NSW workers compensation guide
NSW workers compensation claim records guide
The practical task is not just to complete paperwork. It is to create a dated record of the injury, notification, medical position, wage loss and insurer response so that each later decision can be checked.
Published by NSW Work Injury Claim, the workers compensation service of Stephen Young Lawyers. Updated 20 July 2026.
1. Record what happened before details are lost
Report the injury to the employer as soon as possible. Include the date, cause and affected body part or symptoms. For a gradual condition, record the relevant period, tasks and when symptoms changed. Notice can be oral or written, but a written report, injury-register entry and incident reference reduce later disagreement about what was reported.
Keep photographs, witness names, rosters, messages and any earlier hazard or workload reports. Do not edit the account to sound more legal. A clear factual chronology is more useful than broad conclusions.
2. Confirm the insurer received enough information
An ordinary claim can begin with an initial notification to the insurer. The current SIRA Guidelines allow it to be verbal or written and require identifying information about the worker, employer, injury and notifier, plus treating-doctor details where known. Ask for the insurer name, claim number and notification date.
A formal claim form is not required in every ordinary case. It becomes mandatory in specified circumstances, including relevant-conduct primary psychological injury claims. See the claim-entry guide for the current form rules.
3. Make the medical record practical
Tell the treating doctor how the work event or duties relate to the condition. Where a Certificate of Capacity is issued, it should record the diagnosis, treatment and actual limits on hours, lifting, sitting, standing, driving, concentration or other relevant functions. A certificate supports the claim, but it does not itself establish legal liability.
If the medical history changes, ask why and correct factual errors promptly. The aim is an accurate record, not wording designed to produce a particular outcome.
4. Keep separate evidence for payments and treatment
Weekly payments
Keep payslips, rosters, overtime, allowances, second-job income and changed-hours records. Compare the insurer calculation with the PIAWE material supplied.
Treatment
Keep the referral, treatment plan, clinical rationale, quotation, invoices and written approval or refusal. A treatment dispute is not necessarily a denial of the whole claim.
Capacity
Keep certificates, treating notes, job descriptions, suitable-duties offers and records of attempted duties. Sustainable attendance can matter as much as a list of physical tasks.
5. Read the early insurer response accurately
For an ordinary claim, provisional weekly payments generally start within seven calendar days after valid initial notification unless the insurer determines liability or issues a reasonable excuse allowed by the Guidelines. The reasonable-excuse mechanism concerns weekly payments, not provisional medical payments. Provisional weekly payments can continue for up to 12 weeks, and provisional medical acceptance can cover up to $10,000.
A formal weekly-payment claim is ordinarily determined within 21 days, but provisional acceptance can extend that period. Relevant-conduct primary psychological claims use a separate completed-claim and decision process. The provisional liability guide explains the distinction.
6. Match a response to the stated reason
If the insurer disputes liability, preserve the complete section 78 notice and attachments. Separate questions about work connection, diagnosis, capacity, wages and treatment. A useful response identifies the evidence that answers each reason rather than sending the same bundle again without explanation.
Internal review and Personal Injury Commission options depend on the decision. ILARS funding may be available for eligible workers compensation disputes if an approved lawyer obtains a grant. It is not automatic and should not be assumed before eligibility is assessed.
Common questions
Should I report a work injury in writing?
The law permits notice to be oral or written, but a dated written report is easier to prove. Record the injury, cause and date, and ask for the incident or injury-register reference.
Is a claim form always the first step?
No. An ordinary claim can begin with valid initial notification to the insurer. A claim form is required in particular circumstances under the SIRA Guidelines, including relevant-conduct primary psychological injury claims.
What should a Certificate of Capacity explain?
Where one is issued, it should accurately record the condition, treatment, current work capacity and practical restrictions. It is medical evidence, not a guarantee that liability will be accepted.
What evidence helps with a gradual-onset injury?
Keep a chronology of duties, force, repetition, hours, symptom changes, reports to supervisors, medical attendances and any work changes. The evidence should explain the actual exposure rather than use a general label such as overuse.
What if the insurer has not started weekly payments after seven days?
Check whether the insurer received a valid initial notification and whether it issued a reasonable excuse or liability decision. The seven-day rule concerns ordinary provisional weekly payments. Different rules apply to relevant-conduct psychological claims.
What should I do if the claim is denied?
Keep the full section 78 notice and attachments, identify each reason and obtain advice about the evidence and review or Personal Injury Commission pathway. Do not answer only the outcome; answer the insurer's stated grounds.
Sources
Related pages
This information is general in nature and is not legal advice. Notice, time limits, evidence requirements and insurer obligations depend on the facts and the law applying to the claim.