How to Make a Workers Compensation Claim in Australia: The Step-by-Step Guide for 2026

Australia does not have one national workers compensation system. There are 11 separate schemes: 8 run by the states and territories, and 3 run by the Commonwealth (including Comcare for most federal government and some national employers). Each scheme has its own law, its own insurer or agent, its own claim form, and its own definition of who counts as a 'worker'. That is why the single most important first step is to identify which scheme covers you, usually the one in the state or territory where you normally work.

Your scheme is set by your employer's insurance, not by where the injury happened on a given day. The main authorities are: icare and SIRA in New South Wales; WorkSafe Victoria; WorkCover Queensland (regulated by the Office of Industrial Relations); ReturnToWork SA in South Australia; WorkCover WA in Western Australia; WorkSafe Tasmania; NT WorkSafe; WorkSafe ACT; and Comcare for eligible Commonwealth employees.

Where this guide gives a figure or time limit, it is for the named scheme. Because rates are indexed (usually each year on 1 July, and in NSW partly on 1 April and 1 October) and the law is reformed regularly, always confirm the current number on your scheme's official website before you rely on it. The contact list for every authority is maintained by Safe Work Australia.

• New South Wales: icare on 13 77 22; regulator SIRA
• Victoria: WorkSafe Victoria on 1800 136 089
• Queensland: WorkCover Queensland on 1300 362 128
• South Australia: ReturnToWork SA
• Western Australia: WorkCover WA
• Commonwealth employees: Comcare

No matter which scheme you fall under, the claim process starts the same way. First, tell your employer about the work-related injury or illness as soon as possible. Reporting early protects your claim, starts the insurer's clock, and creates a record. Many disputes come down to whether the injury was reported promptly, so do it in writing (email or a workplace incident form) if you can.

Second, see a doctor. The doctor assesses your injury, decides what treatment you need, and issues a medical certificate, called a certificate of capacity (or work capacity certificate, and a first certificate of capacity in WA). This certificate is the medical backbone of your claim: it says whether you can work, on reduced hours, or not at all. In most schemes you can choose your own doctor.

Third, lodge a claim form with your scheme. You can usually do this online, on paper, and in some schemes by phone. You attach your certificate of capacity and basic details about how the injury happened. From 1 July 2025 in Queensland, a doctor sending a certificate to WorkCover no longer automatically starts your claim, so you must lodge it yourself through the Worker Assist portal or by calling 1300 362 128.

Workers compensation is a no-fault system. You do not have to prove your employer was negligent or did anything wrong to get statutory benefits, you only have to show the injury or illness arose out of, or in the course of, your work.

The clock matters. In New South Wales, Queensland and South Australia the standard time limit is 6 months from the date of the injury (or, for a gradual illness, from the date a doctor first links it to your work). In Victoria, you generally have 6 months to lodge the WorkCover claim itself, but you should report the injury to your employer within 30 days of becoming aware of it.

Missing the deadline is not always fatal. In NSW, if there is a reasonable cause for the delay (such as ignorance, mistake, or absence from the state) a claim can be made within 3 years, and claims involving death or serious and permanent disablement can be made even later. Other schemes have similar discretion to accept late claims for good reason, but you should never rely on it. Lodge as early as you can.

The Comcare scheme (Commonwealth employees) is different again: there is no fixed time bar, but you must claim 'as soon as is reasonably practicable', and a long delay can still cause problems. The safest rule across every scheme is simple: report immediately, see a doctor quickly, and lodge within weeks, not months.

Because these limits are set by each scheme's legislation and can change, confirm the current limit on your authority's website before you assume a deadline has or has not passed. Safe Work Australia publishes a national comparison of the prescribed time periods for claim submission.

Once your claim is in, the insurer or agent investigates and decides whether to accept liability. Decision timeframes differ by scheme. In Western Australia the insurer must give a liability decision (or a deferred decision notice) within 14 days of receiving the claim. In Victoria, the WorkSafe agent has 28 days from receipt to make a liability decision, and for a mental injury claim provisional payments can start within 5 business days. WorkCover Queensland generally aims to decide within 20 business days, and must write to you to explain if it cannot meet that.

Employers also have obligations that speed things up. In NSW, your employer must notify their claims service provider within 48 hours of you telling them about a significant injury, and an excess can apply if they fail to notify their insurer within 5 calendar days. If your employer does not lodge, you (or a nominated representative such as a family member or doctor) can lodge the claim yourself.

If your claim is accepted, benefits usually begin promptly and weekly payments are commonly backdated to your first doctor's visit. You may receive payments for lost wages, plus medical and treatment expenses, rehabilitation, travel to appointments, and return-to-work support.

