How long do I have to make a workers comp claim in NSW?

Six months from the date of injury for the standard claim. For gradual-onset injuries (repetitive strain, mental health, hearing loss), the clock starts when you first became aware of the work-relatedness. The Act allows extensions for late lodgement in many circumstances — psychological injury, delayed diagnosis, or good reason for the delay. Don't assume you're out of time; our team will assess your specific situation on the phone.

Do I have to tell my employer before I lodge the claim?

You should report the injury to your employer as soon as practicable, in writing if possible. The Act doesn't require you to lodge the claim through your employer — you can submit it directly to the WorkCover insurer — but employer notification is a statutory step that affects the insurer's timeline for accepting liability. Our reception team confirms your employer's insurer at booking and handles the notification language with you.

What's the difference between reporting an injury and lodging a claim?

Reporting an injury is the workplace step — telling your employer or filling in the workplace incident register. Lodging a claim is the formal step that triggers the insurance process — submitting the Certificate of Capacity and the worker's claim form to the WorkCover insurer. Reporting an injury alone does not start your weekly payments; you need to lodge the claim for the scheme to engage.

Can I lodge a workers comp claim without seeing a doctor first?

You can start the process, but the claim doesn't move without a Certificate of Capacity from a treating doctor. Practically, the doctor's visit is the first real step. Our clinic books new workers in for same-week appointments specifically so the certificate doesn't become a bottleneck — you don't need a GP referral to come in.

How long until I receive my first weekly payment?

Under the provisional liability rules, the insurer must commence weekly payments within 7 days of receiving a properly completed claim. The insurer has 21 days to make a final liability decision; during those 21 days, provisional payments continue regardless. In practice, most workers see their first weekly payment within 10 to 14 days of lodging.

What is PIAWE and how does it affect my weekly payments?

PIAWE stands for Pre-Injury Average Weekly Earnings. It's the average of your gross earnings in the 52 weeks before injury (or the 12 weeks before, in some cases). For weeks 1 to 13 of your claim, you receive 95% of PIAWE. From week 14 onwards, the rate steps down to 80% of PIAWE if you have no work capacity, or a partial-payment calculation if you've returned to some work. There's a statutory maximum and minimum — both indexed annually.

Will my workers comp claim affect my future employment or insurance?

Your claim is not visible to future employers — there's no public register. Some private insurance providers (income protection, life insurance) ask about past workers comp claims on application forms; you'd answer those honestly when relevant. The Fair Work Act explicitly protects you from adverse action by a current employer for having lodged a claim, including dismissal, demotion or workplace retaliation.

What happens if my employer disputes the injury was work-related?

The employer's view doesn't decide the claim — the insurer does, and the insurer's decision must be based on medical evidence and the Act's eligibility rules. If your employer disputes the work-relatedness, the insurer will weigh it, but a strong Certificate of Capacity and supporting clinical record from our doctors usually carries more weight. If the insurer ultimately denies on this basis, the matter goes to internal review and, if needed, the Personal Injury Commission — funded by IRO at no cost to you.

Making a workers compensation claim in NSW: the full process

Eligibility, the Certificate of Capacity, lodgement, provisional liability, your weekly payments — walked through end-to-end.

The NSW workers compensation scheme is one of the most accessible in the country, but it's also one of the most opaque if you've never used it before. This page walks through the entire claim process from the moment of injury to your first weekly payment landing in your account — what each step is, who's involved, and the realistic timeline.

Call (02) 7238 7379

Step 1

Eligibility — who can claim WorkCover in NSW

The threshold is much lower than most people assume. Worker status, work-link, and within-time are the three real tests.

NSW workers compensation covers almost everyone who works for an employer in the state. The Act defines a "worker" broadly: full-time employees, part-time, casual, fixed-term, apprentices, labour hire workers, and most contractors who work primarily for one principal. The carve-outs are narrow — some specific categories of independent contractor, federal employees (covered by Comcare instead), and military personnel.

The injury or illness must be work-related, but the test is generous. The Act covers injuries that arose "out of or in the course of employment" — which includes the obvious (you slipped on a wet floor at work) and the less obvious (you developed carpal tunnel from years of typing, you experienced psychological injury from workplace bullying, you suffered a stroke while at work). It also covers journey claims (to and from work) in some circumstances, and recess injuries (on authorised breaks).

Aggravation, acceleration or exacerbation of a pre-existing condition is covered — including conditions you didn't know you had. Mental health is explicitly covered and is now one of the fastest-growing claim categories. There is no minimum injury severity threshold for eligibility, though the Act distinguishes between minor injuries (treatment only) and serious injuries (treatment plus weekly payments plus eventual lump sums).

The time limit for lodging a standard claim is six months from the date of injury. For gradual-onset injuries, the clock starts when you first became aware of the work-relatedness — which can be years after exposure for things like industrial hearing loss or asbestos-related disease. Extensions are commonly granted where there's a good reason for delay.

Step 2

The Certificate of Capacity — the anchor of your claim

The COC is the single most important document in any NSW workers comp claim. Without it, nothing else moves. With it written correctly, everything else flows.

The Certificate of Capacity is a SIRA-templated document that a treating doctor produces. It records four things: your diagnosis, the medical opinion on whether work caused or contributed to it, what duties you can and can't do, and the review period (usually 28 days, with the requirement that you see your doctor again before it expires to renew). The certificate is sent electronically by the doctor to the WorkCover insurer.

A first Certificate of Capacity is typically issued at your first medical appointment. Our doctors are set up specifically to take new workers in for same-week appointments — the COC is usually written on the day, in the consulting room with you, and lodged with the insurer the same afternoon. You do not need a GP referral to see one of our doctors; we work directly with new workers as the first medical contact.

