Your case manager is responsible for managing your claim and liaising with all parties to ensure you have the appropriate support
You can claim for workers compensation if you have had time off work or if medical expenses have been incurred due to a work-related injury or illness.
Making a claim
- See your doctor as soon as possible and ask for a Certificate of Capacity (we may not be able to accept back-dated medical certificates). The certificate outlines the nature of your injury, your capacity to work and treatment requirements.
- Complete and sign a Workers Injury Claim form. If you cannot complete the form yourself, you can ask a family member or union official to assist you. Be sure to include all relevant information and attach any supporting documentation such as bills or receipts for treatment.
- A journey accident claim form must also accompany the Workers Injury Claim form for claims made in relation to travel to/from the workplace.
- Give the claim form and your Certificate of Capacity to your employer as soon as possible. Your employer must lodge your claim with us within 48 hours of receiving these forms.
You can find out more information about making a claim by contacting Coal Mines Insurance.
Managing your claim
- Within three days of receiving a claim, a case manager will be assigned to you. Your case manager reviews all documentation and will contact you, your employer and your treating doctor (if required) to assess your claim.
- Your case manager will advise you in writing if your claim has been accepted or denied within 21 days of receiving your claim. If further information is required to assess your claim, this period may be extended for a further 21 days.
- If your claim has been denied, your case manager will provide you with an explanation relating to this decision. If you don’t agree, you can provide further information to support your need for treatment and ask us to review the decision. If you still have concerns, contact your employer or union to discuss.
- If your claim is accepted, then reasonably incurred medical treatment and costs are paid or reimbursed. You may also receive rehabilitation support if required and weekly payments to help you in your recovery and return to work.
- Throughout this process, your case manager will stay in contact with you to ensure you are receiving the right support to assist you in your recovery.
Throughout your recovery you have the right to:
- choose your nominated treating doctor
- choose your approved rehabilitation provider
- choose your treatment providers
- have a say in your return to work plan
- have union representation, if required.