If your claim is rejected, you will get a formal decision notice setting out the reasons and your review rights. Read it carefully and note the review deadline, because some are strict (Queensland gives you 3 months to seek a review of a rejection).

The benefits fall into three broad buckets. The first is weekly income payments while your injury stops you working or reduces your hours. These are based on your pre-injury average weekly earnings (PIAWE in NSW and Victoria, normal weekly earnings in WA and the Comcare scheme), and they typically step down over time. In Victoria, payments are 95% of PIAWE for the first 13 weeks, then 80% from weeks 14 to 130. In NSW, you may receive up to 95% of PIAWE early in the claim, reducing later. In Queensland, the first 26 weeks are commonly paid at 85% of normal weekly earnings (or the award rate).

Weekly payments are capped at a maximum. In Victoria the maximum was $2,930 per week as at 1 July 2025; in NSW the maximum was $2,604.80 for the period 1 October 2025 to 31 March 2026, with NSW indexing on 1 April each year. These figures are indexed regularly, so treat them as indicative and check the current cap on your scheme's site.

The second bucket is reasonable medical, hospital, rehabilitation and related expenses (including travel), for as long as they are needed and approved. The third is a lump sum for permanent impairment, paid once your condition stabilises and is assessed as a whole person impairment (WPI) percentage. Schemes set thresholds: in NSW you generally need 11% or more WPI for a physical injury to receive a lump sum, and 15% or more for a primary psychological injury (the NSW psychological threshold rises to 25% from 1 July 2026 under reforms passed in February 2026).

Under the Comcare scheme, incapacity payments are 100% of normal weekly earnings (less anything you actually earn) for the first 45 weeks, then 75% after that if you are working no hours, generally up to a maximum of 104 weeks. Every scheme has its own rules, so use these as a guide and confirm your entitlements with your scheme or an adviser.

A rejection is not the end of the road. Every scheme has a review and dispute pathway, and using it is free or low cost. The key is to act within the deadline in your decision notice.

In New South Wales, workers compensation disputes are resolved by the Personal Injury Commission, an independent tribunal that handles disagreements between workers, employers and insurers. SIRA also offers help and oversees injury management disputes. In Victoria, the first step is conciliation through the Workplace Injury Commission, which is free and must usually happen before you can go to arbitration or court; the Workers Compensation Independent Review Service can review certain decisions that conciliation does not resolve. In Queensland, a rejected statutory claim can be reviewed by the Workers Compensation Regulator, and you generally have 3 months to apply.

Before a dispute, it is worth getting your medical evidence in order and reading the insurer's reasons closely, because many rejections turn on whether the injury is 'work-related' or on a gap in the medical certificates. Independent advice early can stop a fixable problem from becoming a formal dispute.

For complex claims, serious injuries, permanent impairment lump sums, or common law damages, many people get help from a personal injury lawyer. Accredited Specialists in personal injury are listed on each state law society's register, and reputable firms are ranked in independent guides such as Doyle's Guide. Dispute and serious-injury work is often handled on a no-win-no-fee basis, so ask about costs up front.

The headline rules differ enough that it is worth knowing where your scheme sits. Use this as orientation only, and confirm the current detail with your authority, because figures are indexed and laws are reformed often.

• New South Wales (icare, regulator SIRA): claim within 6 months (up to 3 years with reasonable cause); employer notifies insurer within 48 hours; up to 95% of PIAWE early; 11% WPI threshold for a physical-injury lump sum; disputes via the Personal Injury Commission. Reforms passed February 2026 change psychological-injury thresholds from 1 July 2026.
• Victoria (WorkSafe Victoria): report to employer within 30 days, lodge within 6 months; agent decides within 28 days (5 business days for provisional mental-injury payments); 95% of PIAWE for 13 weeks then 80%; maximum $2,930/week from 1 July 2025; disputes start with free conciliation.
• Queensland (WorkCover Queensland, call 1300 362 128): claim within 6 months; decision aimed within 20 business days; first 26 weeks commonly 85% of normal weekly earnings; you must lodge the claim yourself since 1 July 2025; 3 months to seek review of a rejection.
• South Australia (ReturnToWork SA): claim within 6 months; income support commonly 100% for the first 52 weeks then 80% to 104 weeks; seriously injured workers (30%+ WPI psychiatric or 35%+ physical) can receive support to retirement age.
• Western Australia (WorkCover WA): see a doctor and get a first certificate of capacity; employer lodges with the insurer within about 5 days; insurer decides within 14 days.
• Commonwealth employees (Comcare): claim as soon as reasonably practicable; incapacity at 100% of normal weekly earnings for 45 weeks then 75%, up to 104 weeks.