To lodge a workers' compensation claim, injured employees must complete a Workers’ Compensation Claim Form as soon as possible after the accident or injury has occurred and submit it to their employer with a First Certificate of Capacity completed and signed by a medical practitioner.
The employee then completes an Employer's Report Form and the employer details on the Workers' Compensation Claim Form. Both forms are then submitted to RiskCover by the employer with certificates of capacity, accounts and witness statements (where applicable) within three days of receipt of the claim from the employee.
RiskCover will assess and decide liability under the Workers' Compensation and Injury Management Act 1981 and notify the employee and employer of the decision within 17 days of the employee lodging their claim.
If an employee with an accepted claim experiences a return of symptoms that causes incapacity and/or requires additional treatment after a period of recovery from the original injury, the employee is required to:
- report the recurrence immediately to the employer;
- provide a current certificate of capacity from a medical practitioner; and
- complete a RiskCover Recurrence of Injury Form and submit the form to their employer.
The employer must then submit the employers' report form and certificate of capacity to RiskCover within three days. RiskCover will review the claim and information provided to determine liability.
Online Claims Submission
There are two ways to complete a Workers’ Compensation Claim Form (paper or online).
Effective 17 July 2017, RiskCover launched a new online claims submission system which will be rolled out to subscribing agencies in a phased approach.
Please check with your agency workers' compensation representative who will direct you to the correct process.
The vast majority of workers’ compensation claims progress to the satisfaction of all parties involved, including the worker, however, sometimes an injured employee disagrees with a claims decision made by RiskCover. When this occurs the worker is entitled to seek resolution through the following three stage dispute resolution process.
The employee should discuss the matter with their employer who may be able to resolve it immediately or take up the matter with RiskCover on the employee's behalf.
The employee should contact the RiskCover Injury Services Coordinator/Officer assigned to the claim, who may be able to resolve the matter directly or refer it to RiskCover’s internal dispute resolution process for review.
RiskCover will endeavour to respond to disputes within three working days of their lodgement.
Further information (e.g. new medical or factual evidence) may be required by RiskCover to review the dispute. RiskCover will endeavour to respond within 10 days of receipt of the additional information.
An employee may refer the matter to the WorkCover WA’s Workers' Compensation Conciliation Service. Conciliation may occur where:
- the party is not prepared or able to provide additional information for reconsideration; and
- further information submitted has been reviewed; however, subsequent discussion has failed to resolve the dispute.
Where an injured employee is legally represented, RiskCover will provide the representative with copies of any correspondence that is sent to the employee.