Do I Have a Compensation Claim? First Steps After an Injury in NSW

Reflects the Workers Compensation Legislation Amendment Act 2025 reforms in force from 1 July 2026, the Motor Accident Injuries Act 2017 and the Limitation Act 1969 as they currently stand.

A doctor, a hospital social worker, an HR manager or a union rep has said some version of “you might have a claim”, and you are trying to work out whether that sentence means anything.

This guide is for that exact moment.

The short version: in NSW there is not one compensation system but five, and the words “you might have a claim” tell you nothing about which one is yours. If you were injured at work you can claim workers compensation without proving anyone was at fault, and several deadlines started running the day you were injured, including a six month window to make the claim. If a motor vehicle was involved you may be in the CTP scheme instead, where lodging within 28 days protects your weekly payments. If neither applies, public liability or medical negligence law gives you three years from when the claim was discoverable. Checking whether you have a workers compensation claim costs nothing, because the state funds the legal advice. The most expensive thing you can do is nothing, which official survey data shows is exactly what almost half of injured Australian workers do.

What "you might have a claim" actually means

When a hospital social worker, a treating doctor or an HR manager says “you might have a claim”, they are usually not making a legal assessment. They are pattern matching. Hospital staff see patients whose injuries follow a workplace incident or a car crash and know that a compensation scheme probably applies. HR managers know their employer carries workers compensation insurance and are, in many cases, legally obliged to pass your injury on to that insurer. None of them will tell you which scheme applies, what it pays, or what deadline you are already inside, because that is not their job.

In legal terms, “a claim” in NSW almost always means one of five things. The schemes have different gateways, different deadlines, different funders and different relationships to fault, and it is entirely possible to have claims in two of them at once.

Scheme	Covers	Do you need to prove fault?	Main deadline
Workers compensation	Injury or illness arising out of or in the course of employment, including psychological injury	No. It is a no-fault statutory scheme	Claim within 6 months (s 261, 1998 Act)
CTP motor accident	Injury from a motor vehicle accident on a NSW road, including drivers, passengers, riders and pedestrians	No for an initial period of statutory benefits; fault affects entitlements after that and any damages claim	28 days to protect weekly payments; 3 months to claim
Public liability	Injury on someone else’s premises or caused by their activity or product	Yes. You must prove negligence under the Civil Liability Act 2002	3 years from discoverability (s 50C, Limitation Act 1969)
Medical negligence	Injury caused by treatment falling below a reasonable professional standard	Yes. Negligence plus causation, usually needing expert evidence	3 years from discoverability, 12 year long-stop
TPD and income protection through super	Inability to work caused by any injury or illness, work related or not	No. It is an insurance contract, not a fault claim	Set by the policy; cover can lapse if the account goes inactive

Sources: s 261, Workplace Injury Management and Workers Compensation Act 1998; SIRA Motor Accident Guidelines, Part 4; ss 50C and 50D, Limitation Act 1969; Moneysmart, insurance through super. Retrieved 13/09/2026.

Which scheme is yours? The NSW router

Someone said “you might have a claim”

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Where and how were you injured?

At work, or doing anything connected to work

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Workers compensation. No-fault. Notify your employer now; claim within 6 months. Includes injuries during work breaks and some journeys.

A motor vehicle crash on a road

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CTP motor accident scheme. Claim within 28 days to protect weekly payments, 3 months at the latest. Driving for work? Workers compensation usually applies as well; get advice on the interaction.

On someone else’s premises, or their product or activity

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Public liability. You must prove negligence. 3 years from when the claim was discoverable. Evidence gathered now decides it later.

Medical or dental treatment went wrong

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Medical negligence. Negligence plus expert evidence. 3 years from discoverability, 12 year long-stop.

Any serious injury or illness that stops you working, whatever the cause

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TPD and income protection through super. Runs alongside every other claim. Check your fund before cover lapses.

Claims can stack: a courier hit by a car while working may have workers compensation, CTP and TPD claims at once.

Source note: routing rules drawn from the Workplace Injury Management and Workers Compensation Act 1998, the Motor Accident Injuries Act 2017 and the Limitation Act 1969. Retrieved 13/09/2026.

