Insurance

The claims process

If you are injured at work, you should report the injury to your employer as soon as possible and, if needed, seek medical attention.

If you have sustained a work-related injury or illness you may be entitled to workers compensation.

Making a claim

Injured workers:

  • See your doctor as soon as possible and ask for a SIRA Certificate of Capacity. The certificate outlines the nature of your injury, your capacity to work and treatment requirements.
  • Complete and sign a Workers Injury Claim form. If you cannot complete the form yourself, you can ask someone to assist you. Be sure to include all relevant information and attach any supporting documentation that you think may assist us in making a decision about your claim, e.g. medical reports, scans etc.
  • Give the claim form and your SIRA Certificate of Capacity to your employer as soon as possible.

Employers:

  • Complete and submit an Employer’s Incident Notification Form within 48 hours of the worker advising you of their injury or incident.
  • Send us the worker’s SIRA Certificate of Capacity and Worker’s Injury Claim Form as soon as possible so that we can assess the claim.

If you need more information about making a claim, please contact Coal Mines Insurance. Injury claim forms, and guides on what to do when you’re injured at work, are available from the forms and downloads section.

Managing the claim

  • Within 3 days of receiving the claim, an injury management specialist will contact all parties (worker, employer, treating doctor (if required)) to gather information about the incident. This information will assist the case manager to assess the claim.
  • The case manager will write within 7 days to advise if the claim has been accepted or declined. If more information is needed to assess the claim, the case manager will advise  in writing of what is needed and that a decision will be made within 21 days. This period to make a decision may be extended to 42 days if information continues to be unavailable.
  • If the claim is accepted we will work with the injured worker, employer, and treating doctor and/or specialists to ensure the worker receives the treatment and rehabilitation support needed to help them recover and return to work.
  • If the claim has been declined, the case manager will provide an explanation regarding this decision. If you don’t agree with this decision, you can ask for a review where you may also provide further information to support your claim.

Injured workers have the right to:

  • choose their nominated treating doctor
  • choose their approved rehabilitation provider
  • choose their treatment providers
  • have a say in their return to work plan
  • have union representation, if required.

Employer’s obligations

Throughout the worker’s recovery employers must:

  • consult with the worker, their treating doctor (if appropriate) and the CMI case management team about their injury management and return to work plans
  • identify suitable duties (where reasonably practicable) to support the worker while they recover
  • maintain regular communication  with the worker until they recover from injury and return to their pre-injury duties.