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How to make a claim

Everything you need to know about making a claim, what you’ll need and what to expect at each step. 

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Not all employers are insured by us

We insure most employers in Queensland, but some larger employers are self-insured. 

Thinking about making a claim for workers’ compensation?

We know this can be a hard time. We’re here to help you understand what to do next. 

Download our printable Before you make a WorkCover claim guide (PDF, 0.89 MB).

Time limit to make a claim

You must submit your claim either:

  • within 6 months of receiving a diagnosis for your injury or illness; or
  • within 20 business days of a doctor, nurse practitioner or dentist first assessing your injury as resulting in total or partial incapacity for work.

If you miss the 6 month deadline

We may be able to make an exception if you can show the delay happened because of one of the following:

  • a genuine mistake
  • being away from Queensland or Australia
  • another reasonable cause, like your doctor not telling you there may be a link between your condition and your work.

These rules come from Queensland’s workers’ compensation laws. 

Important: if you lodge your claim late

If you lodge your claim after the 6-month deadline, you’ll need to:

  • tell us why it was delayed
  • give us enough information to support this.

We understand delays can happen.

Even with an explanation, we may still not be able to accept your claim if it doesn’t meet the legislative requirements. 

Steps to make a claim

1. Ask your doctor for a work capacity certificate

A work capacity certificate is a type of medical certificate that tells us about your injury, including:

  • how the injury happened
  • what treatment you need
  • whether you need time off work.  

You should get this at the first appointment for your injury.  

We can't make a decision on your claim without a work capacity certificate.

Public hospital referral

If you go to the hospital with a work-related injury, they may automatically send us your work capacity certificate.

This doesn’t mean you have to make a claim – we won’t start a claim unless you ask us to.

If you choose not to claim, you’ll need to cover any costs related to your injury. 

2. Make your claim

Make a claim online(opens in new tab)

There are other ways to make a claim with us:

  • call 1300 927 928 and speak to a member of our team
  • complete a paper claim form (DOCX, 0.11 MB) and either:
    • upload it using our online service
    • fax it to 1300 651 387
    • post it to GPO Box 2459, Brisbane Qld 4001.

The more information you can give us about your injury, the faster we can assess your claim and help you get back to work.

Give us:

  • your full name, date of birth and contact details (including email and phone number)
  • your employer’s name and location
  • your work capacity certificate
  • details about your injury or illness, including how and when it happened.

Telling your employer

It’s a good idea to tell your employer about your injury and let them know you’re making a claim.

This helps because we’ll need to ask them for some information while we assess your claim. We can often make a decision sooner if they already know. 

3. We’ll review your claim and keep you updated

We’ll check the information you’ve given us.

If we need more details, we’ll contact you as soon as we can (usually within a few business days).  

We may ask you for extra supporting information, like documents or contact details for witnesses to incidents.  

If your claim is for mental injury, you may be able to access support while we make our decision.

4. We’ll review your medical details

Sometimes we may need to talk to you and your doctor or ask for your medical records.

If we need more details, we might ask you to see an independent doctor. If this happens, we’ll explain what’s needed and support you through the process.

5. We’ll contact your employer for information

We’ll give your employer some details about your claim and ask for their response. We only share information that relates to your claim.

We’ll also ask them to confirm your employment and wage details.  

If there’s a dispute about your claim, we’ll make sure the process is fair and everyone has a chance to respond.

6. We’ll make a decision on your claim

We’ll make our decision based on the available facts and medical evidence, and in line with workers’ compensation laws.

Most claims are decided within 20 business days. If it takes longer, we’ll let you know and explain why. You’ll also get the reasons in writing.

If you’re unhappy with the reasons your claim is taking longer than expected, you can ask for the Workers’ Compensation Regulatory Service to review the reasons given.

Find out more about how your claim is decided. 

More to help you understand the process

The Workers’ Compensation Regulatory Service has created information statements for workers (PDF, 0.14 MB) and employers (PDF, 0.14 MB) to help you:

  • navigate the workers’ compensation process
  • understand your rights and obligations. 

If your claim is accepted

Payments and support

There are different types of payments and support to help you, depending on what you need.

We can usually pay for:

  • reasonable and necessary treatment to help you get better
  • part of your wages if your doctor says you can’t work because of your injury (or if you’re working less hours as you recover).

We’ll try to manage your payments to help minimise disruption to your normal life. 

Making sure you get paid

To make payments, we need:

  • your bank details (account name, BSB and account number)
  • a Tax File Number declaration if you’re claiming for lost time at work.

You can add these in the Worker Assist app. 

Your recovery and getting back to work

We’ll work with you, your employer, and your health providers to plan your recovery and help you get back to work.

If your claim isn’t accepted

Find out what happens if your claim isn’t accepted and what your options are.  

Information for employers

With your worker’s consent, you can start the claim process for them by completing a claim form.

You’ll need:

  • the worker’s name, date of birth and contact details
  • your policy number – or your business name, ABN or ACN if you’re not sure
  • details of the injury and when it happened
  • the worker’s work capacity certificate
  • their normal weekly earnings and hours (if they’re taking time off work), plus the amount payable under their industrial agreement.

Employers can make a claim or check existing claims through the WorkCover Connect portal.

If one of your workers has had a work-related injury or illness, you may need to notify Workplace Health and Safety Queensland of the incident.

If your worker was injured, you may also need to report the injury to us.

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