WorkCover claims

WorkCover claims in Queensland, explained clearly.

How the Queensland workers’ compensation scheme works: the two kinds of claim, what each one pays, the time limits, and what to do if a claim is rejected.

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Reviewed by Blake Fraser, Principal Lawyer, Fraser Lawyers Last updated 12 June 2026

Queensland runs a no-fault workers’ compensation scheme. If you are hurt at work, you can be paid without having to prove anyone was to blame. That single feature shapes almost everything else.

The scheme is administered by WorkCover Queensland under the Workers’ Compensation and Rehabilitation Act 2003 (Qld). Almost every Queensland employer that employs workers must hold a current WorkCover accident insurance policy, unless it is licenced to self-insure. When a worker is injured, the claim is made against that insurance, not against the employer’s own pocket.

There are two distinct kinds of claim, and the difference between them runs through this whole page. The first is the statutory claim: no-fault benefits paid while you recover, including weekly payments, medical and rehabilitation costs, and a lump sum for permanent impairment. The second is the common law claim: damages for negligence, which requires proving that the employer’s fault caused the injury. They are not alternatives in the way people often assume, and getting the relationship between them right is where the real decisions sit.

This page explains how the law works and what the process looks like, and it sits alongside the firm’s general account of the personal injury claims process in Queensland. It is general information about Queensland law, not advice about a particular claim.

Scope of work

What we help with

Fraser Lawyers advises on Queensland workers’ compensation matters. This guide covers:

Matter: What it usually involves
Who is covered: Workers and many contractors, and what counts as a work injury
How to lodge a claim: The work capacity certificate, lodgement channels, and the six-month period
Statutory claims: No-fault weekly payments, medical and rehabilitation costs, and lump sums
Common law claims: Damages for negligence, and how they differ from statutory benefits
Permanent impairment: How a degree of permanent impairment is assessed and what it is worth
The Notice of Assessment: The document that opens the door to a common law claim
The lump-sum election: When you must choose between a lump sum and damages, and when you need not
Time limits: The lodgement period and the three-year limitation for common law
Psychological injury: When mental health conditions are covered, and the management-action exclusion
Rejected claims: Review by the Regulator and appeal to the Industrial Relations Commission

Most of these come back to one question that the scheme answers in two stages: first, are you covered and what will the no-fault benefits pay; and second, did someone’s negligence cause the injury, and if so, is a common law claim open to you.

Few people know at the outset which track applies to them, or whether both do. That is not something the outcome of an injury answers on its own. It depends on the medical assessment, the cause of the injury, and the law that sits over both.

Process

What you need to know.

Coverage under the scheme turns on two things: that you are a worker, and that you have suffered an injury connected with your employment.

The scheme covers workers, a category that is broader than just employees. It extends to many contractors and labour-hire workers who, in substance, work under a contract of service rather than running their own independent business. Whether a particular contractor is a worker is a question of substance, not job title, and it is one of the points worth checking early.

An injury for these purposes is a personal injury arising out of, or in the course of, employment, where the employment is a significant contributing factor to the injury. That covers sudden physical injuries, such as a fall or a lifting injury, and conditions that develop over time, such as an industrial disease or an aggravation of an existing condition.

Psychological injury is covered, but with an important limit. A psychiatric or psychological disorder is not an injury under the Act where it arises out of reasonable management action taken in a reasonable way by the employer in connection with the worker’s employment, or out of the worker’s expectation or perception of such action. Both limbs matter: the action must be reasonable, and it must be taken in a reasonable way. This is dealt with in more detail below.

Because the scheme is no-fault, you do not have to prove the injury was anyone’s fault to receive statutory benefits. A worker who contributed to their own injury can still be covered. Fault becomes relevant only at the second stage, if a common law claim for damages is on the table. The firm’s broader workers’ compensation service sits alongside its other personal injury work.

Where a work-related motor vehicle accident is involved, a CTP claim under the Motor Accident Insurance Act 1994 (Qld) may arise alongside the workers’ compensation claim, and the two processes run differently: our guide to CTP claims in Queensland explains that pathway.

