Timeframe
If you, or someone you employ, lodge a compensation claim with WorkCover our claims agent will consider the claim and give you a decision within 10 days. If the claim is accepted, health care and appropriate compensation payments will begin immediately.
Claims determination letter
If you are a worker the decision on the claim will be made in a formal letter called a claims determination letter. This letter will be sent to you directly. Your employer will also be provided with a copy of the claims determination letter.
Claims agent
It may take a little longer than 10 days to get a claims determination if the agent does not have everything needed to assess the claim, or if further information is needed to help make this decision.
If you are an injured worker, the claims agent will talk to the treating doctor (with your consent) before the claim is accepted. In some cases the claims agent may defer the decision and may pay you income maintenance in the interim. Be aware that if your claim is later rejected, you will have to pay back this money. For more information on claim decisions see delayed or rejected claims.
Decisions
Employers Mutual is contracted by WorkCover to provider workers rehabilitation and compensation services to injured workers. The claims agent is responsible for most of the decisions relating to the claim, and the day to day claims management. This includes:
- determining if a claim is eligible for compensation
- managing the claim for compensation
- providing advice to workers and employers on rehabilitation and compensation
- managing and coordinating your rehabilitation and return to work
- providing advice to employers on health and safety in the workplace.