If your claim isn’t accepted or is closed
Sometimes a workers’ compensation claim may not be accepted, or payments may come to an end. We know this can be stressful, so we’re here to explain what happens next and where you can get support.
Support for when life gets tough
When life gets hard – whether with financial stress, health concerns or personal struggles – there’s help and support available.
If your claim isn't accepted
If we can’t accept your claim, our decision is based on medical details, supporting information and what workers’ compensation legislation requires us to consider.
We know this can be disappointing.
We’ll call you to explain why and answer any questions you may have.
We’ll also send you a letter, so everything is clear and in writing. This is called a reason for decision letter.
If your claim has ended or been closed
We’re here to support you, but every claim closes eventually.
We’ll usually keep making payments until either:
- more treatment won’t improve your injury
- your injury no longer stops you from working.
We’ll always make these decisions based on your medical details and supporting information.
If you don’t agree with a decision we’ve made
Some of our decisions can be reviewed by the Workers’ Compensation Regulatory Service (the Regulator).
If you’re unhappy with a decision we’ve made, you may be able to ask us for a reason for decision letter within 20 business days.
You can apply for review within three months of receiving your letter. It’s free to apply.
All reviews are handled independently by the Regulator.
They're not part of a court process, so you won't attend in person.
The Regulator will review your claim and let you know of the outcome.
They might:
- tell us to change our decision
- ask for more information
- confirm our original decision.
If you need treatment that’s not covered
You may be able to get support through other avenues.
You can:
- speak to your private health insurer
- ask your superannuation fund whether you have sickness or accident cover
- talk to your GP about options in the public health system
- if your injury happened in a motor vehicle accident, contact your third-party insurer
- if your injury is psychological, speak with your GP about a mental health care plan or access other mental health supports.
If you don’t think you can work
If your claim has ended but you don't feel able to work, there are a few things you can do.
You may want to:
- speak with your doctor about what tasks you may be able to do
- talk to your employer about any leave you can access
- talk to your employer about modified or alternative duties
- contact your income protection insurer, or check whether your superannuation fund includes sickness or accident cover
- talk to us about the Employment Connect program
- contact Centrelink for more support options.
How we make decisions
Learn more about how we make claim decisions.
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