Work Injury Checklist

Notification of Injury

Is the injury of a nature that needs to be reported to SafeWork SA?	Yes ☐ No ☐
If yes, has this been reported by the organisation? TIP! – Information on SafeWork SA website	Yes ☐ No ☐ NA ☐
Has an incident report been completed?	Yes ☐ No ☐
Does the worker require treatment off-site? If yes, support the worker to make an appointment to see a doctor or access hospital treatment. If no, report as First Aid in accordance with your internal process. TIP! – Worker has the right to choose their doctor, but an employer can recommend (see ‘Choosing your treatment team’ sheet)	Yes ☐ No ☐
If the worker attended for treatment with a doctor or hospital was a Work Capacity Certificate issued? TIP! – A Work Capacity Certificate is required to proceed with a claim.	Yes ☐ No ☐

Reporting an injury & lodging a claim

Does the worker want to make a claim? If yes, you will need to lodge the claim within 5 business days. If no, you may still need to notify the agent of the injury. TIP! – It’s important that if the worker has restrictions and doesn’t want to lodge a claim, that the organisation still provides safe work duties where reasonably able to do so.	Yes make claim Notify only
Was the claim lodged within 5 working days of the worker advising of their intention to claim? TIP! – Claims can be lodged online or via phone with or on behalf of the worker.	Yes ☐ No ☐ Date:[date]
If the worker chooses to make a claim, complete the necessary documentation and provide relevant documents within the work injury toolkit to help the worker feel informed and supported:
Is an interpreter required?	Yes ☐ No ☐
Was the Medical Authority completed?	Yes ☐ No ☐
Did you go through documents for a worker and explain accordingly?	Yes ☐ No ☐
Did you explain processes, procedures and timeframes for claims communications and decisions?	Yes ☐ No ☐
Are there any concerns or potential barriers that need to be addressed? TIP! – Note down any concerns raised by the worker that require follow up or any services recommended (See ‘Health & Wellbeing Supports & Services?’)	Yes ☐ No ☐

Is the worker likely to lose time because of the injury and require income support? If yes, worker’s payslips will need to be provided to Claims Agent. TIP! – This can be provided at time of lodgement or after when requested by Claims Manager.	Yes ☐ No ☐
Does the worker have any pre-planned annual leave? If yes, notify your Claims Agent at lodgement or as soon as possible.	Yes ☐ No ☐
Has the worker been advised of the need for current Work Capacity Certificates throughout their claim?	Yes ☐ No ☐
Have you engaged with the worker’s treating doctor? TIP! – You can attend at the end of the medical review, at a case conference or send a letter (See ‘Letter to treating doctor’)	Yes ☐ No ☐

Supporting return to work

Does the worker have transport restrictions? If yes, speak with the Claims Manager to discuss possible solutions.	Yes ☐ No ☐
Can you identify suitable duties based on the Work Capacity Certificate? If no, seek help from your Claims Manager or clarity from the GP.	Yes ☐ No ☐
Has there been a discussion with the worker’s Supervisor/Manager regarding the identification of potential suitable duties for the worker?	Yes ☐ No ☐
Are you a labour hire organisation? If Yes, host employer involvement is crucial to RTW outcomes - work with the host employer to source suitable duties for the worker. TIP! – The Host employer may have obligations to support your worker return to work. For more information visit ReturnToWorkSA website or contact Employer Education team for support.	Yes ☐ No ☐
Have you set expectations around communication with the worker? TIP! – Refer to ‘Communicating with the worker’ sheet.	Yes ☐ No ☐

Notes

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