If the injured worker requires time off work or medical treatment and wishes to claim these expenses they will need to lodge a Workers’ Compensation claim. If a worker chooses not to lodge a claim, they will need to cover the medical expenses themselves (or through Medicare or their private health insurance), and claim leave entitlements to cover their absence from work.
Subject to the Return to Work Act 2014, an injury is compensable if it arises from employment. This means that if a worker sustains a work related injury resulting in medical treatment and/or time off work, reasonable costs will be paid and return to work assistance will be provided to help the worker to make a safe, early and sustainable return to work.
An injured worker can make a claim by downloading a ReturnToWorkSA Claim Form and providing the information to their manager or supervisor, together with a Work Capacity Certificate supporting the claim completed by the worker’s treating doctor.
Once the claim has been received by DTF Work Injury Services, the Claims Case Manager will review the information submitted and assess the claim. In some circumstances, the Claims Case Manager may require more information before making a determination on the claim. This may include:
- a medical report from the treating doctor
- an independent medical examination
- a statement from the injured worker
- a statement from the injured worker’s employer
- a statement from a colleague of the injured worker.
If a decision cannot be made within 10 business days after a claim is received, the worker will be offered income support by way of ‘interim benefits’. The worker can accept the payment of interim benefits, or they may choose to use their available leave. If the claim is rejected, interim benefits payments made will need to be paid back.
ReturnToWorkSA Claim Form (PDF) 117KB