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* 1. Are you a member of AEAV/UWU

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* 2. What is your full name? (We will not disclose any information you provide without your consent)

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* 3. Have you ever applied for WorkCover?

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* 4. Was it accepted or rejected?

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* 5. How difficult was it to apply for WorkCover

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* 6. How many times have you utilised WorkCover

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* 7. How long were you or currently have been on WorkCover? (Choose our longest claim for survey)

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* 8. What type of injury did you apply for WorkCover?

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* 9. How often did your employer (not including your Return to work advisor) contact you whilst you were on WorkCover?

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* 10. Who has contacted you whilst on WorkCover (may include RTW Advisor)?

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* 11. On a scale of 1-5, how satisfied were you with the contact from your employer?

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* 12. Do you feel that your employer made a reasonable attempt to help you return to work? If yes, how? If not, why?

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* 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.

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* 14. At any time did you feel forgotten or lost in the system? Why?

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* 15. The union would like to do some follow up based on your answers. Can you confirm your worksite, role and best contact time?

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* 16. Please let us know you best contact method by filling out your preferred contact details.

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