Quick Tips and Referral Points

Quick Tips and Referral Points

Quick Tips and Referral Points

Category: Workers Compensation › Claims Process
Audience: Internal – Member Services Division
Last Updated: 2025-10-16 Version: 1.0

Summary

Fast reference for common escalation triggers and next steps.

Key Information

  1. Initial steps: If no insurer response within seven days after submitting a certificate, do a legal referral. If provisional liability not accepted within seven days, do a legal referral.
  2. Investigations: Be careful with social media; for IME attendance/selection, do a legal referral.
  3. Return to Work: If duties are not offered/withdrawn, are demeaning, or employer influence is undue, do a legal referral.
  4. Other claims: Consider motor accident/journey/public liability/discrimination — do a legal referral to assess.
  5. Payments: If PIAWE/top‑up seems wrong, do a legal referral.

Referral or Escalation

Do a legal referral whenever there is uncertainty, delay, denial, suitability disputes, or potential parallel claims.

Practical Tips

  • Document dates, decisions, and communications.
  • Retain copies of certificates and statements.

Related Content

  • First Steps When Injured
  • Provisional Liability
  • Investigation of Claims

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