What is a workplace injury claim?

A workplace injury claim in Australia is a claim for compensation made by a worker who has been injured or made ill in the course of their employment. The compensation is paid under state-based workers' compensation schemes, with separate arrangements for Commonwealth public servants under the Comcare scheme.

Each state and territory operates its own scheme. icare manages the New South Wales scheme, WorkSafe Victoria runs the Victorian scheme, WorkCover Queensland operates in Queensland, ReturnToWork SA in South Australia, the Insurance Commission of Western Australia oversees the WA scheme, WorkSafe Tasmania, Comcare ACT, and the Northern Territory's NT WorkSafe round out the system. Most schemes are funded through premiums paid by employers based on payroll and industry risk. Coverage extends to most employees (some exclusions apply for company directors and very small businesses) and includes both physical injuries and work-related illnesses including stress and psychological injury.

The standard claim process begins with the worker reporting the injury to the employer, who must lodge a claim with the relevant insurer. The worker obtains a certificate of capacity from a treating doctor describing the injury and any restrictions on work. The insurer assesses the claim and, if accepted, pays weekly benefits to replace lost wages (typically 80 to 95 per cent of pre-injury earnings, reducing over time), pays for medical treatment and rehabilitation, and supports return-to-work arrangements with the employer.

Disputes about acceptance of a claim, the level of compensation, or the impairment rating can be taken to the relevant state tribunal: the Personal Injury Commission in NSW, the Workers Compensation Independent Review Office in NSW (for some decisions), the Workers' Compensation Industrial Magistrates Court in WA, and similar bodies in other states. Common-law damages claims may also be available where the injury was caused by the employer's negligence, but generally only after statutory benefits are exhausted and subject to thresholds set by each state. Workers' compensation schemes paid out about 10.6 billion dollars in benefits across Australia in 2022 to 2023.