Lodging a claim

How to lodge a WorkCover claim.

Lodging a statutory claim is a defined process, and the order of it matters.

See a doctor and get a work capacity certificate. A treating doctor, nurse practitioner or dentist assesses the injury and issues a work capacity certificate (sometimes called a workers’ compensation medical certificate). This records the injury, its connection to work, and your capacity for work. It is the medical foundation of the claim, and the entitlement to compensation generally arises when the injury is assessed, not on the day of the injury itself.
Tell your employer. Report the injury to your employer as soon as you can. The employer has its own obligations to record the injury and assist with the claim.
Lodge the application with the insurer. The claim is lodged with WorkCover Queensland, or with your employer’s self-insurer if it has one. You can apply online, by phone, or on a paper form, and the work capacity certificate is lodged with the application.
The insurer decides. The insurer investigates and decides whether to accept the claim. If it is accepted, statutory benefits begin. If it is rejected, there is a review and appeal pathway, set out further down this page.

There is a time limit on lodging. An application for compensation is valid only if it is made within six months after the entitlement to compensation arises, which is broadly when the injury is assessed by a doctor, nurse practitioner or dentist. The limit can be waived in defined circumstances, including where the delay was due to mistake, the worker’s absence from Queensland, or other reasonable cause, and a waiver is required where a medical assessment tribunal decides there are special circumstances of a medical nature. Lodging well after the entitlement arises can also limit how far back weekly compensation is paid, so the practical lesson is to lodge promptly rather than to rely on a waiver.

If you are not sure whether an injury is covered, or whether you are a worker for the purposes of the scheme, that is exactly the kind of question worth resolving before the six months runs rather than after. The steps to take after a workplace accident are set out separately.

The key distinction

Statutory claims compared with common law claims.

This is the distinction that does the most work in Queensland workers’ compensation, and the one most often misunderstood. They are two different things, decided on different bases, paying different things.

A statutory claim is the no-fault claim. You do not have to prove negligence. If you are a worker with a work injury, the scheme pays defined benefits while you recover: weekly payments to replace income, medical and rehabilitation costs, and, where the injury leaves a permanent impairment, a lump sum geared to the degree of that impairment. The benefits are set by the Act, not negotiated.

A common law claim is a claim for damages for negligence. It is not no-fault. To succeed, you have to prove that the employer (or another party) owed you a duty of care, breached it, and that the breach caused your injury. Damages at common law are assessed on the individual circumstances of the case rather than from a statutory table, and can include matters that statutory benefits do not address, such as damages for the full extent of past and future economic loss, and for pain and suffering. Damages are not a fixed figure and depend entirely on the evidence.

The bridge between the two is the Notice of Assessment. Before a common law claim can proceed, the worker’s injury is assessed for a degree of permanent impairment (DPI), and the insurer issues a Notice of Assessment recording that DPI and any lump-sum offer. The Notice of Assessment is the document that opens the common law door. The worker must also give a Notice of Claim for Damages, which starts the pre-court process for the damages claim.

The election. What happens next depends on the DPI:

Where the assessed DPI is less than 20 per cent, the worker must choose: either accept the lump-sum offer of statutory compensation in the Notice of Assessment, or reject it and seek common law damages. It is one or the other. You cannot accept that lump sum and also sue for damages. The worker can defer the lump-sum offer rather than decide straight away, and the offer is deferred automatically if there is no response within 20 business days.
Where the assessed DPI is 20 per cent or more, no such election is required. The worker may both accept the lump sum and pursue a common law claim for damages.

The choice bites on the lump-sum offer for permanent impairment, for the under-20 per cent group. It does not mean a worker loses their weekly payments or medical benefits by keeping a common law claim alive; those statutory benefits are dealt with separately. Because choosing the lump sum closes off the common law claim for that group, it is a decision to take advice on before responding to the offer, not after.

If you disagree with the degree of permanent impairment that has been assessed, there is a pathway for that too. You can seek a reassessment by another doctor, or a review by a medical assessment tribunal, but you must notify within 20 business days of receiving the assessment notice. A medical assessment tribunal’s decision is final.

