Assessment
- The claim will be assessed by WorkCover's claims agent within 10 days where possible.
- The injured worker will be notified in writing with a decision about their claim (in a claims determination letter).
- The employer will also be provided with a copy of the claims determination letter.
- If the claim is accepted, medical and other relevant compensation payments begin.
- If the claim is not accepted, the injured worker can dispute the decision.
If you were hurt at work, reported an injury and sought medical help, there are two ways to lodge a claim for compensation:
- Use the Worker report form or
- Call WorkCover EarlyClaim on 13 18 55 and start your claim over the telephone.
You can choose to give the Worker report form and a Prescribed Medical Certificate (PMC) to your employer or you can lodge it directly with WorkCover.
The claims agent is contracted by WorkCover to provide workers rehabilitation and compensation services to injured workers.
WorkCover's claims agent
Employers Mutual
Level 15, 26 Flinders Street, Adelaide SA
GPO Box 2575, Adelaide SA 5001
Phone: (08) 8127 1100 Fax: (08) 8127 1200
Web: www.emia.com.au
Role and responsibilities
The claims agent is responsible for most of the decisions relating to your claim, including:
- managing and coordinating rehabilitation and return to work plans for the injured worker
- determining if a claim is eligible for compensation
- managing an injured worker's claim for compensation
- providing advice to workers and employers on rehabilitation and compensation
- providing advice to employers on health and safety in the workplace.
Timeframe
A claim for compensation needs to be lodged within six months of the disability arising. For example, if you are injured and have to have time off work, you need to lodge the form within six months from the date that you reported the injury.
In some cases you may be able to lodge a claim after this period. Contact us on 13 18 55 to discuss this if you need clarification.
Medical certificate
Your treating doctor needs to fill out a WorkCover Prescribed Medical Certificate (PMC) if your claim includes time away from your work.
Timeframe for decisions
Decisions on whether claims are accepted or rejected are determined by our claims agent, Employers Mutual.
The claims agent must make a decision about whether a claim is accepted or rejected within 10 business days from receipt of the claim (unless further information is needed to help make the decision).
If you have lodged a claim recently and want more information about the process see acceptance of a claim or contact the agent.