Your First Week on WorkCover NSW: What Actually Happens

Days 1–2: report, lodge, start the clock

The claim formally begins when you notify your employer of the injury and the employer or you lodges the claim with the WorkCover insurer. Under the NSW Workers Compensation Act 1987 section 254, you have 6 months from the date of injury to lodge — but the sooner you lodge, the better. See a doctor early: the sooner the injury is documented, the stronger your claim.

We get you in with a WorkCover doctor within 24–48 hours wherever possible. At that first appointment the doctor assesses the injury, documents the mechanism and early signs, and starts the medical record the insurer will rely on. If the injury is psychological rather than physical, the same approach applies — early documentation is what keeps the claim credible.

Days 3–5: Certificate of Capacity issued, first physio possible

The Certificate of Capacity is the document that does the most work on your claim. The WorkCover doctor writes it at the first substantive appointment — usually day 3 to day 5 — and it records the injury, treatment plan, and work capacity (total incapacity, partial capacity, or fit for suitable duties). The insurer uses this certificate to schedule weekly payments and approve treatment.

Alongside the certificate, the doctor refers you on and we line it up — a physio for musculoskeletal injury, a psychologist for psychological injury, or a rehabilitation provider where graduated return to work is already being planned. Physio can start in this window if the injury is stable enough to benefit from early movement.

If you are not sure whether the insurer has everything they need, you can also check eligibility in parallel through our 7-question eligibility quiz — it surfaces issues (late reporting, contractor status, aggravation claims) that can slow a week-1 decision.

Days 6–7: provisional liability decided, first payment calculated

Under section 267 of the NSW Workplace Injury Management and Workers Compensation Act 1998, the insurer has 7 calendar days from notification to decide provisional liability. In practice, they do one of three things: accept provisional liability and schedule the first weekly payment, write to you saying they need more time and specifying why, or deny the claim (rare at this stage).

If they accept, your first weekly payment is calculated at 95% of your pre-injury average weekly earnings (PIAWE) for the first 13 weeks, capped at the SIRA maximum weekly amount. Our Payment Calculator lets you estimate that figure from your own payslips before it lands.

If they ask for more time, that is also legal — they can take up to 12 weeks under the provisional-liability framework, but they must still pay provisional weekly payments while they investigate. If they decline the claim, we go through the letter with you, explain how to ask for a review and put you in touch with a compensation lawyer if you need one. Most WorkCover disputes qualify for IRO funding, which usually means the legal costs aren't yours.