The clocks started ticking the day you were injured

Nothing about “you might have a claim” sounds urgent, and that is the problem. Several statutory clocks start on the day of the injury, and most of the people who say the sentence do not know the clocks exist.

For a work injury, section 254 of the Workplace Injury Management and Workers Compensation Act 1998 requires notice of the injury to be given to your employer “as soon as possible after the injury happened and before the worker has voluntarily left the employment”. The section says that neither compensation nor work injury damages are recoverable without that notice, although the bar falls away in special circumstances, for example where the employer already knew, was not prejudiced, or the failure came from ignorance or mistake. Do not plan on needing the exceptions. Tell your employer in writing, today.

Once your employer knows, their obligations start. SIRA’s guidance requires the employer to notify their insurer within 48 hours of becoming aware of the injury, after which the insurer must contact you within 3 business days and give you a claim number. If the injury is serious, your employer must also notify SafeWork NSW immediately on 13 10 50. If you cannot reach your employer at all, SIRA says to contact the employer’s insurer directly or call the Independent Review Office on 13 94 76.

Then comes the deadline that actually extinguishes claims. Under section 261, compensation “cannot be recovered unless a claim for the compensation has been made within 6 months after the injury or accident happened”. Delay caused by ignorance, mistake, absence from the State or other reasonable cause can excuse a late claim, but only up to 3 years. Waiting to “see how it heals” is precisely the kind of delay that ends up being argued about in front of the Personal Injury Commission years later.

What starts ticking on day one

Deadlines from the date of injury. Workers compensation in blue, CTP in gold, court claims in grey.

As soon as possible

Notice of injury to your employer (s 254, 1998 Act)

48 hours

Employer must notify their insurer (SIRA)

3 business days

Insurer must contact you with a claim number (SIRA)

7 days

Provisional weekly payments must start, absent a defined reasonable excuse (s 267, 1998 Act)

28 days

CTP claim lodged by now gets weekly payments back to the day after the crash (Motor Accident Guidelines)

3 months

Standard CTP claim deadline (Motor Accident Guidelines)

6 months

Workers compensation claim must be made (s 261, 1998 Act)

3 years

Outer limit for late workers compensation claims; limitation period for negligence claims, from discoverability (s 261; s 50C)

12 years

Long-stop limit for negligence claims from the act or omission (s 50C)

How we got these numbers: s 254, s 261 and s 267 of the 1998 Act; SIRA, what to do after an injury; SIRA Motor Accident Guidelines, Part 4; s 50C, Limitation Act 1969. All retrieved 13/09/2026.

Workers compensation: your first five moves

If the injury is work related, the path is more structured than most people expect, and the early steps do most of the work. One scope note before the steps: police officers, paramedics and firefighters are “exempt workers” who remain under older, more generous rules, and coal miners have a separate scheme, so the payment rates and some limits described in this guide work differently for them, even though the notification steps below still apply.

1. Tell your employer, in writing

An email to your manager or HR beats a corridor conversation, because it creates a dated record of the notice section 254 requires. Include the date and time of the injury or the period over which it developed, how it happened and what the injury is, which is the content SIRA lists. Most workplaces also have a register of injuries; use it as well, not instead.

2. See a doctor and ask for a certificate of capacity

The certificate of capacity is the document the whole scheme runs on. It is your evidence of injury, your fitness-for-work assessment and the basis on which weekly payments are calculated and continued. Ask for it at the first consultation, and read our full guide to what every box on the form commits you to before your doctor fills it in.

3. Let the notification machinery run, and check it did

Your employer has 48 hours to tell their insurer. The insurer must contact you within 3 business days with a claim number. If a week passes and nobody has called, the machinery has stalled: ring the insurer yourself, or the Independent Review Office on 13 94 76.

4. Expect provisional payments, and do not mistake them for acceptance

Under section 267, provisional weekly payments “are to commence within 7 days after initial notification”, unless the insurer has an excuse that the Workers Compensation Guidelines recognise as reasonable. Provisional payments run on provisional acceptance for up to 12 weeks. They are a bridge, not a decision. The insurer can still dispute liability, which is why the formal claim matters.

