My Claim Has Been Approved! Now What? How Workers’ Compensation Claims Work in NSW

You were injured at work, you filed a workers’ compensation claim, and your claim has been approved. This is an important first step towards getting the compensation you deserve for your injury; but once your claim is approved, your work has only just begun.

Workers’ compensation claims require ongoing management throughout your recovery process. Read on to learn more about what you’ll need to do after your claim is approved.

 

Your Documentation 

Once your workers’ comp claim is approved, you’re going to receive a variety of information and paperwork you’ll need to keep up with. The first of these is your claim number. This will identify your claim and will appear on all paperwork related to your workers’ compensation claim.

You’ll also obtain a certificate of capacity from your doctor. This will be how your doctor communicates your current health status, ability to work, and recovery progress to everyone involved in the compensation claims process. You’ll need to keep up with the latest copy of your certificate of capacity in case any questions arise and keep them current at all times.

 

Your Support Team

There will be several people involved in supporting you through your recovery and your workers’ compensation claim process. The first of these, of course, will be the doctor you choose to manage your treatment. They will diagnose you and prescribe you with a treatment plan, as well as communicate your health status to the rest of the people on your team.

You’ll also have a case manager who works for your employer’s insurer and who will be the primary point person handling your case. If you have questions at any time during your recovery, they’ll be able to help you get the answers you need.

Finally, your employer will pick someone at your workplace to manage your recovery process. You’ll coordinate with this person and your doctor to arrange a suitable workplace recovery plan.

 

Recovering at Work

Once your workers’ compensation claim has been approved, your employer is required to make any accommodations needed to allow you to return to work. In some cases, there may be no reasonable way for you to return to work for a period of time after your accident. Your case manager and workplace care coordinator will help you figure out a situation that meets your needs, including helping you find new employment if need be.

Assuming you can return to work, special accommodations will be put in place to make sure you can recover safely. You may only be responsible for part of your previous duties, or you may work limited hours. You may also be assigned a different role in the company until you can return to your previous position.

 

Payments

While you have an active workers’ compensation claim, you’ll receive weekly payments from your employer’s insurer. These will help to cover part of your wages lost as a result of your injury, as well as supporting your workplace recovery. These payments may change as you recover and are able to return to more of your normal work arrangements.

The insurance company will calculate your weekly payment amounts based on your average weekly earnings before the accident. There may also be time limits on how long you can continue to receive these payments. Payments should begin within a week of your insurer receiving notice of your injury unless they issue a reasonable excuse advising that they do not have enough information to commence payments.

 

Expense Reimbursement

In addition to these weekly payments, you may also be able to be reimbursed for some of your medical expenses. If for example you were required to take an ambulance to the hospital, stayed in the hospital for a period of time, or received medical treatment, your employer’s insurer may cover some or all of those expenses.

You may also be able to seek reimbursement if your property (glasses, prosthetic limbs, wheelchair, etc.) was damaged in the accident. We suggest that you talk to your case manager if you think you might qualify for these reimbursements.

 

What You Need to Do

Your work is not over once you receive approval for your workers’ compensation claim. Your first responsibility will be to focus on recovering so you can return to work.

You will need to make sure that your certificate of capacity remains up to date and that everyone has a copy of it at all times. You will need to see your doctor for a new certificate of capacity every twenty-eight days. You must fill out section three on the certificate, and if your circumstances change, you must notify your insurer immediately.

 

Getting More Information 

The workers’ compensation claims process can be confusing, and you may have questions throughout the process. When questions arise, the first person you should contact is your case manager. If they are not able to answer your question, they will be able to direct you to someone who can.

If you feel your case manager isn’t handling your case appropriately, you can contact the Workers’ Compensation Independent Review Office. They’ll be able to investigate your complaint and make any needed changes. If all else fails, you can contact the State Insurance Regulatory Authority (SIRA) with any other questions or concerns.

If you’d like to get help managing your workers’ compensation claim, get in touch with us at Bourke Love Lawyers.

We provide caring, expert assistance and our costs to assist you are covered by the Workers Compensation Independent Review Office.

Contact us today to get the support and compensation you deserve.