A worker strains their back lifting a load. The injury is accepted, the physiotherapy starts, and for a while the file looks straightforward. Nine months on the back is still not right, the return to work has stalled, and something else has arrived: broken sleep, a flat mood, a dread of the workplace. Queensland law does not treat that as part of the back injury. It treats it as an injury of its own.
Under the Workers’ Compensation and Rehabilitation Act 2003 (Qld), a psychological condition that develops out of an accepted physical work injury, often called a secondary psychological injury, has to be identified as an injury in its own right. Whether that happens through an application for compensation, with its own time limit and its own impairment assessment, or through a decision by the insurer on a damages claim, it does not travel automatically with the physical injury. In April 2026 the Court of Appeal upheld the striking out of a worker’s psychiatric claim from her damages proceeding because it had never been put on the file as an injury, although her physical injury had been through the whole statutory process.
What a secondary psychological injury is
The label describes a sequence, not a diagnosis. A primary psychological injury arises from the work itself: a traumatic incident, sustained bullying, an unmanageable workload. A secondary one arises from the consequences of a physical injury, the pain that will not settle, the loss of the job, the financial strain, the fear of reinjury. The conditions are ordinary ones, most often a depressive disorder, an anxiety or panic disorder, an adjustment disorder, or a condition bound up with chronic pain. Where it arose from the work rather than from the injury, the exclusions bite harder, and we cover that in our article on psychological injury WorkCover claims in Queensland.
Parliament wrote the pattern into the Act. Section 208, rewritten in 2024, states that an object of the injury management chapter is to ensure that workers with physical injuries who are at risk of a psychiatric or psychological injury arising from the physical injury receive services to minimise that risk.
The causal test the Act applies
Section 32 defines injury as personal injury arising out of, or in the course of, employment where the employment is a significant contributing factor to the injury. Psychological and physical injuries are no longer held to different thresholds, which is a change from the position many people still believe applies. Until 2019 the section imposed a higher standard on psychological conditions alone: for a psychiatric or psychological disorder, employment had to be the major significant contributing factor. The current reprint of s 32 contains no such limb, and the parallel higher test for aggravations of psychological conditions went with it.
A psychological history does not shut the claim out either. Section 32 also treats an aggravation as an injury where employment is a significant contributing factor to it, confined to the extent of the effects of the aggravation, as our article on pre-existing conditions and WorkCover aggravation claims explains.
One event, two injuries
Section 31 provides that a worker may sustain one or multiple injuries from a single event, whether they appear immediately or over a period. The back strain and the depression that follows it share an event but remain two injuries, and the Act handles them differently at almost every step.
| Step | Physical injury | Psychological injury |
|---|---|---|
| Statutory exclusions (s 32) | None directed at physical injury | Reasonable management action, the worker’s perception of it, and insurer action on the claim |
| Who assesses impairment (s 179) | A doctor | A medical assessment tribunal |
| Multiple injuries, one event (s 179) | Assessed together as one figure | Assessed separately, on its own |
Why it has to be on the file in its own name
In Sawtell v State of Queensland [2026] QCA 62 a depositions clerk injured her lower back at work in May 2021. A notice of assessment issued in April 2022 assessing her permanent impairment at zero, she gave a notice of claim describing a lumbar soft tissue injury, and in April 2025 she amended her pleading to allege a psychiatric injury suffered as a consequence of the back injury. Doyle JA held that the Act nowhere divides injuries into immediate and consequential categories: an impact either is or is not an injury, and how directly it flowed from the event does not answer that question. Each of the back injury and the psychiatric injury was an injury in its own right. As his Honour put it at [38], as a matter of the normal use of language a mental illness, however caused, cannot readily be described as a lower back injury or by any similar expression.
The consequence lay in the damages provisions. Section 237 permits a worker to seek damages for an injury where a notice of assessment has issued for it, or, where none has, if a notice of assessment issued for another injury from the same event and the worker either reached 20 per cent impairment on that injury or elected to seek damages. The worker in Sawtell satisfied that second route. But s 239A provides that a claimant in that position may seek damages for the injury only if the insurer decides the claimant has sustained an injury, and the Court held that this means the unassessed injury. WorkCover had never been asked to decide whether she had a psychiatric injury, so the gate had not been opened. That section also bars an impairment assessment for the unassessed injury, so what a worker gets is the insurer’s decision, with reasons and a right of review, rather than a lump sum offer.