One more point of law applies to the common law claim alone. A common law action for damages for personal injury must be commenced within three years of the date the cause of action arose. That comes from section 11 of the Limitation of Actions Act 1974 (Qld), which sets the limitation period at “3 years from the date on which the cause of action arose”. The statutory claim and the common law claim run on different clocks: the six-month lodgement period is for the statutory claim, the three-year limitation is for the common law claim, and they should not be confused.

Statutory claim and common law claim compared
Feature	Statutory claim	Common law claim
Basis	No-fault. Negligence need not be proven.	Fault-based. The employer’s negligence must be proven.
What it pays	Weekly payments, medical and rehabilitation costs, and a lump sum for permanent impairment, all set by the Act.	Damages assessed on the individual case, which can include past and future economic loss and pain and suffering.
How the amount is set	Set by the Workers’ Compensation and Rehabilitation Regulation 2025 (Qld) by reference to the degree of permanent impairment.	Assessed on the evidence; not a fixed figure.
Precondition	A work injury and a valid application within time.	A Notice of Assessment, and a Notice of Claim for Damages.
Time limit	Apply within six months of the entitlement arising (waivable in defined circumstances).	Commence within three years of the cause of action arising (Limitation of Actions Act 1974 (Qld) s 11).
Can you have both?	DPI under 20 per cent: a binding choice between the lump sum and damages, not both. DPI 20 per cent or more: the worker may take both.

Statutory benefits

What WorkCover pays.

Statutory benefits fall into three groups: weekly payments, medical and rehabilitation costs, and a lump sum for permanent impairment.

Weekly payments replace part of your income while you cannot work, or cannot work fully. They step down over time:

Up to 26 weeks: the greater of 85 per cent of your normal weekly earnings or the amount under the applicable industrial instrument. Where no industrial instrument applies, it is the greater of 85 per cent of normal weekly earnings or 80 per cent of Queensland ordinary time earnings (QOTE), but not more than your normal weekly earnings.
From 26 to 104 weeks: the greater of 75 per cent of normal weekly earnings or 70 per cent of QOTE.
After 104 weeks: the entitlement depends on the worker’s degree of impairment.

The first week of compensation is paid directly by the employer, as the employer’s excess, and WorkCover pays after that. Weekly payments stop at the first of these to happen: a recovered return to work, the receipt of a lump-sum offer, five years of payments, or the statutory maximum total being reached. The structure is “the greater of” two figures rather than a flat percentage, and the QOTE figures are indexed annually, so the rate that applies to a particular worker is worth checking rather than assuming. The current rates are set out on WorkSafe Queensland’s weekly compensation page.

Medical and rehabilitation costs. The scheme pays for reasonable medical treatment, hospital costs, rehabilitation, and related expenses connected with the work injury, including the cost of getting you back to work where that is possible.

Lump sum for permanent impairment. Where the injury leaves a permanent impairment, the worker is assessed for a degree of permanent impairment (DPI), expressed as a percentage, and a lump sum is payable geared to that percentage. The ranges of impairment and the associated payment amounts are set out in the Workers’ Compensation and Rehabilitation Regulation 2025 (Qld), and the dollar value is indexed each year, so the figures below are stamped to the financial year they apply to.

Permanent impairment lump sum (as at the 2025-26 financial year)
Measure	Amount
Value per 1% of permanent impairment	Approximately $4,222.95
Maximum statutory lump sum	Approximately $422,295
Where the impairment is 30% or more	An additional lump sum is payable, on top of the base amount, graduated by the degree of impairment

These amounts are set under the Workers’ Compensation and Rehabilitation Regulation 2025 (Qld), are indexed annually, and are stated here as at the 2025-26 financial year. They are the statutory lump-sum amounts, not a prediction of what any individual claim is worth, and they are separate from any common law damages. The official amounts are published on WorkSafe Queensland’s lump sum payments page.

