Workers' Compensation

When a claim should be made

An employee can make a claim if they sustain any injury or illness that occurs out of or in the course of their work. Employment must be a significant contributing factor to the development of the claimed injury or condition.

If you have not incurred any medical costs or lost time from work associated with the injury, you may not need to make a claim for compensation. However, you should always report the incident related to the injury to your supervisor and enter the incident into the Enterprise Risk Management System (ERMS). This allows for corrective actions to take place to reduce the risk of the incident reoccurring in the future.

If you are not sure whether your injury is compensable, please reach out to the injury management team to discuss your situation before submitting a claim. The team can be contacted via email or call us on 03 903 54000 (Option 2 - Report or follow up on an injury).

Claim Obligations

There are some legislated obligations and requirements that you need to be aware of during the claim process. Multiple parties who have responsibilities under the Act, and we have tried to simplify these in the below table.

Employee
  • Participating and cooperating with the injury management process, making every effort to return to work
  • Advising your supervisor and case manager of any changes in your circumstances as soon as possible
  • Providing Certificates of Capacity until you can return to full, pre-injury hours and duties
  • Providing accurate information about your injury/condition
  • Adhering to medical restrictions at all times (both during and outside of work)
  • Attending recommended treatments and actively participating in a rehabilitation program

Note: Where an employee does not comply with these obligations, it may impact the ongoing status of a claim (eg entitlements may be suspended or terminated)

Employer / Supervisor
  • Maintaining contact and confidentiality with the injured employee
  • Consulting with key people to ensure effective claim and injury management
  • Facilitating processes to enable employees to remain at work or assist with a return to work following injury or illness
  • Assisting with the development of return to work plans and identifying suitable duties, and implementing and monitoring these in the workplace
  • Raising any issues or concerns with the return to work process immediately to the case manager
  • Maintain accurate documentation as needed
Injury Management Team
  • Act in accordance with the relevant legislation
  • Determine liability for all claims for compensation
  • Inform employees about the workers’ compensation claim process, including their compensation entitlements
  • Manage the payments of weekly benefits and any reasonable medical expenses
  • Identifying the needs of the injured employee and facilitating team-work between the employee, employer and treating practitioners
  • Reviewing and monitoring the progress of the rehabilitation program and return to work plan

How to submit a claim

When submitting a claim, you will need to provide the following documents:

  1. Worker’s Injury Claim Form
  2. A copy of the incident report/summary
  3. Certificate(s) of capacity (if applicable)
  4. Medical Invoices/receipts (if applicable)
  5. Any other information relevant to the claim

For the claim to be valid and then assessed in a timely manner, it’s important that all documentation is completed accurately.

Once you have collated all the required documentation, submit your claim directly to the Injury Management team (injury-management@unimelb.edu.au).

What happens after a claim is submitted

Once the Injury Management team receives your claim, you and your department will receive a letter acknowledging receipt of your claim. You may be contacted by phone any clarification is required.

The Injury Management team has 28 calendar days to review and assess your claim for compensation within the meaning and requirements of relevant legislation. You will be advised in the acknowledgement letter of the due date for the decision of your claim.

While the claim is being assessed:

  • further documentation may be requested to support your claim;
  • you may be required to attend an independent medical examination;
  • you may need to participate in an independent investigation to determine the circumstances surrounding your claim.

You will receive a letter advising you of the decision regarding your claim acceptance or rejection either before or on the 28th day specified in your acknowledgement letter.

If your claim is rejected, you will receive a letter advising you why this decision was made and you will be advised on your rights to appeal this decision.

If your claim is accepted, you will be advised of the accepted condition and of your specific entitlements to compensation. You will be allocated a case manager to support you through the claim process and advise you of your obligations under the legislation.

Claim enquiries and support

The Workcover Claim Guide aims to provide information that will enable you to understand your legal obligations and the legal obligations of The University of Melbourne. It also provides information regarding how The University of Melbourne manages its WorkCover claims as a self-insurer.

If you have a question about how to manage or support an injury or need advice on workers’ compensation claims, please contact the Injury Management team.