Most Australian schemes require an insurer to make a first decision within about two to four weeks of receiving a complete claim. So if yours has run past that, or past six months, something specific is usually holding it up. This article explains the timeframes that apply in each state, why claims stall, and what to do about it. It is written for employers and brokers, not injured workers.
How long does WorkCover take to pay? The timeframes by state
There is no single national answer, because workers compensation is run separately in each state and territory. Each scheme sets its own clock for the insurer's first liability decision, the point at which the insurer accepts or disputes the claim.
In New South Wales, the insurer must start provisional weekly payments within seven calendar days of being notified of an injury, unless it has a "reasonable excuse" not to. Provisional liability is a way of getting money and treatment flowing before the full claim is decided. If a full claim form is lodged, the insurer then has 21 days to accept or dispute liability. That is set out in SIRA's Workers Compensation Guidelines.
In Victoria, the WorkSafe agent has 28 days from receiving the claim to accept or reject liability. For mental injury claims, WorkSafe Victoria says an entitlement to provisional payments is usually determined within about five business days, and those payments can continue for up to 13 weeks while the claim is assessed.
In Queensland, WorkSafe Queensland states that WorkCover "aims to make a decision on claims in 20 business days or less, as outlined by legislation," and adds "there's a good chance we'll be able to decide your claim within 10 business days." Since January 2025, WorkCover must also give the worker an information statement within a few days of receiving the claim.
In Western Australia, under the Workers Compensation and Injury Management Act 2023 (in force from 1 July 2024), the insurer must give a liability decision notice or a deferred decision notice within 14 days. If neither is given in time, liability is taken to be accepted. If the decision is deferred, provisional payments must begin (by day 28).
In South Australia, ReturnToWorkSA's claims agents aim to decide within 10 business days.
For Commonwealth employees under Comcare, the statutory timeframe is 20 calendar days for an injury claim and 60 calendar days for a disease claim.
Those are the decision timeframes. They are not the same as how long a claim lasts.
How long does a WorkCover claim take from start to finish?
A liability decision is the beginning, not the end. Once accepted, a claim continues while treatment, rehabilitation and return to work are worked through. Weekly payments (income support while a worker has reduced capacity) also have limits that vary by state and step down over time.
In NSW, for example, SIRA confirms weekly payments are generally available for a maximum of 260 weeks (five years) under section 39 of the Workers Compensation Act 1987, with tighter tests applied after 130 weeks, unless the worker's permanent impairment is above 20%. So "how long does workers comp last" depends on capacity, medical evidence and the rules at each stage, not on a fixed end date.
Most claims resolve without drama. The ones that don't tend to share a small number of causes.
Why claims stall past six months
At IMA we see four recurring reasons a claim becomes a long tail claim, a claim that runs long and costs far more than an equivalent injury should. And the cost doesn't stop at the claim itself: a blown out claim loads your premium for years, which you can see for yourself with the Claim Cost Calculator.
Capacity was never made clear. The certificate of capacity, the treating doctor's document setting out what the worker can and can't do, is vague or out of date, so no one can build a credible plan. The claim drifts.
An unnamed psychological factor is sitting on top of a physical injury. The file treats it as a straightforward back or shoulder injury, but recovery has stalled for reasons no one has named. Until that secondary factor is identified and addressed, the physical claim won't close.
A return to work plan was written but never landed in the workplace. The plan exists on paper. Suitable duties, the real, productive tasks matched to the worker's medical restrictions, were never actually set up on site, so nothing changes.
Responsibility is split and gaps never close. The insurer, the employer and the treating team each assume someone else is driving. No one owns the next step, and weeks pass between actions.
Warning signs a claim is stuck
Watch for these signals:
- The certificate of capacity keeps repeating "no capacity" with no change and no plan to change it.
- Weeks pass with no case conference (a meeting of the worker, employer, insurer and treating team).
- The return to work plan is months old and doesn't match the worker's current capacity.
- No one can tell you plainly what the next step is or who owns it.
Any one of these is worth a second look. Two or more, and the claim is drifting. To run a specific claim against these signals, take the two minute Stuck Claim Check.
What to do about a stalled claim
Get the certificate of capacity current and specific. Confirm who owns the file and the next action. Convene a case conference so the doctor, employer and insurer are aligned. And name any psychological factor that is quietly holding recovery back, rather than working around it.
If a claim has run past six months and none of that is happening, it usually needs someone whose only job is to close the gaps.
Tell us where the claim is stuck and we'll tell you plainly whether we can help. Call 1300 477 662 or get in touch via our contact page.
Frequently asked questions
How long does WorkCover take to pay in Australia?
It depends on the state. In NSW, provisional weekly payments should start within seven days of notification. In Victoria the agent has 28 days to decide liability, in Queensland WorkCover aims for 20 business days (often within 10), in WA the insurer has 14 days to issue a decision or deferral notice, and in SA the aim is 10 business days.
Why is my workers comp claim taking so long?
The most common causes are an unclear certificate of capacity, an unaddressed psychological factor on a physical injury, a return to work plan that was never implemented, and split responsibility between insurer, employer and treating team.
How long does workers comp last?
It varies by scheme and by the worker's capacity and impairment. In NSW, weekly payments are generally capped at 260 weeks unless permanent impairment is above 20%, with stricter tests from 130 weeks.
What counts as a stalled claim?
As a rule of thumb, a claim that has passed the scheme's decision timeframe with no clear reason, or one running past six months with a stale return to work plan and no scheduled next step.
