Have you been injured at work?  If you have incurred medical expenses or require time off work, you need to complete a worker’s injury claim form and provide it to your employer.

Printed forms are available at the post office or one of our offices.  You can also download a copy via this link.

If you require time off work, it is essential to see a doctor and request a medical certificate known as a WorkCover certificate of capacity.  For this certificate to be valid you must sign the consent section and the worker’s declaration on the back.

Sample of a completed form

For important tips about how to complete your worker’s injury claim form, click here to view a sample form.

Where to send your form

As soon as possible following your injury, you must provide your employer with your:

  • worker’s injury claim form
  • WorkCover certificate of capacity
  • bills or receipts of treatment.

You can hand deliver these documents to your employer or post them.  Your employer must forward the documents to the WorkSafe Agent within 10 calendar days of receiving them.

If you experience any difficulty giving your claim to your employer, or your employer refuses to accept the documents, you can send the paperwork directly to WorkSafe.

Getting a response

You can expect to receive a written response from the WorkSafe Agent within 28 days from the date they received the claim.

Uninsured employers

If you have been injured at work and your employer does not have WorkCover insurance, you are still eligible for workers’ compensation.  You should submit your paperwork directly to WorkSafe who will allocate an Agent to process your claim.

Further assistance

If you need assistance in completing your claim form or further information about your entitlements, please contact our legal team on (03) 9321 9988.  Even if you don’t think your injury is serious, we recommend discussing your injury/illness with a lawyer while the details are fresh in your mind. 


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Our No Win, No Fee arrangement means you will only pay legal fees if your claim is successful. *Conditions apply

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