The wording of the COC matters enormously. A certificate that says "unfit for all work" when realistically you could do modified light duties means you receive full weekly payments but lose the opportunity to maintain workplace contact during recovery. A certificate that says "fit for full duties" when you can't actually lift means you return to work too early and risk re-aggravation. Our doctors talk you through the duty restrictions in plain language and write the certificate that reflects the real clinical picture.

Renewing the certificate inside the 28-day window is critical. Lapsed certification halts weekly payments until the next valid certificate is filed. Our reception team books the renewal appointment before you leave the first visit, and sends a text reminder two days before each appointment to make sure nothing slips.

Step 3

Lodging the claim — how it actually happens

There's no single 'submit' button. Lodgement is the combination of three things arriving with the insurer in a short window.

"Lodging the claim" in NSW means three documents reach the WorkCover insurer: the Certificate of Capacity (from your doctor), the worker's claim form (a one-page SIRA form that you sign), and the employer's notice of injury (a parallel workplace incident report). The insurer is then required to act under statutory timeframes.

Identifying which insurer applies to your claim is the first practical step. NSW workers compensation is administered by a handful of approved insurers — icare runs the largest book (most employers in NSW are covered by Nominal Insurer policies issued via icare), and specialised licensed insurers like Allianz, EML, GIO, QBE, Hotelcare, Hostplus and others cover specific industries or self-insured employers. Your employer knows their insurer; if they don't, the icare website has a lookup tool. Our reception team checks this on the phone before your appointment so we can address the certificate correctly.

Once all three documents have reached the insurer, the statutory clock starts. Provisional liability rules require the insurer to commence weekly payments within 7 days. The insurer has 21 days from receipt of the claim form to make a final decision on liability. During those 21 days, weekly payments and reasonable medical treatment continue regardless — you're not waiting for the insurer's blessing to start recovery.

Step 4

Provisional liability — what it covers and why it matters

A quietly important feature of the NSW scheme that most workers don't know exists. It's the bridge that keeps you covered during the insurer's decision window.

Provisional liability is a statutory mechanism in the NSW Workers Compensation Act that requires the insurer to start paying for your weekly payments and reasonable medical treatment within 7 days of receiving a claim — even before they've made a final decision on liability. The provisional cover lasts up to 12 weeks for medical treatment and runs during the 21-day decision window for weekly payments.

What this means in practice: you don't need to wait for the insurer to formally accept your claim before you start receiving payments or before treatment begins. Our doctors continue to see you, our physios continue to treat you, our psychologists continue to see you, and the weekly payments arrive — all on provisional cover, even on a contested claim. The only situations where provisional cover doesn't apply are where the insurer has reasonable grounds to dispute the claim from the outset (those situations are spelled out in the Act and are narrow).

For workers, provisional liability removes the most common anxiety: "What do I live on while they decide?" The answer is that you live on provisional weekly payments at 95% of PIAWE, and you receive treatment funded by the insurer, while the insurer makes its decision. If the claim is ultimately accepted, provisional cover transitions seamlessly into ordinary cover. If the claim is denied, provisional payments already made are not clawed back — and the denial is then challenged through the review process described on our denied-claim page.

Step 5

Your weekly payments — how the formula works

The headline numbers are 95% then 80% of PIAWE, but the underlying calculation has a few moving parts. Here's the realistic picture.

Weekly payments under the NSW scheme are calculated from your Pre-Injury Average Weekly Earnings (PIAWE). PIAWE is the average of your gross earnings — base salary, regular overtime, allowances, bonuses where regular — over the 52 weeks immediately before the injury. For shorter-tenure workers, a 12-week or actual-period average is used instead. The calculation is governed by the SIRA PIAWE Guidelines and is reviewed in detail by the insurer at the start of the claim.

For weeks 1 to 13 of the claim, you receive 95% of PIAWE if you have no work capacity, or a partial-payment calculation if you've returned to modified duties. From week 14 onwards, the rate steps down to 80% of PIAWE if you have no work capacity, or a partial calculation that tops up your reduced earnings to roughly 80% if you've returned to some work.

Both 95% and 80% are subject to a statutory maximum payment amount (capped at a multiple of the average NSW wage, indexed annually) and a minimum payment amount. Workers earning well above the cap will hit the maximum and receive less than 95% in real terms; workers earning below the minimum will receive the minimum. The cap and floor change every April.

At week 130, the insurer conducts a statutory work-capacity review. Most workers are moved off weekly payments at this point unless they meet the higher whole-person impairment threshold (21% WPI or above). The 130-week review is one of the most disputed decision points in the scheme — covered in depth in our 130-week milestone guide.

For an interactive estimate of your weekly payment at each stage, see our workers compensation payment calculator.

Quick Answers

Workers compensation claim FAQs

The questions that come up most often at the start of a NSW claim.

Keep reading

The first step is the doctor visit

Same-week appointments, no GP referral needed, Certificate of Capacity written on the day. One phone call to start the whole process.

Book a Doctor

Or call (02) 7238 7379

Making a workers compensation claim in NSW: the full process

Eligibility — who can claim WorkCover in NSW

The Certificate of Capacity — the anchor of your claim

Lodging the claim — how it actually happens

Provisional liability — what it covers and why it matters

Your weekly payments — how the formula works

Workers compensation claim FAQs

More on workers compensation

Workers compensation doctor

Workers compensation lawyer

Claim denied — what to do

Workers comp pay (PIAWE) explained

Workers Compensation NSW — full guide

The first step is the doctor visit