The Western Australian workers compensation and injury management scheme is based on a ‘no-fault’ principle. This means you do not have to establish that your employer was at fault or negligent to make a claim. You are entitled to compensation if you are a worker, suffer an injury or develop a disease at work and require medical treatment or time off work as a result.
This section contains information about making a claim and attending medical reviews.
Am I a worker?The legal definition of a worker includes full-time, part-time, casual, seasonal, piece and commission workers. Working directors, contractors and sub-contractors may also be defined as workers depending on their working arrangements.
It is important to note that a volunteer does not fall under the definition of a worker under the Workers Compensation and Injury Management Act 2023.
If you are injured, follow these steps to make a claim for workers compensation.
- Immediately seek first aid and report the injury to your employer.
- As soon as possible, see a doctor of your choice and ask for a First Certificate of Capacity.
- Fill out a Workers Compensation Claim Form. If you have difficulty completing the form, speak to your employer. If after speaking to your employer you are still unsure, contact our Advice and Assistance Service on 1300 794 744.
- Make copies of the Certificate and Claim Form for your records and give the original documents to your employer.
- Your employer has seven days to complete their section of the Claim Form and lodge both documents with their insurer. Penalties can apply for failing to lodge the claim within seven days.
- The insurer will notify you within 14 days after receiving your claim form.
Your employer’s insurer is required to give you either a liability decision notice or a deferred decision notice within 14 days after receiving your claim.
Liability Decision Notices (Claim accepted, claim not accepted or claim deferred)
- Accepted
If your claim is accepted, you will receive weekly income compensation payments (if your injury prevents you from working) and medical and health compensation for reasonable expenses.
- Not accepted
If your claim is not accepted, no compensation will be paid and the insurer will advise you of the reason. If you disagree with the insurer’s decision, you can approach the insurer to reassess the decision. If still unresolved, you may lodge an application with the WorkCover WA’s Conciliation and Arbitration services.
- Deferred
The insurer may defer your claim should further information be required. If your claim is deferred, the insurer must give you a liability decision notice before the provisional payments day (the day after the period of 28 days beginning on the day the claim was received by the insurer). If a liability decision notice cannot be given in 28 days after receipt of the claim, provisional payments will become payable. The deferred decision notice will include the date from when provisional payments are payable. For further information see Provisional Payments.
Claim taken to have been accepted
Your claim will be taken to have been accepted if a liability decision notice or deferred decision notice is not given to you within prescribed timeframes.
14 days
If a liability decision notice or a deferred decision notice is not given to you within 14 days after receiving a claim, the insurer is taken to have accepted your employer is liable to compensate you. Your employer is liable for payment to you of any income compensation and medical and health expenses resulting from your injury.
120 days
If a deferred decision notice is given to you within 14 days of the insurer receiving your claim, but a liability decision notice is not given to you within 120 days of receiving your claim, the insurer is taken to have accepted your employer is liable to compensate you. Your employer is liable for payment to you of any income compensation and medical and health expenses resulting from your injury.
The deferred decision notice will include the date from when the claim is taken to have been accepted.
Your employer’s insurer or a self-insurer may refer you to a medical practitioner of their choice before or after your claim has been accepted for the purposes of providing a written report on your medical condition.
If you do not attend an appointment or obstruct an examination, it may impact your entitlement to compensation.
There are limits on when and how often an insurer or self-insurer can require you to attend a medical examination.
You are not required to attend medical reviews:
- more frequently than once every two weeks
- at any time other than during reasonable hours
- with more than three medical practitioners who are specialists in the same field of medicine.
The insurer or self-insurer is required to give you a copy of the written report within 14 days of the report being provided to them.
For more information, see Return to work.
