Comcare Workers Compensation: The Complete Guide
Hurt at work in a Commonwealth or licensee job? We know your scheme and we can see you. This page explains the rest in plain English.
Comcare is the national workers compensation scheme for Australian Government employees and self-insured corporate licensees. Whoever you work for, the help is the same: our doctors complete the certificate of capacity, our psychologists and physiotherapists deliver the treatment, and our doctors refer on for specialist opinions, imaging and surgical care when an injury needs it. Treatment runs in person across NSW and in Canberra, or by telehealth Australia-wide. Certificate appointments are booked in person.
Does Comcare Cover You?
Comcare follows your employer, not your postcode. If you work for any of these four groups, you're under the same Commonwealth law, the Safety, Rehabilitation and Compensation Act 1988 (SRC Act), and we can help.
Commonwealth APS & statutory authorities
If you work for an Australian Public Service department or Commonwealth statutory authority — Services Australia, the ATO, Home Affairs, Defence's civilian staff and the rest — this is your scheme. Claims are determined by Comcare itself.
ACT Government (ACTPS)
ACT Government employees — nurses, teachers, Territory public servants — are covered by the same SRC Act. The ACT Government self-insures, and EML manages the claims. Same law, different claims manager.
National self-insured licensees
If your employer is one of the roughly 40 corporations holding self-insurance licences under the SRC Act (Telstra, Australia Post, ANZ, Commonwealth Bank, NAB, Medibank, Optus, Linfox, John Holland, Ramsay Health Care, Virgin Australia and others), the same rules apply, decided by your employer's own claims manager.
Not covered: ADF members
Serving and former Defence Force members are outside the Comcare compensation scheme. Military compensation is administered by DVA, with all new claims under the MRCA from 1 July 2026. Defence's civilian APS employees stay in Comcare.
At 30 June 2025 the scheme covered 491,781 full-time-equivalent workers across Australia. Because it's a national scheme, it follows you wherever you work: the same rules apply to an APS worker in Canberra, a Telstra technician in Perth and an Australia Post employee in regional Queensland.
Who Do You Work For?
Not Sure Which Scheme You're Under? One Question Sorts It
You don't need to learn how any of this fits together. Tell us who you work for and we'll handle the rest. It's worth getting right early, because paperwork sent to the wrong claims manager goes nowhere, and that costs weeks. The one question that sorts it: who is your employer?
- ✓Australian Government agency or statutory authority: you're under Comcare. This guide is for you.
- ✓ACT Government: same Commonwealth law, but your claim is managed by EML, not Comcare. See our guide to ACT Government workers compensation claims through EML.
- ✓A self-insured licensee corporation (Telstra, Australia Post, the big banks and others): same SRC Act rules, decided by your employer's claims manager.
- ✓A private-sector employer in Canberra: you're not under Comcare at all. Your claim runs through the ACT private scheme and a licensed insurer. Start with our guide to workers compensation in Canberra and the ACT.
Still not sure? Our which-scheme checker for Canberra workers sorts it out in about a minute, or call (02) 7238 7379 and we'll work it out with you on the phone.
Why It Matters
Different claims managers
Comcare, EML and corporate claims teams each run their own forms and portals, and a claim lodged with the wrong one goes nowhere.
WorkSafe ACT decides nothing
It regulates workplace safety in the Territory. It does not determine compensation claims in any of the four groups.
Residence is irrelevant
An APS employee living in Queanbeyan is a Comcare patient. A private-sector worker living in Canberra but employed in NSW is not. The employer decides the scheme.
What Do I Do Now?
The Comcare Claim, Step by Step
Five steps take you from the day you're hurt to the day treatment and payments start, and since April 2024, the decision deadlines are written into the regulations, so you know how long each stage is allowed to take.
Report the injury to your supervisor
Follow your agency's reporting procedure and do it early, even if you haven't decided whether to claim. For a psychological condition, the date you first sought treatment matters to how the claim is assessed later. Reporting and seeing a doctor promptly keeps your options open.
