Frequently Asked Questions

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Workers' Compensation Claims

Who and what is covered?

We provide workers’ compensation cover for WA Government agencies and their employees for injuries sustained in the workplace. All employees are covered at work in their normal activities, including during mandated break times.

Employees carrying out authorised duties for their employer at a location other than their usual workplace will be covered for workers’ compensation. This cover extends to employee attendance at locations outside their normal workplace such as seminars, training programs, team building activities, school camps and for work while engaged in regional, domestic and international travel.

In some circumstances, employees will also be covered for injuries sustained while travelling to and from these alternative locations as long as there are no substantial deviations or interruptions in the journey.

Employees are entitled to workers’ compensation if they are injured travelling between two workplace locations.

Am I covered when travelling to and from work?

Generally, employees are not covered while travelling between home and work. Under certain circumstances, workers’ compensation cover may apply.  

If you are a member of a union, you may also be covered for your journey through them.

What is required to make a claim?

If you are injured at work:

  • Ask your employer if you can submit your claim online. If you are able to use this facility they will provide you with the necessary information.
  • Otherwise, complete a workers' compensation claim form; and
  • Submit the form and a First Certificate of Capacity, signed by a medical practitioner to your employer.
When will a decision be made?

You will be notified within 17 days of your claim being lodged with your employer if your claim is accepted, declined or pended.

What am I covered for?

You may be entitled to:

  • Time lost from work due to your injury, in the form of weekly compensation.
  • Prescribed medical treatment to support your recovery.
  • Cost of travel for injury related medical appointments.
  • Support from an Approved Workplace Rehabilitation Provider to assist with your return to work.
  • Compensation for permanent impairment.
What will happen with my pay once my claim is accepted?

Your employer will pay you as normal and seek reimbursement from the Insurance Commission.

If you have used sick leave while waiting for a decision on your claim this will be credited back to you.

Contact your employer if you have any questions about how your weekly payments are calculated.  

If you need more help contact your claims officer.

What happens if I am not fit for work or have restrictions?

You will be supported to return to work by your employer, your GP and your claims officer.  This may include a graduated return to work with restrictions on your duties and/or hours.

How can I get an update on my claim?

Contact your claims officer - see any letter from us for those details - we aim to respond to queries within two business days.

To help us respond more quickly, please provide your claim number and full name on all correspondence along with an email or phone number where we can contact you.

Can I seek treatment if my claim is pended?

Ask your treatment provide if you need to pay while a claim is being determined.  Accounts are held until a decision is made.

Once a claim decision has been made, if it is accepted reasonable treatment will be paid via your claim. If it is declined it is your responsibility to pay for treatments/accounts.  

If you are unsure, please contact your claims officer.

How does the Insurance Commission work with me?

We aim to work with you in a positive, honest and professional manner.  We understand the time following an accident or injury can be difficult.  

We are committed to managing your claim promptly and efficiently.

We will keep you updated on your claim as it progresses.

How do I submit accounts for reimbursement?

To enable us to reimburse you as quickly as possible the best way is to email:

  • Attach a PDF format version of your account to invoices@icwa.wa.gov.au.
  • In the subject line type your full name and claim number.
  • Leave the body of the email blank.

Alternatively, post your accounts to GPO Box K837, Perth WA 6842.

What if I have more information to provide?

Please email your claims officer directly.

How quickly will my account reimbursement be refunded?

We aim to reimburse you within 10 days of an account being received when your claim has been  approved and you have completed and EFT form.

What if I do not agree with a claims decision or have a complaint?

Contact your claims officer in the first instance to see if the issue can be resolved.

You can also request for the decision to be internally reviewed by a senior member of staff.

If that is not satisfactory to you, WorkCover WA's Conciliation and Arbitration Service provides an independent process to review claims decisions. Call 1300 794 744.

Injury Management
What is injury management?

Injury management involves the employee, employer and treating medical practitioner actively assisting an employee to remain at or return to work. This can involve planning the treatments and rehabilitation services the employee requires.

When will injury management start?

Once we confirm liability for a workers’ compensation claim, you can access a range of treatments and workplace rehabilitation services to assist your injury management.

Who decides what provider will be used?

You have the right to decide who the providers are for treatment and rehabilitation services.

What treatment types are available?

Treatments are available to help you recover from a workplace injury. As part of your approved claim, we pay for treatments that are necessary and reasonable to aid your recovery. The treatments approved for payment include:  

  • General Practitioners (GPs);
  • medical specialists;
  • physiotherapists;
  • chiropractors;
  • ambulance;
  • chemist expenses;
  • psychologists;
  • dentists;
  • hydrotherapists;
  • occupational therapists; and
  • osteopaths.
Can I choose my own treatment provider?

WorkCover WA sets the fees payable to medical and therapeutic providers. Any gap between the providers’ fees and the rate payable by us may need to be covered by you.

You can choose your own provider, however to make sure you are not out of pocket you will need to request they bill us directly using the prescribed rates.

Can I use a workplace rehabilitation provider?