5. Make the claim itself

Notification is not a claim. The claim, with the claim form and certificate of capacity, is what section 261 gives you 6 months to make, and it is the step people skip when an insurer is already paying provisionally. Make it anyway. If the injury later turns out to be worse than it looked, the accepted claim is the foundation every later entitlement is built on, including the lump sums covered in our 2026 lump sum guide.

The money: what weekly payments actually pay

Weekly payments under workers compensation are a percentage of your pre-injury average weekly earnings, called PIAWE. SIRA defines PIAWE as the average of your ordinary earnings plus any permissible shift and overtime amounts. The percentages then step down over time. Under SIRA’s claims guide, the first entitlement period, weeks 1 to 13, pays up to 95 per cent of PIAWE. From week 14 to week 130, a worker with no capacity receives up to 80 per cent, while a worker back at work for 15 hours or more per week receives 95 per cent less current earnings. After 130 weeks the rate is 80 per cent less current earnings, and continuing at all depends on work capacity rules, with tighter limits again for psychological injuries under the 2026 reforms.

A worked example. Sofia is a warehouse storeperson on a PIAWE of $1,400. Off work entirely, she receives up to $1,330 a week for the first 13 weeks (95 per cent of $1,400). From week 14, still with no capacity, that drops to $1,120 (80 per cent). If she returns on light duties at 20 hours a week earning $700, her payment in the second period becomes $1,330 less $700, that is $630 on top of her wages. The percentages come from SIRA’s claims guide; the dollar figures are our arithmetic on a hypothetical PIAWE, and every real PIAWE calculation has its own complications, which is exactly why our certificate of capacity guide tells you to check the insurer’s PIAWE letter line by line.

Medical and treatment expenses are paid on top of weekly payments, and permanent impairment lump sums are a separate entitlement again. The point for a brand-new claim is simpler: the scheme replaces most of your wage in the early months, so there is no financial reason to tough it out unpaid while you decide whether to claim.

Road accidents: the CTP scheme and the 28-day trap

If a motor vehicle caused the injury, the compulsory third party (CTP) scheme under the Motor Accident Injuries Act 2017 usually applies rather than, or as well as, workers compensation. Every registered NSW vehicle carries a green slip, and the scheme pays statutory benefits, weekly income support, treatment and care, to anyone injured in a motor accident, including at-fault drivers for an initial period.

The timing rule is meaner than the workers compensation one. Under Part 4 of SIRA’s Motor Accident Guidelines, a claim for statutory benefits should be made within three months of the accident, but “to be entitled to receive weekly payments of statutory benefits from the day after the date of the motor accident”, the claim must be made “within 28 days after the date of the accident”. Miss the 28 days and you can still claim, but the weekly payments do not reach back to the crash. Once the insurer accepts liability it must start weekly payments within 10 business days, decide treatment requests within 10 days of receipt, and pay approved invoices within 20 days.

The overlap case is the one that catches workers: injured in a crash while driving for work. Both schemes can be engaged, and journeys to and from work sit in their own category, because SIRA’s journey claims guidance requires “a real and substantial connection between your employment and the accident or incident” before an ordinary commute is covered by workers compensation, and points commuters injured in motor crashes to the CTP scheme instead. Which scheme you claim in first affects who pays, what you can recover later and how the insurers reimburse each other. This is one of the few first-week decisions where legal advice changes the outcome, and it is a topic we will cover on its own; for now, protect both positions by notifying your employer and lodging the CTP claim inside 28 days.

Injured somewhere else: public liability and medical negligence

A fall in a shopping centre, a dog attack in a park, an injury at a rented property or during a paid activity: these sit outside the statutory schemes. There is no insurer obliged to contact you within 3 business days and no provisional payments. A public liability claim is a negligence claim under the Civil Liability Act 2002, and it is on you, in practice on your lawyer, to prove the occupier or operator breached a duty of care and that the breach caused the injury.