See a doctor for the certificate of capacity
Comcare's certificate (the form was last updated in February 2026) must be completed by a legally qualified medical practitioner: a GP or a specialist such as a psychiatrist. A psychologist cannot complete it. For a psychological claim, Comcare asks that the diagnosis be made against DSM-5-TR or ICD-10 criteria: a named condition, not “stress”. This is the document the whole claim stands on, and it's what our doctors do every day.
Lodge the claim form
Submit Comcare's online claim form (or the paper version). Your employer receives it, completes the employer section and submits it on. For a psychological claim, a written statement setting out the events you say contributed is worth preparing carefully, because it frames how the claim is assessed.
The decision on your claim
A claims manager decides liability under section 14 of the SRC Act, within statutory timeframes: 20 calendar days for an injury claim, 60 for a disease claim, and psychological conditions are almost always assessed as diseases. That means two things: your employment must have contributed to the condition “to a significant degree”, and the reasonable-administrative-action exclusion is considered (more on that below). The clock pauses while further information is sought.
Treatment and payments begin
Once liability is accepted, reasonable medical treatment is funded under section 16 (billed direct to the scheme at its published rates for approved care), and incapacity payments run while you're certified unfit. Treatment approvals sit with your claims manager, which is why the paperwork behind them (referrals, directives, treatment plans) matters as much as the appointments themselves.
Quick Facts
20 days
Statutory deadline to decide an injury claim (since 1 April 2024).
60 days
Deadline for disease claims: the category covering psychological conditions.
GP or psychiatrist
The only practitioners who can complete a certificate of capacity. A psychologist cannot.
5 sessions
Psychology funded before a Psychology Treatment Plan is required.
Psychological Injury Under Comcare
If your injury is psychological, you are far from alone in this scheme. The numbers below are Comcare's own published figures: its annual report, scheme dashboard, premium presentations and psychological injury factsheet.
37%
of Australian Government claims are psychological (Comcare dashboard, financial year to date at 30 September 2025), against 13% scheme-wide in 2024-25.
~half
of the entire 2025-26 Comcare premium is attributed to psychological disease: 0.47 of 0.98 percentage points.
57%
return-to-work rate for psychological claims in 2023-24 and 2024-25, against roughly 89% for physical injuries.
31+ wks
median time off work for a psychological claim, on Comcare's psychological injury factsheet, and the longest recovery tail in the scheme.
The Exclusion Most Psych Claims Turn On
The SRC Act excludes a psychological injury that was suffered as a result of “reasonable administrative action taken in a reasonable manner” in respect of your employment (section 5A). The Act treats things like reasonable performance appraisals, counselling (formal or informal), suspension and disciplinary action, and decisions about promotion or transfer, as administrative action.
In a disputed claim, the argument is rarely about whether such action happened. It's about whether the action was reasonable, whether it was carried out in a reasonable manner, and whether your condition would have developed anyway from other work factors. The test is objective. It looks at what was actually done, not at how it felt or what consequences you feared.
What the exclusion does not ordinarily reach: bullying and harassment, sustained work pressure, occupational violence and exposure to traumatic events. On Comcare's published figures, bullying and harassment is the single largest cause of accepted mental-stress claims, with work pressure second. A claim isn't hopeless because a performance process exists somewhere in the background. What matters is what actually caused the condition, and that is a clinical question before it is a legal one.
There is also a second threshold: as a disease, a psychological condition must have been contributed to by your employment “to a significant degree”, meaning more than a marginal connection. Both questions are answered largely from the clinical record, which is why the file matters so much.
What a Strong Clinical File Looks Like
Claims are assessed on what is in the clinical file. Here is what a complete one contains, and every part of it is buildable from the first appointment:
- ✓A named diagnosis.A DSM-5-TR or ICD-10 condition on the certificate, not “stress” or “work issues”.
- ✓The work events, documented and dated. Specific incidents with dates, consistent across the claim form, your statement and the clinical notes.
- ✓Functional impact in concrete terms. What you can and can't currently do at work, with capacity described specifically, not in general labels.
- ✓Early, consistent treatment. Treatment records that start promptly and certificates that follow the clinical story without gaps or contradictions.
