Workers Compensation Lawyers Sydney & NSW — Get the Full Entitlements You’re Owed

How to make a Workers Compensation Claim in NSW

Step 1: Report the injury immediately Notify your employer in writing as soon as possible. You must record the incident in the workplace Register of Injuries. Include the date, time, and how the injury occurred.

• Why this matters: Reporting within 48 hours helps ensure your provisional liability payments can start within 7 days.

Step 2: Consult a doctor for a SIRA Certificate of Capacity Visit a doctor (you have the right to choose your own) and tell them the injury is work-related. Do not just ask for a standard medical certificate; you specifically need a SIRA Certificate of Capacity.

• Note: This document defines your medical restrictions and is required for weekly payment calculations.

Step 3: Lodge your claim with the insurer Your employer is required to forward your injury report to their insurer within 48 hours. However, you can also lodge the claim yourself by submitting a Workers Injury Claim Form directly to the insurer.

Step 4: Wait for the Insurer’s Decision Once the insurer receives the claim, they must decide on “provisional liability” within 7 days. This allows them to start paying for medical expenses and weekly benefits (up to 12 weeks) while they fully investigate the claim.

Step 5: If Approved (Acceptance of Liability) If the insurer accepts liability, you will receive weekly payments (based on your Pre-Injury Average Weekly Earnings or PIAWE) and coverage for reasonable medical treatment.

Step 6: If Denied or Disputed If the insurer denies liability or offers an incorrect payout amount, you have the right to request a review.

• Action: Contact Care Compensation Lawyers immediately. We can challenge the Section 78 notice and fight for your entitlements through the Personal Injury Commission. We also seek fundding through the Independant Review Office.

What Is Workers’ Compensation in NSW?

Workers compensation is a compulsory statutory insurance scheme in New South Wales designed to support employees who suffer a work-related injury or illness. It is governed primarily by the Workers Compensation Act 1987 and the Workplace Injury Management and Workers Compensation Act 1998.

How “Injury” is Defined by Law Under Section 4 of the 1987 Act, an “injury” is defined broadly to ensure workers are protected. It includes:

• Personal Injury: Physical harm arising out of or in the course of employment (e.g., a fall, cut, or fracture).
• Disease Injury: A disease contracted or aggravated by work, provided that employment was the main contributing factor (Section 4(b)).
• Psychological Injury: Mental health conditions such as stress or PTSD, where work is a substantial contributing factor.

What the Scheme Covers

Regulated by the State Insurance Regulatory Authority (SIRA), the scheme provides three main pillars of support:

1. Weekly Payments: Income replacement calculated on your Pre-Injury Average Weekly Earnings (PIAWE) while you are unfit for work.
2. Medical & Rehabilitation: Coverage for “reasonably necessary” medical treatment, hospital expenses, and rehabilitation services to help you return to work.
3. Lump Sum Compensation: A tax-free payment for permanent impairment if your injury reaches a specific threshold (generally greater than 10% Whole Person Impairment).

How the NSW system works

It is a statutory, no-fault scheme

Benefits are paid by the employer’s workers compensation insurer

The purpose is to support recovery and return to work

Who Can Make a Workers Compensation Claim?

You are generally eligible to claim workers compensation if you are a “worker” as defined under the Workplace Injury Management and Workers Compensation Act 1998. This covers:

• Employees: Full-time, part-time, and casual workers.
• Deemed Workers: Certain contractors and subcontractors who are “deemed” to be workers for insurance purposes (e.g., if you do not employ others and are not a separate business entity).
• Labour Hire Workers: Typically covered by the recruitment agency’s insurance.
• Emergency Service Volunteers: While standard volunteers are generally excluded, specific groups like Rural Fire Service (RFS) and SES volunteers are covered under the Workers Compensation (Bush Fire, Emergency and Rescue Services) Act 1987.

The “Link to Employment” Test To claim, your work must be a contributing factor to the injury. The legal threshold depends on the type of injury:

1. Personal Injury: Work must be a “substantial contributing factor” (Section 9A).
2. Disease Injury: Work must be the “main contributing factor” (Section 4).
3. Psychological Injury: Work must be a “substantial contributing factor”.

• A volunteer in some circumstances

If work caused or significantly contributed to your injury or illness, you are generally eligible to claim.

What Injuries and Illnesses Are Covered?

he NSW workers compensation scheme covers three main categories of injury. To be eligible, your employment must be a “significant” or “substantial” contributing factor, depending on the injury type.

1. Physical Injuries (Personal Injury)

This includes sudden injuries or those that develop over time due to the nature of your work.

• Musculoskeletal Injuries: Back, neck, and shoulder injuries (e.g., herniated discs, rotator cuff tears).
• Fractures & Soft Tissue Damage: Sprains, strains, and broken bones caused by falls or machinery.
• Repetitive Strain Injury (RSI): Overuse injuries such as carpal tunnel syndrome or tendonitis caused by repetitive tasks.

2. Psychological Injuries

Under Section 11A, you can claim for psychological injury if work was the “substantial contributing factor.”

• Work-Related Stress: Conditions like anxiety, depression, or PTSD caused by excessive workload or traumatic events.
• Bullying & Harassment: Psychological trauma resulting from a hostile work environment.
• Note: You cannot claim compensation if the injury was caused wholly or predominantly by “reasonable management action” (e.g., a reasonable performance appraisal or transfer).

3. Disease & Industrial Deafness

Dust Diseases: Conditions like Silicosis or Asbestosis are handled by a separate scheme (iCare Dust Diseases Care). If you suspect a dust disease, contact us immediately as the process differs from standard claims.

Industrial Deafness: Permanent hearing impairment caused by long-term exposure to workplace noise.

Occupational Diseases: Illnesses like dermatitis or asthma aggravated by your work environment.

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What Compensation & Entitlements Can You Receive?

In NSW, your entitlements depend on the severity of your injury and your capacity to work. The scheme is tiered, meaning more serious injuries unlock longer-term support.

1. Weekly Payments (Income Support)

If you cannot work, you are entitled to weekly payments to replace lost wages. These are calculated based on your Pre-Injury Average Weekly Earnings (PIAWE).

• First 13 weeks: You receive 95% of your PIAWE.
• Weeks 14 – 130: You receive 80% of your PIAWE (or 95% if you have returned to work for at least 15 hours/week).
• After 130 weeks: Payments usually cease unless you have a Whole Person Impairment (WPI) of greater than 20% or are working at least 15 hours per week.

2. Medical & Rehabilitation Expenses (Section 60)

Under Section 60 of the Workers Compensation Act 1987, the insurer must pay for all “reasonably necessary” medical treatment.

• What is covered: GP visits, surgery, physiotherapy, psychology, and medication.
• How long does it last?
  • less than 10% WPI: Up to 2 years after weekly payments stop.
  • 11% – 20% WPI: Up to 5 years after weekly payments stop.
  • More thjan 20% WPI: For life.

3. Lump Sum Compensation (Section 66)

You may be entitled to a tax-free lump sum payment if your injury results in permanent impairment. This is separate from your weekly wages.

Note: You can generally only make one claim for permanent impairment, so it is critical to wait until your injury has fully stabilized (Maximum Medical Improvement).

Physical Injury Threshold: Your impairment must be assessed as greater than 10% (i.e., 11% or more).

Psychological Injury Threshold: Your impairment must be assessed as at least 15%.

KEY REMINDER: Strict time limits apply. The earlier you get advice, the better we can protect your claim.