Personal Injury

Navigating and managing your workers compensation claim

A common thread in my line of work for a few years is simply, Workers have little to no idea of what to do when they suffer a work-related injury. They have no clear idea of of what is expected of them. They follow instructions from their Employer and Insurer and sometimes, they become lost or disillusioned by the process which can lead to disputes which can then lead to resentment, stress, a troubled relationship with the employer and insurer which can even affect their rehabilitation and whatever they hold dear in life outside of work.


I have listed some tips on how workers, legal practitioners and even medical practitioners can maintain a good, working relationship with the insurer and employer in managing a workers compensation claim.


1. Always keep a paper trail. 

Workers should always keep copies of documents, forms and correspondence including emails. If workers are corresponding over the phone, make a note of all conversations. If you are unsure as to the advice or conversation, ask for an written form, letter or request. Correspondence can be valuable, as most disputes and the breakdown of the working relationship with the insurer or employer arises partly to miscommunication or lack of understanding.


2. Better the question asked, than not at all.

Workers Compensation is a complex area of law and it is always evolving, always being reviewed and it is important to know what your obligations are and what rights and entitlements you have under the law. There is no shame in asking the question that you need answered, this is about your health and recovery.


3. Ensure Certificates of Capacity are completed properly.

All parties in the system underestimate the value and importance of Certificates of Capacity. They must be filled out comprehensively by your medical practitioner. Details on treatment, work capacity, referrals and important information in these Certificates go a long way for Workers, Doctors, Insurers and Employers understanding the true extent of an injury, rehabilitation, capacity for work and other details to manage your claim. Please ensure your treating medical practitioner completes these Certificates, you can avoid further action by the Insurer if they believe the extent of your injury, rehabilitation or capacity is not ascertainable or inconsistent.


4. Be Proactive

Call, email, write a letter. There is nothing worse than just waiting. The system is not perfect, if you are waiting for a decision or a response, take steps to ensure you try, to the best of your ability, to get the answers you need. In doing so, follow tip '1'. There may be a point where you might need to get assistance from a legal practitioner, SIRA or the Workers Compensation Independent Review Office (WIRO), but at least you have done your part.


5. Mental Health

Any injury can have a huge effect on one's mental health. This is an important issue in today's world and injured workers are a highly vulnerable group. Speak to your treating medical practitioner, counselor or someone close to you about how you feel about your injury and the system. There is no issue in getting help and it is readily available. If there is a  psychological component to your injury, ensure your treating practitioners diagnose this and keep the insurer informed with comprehensive Certificates of Capacity and referrals.



**This article was written in respect of the NSW Workers Compensation scheme, but general principles of good practice can be applied in any relevant jurisdiction.