Can an employer dispute a WorkCover claim?

Yes, an employer can dispute a WorkCover claim. It’s only fair that they get to have their say.

No matter what an employer thinks about a WorkCover claim however, they must complete the employer section on the claim form, and send it off to their WorkCover insurer within the prescribed time limits. If claim forms are not sent off by employers to the insurance company, penalties can apply.

How can an employer dispute a WorkCover claim?

To lodge a WorkCover claim, a person needs to complete a WorkCover claim form and provide a copy to your employer.

Your employer is then required to complete their sections of the form, and then send it off to their insurance company for processing.

Even if an employer wishes to dispute liability, the claim still must be sent off.

The sections of the form an employer needs to complete are these (below):

The employer injury claim report looks like this:

WorkCover claim form employer section 1

The employer can also complete the Employer Injury Claim Report document.

On this form, there is a section for your employer to specify if they wish to dispute the claim, and to provide the reasons why (see below):

Employers workcover claim form dispute a claim

During the processing of a WorkCover claim (when the insurer is determining whether to accept or reject a claim) the insurer may commission what’s called a circumstance investigation report.

This involves a person speaking to your employer (or a representative) and other relevant people (eg: colleagues) and taking statements from them. At this point, your employer is able to make a statement setting down their view of the matter.

If the claim is rejected, the first step in appealing the matter is to proceed to conciliation. Your employer is able to attend the conciliation and have their say again.

If the matter does not resolve at conciliation, and you elect to proceed to the Magistrates’ court, there is the possibility that if your matter proceeds to hearing before the court, your employer (or a representative from your employer) may be one of the people who gives evidence.

Conclusion

Yes, an employer can dispute a WorkCover claim. They must do so by providing their instructions and any supporting material they may have, to the WorkCover insurance company.

It’s only fair that your employer gets to have their say when it comes to your WorkCover claim. And sometimes, this might mean disputing the claim.

However, an employer is required to sign their section of the WorkCover form and send it off to their WorkCover insurance company within the prescribed time limits. An employer cannot dispute a WorkCover claim directly with an employee and choose not to send off a claim.

If a WorkCover claim is rejected, then there are a number of further opportunities where an employer is able to have their say should they wish to dispute a claim.

Please keep in mind that the information contained on this page should not be considered legal advice and no content on this site should replace the need to obtain advice tailored to the specific facts of your case. The facts of a case can significantly alter the advice that can provided. This site only provides general advice. Read more here.

Sidebar graphic of WorkCover benefits guide

To contact Michael or Peter call 1800 746 442 or email [email protected]

Written by the Work Injury Site team