Information for Injured Workers

Useful Documents

pdf

Worker Expense Reimbursement Claim Form

Updated 16th June 2020
Claims

For workers to complete when seeking reimbursement from StateCover for e.g. pharmacy, travel, and other out-of-pocket expenses because of their workplace injury.

266kb
pdf

EFT Authorisation Form - Worker

Updated 16th June 2020
Claims

Form for a worker to request and authorise StateCover to make payments directly by EFT.

610kb
pdf

Information Authority

Updated 16th June 2020
Claims

To be completed by the worker to permit StateCover to collect personal and health information so their claim can be assessed and effectively managed.

610kb
pdf

Employee Claim Form

Updated 5th June 2020
Claims

Claim form a worker can complete to make a workers’ compensation claim with StateCover.

474kb