What to expect in the first seven days of a claim
Once you have lodged the claim on behalf of your worker or have been notified of their claim lodgement via your Claims Service Provider, the next step is to support your worker with their recovery.
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Key takeaways
- You will be assigned a case manager from your claims service provider, they will be your ongoing contact.
- Set communication preferences and a communication plan with your injured worker to support them through the claims process and return to work.
Who can I speak to?
Once the injury notification is lodged and the claim is set up in the claims system, it will be assigned to a case manager who will be your ongoing point of contact throughout the life of the claim.
Back to top ⇡What will my case manager be doing?
During the first seven days of a claim your assigned case manager will be:
- Contacting all the relevant parties to understand what has happened in the workplace that has led to an injury. This will involve liaising with yourself as the employer, reaching out to the injured worker to start introductions and provide a summary of the claim process. They will also contact the Doctor (where appropriate) to request medical information. The case manager will aim to make these calls within three business days of receiving the claim.
- Reviewing any information that has been sent to the claim such as certificates of capacity, any medical reports or any incident reports.
- Calculating the injured worker's wage entitlement and ensuring there is a way to process payments – via yourself as the employer or directly to the injured worker.
- Trying to understand what (if any) treatment the injured worker has had to date.
- Determining if any further investigations may be required to provide relevant information to determine liability for the claim.
Information the case manager may request from you
Wage information
To assist with the Pre-Injury Average Wage Entitlement (PIAWE) or Current Weekly Wage Rate (CWWR- for exempt workers) calculation, you will need to provide:
- Details of all gross earnings received by the worker: payroll records in Excel format, or if that isn't possible, copies of payslips.
- A completed PIAWE form. Completing the form may reduce the need for your claims service provider to contact you for more information and will increase the likelihood that PIAWE will be calculated correctly
- 52 weeks of wage information backdated from the date of injury, including evidence of recent promotions (if applicable), or any leave without pay.
From September 2019, the employer and the worker have the option of agreeing on the PIAWE amount to be used for determining the worker's weekly compensation payments. Find out more in Calculating PIAWE.
Medical information
- Any certificates of capacity or medical information you have received to date relating to the injury.
- Any invoices received from medical appointments relating to the injury.
Return to work information
- Whether there has been any time off work as a result of the injury.
- Details about the injured workers pre-injury role.
- Whether you are able to offer suitable duties in the workplace, and if so, what modifications are available to support the worker.
- What other support you are able to offer the injured worker to support their recovery and return to work, such as regular check ins, implementing a buddy system, keeping your worker connected with the workplace.
- Whether you would like the assistance of a workplace rehabilitation provider to assist with the development of a return-to-work plan.
Upload supporting documents for your claim
Back to top ⇡Ongoing communication
The claims journey can be a difficult time for an injured worker. They are likely facing uncertainty and confusion around their future – both of which can be extremely confronting.
It's important to build trust with your worker through regular communication to support them with their wellbeing and the return-to-work process.
Each individual is going to respond differently to their workplace injury and will require a tailored approach to their communication needs.
In the first instance we recommend discussing with your worker what their preference for communication is. For example:
- how often they would like to be contacted by you or someone else from the business
- if they have a preferred day and time for the call
- whether they would like to be kept updated with work-related topics (such as a brief overview of how the team is tracking, or community announcements in the workplace such as births, marriages etc.)
- their preferred communication tool: phone call, video chat, email, face-to-face meetings
- how much they want to be disclosed to their immediate team.
When a communication schedule is agreed upon, it's crucial to keep to that commitment. It sets the foundation for trust.
If changes do need to be made to the schedule, it's important to be transparent with the injured worker.
Back to top ⇡