Deciding a claim

When we asses an application for compensation, we take into account the individual circumstances of the application and assess it against the criteria contained in the relevant workers’ compensation legislation.

When assessing an application, we must decide whether (according to legislation):

• the person making the application was defined as a ‘worker’
• the person making the application suffered an ‘injury’
• the person’s employment was a ‘significant contributing factor’.

According to the latest amendments, WorkCover Queensland has 20 business days to decide an application for compensation

We try to assess all applications as quickly as possible, some factors can increase the time taken to assess and make a decision on an application. These include:

• workers and employers who do not provide us with true and accurate information
• workers and employers who do not provide all the necessary information (employers information, Workers' Compensation Medical Certificates).

What if a claim is not accepted?

If we do not accept a claim, under the Workers’ Compensation and Rehabilitation Act 2003, we must send a letter to the worker advising them of the decision and the reasons for the decision. A letter will also be sent to your employer and any treating practitioners advising them that the claim has not been accepted.

If you are are not happy with the decision, then you can apply for a review. If you would like more information on having a WorkCover Queensland decision reviewed, call us on 1300 362 128.