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Claims management guide
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Understanding the claims journey
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Understanding the claims journey
Information to help people understand the workers compensation claims process.
General overview
Eligibility
Making a claim
Claims decisions
Medical and related services
Recovery at work
Weekly payments
Other compensation payable
Resolving complaints and disputes
Claims management other
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Insurer guidance
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Insurer guidance
Guidance notes to support insurers to meet legislative and regulatory claims handling requirements and expectations.
General / overarching principles
Eligibility / compensable injuries
Claims and injury management
Claims management other
Compensation payable
Medical and related services
SIRA funded programs
Decision notices and disputes
Common law and recoveries
Other NSW schemes
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Legislation and regulatory instruments
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Legislation and regulatory instruments
Legislation and Regulations
Guidelines
Other instruments
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Forms and publications
About the guide
Glossary
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Insurer guidance
Other NSW schemes
GN 10.1 Dust Diseases
RHC
GN 10.1 Dust Diseases
Insurer guidance
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General / overarching principles
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GN 1.1 Workers compensation - a brief history
GN 1.2 Overview of changes and reforms
GN 1.3 Worker access to personal information
GN 1.4 Worker authorisation or consent
GN 1.5 Procedural fairness
GN 1.6 Fraud
GN 1.7 Insurers' Guarantee Fund (IGF)
Eligibility / compensable injuries
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GN 2.1 Worker or contractor
GN 2.2 Injury
GN 2.2A Disease injury
GN 2.3 Managing claims for workers with a psychological injury
GN 2.4 Journey claims
GN 2.5 Recess claims
GN 2.6 Hearing loss claims
GN 2.7 Consequential loss
Claims and injury management
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GN 3.1 Initial notification of injury
GN 3.2 Initial liability decision - provisional, reasonable excuse or full liability
GN 3.3 Certificate of capacity
GN 3.4 Pre-approval of treatment
GN 3.5 Injury management plans
GN 3.6 Investigating changes in capacity
GN 3.7 Case conferencing
GN 3.8 Rehabilitation services during case management
GN 3.9 Work capacity assessments and decisions
GN 3.10 Section 39 Cessation of weekly payments after 5 years
GN 3.11 Section 59A
GN 3.12 Surveillance
GN 3.13 Factual investigations
GN 3.14 Return to work - early intervention
Claims management other
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GN 4.1 Interpreter services
GN 4.2 Workers living overseas
GN 4.3 Invoices and reimbursements
GN 4.4 Recovery of overpayments
GN 4.5 Recovery of Centrelink benefits from lump sum payments
GN 4.6 Payments to Medicare Australia
GN 4.7 Retiring age notification
GN 4.8 Closing a claim
Compensation payable
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GN 5.1A Calculating PIAWE
GN 5.1 Calculating PIAWE for workers injured before 21 October 2019
GN 5.2A Calculating weekly payments
GN 5.2 Calculating weekly payments for workers injured before 21 October 2019
GN 5.3 Making weekly payments
GN 5.4 Weekly payments after the second entitlement period
GN 5.5 Payments to workers with highest needs
GN 5.6 Weekly payments for exempt workers
GN 5.7 Permanent impairment
GN 5.8 Property damage
GN 5.9 Domestic assistance
GN 5.10 Commutations
GN 5.11 Compensation and other work entitlements
GN 5.12 Death claims
GN 5.13 Indexation
Medical and related services
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GN 6.1 Determining liability for medical and related treatment
GN 6.2 Surgery
GN 6.3 Nominated treating doctor and specialists
GN 6.4 Allied health practitioners
GN 6.5 Independent consultants
GN 6.6 Referral to an injury management consultant
GN 6.7 Aids and modifications
GN 6.8 Independent medical examinations
SIRA funded programs
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GN 7.1 SIRA funded programs general
GN 7.2 Recover at Work Assist program for Small Business
GN 7.3 Work trial
GN 7.4 JobCover placement program
GN 7.4A JobCover6
GN 7.5 Training program
GN 7.6 Transition to work
GN 7.7 Equipment and modifications
GN 7.8 Connect2work program
Decision notices and disputes
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GN 8.1 Insurer decision and decision notice requirements
GN 8.2 Insurer participation in disputes and mediations
GN 8.3 Personal Injury Commission - member decisions and appeals
GN 8.4 Medical assessments and appeals
Common law and recoveries
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GN 9.1 Recoveries
GN 9.2 Work injury damages
Other NSW schemes
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GN 10.1 Dust Diseases
GN 10.2 Volunteers
RHC
Published: 30 April 2024
Last edited: 11 June 2024
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Related: Legislation and regulations
Workers' Compensation (Dust Diseases) Act 1942
Work Health and Safety Regulation 2017 - Division 6 Health Monitoring
Useful resources
Safework Australia - Engineered Stone Resources
icare - Dust Diseases Care
Contact SIRA
Phone
13 10 50
Email
[email protected]
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