If you are about to talk to someone about a workers compensation claim, the conversation is easier when the paperwork is in front of you. This is what to gather, and what each document does.
What to gather
Your claim number, if a claim has been made. It is on the letters from the insurer. If no claim has been made yet, say that instead — it changes what the first step is.
Every certificate of capacity. These describe what work you can and cannot do. They are completed by a treating health practitioner, and not necessarily always the same one: the State Insurance Regulatory Authority’s guidance on certificates of capacity for workplace injuries says a subsequent certificate may be issued by a SIRA-approved treating physiotherapist or psychologist, within their area of expertise. Bring all of them, not only the current one. What a certificate contains is set out in our guide to certificates of capacity.
Everything the insurer has sent you. Decisions about liability, about weekly payments and about treatment are made in writing. Bring the letters as they arrived, including the ones you disagree with.
Who is treating you. The names of your GP, any specialist, and any physiotherapist or psychologist involved.
What you told your employer, and when. The date you reported the injury and who you reported it to, with any email or message you sent.
What a certificate of capacity is doing
A certificate of capacity is a medical document about your ability to work. It records the injury, what you can do at the moment and for how long. The insurer relies on it, so it is worth reading each one and saying so if something in it does not match your own account of what you can do.
What an insurer’s decision is
An insurer administering a claim makes decisions and gives them in writing. Those decisions are the insurer’s to make, and they are not advice to you. Where you disagree with one there is a dispute process, and our guide to disputing a decision sets out what it involves. In New South Wales, disputes between injured people, employers and insurers are dealt with by the Personal Injury Commission, which describes itself as resolving those disputes rather than acting for either side. The State Insurance Regulatory Authority publishes the rules the scheme runs under.
Two things to say at the start
Any date you have been given. A date on a letter, a review date, or a hearing date — say so first, because the rest fits around it.
Anything about your job as well as your injury. Whether you are still employed, on reduced hours, or worried about being replaced. Those questions run on their own timetable.
General information, not legal advice. It does not take into account your circumstances, your injury or your claim, and it does not create a lawyer and client relationship. If you want advice about your own claim, tell us what has happened.