To support you to remain at or return to work, workplace rehabilitation services may be required. In some cases, an adjustment of duties may be needed to return to work.  

Workplace rehabilitation providers may offer the following services:

  • case management;
  • vocational assessment and job placement;
  • worksite assessment; and
  • functional capacity evaluation. 

WorkCover WA provides a list of approved workplace rehabilitation providers.

Can I claim travel costs for getting to and from appointments?

You can claim reasonable costs for travelling to and from necessary medical and therapeutic appointments.

In order to recoup travel costs, we require evidence of travel, which may include a statement indicating appointment attended and kilometres travelled. WorkCover WA prescribes the payable rate per kilometre that we can pay.

In some situations, you may be unable to travel by personal motor vehicle or public transport to medical and therapeutic appointments. In this case, please contact your claims officer to discuss alternative arrangements.

Is there a limit to the amount I can claim for treatments?

For every claim, limits apply to the amount you may claim for reasonable and necessary workers’ compensation injury treatments.

The prescribed amount is set by WorkCover WA for medical treatments and weekly expenses. These prescribed amounts ensure that all injured employees have access to the same amount of financial assistance, though some injured employees will require more assistance than others.

Can I go on holiday while I have an active claim?

You can continue to access their accrued annual and long service leave entitlements.

During injury management, a return to work program may be established. If you are involved in return to work program you may be advised to avoid taking annual and/or long service leave to ensure the success of the return to work program.

However, you have the right to take annual leave and/or long service leave while recovering.

What if I am permanently impaired?

Once workplace injuries stabilise and any permanent impairment can be assessed, you may be entitled to further entitlements set out in Schedule 2 of the Workers’ Compensation and Injury Management Act 1981. Schedule 2 entitlement amounts are prescribed and maintained by WorkCover WA.

Permanent impairment is assessed in percentage terms and expressed for each part of the body. If you are permanently injured, we will arrange a medical assessment to be conducted by a WorkCover WA approved medical specialist.

For further information talk to your claims officer.

What happens if my injury comes back after I return to work?

Despite recovering, you may experience a return of your original injury symptoms and require further treatment.

In this case you must report the injury recurrence as soon as possible to your employer after the injury returns. When reporting the recurring injury, you must provide the following documents to your employer:

After your employer receives the recurrence of injury claim form, the completed form, medical certificate and any other supporting documents must be submitted to us within three days.

We will then review the claim and provide a decision on liability.

Property and Business Interruption Claims
What is covered?

We provide motor vehicle cover to WA Government agencies for physical loss or damage to property owned by an agency or property in the care, custody and control of an agency.  

Cover is also provided for loss of, or damage to property (excluding money or jewellery) belonging to an employee or volunteer of the agency used in connection with the business of the agency and which is not otherwise insured.

Is there a timeframe for lodging a new claim?

Apart from property in transit claims there is no timeframe to lodge a new property claim.  However, you are encouraged to lodge a claim form as soon as possible from the date of the incident.

If my personal property is damaged, do I have to provide proof of purchase?

In most cases proof of purchase is a requirement to verify the lost/damaged item.

Is there an excess?

This is dependent on the individual agency’s cover. Some agencies choose to have an excess, but most don’t, check your cover document or contact us.  

Claims for personal property do not have an excess applied.

How do I make a claim?
  1. Complete an online claim or a Property Claim Form.
  2. Attach a quote for repairs and/or replacement.
  3. Attach any supporting documentations such as invoices or receipts.
  4. If applicable, attach an asset or resource listing.
  5. The form must be signed by an authorised person at the agency.
What happens when my claim is received?

We will confirm your agency has the appropriate cover and may request further information.  If we have all information to hand we will notify the agency and process the claim.

Will there be any further assessment of the claim?

A loss adjuster may be appointed to assess the claim if it is in excess of $10,000, a complex or catastrophic claim or the details of the claim are not clear.

Employee Property In Transit
What is covered?

On occasion, employee’s personal property is damaged or lost while in transit or placed in storage when transferred in their employment. We provide cover for physical loss or damage to household furniture, personal effects, watercraft and vehicles.

Watercraft and vehicles are only covered if they are transported by professional carriers.

Is there a timeframe for lodging a new claim?

Yes.  The claim must be lodged within 30 days of the date of delivery or receipt of the property.

If my personal property is damaged, do I have to provide proof of purchase?

In most cases proof of purchase is a requirement to verify the lost/damaged item.

Is there an excess?

This is dependent on the individual agency’s cover. Some agencies choose to have an excess, but most don’t, check your cover document or contact us.  

Claims for personal property do not have an excess applied.

How do I make a claim?

Complete an online claim or a Property Claim Form.

Attach a quote for repairs and/or replacement.

Attach any supporting documentations such as invoices or receipts.

Attach photos of the damaged item(s) and a copy of your inventory/condition report.

The form must be signed by an authorised person at the agency.

What happens when your claim is received?

We will confirm your agency has the appropriate cover and may request further information.  If we have all information to hand we will notify the agency and process the claim.

Will there be any further assessment of the claim?