- ✓A doctor and psychologist on the same page. When the certifying doctor and the treating psychologist share one file, the certificate, the referral and the treatment notes tell one coherent story. That is the model our clinic runs.
First Responders
For Commonwealth and ACT Government first responders — AFP, Australian Border Force, firefighters, ambulance officers and emergency services staff — PTSD suffered or aggravated on or after 15 December 2023 is presumed to be work-related under the scheme's first-responder provisions. The diagnosis (against DSM-5-TR) may be made by a psychologist or a doctor, though the claim itself still needs a doctor's certificate.
How Comcare Psychology Treatment Actually Works
There's no provider panel and no scheme registration. Any AHPRA-registered psychologist can treat you. What the scheme does have is a precise approval workflow, and claims stall when a step is skipped. We run every step for you; here's what happens behind the scenes.
1. Doctor referral + directive
Psychology is compensable as treatment at the direction of a doctor. That means a diagnosis, a referral, and a directive setting out the form, frequency and duration of treatment, with doctor follow-up. Our doctors write all of it in-house.
2. Claims manager approval
Treatment is approved in writing by your claims manager, wherever possible in advance. Approved treatment is billed direct to Comcare at the scheme's published rates, with nothing for you to pay for approved care.
3. Five initial sessions
Comcare funds an initial five psychology sessions, each up to 60 minutes, without a treatment plan. Enough to start properly while the longer-term plan takes shape.
4. Psychology Treatment Plan
Beyond five sessions (or after a 12-month gap, or on a change of clinic) your psychologist submits a Psychology Treatment Plan for continued blocks of care. It's a routine document for a clinic that works the scheme.
5. Longer sessions need prior approval
Consultations over 60 minutes require prior approval through a Psychology Extended Consultation Request, in any modality. Build it into the plan rather than discovering it at billing time.
6. Telehealth at full parity
Comcare publishes telehealth psychology item codes paid at exactly the same dollar rates as in-person consultations, up to 90 minutes. Approved patients can be treated by video from anywhere in Australia.
The referral, the directive, the approval and the plan are the four documents that keep Comcare psychology funded without interruption. Our doctors and psychologists run them as one workflow. See our Comcare psychologist service for how treatment itself is delivered.
More Than a Certificate: What Your Claim Can Fund
Section 16 of the SRC Act funds reasonable medical treatment obtained in relation to a compensable injury, and that reaches considerably further than a certificate and a course of counselling. This is the range our clinic covers, and how each part is funded.
Doctors: GP or specialist
The load-bearing role in every Comcare file. Only a legally qualified medical practitioner can complete a certificate of capacity, and Comcare's own description of the treating doctor's job runs wider than that: diagnose and assess, certify capacity, treat, refer on for specialist treatment, advise on alternative duties or workplace modifications, review proposed return-to-work plans and take part in case conferences.
Psychologists
Funded as therapeutic treatment at a doctor's direction: a diagnosis, a referral, and a written directive setting out the form, frequency and duration of treatment. Five sessions of up to 60 minutes to begin, then a Psychology Treatment Plan. Psychology rates are national rather than state-based, and telehealth items are paid at the same dollar amounts as in-person up to 90 minutes.
Physiotherapists
Hurt and need a physio? You can start straight away: no referral needed, and Comcare states that plainly. Five sessions to begin, then a Physiotherapy Treatment Plan, which Comcare also pays your physiotherapist to prepare and submit. Physiotherapy rates are set state by state, unlike psychology. The ACT's have been aligned with the NSW rates since 1 July 2025, and the ACT telehealth items published from February 2026 carry the same dollar values as the in-person equivalents.
Specialist and surgical opinions
Medical procedures including surgery sit squarely inside the Act's definition of medical treatment. Our doctors refer for a specialist opinion and write the clinical case behind it; the claims manager approves in advance wherever possible and issues a written determination stating what has been approved and for how long. Where any operation is performed is a decision made with you, and it follows that approval.
