occurred, causing injury (including psychological injuries and illnesses);
  • Whether the injury you sustained is a compensable injury is defined under Workers' Compensation and Rehabilitation Act 2003 (Qld) ("the Act") as:
  • "...a personal injury arising out of, or in the course of, employment if the employment is a significant contributing factor."
  • A connection between the injury sustained and employment is paramount. If you get injured, your injury will generally be considered "work- related" if it occurred while you were working or because of your work. However, just because an injury occurs at your workplace, it does not mean it is because of your work. Similarly, if you are injured because of your work but outside of your workplace, your injury might be work-related.
  • An injury includes an aggravation of a pre-existing injury (which need not be an injury resulting from your employment). Requirements for psychological injuries arising out of certain circumstances vary. You can read more about psychological injury claims in our blog, "I've suffered a psychological injury at work. What do I do?"
  • The correct worker's compensation medical certificate (a work capacity certificate) must have been completed by a medical practitioner;
  • You should include any relevant evidence to support your application for worker's compensation. For example, incident reports, medical reports and witness statements.

What worker's compensation benefits are available in Queensland?

Injured workers in Queensland with an accepted worker's compensation claim may be entitled to:

  • weekly payments for loss of wages;
  • reasonable medical expenses related to the workplace injury;
  • lump sum compensation for permanent impairment; and
  • travel expenses when travelling to/from medical appointments.

In addition to your statutory (no-fault scheme) entitlements, if your injury was caused by the negligence of another person or entity, you may also be entitled to common law damages.

Time limits for worker's compensation claims in Queensland?

Under the Act, generally, an application for compensation should be lodged within 6 months after the entitlement to compensation for the injury arises. A WorkCover insurer, under certain special circumstances, may consider a late application.

If you've lodged a worker's compensation claim outside the 6-month time limit and the claim has been denied, you should seek legal advice from a worker's compensation lawyer.

How long does the insurer have to make a decision on my worker's compensation claim?

The WorkCover insurer has 20 business days to make a decision on your application, however, they may require more time to undertake further investigation or to obtain further information to assist in making a decision. The insurer has an obligation to communicate the outcome with you in writing.

Can I appeal an adverse decision on my worker's compensation claim?

If your worker's compensation claim is rejected, the WorkCover insurer must advise you of that decision (within 20 business days, as mentioned earlier, and they must also advise you of the reasons for denying your claim in writing.

If you disagree with the insurer, you are entitled to have the decision reviewed within 3 months of receiving the decision and reasons for the decision. You should seek legal advice from a lawyer experienced in Queensland worker's compensation claims, if you wish to review an adverse decision.

Get help from a Queensland worker's compensation lawyer

When considering lodging a worker's compensation claim in Queensland, it is important to understand your eligibility to claim, provide all the necessary documentation and evidence (including your work capacity certificate) and be mindful of time limits. If you're unsure of your rights and entitlements, or you've received an adverse decision from the WorkCover insurer at any time, you should seek legal advice.