SMALL BUSINESS. making a difference INJURY MANAGEMENT KIT

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1 SMALL BUSINESS INJURY MANAGEMENT KIT Notify your workers compensation insurer of the injury within 48 hours. You will also need to notify WorkCover of workplace fatalities and certain serious incidents. Give the injured worker s package to your injured worker (or their representative) as soon as possible. Make sure the details of the injury are put in your register of injuries. Information about the register is overleaf. Talk to your insurer, injured worker (and anybody representing them), treating doctor and others involved in your worker s injury management. Forward all medical certificates, receipts and accounts to your insurer, promptly. Be involved in your worker s return to work. The treating doctor s letter (attached) outlines your interest in helping your injured worker get back to work on suitable duties. Fill it in and ask your worker to give it to their treating doctor. Read the enclosed Employer s guide what to do if an injury occurs, Suitable duties information for employers and injured workers, Your recovery and return to work after a workplace injury and the Standard return to work program. Get more information about coordinating return to work duties from your insurer s case manager or a workplace rehabilitation provider. Complete an incident information form (attached) and use it to help you identify ways to prevent further incidents. Keep good records you may be asked by your insurer or a WorkCover inspector to provide information relating to your worker s claim. For further information, contact your insurer, phone the WorkCover Assistance Service on , or visit making a difference

2 REGISTER OF INJURIES Workplaces are required to keep a register of injuries in a readily accessible place. Failing to keep a register can result in a fine of up to $5500. Injured workers are entitled to enter the details of the incident in the register whether or not it results in a workers compensation claim. By doing so, the worker protects their right to make a claim at a future time. Some insurers provide a register of injuries. They can also be purchased from stationery suppliers. If employers want to make up their own register, it should be in a format outlined below. Workers Compensation Regulation 2003, Clause 36, Form 2 Register of Injuries Particulars: Name of injured worker: Address: Age: Occupation: Industry in which worker was engaged: Operation in which worker was engaged at time of injury: Date (or deemed date) of injury: / / Hour: am/pm Nature of injury: Cause of injury: Remarks: (Signed) (Address) (Date) (Entries in this register should, if practicable, be made in ink.) Note The employer s full name and address, together with the name of the employer s insurer and the insurer s address, should be written in ink on the inside cover of the register.

3 TREATING DOCTOR Employer s name Address Telephone (Date) Dear Doctor (Name of doctor) is employed by (Name of injured worker) (Name of employer) Our policy is to encourage the early return to work of our workers, as soon as practicable following an injury or illness. Where possible, they are returned to their usual work, or some suitable work within their capacity. We would appreciate your assistance in formulating a return to work plan to ensure the injured worker, who is employed as a (injured worker s occupation with brief description of their duties if needed) can return safely to their usual work, or to other suitable work. Please provide information on the WorkCover medical certificate that may assist in formulating a suitable return to work plan. Call me should you need details about suitable duties that we can make available to the worker. We look forward to your contribution to our rehabilitation effort. Yours sincerely, Return to work coordinator/nominated person

4 INCIDENT INFORMATION FORM Use this form to: keep as a record your insurer may need this information to investigate a claim know the facts about the incident take necessary action to prevent further incidents notify WorkCover, if required. Site details Injured worker details Name: Contact Number: Address: Date of birth: Injury details One of these boxes must be ticked Did the injury occur: At work meal break At work working at usual workplace Commuting/journey Time of injury am/pm Time notice received am/pm At work road traffic accident Away from work during recess period At work working away from normal place of work Date of injury Date notice received from worker To whom was the notice given? Full address and place where injury occurred (accident location) Postcode Names and addresses of witnesses (if any)

5 How did the injury happen? List the sequence of events that led to the accident Treating doctor s name and phone number Name: Phone number: Time lost particulars Date and time worker first ceased work Date: / / Time: am/pm Has worker resumed: a. Normal work duties? No Yes Date: / / Time: am/pm b. Selected/suitable duties? No Yes Date: / / Time: am/pm Corrective action What corrective action has been taken to prevent incidents like this happening again? Name (printed): Signature: Position:

6 Disclaimer This publication may contain occupational health and safety and workers compensation information. It may include some of your obligations under the various legislations that WorkCover NSW administers. To ensure you comply with your legal obligations you must refer to the appropriate legislation. Information on the latest laws can be checked by visiting the NSW legislation website ( or by contacting the free hotline service on This publication does not represent a comprehensive statement of the law as it applies to particular problems or to individuals or as a substitute for legal advice. You should seek independent legal advice if you need assistance on the application of the law to your situation. WorkCover NSW Catalogue No. WC02226 WorkCover Publications Hotline WorkCover NSW Donnison Street Gosford NSW 2250 Locked Bag 2906 Lisarow NSW 2252 WorkCover Assistance Service Website ISBN Copyright WorkCover NSW 0909