How to fill in your work injury claim form

If you have had an accident at work then you should make sure you follow some simple steps which will help make your personal injury claim a lot easier.

To begin with you should make sure you have reported your accident to someone within the company and then should have noted it down within the company’s book.

Although some people think it isn’t always important to note an accident at work it is no matter how small the injury should always be noted down and you should always alert the health and safety officer on site who will make a note.

Accessing and completing the claim form

A worker can access a Worker’s Injury Claim Form (Claim Form) from the following places:

·         their employer

·         the agent

·         an Australian post office or outlet

·         WorkSafe Advisory Service

·         a writeable PDF version of the Claim Form available on the WorkSafe website.

Where the worker chooses to access the writeable PDF version of the Claim Form they will have the choice to:

·         print the form off and complete it by hand by writing clearly with a pen


·         complete the form online before printing it off to sign the declaration.

The worker must sign the Authority to Release Medical Information and Declaration in the Claim Form for it to be considered valid.

What fields need particular attention

It is extremely important that you give as much information possible about the “injury/condition” you sustained.

For example: just writing “hurt my shoulder” whilst lifting a heavy box is not really sufficient, because later on, workcover may argue that any “additional/other injuries” you sustained (became aware of later) were not reported on the claim form and therefore they won’t accept liability. This becomes extremely important later on when you will claim impairment benefits under section 98C of the Act.

So it is best that you write as much information as possible about the ‘injury’; for example: “hurt my Right (or Left) shoulder and arm whilst lifting” – then add what exactly you felt, for example ” I felt a clunk in my right shoulder; I had pins and needles along the entire arm; my neck also hurts as well as the right side of my back…”. Here you have covered yourself for a potential injury to your shoulder,your arm, your neck, your back, a nerve.

Example of a “good injury claim form”

A fellow worker fell from a ladder at work and hurt his right shoulder. He wrote on the claim form that he had fallen off a ladder and landed on his right shoulder/right arm and felt pain in the right shoulder/right arm/right side of neck and right side of body. He not only had a fractured shoulder, but later on it was discovered that he also had a neck injury for which he had to have surgery. Whilst he only had a little bit of tenderness in the neck at the time of the incident (and nearly did not bother writing this on the claim form) he ended up with major surgery to the neck. Had he not mentioned the neck pain (however slight) workcover may have not admitted liability for his neck injury!



6 Responses to “How to fill in your work injury claim form”

  1. @Playera – you can fill in a workcover claim form and put in either the date when you first became aware that you developed pain in your wrist, or, better write on the form “over the course of my employment” See The importance of an accurate injury claim form

    You will also need a certificate of capacity (workcover medical certificate) issued by your GP or other treater confirming you suffer from your condition because of your work. A diagnosis will be extremely important too if you want your claim to be approved. I.e. it could be that you suffer from  e.g carpal tunnel syndrome and that won’t be visible on xray. Your GP ought to refer you to an orthopedic surgeon to make a proper diagnosis… Some conditions such as you describe may also be due to rotator cuff tears in the shoulder, again a diagnosis needs to be made, and we would suggest it should be made prior to lodging the claim if possible… to have the best chance at having your claim accepted.

  2. Hi ,,i have had pain in my wrist ,wich progressed to shooting pain to my elbow and shoulder ,I’m a city bus driver and can’t afford to miss work so I kept working ,,now I have a worst pain ,my hand falls asleep can’t hold anything to long it even cramps my thumb and the pain tht shoots of my arm is really painful ,wnt to a walk in center had X-rays ,,nothing showed so just got pain killers the ? Is how do I file a wrkrs comp wit no real accident?

    [note by admin- we have unprivatized this comment – again when you mark a comment as private only admin can read your comment, or, if you used the “reply” button, the person you replied to – see “how to comment” ]

  3. Not only is filling in the claim form correctly important – but perhaps more important is seeking legal advice either directly with a solicitor or via your union.

    What might start out small might end up being big. Your employer, via the workers compensation insurance company, will do whatever it can to reduce its expenditure on you. They are not acting in yours best interests – this is all about money – nothing more, nothing less.

    The insurance company employees receive team bonuses for closing off claims within certain periods. There is immense pressure on them to do this – such action is almost certainly to the detriment of the injured worker.

    Look after your interests as the insurance companies will use a variety of tricks to try and catch you out – they treat everyone as a cheat when probably the biggest cheats and unethical industry players are the insurance companies themselves. Remember they have massive resources and industry knowledge behind them!

    • You could not have summarised it better! Love the last paragraph: they are the biggest unethical cheats and yet treat us like we’re some criminals!
      Thanks for commenting – much appreciated 😉

  4. Hi
    You are absolutely right!It’s probably the most important step because,as you said, workcover will do everything possible to avoid liability for an injury suffered at work. In my case I had tripped over a cable (which should not have been there) and it later appeared that I had not only broken my left wrist, but also had some damage done to a ligament in my left knee. Whilst I had a bit of pain in my knee at the time of the incident I thought that it was just a little bruised and I did not write this on my claim form. Workcover admitted/approved liability for my broken wrist but NOT for my knee because I had not mentioned anything about my knee on the claim form. Whilst the wrist healed very quickly I did have to undergo 2 operations on my knee,which is still not right and workcover is NOT paying for any of it (surgery,time off etc). Be VERY CAREFUL!

    • Hi “nobody”, I am truly sorry for what has happened to you re your dreadful knee injury. It just reinforces the tactics of workcover – it’s all about money and they will deny you everything possible from day one. Have you at least spoken to an experienced solicitor (specialised in workcover injuries)? My solicitor recently (7 years after the accident) was managed to appeal a secondary psychiatric injury,which has now been successfully included in my claim. I did not write on my claim form that I was psychologically/emotionally injured from the accident -it’s the last thing you think of! Let me know if you need more help (i.e. name of my law firm/solicitor). Good luck and you’re in my thoughts.