Workers’ Voice study has released a new practical resource, “Four Phases of a Workers’ Compensation Claim”, designed to help injured workers, employers, and practitioners better understand the workers’ compensation process.
We know that workers’ compensation systems can feel overwhelming and frustrating especially when you’re already dealing with the impact of a workplace injury or illness. This resource is designed to help make the process easier to understand by providing a clear, plain-language overview of how a workers’ compensation claim generally unfolds.
The information shared here is intended as a general guide only. Every claim is different. If you can, we encourage seeking support early to help you navigate your claim and understand your options.
This overview was developed with the guidance and insight of the Workers’ Voice lived experience advisory group to whom we are deeply grateful.
- Phase 1: The Worker is Injured – Download
- Phase 2: A Claim Decision is Made –Download
- Phase 3: Benefits and Services are Provided –Download
- Phase 4: The Claim Ends – Download
Phase 1 Overview: The Worker is Injured
Overview: In Australia about 500,000 people are injured at work every year. Many thousands more have an illness or disease due to their work.
Some injuries or illnesses will be sudden or will develop gradually and may worsen over time and others will have a fluctuating course where people feel fine one day and ill the next.
If you think your injury or illness is due to work, you may be able to make a workers’ compensation claim. Workers’ compensation can provide funding for treatment for your injury and illness, wage replacement while you are unable to work, and pay for services to help you return to work.
Just like personal injury insurance (greenslip in NSW) is required for a motor vehicle, employers are required to have insurance to support workers if they are injured at work.
National data from Safe Work Australia shows that every year, about 130,000 people have an accepted workers’ compensation claim that involves at least 5 days off work.
Download our comprehensive document below for a detailed overview of this phase.
Phase 2 Overview: A Claim Decision is Made
Once you submit your workers’ compensation claim to your employer, the claim is then passed on to an insurer (also called a claims agent). The insurer is responsible for deciding whether to accept or reject your claim.
Download our comprehensive document below for a detailed overview of this phase.
Phase 3 Overview: Benefits and Services
Once a claim has been accepted, a range of benefits and services are provided to support the injured worker’s recovery and safe return to work. Each claim is assigned a claim number and a claims manager, who is responsible for coordinating claim-related processes and services.
The claim number will remain the same until the claim ends, however, it is common for the assigned claims manager to change over the life of the claim.
The duration of this stage can vary significantly — from a few days to several years —
depending on the nature and severity of the workers’ injury or condition.
There are generally two types of claims:
- Medical-only claims: where the worker requires medical treatment but is able to continue working, possibly with modified or restricted duties.
- Time-loss claims: where the injury or illness prevents the worker from performing their job for a period of time. In these cases, compensation may include both medical expenses and a proportion of lost wages.
- Download the full document here.
Phase 4 Overview: The Claim Ends
Most workers’ compensation claims finish when the injured worker has recovered enough to return to work and no longer needs support from the insurer for medical treatment or income payments.
However, you can return to work while still receiving medical treatment or rehabilitation. Many workers go back on light or modified duties while continuing physiotherapy, counselling, or other care — this is completely normal and supported under the system.
For some people, recovery happens quickly — within a few days or weeks. For others, it takes months or even years, and some may try returning to work a few times before they’re ready to stay in their role permanently.
A small number of workers have serious or long-term injuries that keep them on the workers’ compensation system until they reach retirement age.
Download the full document here.