None of this turns a symptom into a fresh claim. The Court accepted that an injury can be described at different levels of generality, and that a general description will usually capture the expected ancillary effects of the injury described. What it will not stretch to is an impact remote from that description, and a mental illness is such an impact. The Court of Appeal made a similar point about two psychological conditions in Apelu v Lusty Tip Trailers Pty Ltd [2024] QCA 158 at [46], with much depending on the evidence about the particular conditions.
The exclusions that most often defeat these claims
Section 32 puts three categories of psychological disorder outside the definition of injury: disorders arising out of, or in the course of, reasonable management action taken in a reasonable way by the employer; the worker’s expectation or perception of reasonable management action being taken against them; and action by the Regulator or an insurer in connection with the worker’s application for compensation.
The third bites hardest in secondary claims, because much of the distress a worker reports accumulates after the claim is lodged. Rejected treatment requests, surveillance, repeated examinations and a suspension of weekly payments are all capable of being action by an insurer in connection with the application, and a disorder arising out of that sits outside the definition. Whether an exclusion applies turns on the circumstances the disorder in fact arose out of, which is a question for the evidence, not on whether anyone behaved badly. The first two categories matter once a worker is back on suitable duties, where a reaction to a performance conversation or a redeployment can fall on the excluded side even though the physical injury is accepted.
Timing: the injury runs on its own clock
Section 131 requires an application for compensation for an injury to be lodged within 6 months after the entitlement to compensation for that injury arises. The words are “for the injury”, not “for the event”. Section 141 fixes when the entitlement arises: on the day the worker’s injury is assessed by a doctor. For a secondary condition that day usually falls well after the incident, so the six-month window opens when a doctor assesses the psychological condition, not when the back was hurt. Section 132 sets the mechanics, the approved form supported by a certificate from a doctor who attended the worker.
Delay costs twice. Where an application is lodged more than 20 business days after the entitlement arises, s 131 limits the insurer’s liability to a period starting no earlier than 20 business days before lodgement, so benefits can be lost even on a claim that is accepted. The six-month limit is not absolute: the insurer must waive it where satisfied that special circumstances of a medical nature decided by a medical assessment tribunal exist, and may waive it for mistake, absence from the State or a reasonable cause. If an application is rejected, the review and appeal pathway has its own strict window.
How permanent impairment is worked out
Section 179 does something distinctive with psychological injuries. Impairment for a psychiatric or psychological injury is assessed by a medical assessment tribunal, where another injury is assessed by a doctor, and the assessment must be made as required by the scheme directions the Regulator makes under s 329A, which in 2024 replaced the Act’s former reference to the guidelines for evaluation of permanent impairment.
The rule that surprises people most sits in the same section. Where a worker sustains permanent impairment from multiple injuries in one event, the injuries other than the psychiatric or psychological injury are assessed together to produce one figure, and the psychological injury is assessed separately to produce another. The two do not combine. A worker with a back impairment and a psychological impairment holds two percentages, and each is measured against the 20 per cent threshold on its own.
Section 185 requires the notice of assessment to issue within 10 business days of the insurer receiving the assessment, and where there are multiple injuries in an event, only once impairment for all of them has been decided. Where the notice states impairment below 20 per cent and offers lump sum compensation, s 189 requires the insurer to advise the worker that an irrevocable election must be made between accepting that offer and seeking damages, and s 239 confirms the worker cannot have both and cannot change the election once given. We set that decision out in our article on the 20 per cent impairment election.
Published 11 September 2026.
Where this leaves an injured worker
The pattern in these files is consistent. The physical injury is managed properly, the psychological consequences are discussed with treating doctors and mentioned in reports, and everyone assumes they are travelling with the accepted claim. They are not. The evidence needed is usually the evidence a treating psychologist or psychiatrist is already generating. What the Act turns on is whether the condition was identified as an injury in its own right, and when.
Related reading
- Psychological injury WorkCover claims in Queensland
- Independent medical examinations in Queensland: what to expect and your rights
- How Fraser Lawyers helps with WorkCover claims
- Contact Fraser Lawyers
Need advice? Time limits and elections in a workers’ compensation claim are strict and easy to miss, and a psychological injury runs on its own timetable. If this is your situation, contact Fraser Lawyers to understand your rights and where you stand, with no obligation. |
This article is general information only and is not legal advice. Queensland law and the figures referred to can change, and every situation turns on its own facts. Contact Fraser Lawyers for advice specific to your circumstances.
If you would like to discuss your matter, you can book a consultation or call (07) 5554 6116.