The time limits work differently too. Under section 50C of the Limitation Act 1969, a personal injury action must be brought within 3 years “from and including the date on which the cause of action is discoverable by the plaintiff”, with a 12 year long-stop “from the time of the act or omission alleged to have resulted in the injury”. Section 50D makes a claim discoverable when you know, or ought to know, that the injury has occurred, that it was caused by the defendant’s fault, and that it is serious enough to justify an action. Three years sounds generous next to workers compensation’s six months. It is not, because negligence claims live or die on evidence: the puddle gets mopped, the CCTV gets overwritten on a 30 day cycle, the witness moves interstate. The claim may be discoverable for three years; the proof often is not.

Medical negligence follows the same limitation rules with an extra layer: you generally need an independent expert to say the treatment fell below a reasonable standard, and hospitals’ own records are the battleground. If a hospital social worker is the person who said “you might have a claim” about the treatment itself, ask the hospital for your complete records now. You are entitled to them, and they are cheapest to obtain before anyone is defensive.

The claims nobody mentions: TPD and income protection through super

Almost no doctor, HR manager or hospital social worker will mention the claim that sits inside your superannuation, because it has nothing to do with where you were injured. According to Moneysmart, most super funds automatically provide life cover, total and permanent disability (TPD) insurance and often income protection to members aged 25 and over with sufficient balances. TPD pays a lump sum if injury or illness leaves you unable to work in your usual occupation, or any occupation, depending on the policy wording. It does not care whose fault the injury was, whether it happened at work, or whether you have another claim running.

Two things matter in the first weeks. First, find out what cover you actually hold: log in to each fund you have ever had, or ask the fund directly for the insurance terms. Second, do not let the cover die while you wait. Moneysmart notes that “by law, super funds cancel insurance on accounts with no contributions for at least 16 months”, which is exactly what happens to an injured worker who stops earning and stops receiving contributions. If a serious injury has taken you out of work, checking the box that keeps your insurance active is one of the highest-value pieces of admin available to you, and a TPD claim can run alongside workers compensation, CTP or negligence claims rather than instead of them.

What changed on 1 July 2026, and what it means for a brand-new claim

The Workers Compensation Legislation Amendment Act 2025 took effect on 1 July 2026, and if your injury or notification is after that date, most of what older guides say about psychological claims no longer describes your claim. The essentials, from SIRA’s reform FAQs:

A primary psychological injury is now compensable only where it was caused by a defined “relevant event” with a real and direct connection to employment, and employment must be the main contributing factor. Relevant events include sexual harassment, racial harassment, bullying, excessive work demands, acts or threats of violence, indictable criminal conduct, and witnessing traumatic incidents or vicarious trauma. Claims resting on bullying, racial harassment or sexual harassment follow a new pathway: the worker lodges the claim, the insurer must decide within 42 days, and the worker receives interim payments at 75 per cent of pre-injury average weekly earnings while the question is decided. If the insurer disputes that the conduct meets the legislative definition, that dispute goes to the Industrial Relations Commission before the Personal Injury Commission deals with the rest.

Entitlements changed too. Weekly payments for psychological injuries generally run up to 130 weeks, medical treatment remains covered for up to a year after weekly payments stop, and the whole person impairment threshold for extended benefits is 25 per cent for psychological injuries notified on or after 1 July 2026. Workers notified before that date keep the old settings, including the 15 per cent WPI threshold for work injury damages. There is also a structural change that affects every serious claim, physical or psychological: one single permanent impairment assessment per injury now feeds every entitlement, so the sequencing of medical assessments has consequences it never used to have. Our lump sum guide covers that in detail. A further phase arrives in mid-2027, when a new permanent impairment framework with SIRA-approved assessors commences, and SIRA has flagged further updates on “reasonable and necessary” treatment standards for October 2026, so treat any guide, including this one, as dated the moment SIRA’s reform hub says otherwise.

Psychological injury claims notified from 1 July 2026

The new gateway, step by step

STEP 1

Was the injury caused by a relevant event? Sexual or racial harassment, bullying, excessive work demands, violence or threats, indictable criminal conduct, witnessing trauma, vicarious trauma.

STEP 2

Is there a real and direct connection to employment, with employment the main contributing factor? Both are required for the claim to proceed.

