Last updated 8 May 2025

The workers’ compensation rights are outlined in the Workers’ Compensation and Rehabilitation Act 2003 (Qld) (WCR Act) with additional rights to compensation added under ch 4A of the WCR Act.

Eligibility

To be eligible, a worker must establish that they:

A worker may not be entitled to receive compensation for serious personal injury (ch 4A WCR Act), although they have suffered serious personal injury, if the only reason the worker’s application for compensation was accepted was because of ss 34(1)(c) or 35 of the WCR Act. Those sections, generally, deal with temporary absences from work or instances where a worker is on a journey before, after or between work. If ch 4A compensation has been denied by an insurer because a worker was only entitled to compensation because of ss 34(1)(c) or 35, advice from a lawyer should be sought urgently to ensure that the worker does not lose any entitlements.

In addition, an injured worker will be ineligible if their injury was caused by the worker’s serious and wilful misconduct.

This does not mean, however, that a worker who sustains an injury in circumstances that prevents them from being eligible under the WCR Act to ch 4A compensation cannot apply for compensation under the NIIS Act, even if they are on a journey or a temporary absence from work. If a worker has suffered a serious personal injury, they should seek advice from a lawyer about their entitlements to compensation as compensation may still be available.

Application

On acceptance of an injured worker’s application for statutory compensation, the worker can request to be assessed, or the workplace insurer can decide to have the worker assessed, to determine whether the worker is entitled to treatment, care and support payments for the injury. If assessed with such an injury, the worker will be an eligible participant under ch 4A of the WCR Act and be entitled to receive benefits on account of treatment, care and support needs.

The workplace insurer must ensure this assessment is carried out within 20 business days of the request being made (s 232M(3) WCR Act), unless otherwise agreed by the parties. After the assessment, the injured worker will be advised of their eligibility in writing within 10 days of a decision being made (s 232M(6) WCR Act).

An injured worker may be assessed as either a lifetime or an interim participant (s 232M(4)(a) WCR Act).

If accepted as a lifetime participant, the worker is entitled to have their necessary and reasonable treatment, care and support needs paid for, for as long as the worker is a participant.

If the worker is deemed to be an interim participant, the insurer will pay these costs for a period of two years. At the end of the two-year interim period, the worker will be reassessed to determine whether they are eligible to be a lifetime participant (s 232S WCR Act).

If an injured worker disagrees with the outcome of their assessment, they are able to have the decision reviewed. In the first instance, the aggrieved worker will have three months from the date they received written notice of the original decision from the relevant insurer to lodge an application for review with the Workers’ Compensation Regulator.

In the event the Regulator affirms the insurer’s decision, the aggrieved worker will then have the right to lodge a notice of appeal with the Queensland Industrial Relations Commission. The notice of appeal must be lodged within 20 business days of the worker receiving the Regulator’s decision.

Common law damages

A participant under ch 4A of the WCR Act reserves the right to bring a common law claim for damages.

However, any participant under ch 4A, who is considering pursuing a common law claim for damages should seek legal advice in respect to whether they should seek and accept damages on account of any treatment, care and support needs. This is because, in accepting damages on account of such needs, the participant will be precluded from receiving benefits under ch 4A of the WCR Act in the future (though they may be entitled to additional payments after five years under s 232ZD of the WCR Act).