A loss adjuster may be appointed to assess the claim if it is in excess of $10,000, a complex or catastrophic claim or the details of the claim are not clear.

Motor Vehicle Claims
What is covered?

We provide motor vehicle cover to WA Government agencies for loss or damage to registered vehicles belonging to, hired, leased or borrowed or in the care, custody or control of the agency for any cause or event (not otherwise excluded) happening anywhere in Australia.

What happens if I have an accident?

In the first instance contact your agency's Fleet Manager/Coordinator at Fleetcare on 1300 655 170.

Do I need to obtain an estimate for repairs?

Yes. 

The agency should obtain a repair estimate from a licenced repairer.

Is there a preferred repairer?

No.  We do not have preferred repairers and are unable to make recommendations.

Can I undertake repairs straight away?

No.  You must lodge a Motor Vehicle Claim Form with us first and the vehicle will be assessed and authorised by one of our nominated vehicle assessors.

What if the crash involves a personal vehicle?

If an agency employee uses their personal motor vehicle for the purposes of official business with the consent of the agency, cover is provided for loss, damage or liability.  Managing the claim and repairs of the vehicle should be arranged in consultation with the agency’s fleet manager or with us.

What if the crash involves another vehicle?

If damage is caused to another person's vehicle (third party) they should lodge a claim with their insurer.  We will liaise directly with the third party's insurer regarding payment for the damage caused.

Should I admit liability if it was my fault?

No. The agency must not admit liability to a third party.  Liability will be assessed by us and advice will be provided directly to the third party.

How do I make a claim?
  1. Complete on online claim or a Motor Vehicle Claim Form.
  2. Attach a repair estimate from an authorised repairer.
  3. Attach any information or correspondence regarding any third party involved.
What happens when my claim is received?

We will confirm your agency has the appropriate cover and automatically appoint an Assessor (with the exception of glass claims). The damage will be assessed and repairs authorised within two days of receipt of the claim.

What if the vehicle is written off?

In the event that a vehicle is assessed as a total loss, we will pay the higher termination value of the vehicle as confirmed by the fleet manager.  If the agency does not have a fleet manager, we will pay based on the current market value of the vehicle.

Liability Claims
What does liability cover include?

We provide a range of liability cover to agencies including, but not limited to:

  • general liability cover for claims lodged against an agency for any legal liability resulting from an occurrence in connection with its activities;
  • employment practices liability cover for claims made against an agency for employment related disputes;
  • professional liability cover for claims made against an agency for its errors or omissions in the rendering of, or failure to render, professional advice or services by the agency; and
  • medical treatment liability cover for claims made against an agency for bodily injury, mental injury or death of a patient caused by its rendering of, or failure to render, medical or health services (other than first aid).

Liability claims will generally be made after an incident in which a member of the public has notified the agency of an incident that may result in a potential liability.

How do I make a claim?

After an incident, a member of the public should notify the relevant agency in writing as soon as possible. Agencies can lodge a general liability or a professional liability claim by completing and returning a  General Liability Claim Form or a  Professional Liability Claim Form, respectively.

What happens once my claim has been lodged?

Each claim is different and must be assessed according to the circumstances. This makes it difficult to give an accurate estimate on how long it will take us to make a decision.

We will make every effort to assess the claim in a reasonable time frame once the claim has been lodged. Some delays may occur depending on the nature of the incident and the availability of information.

How will I know if my claim has been accepted?

Once we determine liability, all parties will be notified in writing.

Disputing a Workers' Compensation Claim
What happens if I'm not happy with a claim decision?

We will fairly review all workers’ compensation claims in accordance with the provisions of theWorkers’ Compensation and Injury Management Act 1981and endeavours to provide the best possible outcome for the employee and the employer.

If you disagree with a workers’ compensation claim decision made by us, you can access a dispute resolution process.

What should I do first if I am not happy with a decision?

In the first instance, discuss your concerns or issues with your employer.  They may be able to resolve the matter immediately or take it up on your behalf with us.

What if I am not happy with my employer's response?

If your employer is unable to resolve your issue, contact the claims officer assigned to your claim (their details will be on the letter your initially received from us).  

If the claims officer is unable to resolve your issue they will refer it to someone more senior for review.

You will receive a response from us within three working days of receipt of your complaint.

If the matter cannot be resolved by the initial informal discussion, and further information (e.g. new medical or factual evidence) that may allow a decision to be reconsidered is subsequently provided, we will review the further submission within 10 days of receipt and notify you whether or not the dispute can be resolved.

What if I'm still not happy with the decision after initial review?

If you are not happy with the decision after it has been reviewed by us, you can refer the matter to WorkCover WA Conciliation Service for determination where:

  • you are not prepared or are unable to provide additional information for reconsideration; and
  • the further information submitted has been reviewed; however, subsequent discussion has failed to resolve the dispute.

If you are legally represented, we will provide the representative with correspondence sent to you.

If you need assistance to resolve a dispute to a claim, at any time you can contact WorkCover WA for advice and assistance on 1300 794 744.

Page Last Updated 03 Aug 2018