STEP 3 (conduct claims)

Bullying and harassment claims: insurer must decide within 42 days; the worker receives interim payments at 75% of PIAWE while it is assessed.

STEP 4 (if disputed)

Disputes about whether the conduct meets the definition go to the Industrial Relations Commission first; other disputes go to the Personal Injury Commission.

IF ACCEPTED

Weekly payments up to 130 weeks, treatment for up to a year after payments end, and a 25% WPI threshold for extended benefits.

Source note: all steps, timeframes and thresholds from SIRA’s workers compensation reform FAQs and the SIRA reform hub, retrieved 13/09/2026. Applies to claims notified on or after 1 July 2026.

What it costs to find out if you have a claim

For workers compensation, the answer is nothing. The Independent Review Office runs ILARS, the Independent Legal Assistance and Review Service, which funds legal advice from approved lawyers for injured workers, including the cost of medical reports, when there is a dispute with an insurer or an entitlement is being challenged. You contact an IRO-approved lawyer, the lawyer applies, and IRO assesses the funding application within 5 business days. The scheme applies to workers compensation matters only, not motor accident claims, and IRO must be satisfied the matter has a reasonable chance of success. The practical consequence: any NSW worker who pays out of pocket just to find out whether they have a workers compensation claim has been badly advised.

For CTP claims, legal costs in statutory benefits disputes are regulated and in many cases recoverable, and most firms assess motor accident and negligence claims for free and act on no win, no fee terms for the claims they take on. What those retainers cover, and what happens to disbursements if you lose, varies enough that our guide to what personal injury lawyers cost is worth ten minutes before you sign anything.

Whether you have a claim worth pursuing is a different question from whether you have a claim, and the data says people answer it badly on their own. The ABS work-related injuries survey for 2021-22 found 497,300 Australians experienced a work-related injury or illness in that year, and 43 per cent never applied for workers compensation. Of those who did not apply, 39 per cent thought the injury too minor or compensation unnecessary, 14 per cent did not think they were eligible and 10 per cent were not covered or not aware of the scheme. Meanwhile Safe Work Australia’s national statistics put the median compensation paid on a serious claim at $15,100 with a median 7 working weeks off (2020-21 data). People routinely leave five figures on the table because someone said “you might have a claim” and nobody said what to do next.

Six mistakes people make in the first six months

Waiting for HR to “sort it out”. HR’s notification duty runs to the employer’s insurer, not to your interests. The notice section 254 cares about is yours, and the six month clock in section 261 runs whether or not HR ever files the paperwork. Give written notice yourself and keep a copy.
Assuming fault decides eligibility. Workers compensation and the first phase of CTP statutory benefits are no-fault. People rule themselves out because “it was my own clumsiness”, which is legally irrelevant to a statutory claim and one of the reasons the ABS found 14 per cent of non-applicants did not think they were eligible.
Letting the 28-day CTP window close while the workers compensation question gets sorted. If a vehicle was involved, lodge the CTP claim inside 28 days even if you expect workers compensation to respond, because back-dated weekly payments are what the deadline protects.
Leaving the first consultation without a certificate of capacity. Going back for it later means a second appointment, a gap in the evidence and a slower claim. Ask at the first visit, and check what the doctor writes.
Treating provisional payments as an accepted claim. Section 267 payments are provisional for up to 12 weeks and can stop. The formal claim, made within six months, is what secures your position. Make it even when money is already arriving.
Paying for advice ILARS would have funded, or getting none at all. For workers compensation, state-funded advice through IRO-approved lawyers exists precisely for the “do I have a claim?” question. Using it early costs nothing and prevents most of the mistakes above.

Where the existing guides disagree, and who is right

We compared the highest-ranking commercial guides for this topic against the legislation and the regulators. Three points of conflict matter for a new claim.

