WorkCover in NSW: what people mean by it, and what the scheme is actually called
Almost everyone still says WorkCover. The word stopped being the name of anything official in New South Wales in 2015, when the old WorkCover Authority was wound up and its insurance and regulation roles were separated, and the scheme most people mean is now run by icare and regulated by SIRA. None of that changes what an injured worker is entitled to. Knowing which body does what saves a week of phone calls, and it is often the difference between physiotherapy starting now and physiotherapy starting once someone works out who approves it.
By Andrew Ellis, AHPRA registered physiotherapist · October 2026
The short version
- WorkCover is the old name: the NSW scheme is run by icare
- A scheme agent runs your claim: EML, Allianz, Gallagher Bassett, GIO or QBE
- SIRA writes the rules and caps the fees, and does not approve treatment
- The insurer approves your physiotherapy through a treatment request, and pays for it
WorkCover is a name people kept, not a scheme
People still call it WorkCover. Workers say they are on WorkCover, employers ask for the WorkCover forms, and WorkCover physiotherapy is still the phrase we hear most often on the phone. Nobody is wrong to use it. It is simply not what the New South Wales system is called any more, and the gap between the word and the machinery behind it is where a lot of avoidable delay comes from.
The WorkCover Authority of New South Wales was a real organisation that ran both the insurance side and the safety side of workplace injury for decades. In 2015 it was wound up and its roles were handed to separate bodies: icare, which stands behind the scheme as the insurer, and the State Insurance Regulatory Authority, known as SIRA, which regulates it. The word survived the split because it had been in everyone's vocabulary for a generation, because nothing simple replaced it, and because WorkCover is still a live name in some other jurisdictions.
Practically, nothing about your entitlements depends on which word you use. Say WorkCover to us and we will know exactly what you mean. The reason to learn the real names is narrower than that: the letters, forms and phone numbers you are handed will carry them, and knowing which body does what is how you reach the right person first time.
What people say, and what it actually is
| What people say | What it actually is |
|---|---|
| I am on WorkCover | You have a New South Wales workers compensation claim, handled by a scheme agent for icare |
| My WorkCover certificate | A certificate of capacity, the scheme's own form, and not an ordinary medical certificate |
| WorkCover approved my physio | Your insurer approved an Allied Health Treatment Request from your physiotherapist |
| I need to ring WorkCover | You ring your case manager at the scheme agent named on your claim letter |
| WorkCover will not approve more physio | Your insurer has not approved the latest treatment request, and your physiotherapist can submit another one with updated reasons |
Who actually does what
icare, or Insurance and Care NSW, is the government agency that stands behind the main New South Wales workers compensation scheme, known as the Nominal Insurer. It also sits behind the Treasury Managed Fund for government employers, and separate schemes for people with very serious injuries. icare is the insurer in the formal sense, but it is usually not who you speak to day to day.
The scheme agent is who you actually deal with. Claims for the Nominal Insurer are handled by claims service providers that icare appoints, and the names that come up include EML, Allianz, Gallagher Bassett, GIO and QBE. Your case manager, the person who approves treatment and manages your weekly payments, works there rather than at icare. Your claim letter tells you which agent you have, so keep it somewhere you can find it. Some employers are self insured, or covered by the Treasury Managed Fund, and their claims are handled by another organisation again.
The regulator
SIRA, the State Insurance Regulatory Authority, is the regulator. It writes the guidelines insurers and treating practitioners have to work under, sets the maximum fees that can be charged for treatment on a claim, and oversees how claims are handled. SIRA does not treat you and does not approve your physiotherapy, but every rule your insurer applies to your claim comes from there. If a payment or an approval has stalled, that is your case manager, not the regulator.
Which one do you ring
Payments and treatment approvals go to your case manager at the scheme agent named on your claim letter, and to SIRA only if they cannot be resolved there. Ringing the wrong body just adds delay.
