Defensive tactics for WorkCover claim handling

Safety Jon
Nov 4
3 min read

Here is a concise, practical playbook for handling medical assessments and claim reopenings, so you can protect yourself, maintain momentum, and stay calm under pressure.

Why this matters

Insurers and agencies often change case handlers, reopen claims, or add requirements. A clean paper trail gives you legal protection, faster resolution, and mental clarity.

What to document every time

Who you spoke with, when, how, and why
Exact requests made of you and any deadlines
What you provided in response, and on what date
Any decisions made, who made them, and the stated reasons
What action you expect from them, and by what date

Always request written reasons.

If told you must attend an assessment or provide extra info, reply in writing and ask for:

The legal or policy basis for the requirement
The specific questions to be answered by the assessor
The scope is limited to compensable injuries only
How your existing treating practitioner reports have been considered
How privacy will be protected, and who will receive the report

Keep scope tight

You can reasonably ask that any assessment focus on the accepted work injury only and that unrelated history is excluded unless they provide a clear, lawful basis. If they still insist, ask them to confirm that basis in writing.

Declare or not declare

If a condition is stable and treated, and your treating team has not raised any work safety concerns, you can state that in writing and attach current clearances. If a form demands disclosure, answer truthfully, but you can add a note limiting relevance to work capacity and safety. Keep copies of what you submit.

Fast file system

One email thread per requirement
A4 PDF for each attachment, named YYMMDD Topic v1.pdf
Running index file named 00 Index YY.xlsx listing date, sender, subject, action, due date, status

Delay diary

Start a simple log. Each entry should include:

Date and time
What was promised and by whom
Due date given
Follow-ups you sent at 48h and five business days if no response. This becomes evidence of unreasonable delay.

Model emails you can paste

Request for written reasons and scope...

Subject: Request for written reasons and defined scope of assessment

Body: Hello [Name],

Thank you for your message on 02 Nov 25. Please provide the written reasons for the proposed medical assessment, including:

The legal or policy basis
The specific questions for the assessor
Confirmation that the scope is limited to the accepted work injury
How my treating practitioner's reports have been considered
Who will receive the report, and how will privacy be protected

On receipt, I will cooperate and schedule it promptly.

Regards,

[Name]

Delay follow-up...

Subject: Follow-up on outstanding decision

Body:

Hello [Name],

Following my email on 28 Oct 25, the response fell due on 31 Oct 25. Please provide the decision or a revised timeline by 1600h today so I can plan next steps.

Regards,

[Name]