Emergency Services WorkCover experience Question Title * 1. Are you a member of AEAV/UWU Yes No Question Title * 2. What is your full name? (We will not disclose any information you provide without your consent) Question Title * 3. Have you ever applied for WorkCover? Yes No Question Title * 4. Was it accepted or rejected? Accepted Rejected Question Title * 5. How difficult was it to apply for WorkCover Very easy Somewhat easy Neutral Somewhat difficult Extremely difficult Very easy Somewhat easy Neutral Somewhat difficult Extremely difficult Question Title * 6. How many times have you utilised WorkCover Once Twice Three times or more Question Title * 7. How long were you or currently have been on WorkCover? (Choose our longest claim for survey) 0-10 weeks 11-25 weeks 26 -52 weeks 53 -78 weeks 79-130 weeks Question Title * 8. What type of injury did you apply for WorkCover? Mental health injury Physical injury Question Title * 9. How often did your employer (not including your Return to work advisor) contact you whilst you were on WorkCover? About once a week A few times a month Once a month Less than once a month Bi monthly Quarterly Half yearly Yearly I wasn't contacted Question Title * 10. Who has contacted you whilst on WorkCover (may include RTW Advisor)? Manager Human Resources Department Return to work Advisor No one - was not contacted Question Title * 11. On a scale of 1-5, how satisfied were you with the contact from your employer? DEEPLY DISSATISFIED SOMEWHAT DISSATISFIED NEUTRAL SATISFIED DEEPLY SATISFIED DEEPLY DISSATISFIED SOMEWHAT DISSATISFIED NEUTRAL SATISFIED DEEPLY SATISFIED Question Title * 12. Do you feel that your employer made a reasonable attempt to help you return to work? If yes, how? If not, why? Question Title * 13. Were there any unresolved issues (such as workplace culture, physical/ergonomic issues) that prevented you returning to work sooner or at all? If so, please explain. Question Title * 14. At any time did you feel forgotten or lost in the system? Why? Question Title * 15. The union would like to do some follow up based on your answers. Can you confirm your worksite, role and best contact time? Question Title * 16. Please let us know you best contact method by filling out your preferred contact details. Address Address 2 City/Town State/Province Email Address Phone Number Done