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 lodging on the same day is always better. Every day of delay compresses the evidence window.

Our doctors see workers within 24–48 hours of the injury wherever possible. At that first appointment we assess the injury, document the mechanism and early signs, and start the clinical 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. Our WorkCover doctor issues 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, our doctor refers into our own team — WorkCover physios for musculoskeletal injury, psychologists for psychological injury, or rehabilitation providers 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 deny, our compensation lawyers take the dispute from that point forward at no cost to you.