Step-by-Step Guide for Workers in Bankstown and Western Sydney

If you’ve been injured or become unwell because of your job, understanding how to make a workers compensation (WorkCover) claim is essential. The process can feel complex at first, but with the right medical support and documentation, it can be managed smoothly and efficiently.

At Advanced Health Medical Centre in Bankstown, WorkCover-approved GPs help patients navigate the claim process, ensuring injuries are properly assessed and the correct paperwork is completed for submission to employers or insurers.

1. Report the Incident to Your Employer

Notify your supervisor or employer as soon as possible after a workplace injury or illness occurs.
Provide clear details about what happened, when it happened, and the symptoms you’re experiencing.
Prompt reporting helps establish your claim and ensures your employer can meet their legal obligations.

2. Book a Medical Assessment

Make an appointment with a workers compensation GP to have the injury assessed.
The GP will take a medical history, perform an examination and determine how the condition affects your ability to work.
This consultation forms the foundation of your WorkCover claim and guides both treatment and recovery planning.

3. Obtain a WorkCover Certificate of Capacity

After your assessment, the GP will issue a Certificate of Capacity, which records:

• The nature of the injury or illness
• Recommended treatment
• Any work restrictions or modifications needed
• An estimate of your capacity to work

This certificate must be submitted with your claim. It is also updated at regular review appointments as your recovery progresses.

4. Lodge Your Workers Compensation Claim

Once the certificate is completed, it needs to be provided to your employer or directly to the insurer.
In most cases, you will also need to complete a Workers Compensation Claim Form (available through your employer, insurer, or the NSW State Insurance Regulatory Authority).

Include all supporting documents such as incident reports, medical certificates and receipts for any early treatment costs.

5. Await Claim Review and Approval

After submission, the insurer will assess the claim.
They may contact you, your employer, or your GP to confirm details and ensure eligibility.
If the claim is approved, your medical treatment, rehabilitation and related expenses will generally be covered under WorkCover.
If more information is required, your GP can assist by providing additional documentation or clarification.

6. Begin Treatment and Rehabilitation

Once your claim is active, your GP coordinates ongoing medical care and referrals as needed.
This may include physiotherapy, imaging, dental care, or specialist consultation.
Regular reviews help track progress and update your certificate so your employer and insurer remain informed about your recovery.

7. Plan Your Return to Work

When medically ready, you and your GP can work with your employer to design a return to work plan.
This plan may include light duties, flexible hours or gradual reintegration to help you transition safely back into your role.
Returning to work early in a modified capacity often supports faster and more complete recovery.

What Happens If a Claim Is Delayed or Declined

If your claim is not approved straight away, you can still receive medical care while awaiting the insurer’s decision.
If the claim is declined, you have the right to request an internal review or appeal through the Workers Compensation Independent Review Office (WIRO).
Your GP can provide medical reports or additional information to assist with this process.

Tips for a Smooth Claim Process

• Report the incident promptly.
• Keep copies of all forms and medical certificates.
• Attend all scheduled medical and review appointments.
• Maintain regular contact with your employer and insurer.
• Follow treatment advice closely to support recovery.

Clear communication and consistent documentation help ensure your claim runs efficiently.