What the guides say	What the primary sources say	Who is right
WorkCover Hub structures its advice around lodging the claim within 48 hours of injury.	The 48 hours belongs to the employer: SIRA requires the employer to notify their insurer within 48 hours. The worker’s own claim window is 6 months under s 261.	The Act and SIRA. Notify immediately, but do not panic-lodge an incomplete claim in two days; get the certificate of capacity right first.
Withstand Lawyers and others state the insurer must begin payments within seven days of notification.	Section 267 requires provisional payments within 7 days absent a Guidelines-defined reasonable excuse, on provisional acceptance for up to 12 weeks. It is not an acceptance of the claim and it can stop.	Both, but the guides omit the half that matters: the payments are provisional. Workers who relax at day 7 and never lodge the formal claim are the losers.
Most top-ranking first-steps guides, including WorkCover Hub and Withstand, describe psychological claims with no mention of the 1 July 2026 changes; Law Partners is a rare exception.	SIRA’s reform FAQs: psychological claims notified from 1 July 2026 need a relevant event, face a 42 day conduct-claim decision pathway through the IRC, and carry a 25% WPI threshold for extended benefits.	SIRA. For any psychological injury notified after 1 July 2026, a pre-reform guide is not merely dated, it describes a different scheme.

Frequently asked questions

Can I claim compensation if the accident was my fault?

For workers compensation, yes. It is a no-fault scheme, and your own carelessness does not disqualify you, though serious and wilful misconduct can. CTP statutory benefits also start on a no-fault basis, with fault affecting entitlements after the initial period and any damages claim. Fault only decides everything in negligence claims such as public liability.

How long do I have to make a workers compensation claim in NSW?

Six months from the injury or accident under section 261 of the 1998 Act. Late claims can be accepted up to three years where the delay came from ignorance, mistake, absence from the State or other reasonable cause. Notice to your employer is separate and must be given as soon as possible.

Who pays me while I am off work?

For an accepted or provisionally accepted workers compensation claim, the employer’s insurer pays weekly payments starting at up to 95 per cent of your pre-injury average weekly earnings for the first 13 weeks, then stepped-down rates. Provisional payments must generally start within 7 days of the insurer being notified.

Do I need a lawyer to make a claim, and what does it cost?

You do not need a lawyer to notify your employer or lodge a workers compensation claim. If anything is disputed, or you are unsure what you are entitled to, advice through an IRO-approved lawyer is funded by ILARS and costs you nothing for workers compensation matters. Motor accident and negligence claims are usually assessed free and run on no win, no fee terms.

Can I claim if I was injured driving to or from work?

An ordinary commute is covered by workers compensation only where there is a real and substantial connection between your employment and the accident. If the crash involved a motor vehicle, you can generally claim CTP statutory benefits instead, and lodging within 28 days protects your weekly payments. Injured while driving for work, rather than to work, both schemes may respond, so get advice on which to lead with.

Someone at the hospital said I might have a claim. Do I have to do anything right now?

Three things, none of which commit you to anything: give written notice to your employer if work was involved, ask the treating doctor for a certificate of capacity, and note the date of the injury, because every deadline in this article counts from it. Deciding whether to pursue the claim can come later; keeping the option alive cannot.

Primary sources

Legislation: Workplace Injury Management and Workers Compensation Act 1998 (notice of injury s 254, time for claims s 261, provisional payments s 267); Workers Compensation Act 1987; Motor Accident Injuries Act 2017; Limitation Act 1969, ss 50C and 50D; Civil Liability Act 2002.

Regulators and agencies: SIRA, what to do after an injury; SIRA reform FAQs; SIRA reform hub; SIRA reform commencement news; SIRA claims guide, weekly payments and PIAWE; SIRA workers compensation benefits guide (July 2026); SIRA Motor Accident Guidelines, Part 4; SIRA, work break and journey claims; Independent Review Office, get legal advice; SafeWork NSW, notify SafeWork; Personal Injury Commission; Moneysmart, insurance through super.

Statistics: ABS, Work-related injuries, 2021-22; Safe Work Australia, Australian workers’ compensation statistics.

This article is general information about NSW law as at 13 September 2026, not legal advice. Time limits and entitlements depend on your circumstances and can change, particularly while the 2026 reforms are being implemented. Get advice on your own situation before acting.

If the next step for you is finding someone to run the claim, start with our reviewed list of the best compensation lawyers and law firms in Sydney.