Compensation payments
Weekly payments will be payable, in most cases, within seven (7) days of Employers Mutual being notified of a workplace injury by telephone or receipt of a WorkCover Claim form.
For payments to commence, the mandatory information (shaded on the claim form) must be received by Employers Mutual or WorkCoverSA. A WorkCover Medical Certificate from the doctor must also be provided. The employer and injured worker will receive a letter within seven (7) days advising whether compensation payments will commence and what to do if you don’t agree with the decision.
For an injured worker to receive ongoing compensation eg. if the injury requires longer than 13 weeks of weekly payments or more than a cumulative total of $5000 in medical and other related expenses, information will be provided to the worker and employer by Employers Mutual on how to do this.
Claims agent
Employers Mutual is contracted by WorkCover to provider workers rehabilitation and compensation services to injured workers. The claims agent is responsible for most of the decisions relating to the claim, and the day to day claims management. This includes:
- determining if a claim is eligible for compensation
- managing the claim for compensation
- providing advice to workers and employers on rehabilitation and compensation
- managing and coordinating your rehabilitation and return to work
- providing advice to employers on health and safety in the workplace.
If you are an injured worker, in many cases, Employers Mutual or your self-insured employer will talk to the treating doctor (with your consent) before a decision is made to commence payments.
For more information on claim decisions, see complaints and disputes.
Claims determination letter
If you are a worker, the decision on the claim will be made in a formal letter called a claim determination letter. This letter will be sent to you directly, detailing how your claim for compensation has been determined. Your employer will also be provided with a copy of the claim determination letter.