Whichever state you are in, the claim moves through the same five steps. The forms and the insurers differ; the shape of the process does not.
Who can claim
Any worker injured in the course of employment can make a statutory claim, whether the injury happened in a single incident, built up over time through repetitive strain, or is a psychological injury arising from the work. The statutory claim is no fault: you do not have to show that anyone did anything wrong.
It pays treatment, rehabilitation, weekly payments while you cannot work and a lump sum for permanent impairment. Where the injury is serious and the employer was negligent, a separate damages claim may follow, and that is usually worth far more than the statutory benefits alone.
The steps below apply to both, with the damages claim picking up at the medical examination.
Lodge the claim
Every claim starts with notifying the insurer that a claim is being made. Which insurer depends on the type of claim: the compulsory third party insurer of the vehicle at fault, the workers compensation insurer of your employer, or the public liability insurer of the person or business responsible for the place where you were hurt.
The paperwork differs between states, and strict timeframes set by the regulator apply to lodgement, so the first job is to get the right form to the right insurer with the medical certificate that supports it. We lodge the claim for you and deal with the insurer from that point on.
Rehabilitation
Once the claim is accepted, the focus turns to your recovery. The insurer funds reasonable treatment and rehabilitation, which can include specialist appointments, physiotherapy, psychological support and help returning to work where that is realistic.
Attending treatment and following medical advice matters for two reasons: it gives you the best chance of recovering, and it builds the record of your injury and its effect on your life that everything later in the claim rests on. Weekly payments for lost income run during this period where you cannot work or can only work reduced hours.
Medical examination and whole person impairment
When your condition has stabilised, a medical examination assesses the permanent effect of the injury, expressed as a percentage of whole person impairment. The examiner is independent of your treating doctors and works to a standard set of guidelines.
The percentage is not a valuation of your claim, but it opens or closes doors: it determines what lump sum entitlements are available, and in some schemes whether a claim for damages can proceed at all. We prepare you for the examination and, where the result does not reflect your condition, arrange a further opinion.
The settlement conference
The parties may meet to try to resolve the claim prior to filing the matter in court. However, once the matter is filed in court, the parties must meet to try to resolve the claim before a full hearing. The settlement conference is where the evidence gathered so far, medical, employment and financial, is put against the insurer and a figure is negotiated.
We prepare a detailed account of your losses beforehand, so that the number on the table is built from evidence rather than from the insurer's opening position. Most claims resolve at this stage or shortly after it. Our library covers what to expect at this stage.
Court, if it does not settle
If the conference does not produce an acceptable offer, proceedings are filed in court. Filing does not end negotiation; many claims settle after proceedings start and before a hearing.
A full trial is the exception, reserved for claims where the insurer disputes liability or the extent of the injury and will not move. We tell you plainly, before proceedings are started, what a trial would involve, what it would cost and what we think the likely outcome would be, so that the decision to go on is yours and an informed one.