WorkCover benefits are also separate from any entitlement a worker may have under their superannuation or insurance, such as a total and permanent disability or income protection claim, which can run alongside a work injury and is assessed under the policy rather than the workers’ compensation scheme.

If a claim is rejected

Review and appeal.

An insurer does not have the last word. If WorkCover Queensland or a self-insurer rejects a claim, or makes another decision you disagree with, there is a defined pathway to challenge it, and it runs in two stages.

Stage one: review by the Workers’ Compensation Regulator. You can apply to the Workers’ Compensation Regulator for a review of the insurer’s decision. The application must be made within three months of receiving the written decision. The Regulator is independent of the insurer and reconsiders the decision on its merits.

Stage two: appeal to the Queensland Industrial Relations Commission. If you are still dissatisfied after the review decision, you can appeal to the Queensland Industrial Relations Commission (QIRC). That appeal must be lodged within 20 business days of the review decision. The two stages have different time limits and should not be run together in your mind: the three months is for the review application; the 20 business days is for the QIRC appeal.

Knowing that a right of review exists, and the dates that go with it, is half the value. A rejection is the start of a defined process, not the end of the matter, but the time limits are real and they are short.

Official sources.

Time limits

Deadlines and risks.

Time limits in the WorkCover scheme are unforgiving, and there is more than one of them running at once.

The statutory claim must be lodged within six months after the entitlement to compensation arises, which is broadly when a doctor, nurse practitioner or dentist assesses the injury. The limit can be waived in defined circumstances, including mistake, absence from Queensland, or other reasonable cause, but a waiver is not guaranteed and is best not relied upon. Lodging well after the entitlement arises can also cut back how much weekly compensation is paid for the earlier period.

The common law claim runs on a separate three-year clock. Under section 11 of the Limitation of Actions Act 1974 (Qld), a personal injury action must be commenced within three years of the date the cause of action arose. A common law claim also cannot proceed until the injury has been assessed and a Notice of Assessment issued, and that assessment takes time, which is why the three years can be tighter in practice than it looks.

If a claim is rejected, the review application to the Regulator must be made within three months, and any further appeal to the Queensland Industrial Relations Commission within 20 business days of the review decision. The common thread is that each step has its own deadline, and missing one can foreclose options that were otherwise open.

What we do

How Fraser Lawyers acts in these matters.

Fraser Lawyers advises workers on how the Queensland scheme applies to their injury, and on the decisions the scheme forces along the way.

That includes whether you are covered, how to lodge a statutory claim within time, what the Notice of Assessment means once it arrives, and, where the question arises, whether a common law claim is open and what the choice between a lump sum and damages under the Workers’ Compensation and Rehabilitation Act 2003 (Qld) involves. Where a claim has been rejected, the firm advises on review by the Regulator and appeal to the Queensland Industrial Relations Commission.

Blake Fraser, the firm’s Principal Lawyer, handles these matters personally from the Bundall office, for clients on the Gold Coast and across Queensland. Where a claim is not viable, the firm says so plainly and early.

Fraser Lawyers can act on eligible workers’ compensation claims under a conditional costs agreement, sometimes described as a no win, no fee arrangement. Conditions apply. You may be liable for disbursements regardless of outcome.

Practical

Documents to bring.

Your work capacity certificate The workers’ compensation medical certificate from your treating doctor
Any WorkCover claim documents Your claim number and any letters or decisions from the insurer
Your Notice of Assessment If one has been issued, with any lump-sum offer it records
Medical records and reports Hospital, specialist, and GP records relevant to the injury
Imaging and test results Scans, X-rays, and reports connected with the injury
Details of your employment Your role, your employer, and whether you are an employee or a contractor
Your earnings information Payslips or a payment summary, to work out normal weekly earnings
A timeline of what happened Dates, how the injury occurred, and who was told, written while it is fresh
Correspondence with your employer Anything about the injury, the incident, or your return to work
Your identification Driver’s licence or passport

Pathway

The likely path.

Step 1: Initial assessment.