Hospital treatment
Treatment and maintenance at a hospital is its own head of compensable treatment: operative treatment, nursing services, day procedures, room charges, meals and anaesthesia, in a public or a private hospital. What the scheme does not fund is the extras: room upgrades, television hire, phone calls.
Imaging and pathology
Examinations, tests and analyses carried out at a doctor's request — X-rays, MRI scans, pathology — are compensable in their own right under the Act, and that extends to paying for the report on the examination. Our doctors order them and read them back to you in plain terms.
Reports for the claims manager
A report on your treatment or your progress is not classed as medical treatment at all. It is paid separately, when the claims manager asks for the information. In a contested psychological claim, that report is often the single most useful document on the file. When the claims manager requests it, the scheme pays for it separately from your treatment; if you want one it has not asked for, talk to us first.
How Anything Gets Approved
Whatever the service, the claims manager asks the same four questions the Act asks: is what you are claiming medical treatment; was it obtained in relation to your compensable injury; was it reasonable in the circumstances to obtain it; and what amount is appropriate to it. Comcare's guidance is to seek approval in advance wherever possible, and the determination comes back in writing, stating the level of service approved and the period it covers. Invoices are usually paid within 28 days.
There is no provider panel and no scheme registration to clear. AHPRA registration, no conditions preventing practice, and meeting Comcare's service provider standards is the whole gate, which is why the paperwork, not the accreditation, is what decides whether your care is funded without interruption.
Two practical notes. Comcare's published rates are upper limits rather than fixed prices, and claims managers are not bound by them. And the scheme will not pay a non-attendance or cancellation fee for an appointment you did not attend, so if something comes up, tell us and we will move it.
Two Things We Don't Do
Workplace rehabilitation. Only workplace rehabilitation providers approved by Comcare can deliver rehabilitation services in this scheme, and they are engaged by your employer acting as the rehabilitation authority under sections 36 and 37, not chosen by you, and not supplied by us. We are a treating clinic and we don't hold ourselves out as anything else. What our doctors do is the treating doctor's role Comcare describes: advising on alternative duties and workplace modifications, reviewing proposed return-to-work plans, and joining case conferences, which the scheme pays for where a Comcare employee attends or Comcare has asked for the conference.
Independent medical examinations. A section 57 examination is arranged by your claims manager, not by us. We sit on the treating side of the file, and that is the side we stay on.
Will I Be Paid?
Incapacity Payments: How You're Paid While You Can't Work
While you're certified as having reduced capacity, the scheme pays incapacity payments under section 19 of the SRC Act. The formula is set by the Act, and the dollar outcome depends entirely on your own pre-injury earnings, so treat any website quoting you a figure with suspicion. The structure is:
- ✓The first 45 weeks:100% of your normal weekly earnings, minus anything you actually earn. The 45 weeks are counted cumulatively, so part-weeks of incapacity don't burn full weeks of entitlement.
- ✓After 45 weeks:75% of normal weekly earnings if you're not working, stepping up through 80%, 85%, 90% and 95% as the proportion of your normal hours you work increases, back to 100% once you're working full hours.
- ✓Normal weekly earnings are set from the two-week period before your injury and can include regular overtime and certain allowances.
Worth knowing at a high level: incapacity payments are taxable, accessing superannuation can reduce them, Centrelink payments for the same period are recovered, and payments generally stop at pension age. The step-down structure is one reason the return-to-work planning in a psychological claim deserves as much clinical attention as the treatment itself.
The Shape of It
100%
of normal weekly earnings (less actual earnings) for the first 45 cumulative weeks.
75–100%
after 45 weeks, scaled by how many of your normal hours you're back working.
2 weeks
the pre-injury period your normal weekly earnings are calculated from.
If Your Comcare Claim Is Declined
A declined determination is a decision point. The review path is structured and deadline-driven, and at the tribunal stage there is no application fee for workers compensation matters (as at August 2026).
1. Reconsideration
Request it within 30 days of receiving the determination. An independent reconsiderations officer reviews the decision and — since April 2024 — must decide within 30 days. It is the first point at which fresh material goes in front of a fresh decision-maker, which is why an up-to-date clinical record is what gets prepared for it.