What that means if you have just been injured
The practical sequence has not changed because the name did. Tell your employer as soon as you can, and make sure it lands in writing somewhere, whether that is an incident form, the register of injuries or an email you keep a copy of. Then see a doctor and ask for a certificate of capacity, which is the scheme's own form and not the same thing as an ordinary medical certificate.
Your employer notifies their insurer, and in New South Wales they are required to do that within 48 hours of becoming aware of a workplace injury, which is one reason telling someone early matters so much. The insurer opens the claim and sends you a claim number and the name of your case manager. That letter is usually the first place you find out which scheme agent you are actually dealing with.
Keep the claim number where you can get at it, because every provider you see needs it to bill the insurer instead of you. If liability on the claim has not been decided yet, insurers can often start paying for some treatment on a provisional basis while they work through it, so an undecided claim is not automatically a reason to sit and wait. Ask your case manager or your physiotherapist what is in place rather than assuming nothing is.
What to do after an injury at work in NSW
- Tell your employerReport it as soon as you can and make sure it lands in writing, on an incident form, the register of injuries or an email you keep.
- Get a certificate of capacitySee a doctor and ask for the scheme's own form by name, not an ordinary medical certificate.
- Let the insurer open the claimYour employer notifies their insurer within 48 hours, and you are sent a claim number and the name of your case manager.
- Take the claim number to your physioEvery provider needs it to bill the insurer instead of you, so keep it where you can get at it.
What it means for getting physiotherapy paid for
Nobody at icare or SIRA approves your physiotherapy. The insurer handling your claim does.
This is where the naming confusion actually costs people time. Nobody at icare or SIRA books your physiotherapy or approves your sessions. Your treatment is approved by the insurer handling your claim, on the recommendation of the practitioner who is treating you.
For physiotherapy the mechanism is the Allied Health Treatment Request, usually shortened to AHTR. Your physiotherapist assesses you, then submits that request to the insurer setting out what they recommend, why, and over what period. The insurer approves it and treatment goes ahead. In practice a first consultation can usually proceed while the request is being prepared, and your physiotherapist should be able to tell you exactly how many sessions are approved on your claim so the next request goes in before they run out.
What you pay
On an accepted claim you do not pay for treatment the insurer has approved, because the practice bills the insurer directly and the fees are capped by SIRA. Our WorkCover physiotherapy page sets out the billing, the pre approved sessions and the reporting in full.
- Your physiotherapist assesses you
- An Allied Health Treatment Request goes to the insurer
- The insurer approves the sessions
- The practice bills the insurer, not you
Where the old name still trips people up
Three places, and they are all easy to avoid. First, the certificate. People ask a doctor for a WorkCover certificate, and the document the claim actually runs on is the certificate of capacity, so asking for it by name can save a second appointment. Employers get far more out of that form than the first line of it, which is worth a read on its own.
Second, ringing the wrong body. A problem with payments or an approval goes to your case manager at the scheme agent first, and to SIRA only if it cannot be resolved there. Ringing the regulator about something your case manager decides just adds delay.
Third, other states. WorkCover is still a live name in some other jurisdictions, including WorkCover Queensland and WorkCover WA, so a form or a web page you found by searching WorkCover may belong to a different scheme with different rules. If you were injured at work in New South Wales, check that what you are reading is New South Wales.
The label matters less than the machinery. If you know that icare stands behind the scheme, a scheme agent runs your claim and SIRA writes the rules, you can ring the right number first time and get treatment moving. Call it WorkCover if that is easier. We will know what you mean.
Good to know before you book
Is WorkCover still called WorkCover in NSW?
Who actually handles my NSW workers compensation claim?
Do I pay for physiotherapy on a WorkCover claim in NSW?
What does SIRA do on my workers compensation claim?
Can I choose my own physiotherapist on a NSW claim?
This guide is general information, not a diagnosis or a substitute for an assessment. If you are concerned about your symptoms, book an appointment or see your GP.
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