The first conversation covers what happened, the injury, your employment, and where the claim currently stands. The aim is to identify whether you are covered, which track applies, and what the immediate deadlines are. You leave with a clear view of how the law applies and what the next step is.

Step 2: Lodging or reviewing the statutory claim.

If a statutory claim has not been lodged, the work capacity certificate and application are prepared and lodged within the six-month period. If a claim is already on foot, the firm reviews where it sits and what benefits are being paid.

Step 3: Permanent impairment and the Notice of Assessment.

Where the injury has stabilised, the degree of permanent impairment is assessed and the insurer issues a Notice of Assessment. The firm advises on what the assessment and any lump-sum offer mean, and whether they are soundly based.

Step 4: The election and the common law question.

If a common law claim may be open, the firm advises on whether to pursue it, and, for an impairment under 20 per cent, on the binding choice between the lump sum and damages. This is the decision to take advice on before responding to the offer, not after.

Step 5: Common law claim or review.

If a common law claim proceeds, the Notice of Claim for Damages is given and the pre-court steps are run, with the three-year limitation period in view. If instead a decision has been rejected, the firm runs the review to the Regulator and, if needed, the appeal to the Queensland Industrial Relations Commission.

Step 6: Resolution.

Most claims resolve without a hearing, by acceptance of statutory benefits, by settlement of a common law claim, or through the review process. If a matter does need to be decided by a court or the Commission, the earlier steps are what make a sensible resolution possible.

Frequently asked

Questions we hear often.

Plain-English answers to the questions clients tend to ask. If your question is not here, call us.

Get in touch

How do I make a WorkCover claim in Queensland?

See a doctor and get a work capacity certificate, which records the injury and its connection to work. Tell your employer about the injury. Then lodge an application with WorkCover Queensland, or your employer’s self-insurer, online, by phone, or on a paper form, with the certificate. The insurer investigates and decides whether to accept the claim. The application must be made within six months after the entitlement to compensation arises, which is broadly when the injury is assessed by a doctor, nurse practitioner or dentist.

What injuries does WorkCover cover?

The scheme covers a personal injury arising out of, or in the course of, employment, where the employment is a significant contributing factor. That includes sudden physical injuries, conditions that develop over time, industrial diseases, and the aggravation of an existing condition. Psychological injury is covered, subject to an exclusion for disorders arising out of reasonable management action taken in a reasonable way by the employer. Because the scheme is no-fault, an injury can be covered even where the worker contributed to it.

What is a work capacity certificate?

A work capacity certificate, sometimes called a workers’ compensation medical certificate, is the medical certificate completed by a treating doctor, nurse practitioner or dentist. It records the injury, its connection to your work, and your capacity for work, including any restrictions. It is the medical foundation of a statutory claim and is lodged with the application. The entitlement to compensation generally arises when the injury is assessed in this way, rather than on the day the injury occurred.

How long do I have to make a WorkCover claim?

A statutory claim must be lodged within six months after the entitlement to compensation arises, which is broadly when a doctor, nurse practitioner or dentist assesses the injury. The insurer can waive the time limit in defined circumstances, including where the delay was due to mistake, absence from Queensland, or other reasonable cause, and a waiver is required where a medical assessment tribunal decides there are special circumstances of a medical nature. A common law claim runs on a separate three-year limitation period. Because a waiver is not guaranteed, lodging promptly is the safer course.

What is the difference between a statutory claim and a common law claim?

A statutory claim is the no-fault claim: you do not have to prove negligence, and the scheme pays defined benefits, including weekly payments, medical and rehabilitation costs, and a lump sum for permanent impairment. A common law claim is a claim for damages for negligence: you must prove the employer or another party was at fault and that the fault caused your injury, and damages are assessed on the individual case rather than from a statutory table. A common law claim requires a Notice of Assessment first, and must be commenced within three years under section 11 of the Limitation of Actions Act 1974 (Qld).

What does WorkCover pay?

