How your claim is decided

Download our guide to your WorkCover claim (PDF, 1.11 MB).

How we decide your claim

We look at several key things when reviewing your claim. This helps us work out if we can accept it under Queensland workers’ compensation legislation.

We consider:

• whether you made your claim in time
• whether you are considered a Queensland worker
• where and how you were employed at the time of your injury
• where and how the injury happened
• whether your work played a significant part in why you were injured – we call this a ‘significant contributing factor'.

These requirements come from workers’ compensation legislation.

How different injuries are decided

Every claim is unique, and sometimes we need extra information before we can make a decision.

Some types of injuries follow specific criteria, including:

• Mental injuries
• Industrial deafness
• Injuries travelling to from or for work or on scheduled breaks
• Aggravated injuries or ongoing symptoms
• Work-related respiratory diseases or diseases contracted while doing your job, for example Q-fever
• Death caused by a work-related event or by illnesses like mesothelioma or malignant skin cancer, that develop over a long period of time (called ‘latent onset’).

If your claim isn’t accepted

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

Making a common law claim

You have the right to sue your employer if you believe their negligence contributed to your injury. This is called a common law claim.

You might choose not to make a statutory claim (for benefits like weekly compensation, medical costs or rehabilitation costs) and instead pursue a common law claim for damages.

These claims follow a similar initial decision-making process to statutory claims.

If you have more questions about your claim

Get in touch. We're here to help.