2. The ART
If the reconsideration goes against you, apply to the Administrative Review Tribunal within 60 days. There's no application fee for workers compensation matters, as at August 2026, and the tribunal can affirm, vary or set aside the decision.
3. Federal Court
Either party can appeal an ART decision to the Federal Court within 28 days, but only on a question of law. Very few claims travel this far; most disputes resolve at reconsideration or at the tribunal, often by agreement.
If You're Sent for an Independent Medical Examination
Along the way, the claims manager may require an independent medical examination (IME) under section 57. The scheme's own rules put real guardrails around this: the delegate is expected to rely on existing information first, including seeking it from your treating practitioners, before requiring an examination. You must be consulted on the examiner's specialty and identity (with a window to object), on the format (face-to-face or video), and on support arrangements. Examinations are ordinarily limited to once per six months for the same condition.
One thing to take seriously: refusing or obstructing an IME without a reasonable excuse suspends your compensation rights until you attend. If a request seems premature or the format doesn't work for you, the answer is to raise it through the consultation process, not to skip the appointment.
Medical First, Legal When Needed
A determination turns in large part on the clinical record: the diagnosis, the documented events, the continuity of treatment. Reviewing and completing that record is medical work, and it is where our doctors and psychologists start.
Whether you go to reconsideration or the Administrative Review Tribunal with a lawyer or on your own, the clinical evidence is the part we can put right. We are a medical clinic, not a law firm; we don't give legal advice, and nothing on this page is advice about your case.
Deadlines are the trap: 30 days to request reconsideration, 60 days to reach the tribunal. If a determination has just landed, don't sit on it. Call (02) 7238 7379 and get the clinical review moving while the clock is still friendly.
One Clinic for the Whole Comcare Claim
The Comcare scheme has a structural quirk: the certificate must come from a doctor, the treatment for a psychological injury comes from a psychologist, and the funding runs on paperwork that connects the two. Split across two practices, that paperwork usually ends up being carried by the patient. We built the clinic so nobody has to, and the clinical side and the claims side both sit here.
- ✓Our doctors complete the certificate of capacity with a proper DSM-5-TR diagnosis, and write the referral and directive that make psychology fundable.
- ✓Our psychologistsdeliver the treatment — the funded five sessions, then care under a Psychology Treatment Plan — in person across NSW and in Canberra, or by telehealth Australia-wide at the scheme's full published rates.
- ✓Our physiotherapists, and referrals onward for specialist opinions, imaging and surgical care. Physiotherapy needs no referral to start under this scheme; the rest our doctors arrange and document, so the approval request reaches your claims manager with a clinical case already attached.
- ✓One file. The certificate, the referral, the treatment notes and the return-to-work plan are written from the same clinical record, so they read as one account rather than three.
- ✓Approved treatment billed direct to Comcare at scheme rates. Because Comcare is national, so are we: in-person appointments across New South Wales and in Canberra, and telehealth treatment for licensee and APS employees anywhere else in the country. Certificate appointments are booked in person.
Injured under the NSW scheme instead? The rules differ in important ways (provisional liability, SIRA approval, different exclusion wording), so start with our guide to psychological injury under NSW workers compensation rather than this one.
Doctor-anchored
Certificates with our doctors
Only a GP or psychiatrist can certify a Comcare claim. Ours complete these certificates as everyday clinic work, at in-person appointments.
National reach
In person, or by telehealth
In-person appointments across NSW and in Canberra; telehealth treatment everywhere else, with Comcare's psychology items paying full parity to 90 minutes. See our Comcare psychologists.
Canberra footing
Built for the capital's schemes
Comcare, ACTPS/EML and the private scheme: our Canberra and ACT hub covers all of them.
Comcare Claim Questions, Answered
Not sure which scheme you're under in the first place? Run through our Canberra which-scheme checker. It takes about a minute.
Start Your Comcare Claim Properly
A certificate written to the scheme's requirements, treatment and paperwork on one file, and people who work this scheme every week. Talk to us first.
Call (02) 7238 7379