Statutory benefits come in three groups. Weekly payments replace part of your income: for the first 26 weeks of incapacity, broadly the greater of 85 per cent of your normal weekly earnings or the relevant industrial-instrument rate, stepping down after that. The scheme also pays reasonable medical, hospital and rehabilitation costs connected with the injury. And where the injury leaves a permanent impairment, a lump sum is payable, geared to the assessed degree of impairment. The weekly and lump-sum figures are set by statute and are indexed.

How much is a permanent impairment lump sum in Queensland?

The lump sum is geared to the degree of permanent impairment, expressed as a percentage. The ranges of impairment and the amounts that attach to them are set out in the Workers’ Compensation and Rehabilitation Regulation 2025 (Qld) and are indexed each year, and WorkSafe Queensland publishes the current figures. Where the degree of permanent impairment is 30 per cent or more, an additional lump sum is payable on top of the base amount. These are statutory amounts, not a prediction of any individual claim, and they are separate from common law damages.

How is the degree of permanent impairment assessed?

Once the injury has stabilised, it is assessed for a degree of permanent impairment (DPI), expressed as a percentage. The assessment is a medical exercise, carried out against recognised guides, and the insurer records the result in a Notice of Assessment along with any lump-sum offer. The DPI percentage matters for two reasons: it sets the statutory lump sum, and it determines whether the choice between a lump sum and common law damages applies, which it does only where the DPI is under 20 per cent. If you disagree with the assessment, you can seek a reassessment by another doctor or a review by a medical assessment tribunal, but you must notify within 20 business days of receiving the assessment notice, and a tribunal’s decision is final.

What happens if WorkCover rejects my claim?

A rejection can be challenged. You can apply to the Workers’ Compensation Regulator for a review of the decision within three months of receiving it in writing. The Regulator is independent of the insurer and reconsiders the decision on its merits. If you are still dissatisfied after the review decision, you can appeal to the Queensland Industrial Relations Commission within 20 business days of that decision. The two stages have separate time limits, and both are short, so a rejected decision is worth acting on promptly.

Can I sue my employer as well as claim WorkCover?

Sometimes. A statutory (no-fault) claim and a common law (negligence) claim are different things. Whether you can do both depends on the assessed degree of permanent impairment. Where the DPI is less than 20 per cent, you must choose between accepting the lump-sum offer of statutory compensation and rejecting it to seek common law damages: it is one or the other, and the lump-sum offer is deferred automatically if you do not respond within 20 business days. Where the DPI is 20 per cent or more, you may accept the lump sum and also pursue a common law claim. A common law claim still requires proof that the employer’s negligence caused the injury.

Does WorkCover cover psychological injury?

Yes, psychiatric and psychological disorders can be covered, but with a defined exclusion. Under the Workers’ Compensation and Rehabilitation Act 2003 (Qld), an injury does not include a psychiatric or psychological disorder arising out of reasonable management action taken in a reasonable way by the employer in connection with the worker’s employment, or out of the worker’s expectation or perception of such action. Both limbs matter: the management action must be reasonable, and it must be taken in a reasonable way. Examples of management action include transfer, demotion, discipline, redeployment, and dismissal.

Is there a maximum WorkCover payout in Queensland?

Yes. There is a statutory cap on the lump sum for permanent impairment. The cap is geared to the assessed degree of permanent impairment and is set and indexed each year under the Workers’ Compensation and Rehabilitation Regulation 2025 (Qld), and WorkSafe Queensland publishes the current figures. An additional lump sum is payable where the degree of impairment is 30 per cent or more. These statutory caps do not apply to a common law claim, where damages are assessed on the individual circumstances of the case rather than from a statutory table. The statutory figures are indexed each year on 1 July.

Personal injury claims in Queensland run to strict time limits. Some apply within months of the injury or accident, the limits differ by claim type, and a few, such as hit-and-run claims against the Nominal Defendant, cannot be extended.

Talk to Fraser Lawyers about a WorkCover matter.

A short conversation is usually enough to understand whether you are covered, which track applies, and what the next step is. Fraser Lawyers is based at 86 Bundall Road, Bundall, and acts for clients across the Gold Coast and Queensland.

Call (07) 5554 6116 Send a short enquiry