The WorkCover claim process in Victoria

Workcover claim process 

WorkCover claim process

WorkCover Claim Process in Victoria

This chart explains the general process for lodging a WorkCover claim in Victoria, from understanding what WorkCover is, through to lodging the claim and what happens if the claim is accepted or rejected.

Important: This flowchart provides general information only. It is not legal advice and does not determine whether a WorkCover claim will be accepted. Every claim depends on its own facts, medical evidence and the insurer's assessment.
Start

What is WorkCover?

WorkCover is the Victorian workers compensation scheme. It is designed to cover the cost of benefits if employees are injured or become ill because of their work.

  • Victorian employers are required to have WorkCover insurance.
  • Full-time, part-time and casual workers can all be covered.
  • The Victorian scheme is run by WorkSafe Victoria.
WorkCover can potentially pay medical and like expenses, weekly payments, impairment benefits and, in some cases, common law damages.
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Step 1

Check the basic claiming criteria

Before lodging a claim, it is useful to consider whether the basic WorkCover criteria may be satisfied.

Connection to Victoria Your employment must be connected to Victoria in some way. This may be because you normally work in Victoria, are based in Victoria for work, or your employer's main place of business is in Victoria.
There must be an injury An injury can include a physical injury, mental injury, industrial deafness, disease, workplace stress, bullying-related condition, or an aggravation or deterioration of a pre-existing injury or disease.
You must be a worker A worker is generally someone who performs work for an employer, or agrees to perform work, at the employer's direction, instruction or request.
It does not necessarily matter if the injury occurs outside Victoria, or even outside Australia, provided the employment has the required connection to Victoria.
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Step 2

See your doctor

You should see your doctor as soon as possible after the injury or illness. This is important both for treatment and for documenting what happened.

  • Tell your doctor how the injury happened.
  • Describe your symptoms clearly.
  • Ask for treatment and any necessary referrals.
  • If you need time off work or reduced duties, ask about a certificate of capacity.
Your doctor may need to provide a medical report regarding your injury at some point during your WorkCover matter
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Step 3

Notify your employer of the injury

You should notify your employer as soon as possible regarding the injury. Ideally, this should be done in writing or recorded in the workplace injury register.

  • Use the workplace injury register if one is available.
  • You can also report the injury by email or text message.
  • Keep a copy of anything you send or complete.
  • Record the date you reported the injury.
There is a 30 day notice period for reporting an injury after becoming aware of it. However, late reporting does not automatically mean a claim cannot be accepted.
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Step 4

Complete the WorkCover claim form

The WorkCover claim form is the document used to start the claim process. What you write on the form matters, both for the initial decision and potentially later if you pursue a lump sum claim.

Read Part 2 carefully Take care when answering questions about how, when and where the injury occurred.
Explain how the injury relates to your work Be clear in your descriptions.
Disclose previous similar injuries If you have had a similar injury or condition before, whether work-related or not, it is usually better to list it.
Don't over explain You will have the opportunity to provide more information regarding your injury later on once the claim has been lodged.
Sign the form The form must be signed before it is lodged.
Leave employer lodgement details blank The employer section of the form should be completed by the employer, not the worker.
You can usually obtain the claim form from WorkSafe, some post offices, some GPs, or online.
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Step 5

Lodge the claim form

Once completed, the claim form can be given to your employer or lodged directly with WorkSafe Victoria. You should keep a copy before handing it over.

  • Take a photocopy or photo of the completed form.
  • Record the date you gave the claim form to your employer.
  • Ask for a copy once the employer has completed and signed their section.
  • If claiming weekly payments, include the date you ceased work because of the injury.
  • If claiming weekly payments, provide a certificate of capacity.
Weekly payments are not payable unless you have provided a valid certificate of capacity.
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Step 6

Employer forwards the claim

Once your employer receives the WorkCover claim form, they must forward the claim documentation to the WorkCover insurer or WorkSafe together with the medical certificate.

  • The employer must pass the claim on to the insurer.
  • The employer does not decide whether the claim is accepted or rejected.
  • The insurer is responsible for determining the claim.
  • The employer may provide their view to the insurer, but they cannot determine the claim themselves.
If you have not heard from an insurer within about four weeks of lodging your claim, you may wish to follow up with your employer or contact WorkSafe Advisory.
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Step 7

The insurer assesses the claim

The claim is assessed by a WorkSafe authorised insurer or self-insurer. This may include EML, xChanging, Gallagher Bassett, Allianz, or a self-insuring employer.

Claim form and medical material The insurer will review the claim form, medical certificate and any available medical information.
Independent medical examination The insurer may require you to attend an independent medical examination. The insurer pays for the examination.
Circumstance investigation In some claims, particularly psychological injury claims or claims with factual disputes, an investigator may speak to witnesses and prepare a report.
Refusing to attend an independent medical examination may result in the claim being rejected.
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Decision point

Insurer decision

The insurer must give written notice either accepting or rejecting the claim within the relevant decision period. In some situations, if a decision is not made in time, the claim may be deemed accepted and weekly payments may need to be made.

Common reasons for rejection include the insurer saying the injury was not caused at work, a pre-existing injury is involved, or there is a dispute about what happened.
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Accepted ✅

What happens if the claim is accepted?

If the claim is accepted, you should receive written confirmation from the insurer.

  • Medical and like expenses may be paid.
  • Weekly payments may be paid if claimed and supported by certificates of capacity.
  • Entitlements may be back paid to the date of injury.
  • You may later be able to pursue an impairment benefit.
  • You may potentially be able to pursue a common law claim if negligence caused the injury or condition.
If the claim is accepted at conciliation later, entitlements may still be back paid as if the claim had been accepted initially.
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Rejected ❌

What happens if the claim is rejected?

If the claim is rejected, that does not necessarily mean the matter is over.

  • You can ask the insurer to review the decision.
  • You can proceed to conciliation.
  • You should consider legal advice before deciding what to do.
  • If the matter does not resolve at conciliation, it may proceed to the Medical Panel or Magistrates’ Court.
  • If factual issues are involved, the Magistrates’ Court may be the required pathway.
If you cannot work while the claim is rejected, possible income options may include leave entitlements, income protection if available, or Centrelink.
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Final note

How long do you have to lodge a WorkCover claim?

There is no fixed deadline for lodging a WorkCover claim in Victoria for no-fault entitlements such as medical expenses, weekly payments and impairment benefits. However, the earlier you lodge, the better.

  • Earlier claims are often easier to support with evidence.
  • Written records such as emails, text messages or diary notes can help.
  • Medical notes from doctors or other health practitioners can be very important.
  • There is a 30 day notice period for notifying the employer of the injury.
  • Late claims can still be accepted, but evidence becomes more important.
A six year deadline may apply to common law damages claims, which is separate from the no-fault WorkCover claim process.

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.

To contact Michael or Peter please visit the contact page.

This article was last reviewed and updated on August 18, 2026. This article was first published on May 4, 2021.

  • Michael

    This article was written by Michael who is a Victorian lawyer who practices in WorkCover and personal injury matters. He has 20 years of experience in personal injury matters. This article was written in collaboration with his colleague Peter. The Work Injury Site is where they publish WorkCover and work injury related information. Both Michael and Peter have a law firm that assists people across Victoria with their WorkCover and personal injury matters. You can read more about Michael here.

  • Peter

    This article was written by Peter who is a Victorian lawyer who practices in WorkCover and personal injury matters. This article was written in conjunction with his colleague Michael. The Work Injury Site is where they publish WorkCover and work injury related information. Both Peter and Michael have a law firm that assists people across Victoria with their WorkCover and personal injury matters. You can read more about Peter here.

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