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What is a work capacity decision?

The NSW Workers Compensation system determines a worker’s entitlement to weekly payments of compensation.

The “Work Capacity Decisions” were introduced into the NSW Workers Compensation system to determine a worker’s entitlement to weekly payments of compensation. The insurer must undertake a work capacity assessment to determine whether a worker is fit for work, unfit for work or partially fit for work. It is a process involving information gathering, usually including a medical assessment of the worker’s functional, vocational and medical status to make a decision as to whether they are fit to return to work or not.

What is a Work Capacity Decision?

The “work capacity decision” is a decision made by the insurer about:

  • The worker’s current work capacity
  • What constitutes suitable employment for a worker
  • The amount the injured worker is able to earn in suitable employment
  • The amount of pre injury average weekly earnings and current weekly earnings
  • Whether a worker is, as a result of injury, unable without substantial risk of further injury to engage in employment because of the nature of that employment
  • Any other decision that affects a worker’s entitlement to weekly compensation.

A work capacity decision can be made at any time throughout the life of the claim, but in particular will be made at or prior to being in receipt of weekly benefits for a period of 130 weeks of compensation (2.5 years). This period is important as a worker is only entitled to receive weekly payments beyond 130 weeks if they are either;

  1. Totally unfit for work or
  2. If the work capacity decision accepts that the worker is partially unfit for work, the worker must be working at least 15 hours per week.

A work capacity decision can be appealed and the NSW government has now allowed payment for legal costs if the decision was made after 16 December 2016. A work capacity decision can be reviewed as followed:

Review by insurer.

A worker may request an internal review of a work capacity decision by the insurer after receiving that decision, the worker must give a completed Work Capacity – Application for Internal Review by Insurer form to the insurer specifying the grounds on which the review is being sought with any information on why you disagree with the decision and including medical information.

Review by WorkCover NSW.

If the worker is not satisfied with the outcome of the insurer’s internal review, or if the review is not completed within 30 days, the worker may lodge a Work Capacity –Application to Merit Review Authority form. The worker must lodge an application of Merit Review within 30 days of receiving the insurer’s decision with Workcover NSW.

Review by the WorkCover Independent Review Office

If the worker is still not satisfied with the outcome of the Work Cover Merit review, the worker may lodge an Application for Receiving Review from the Work Cover Independent Office (WIRO) within 30 days of receiving the review decisions, contact WIRO on 139 476.

The Work Cover Authority of NSW has issued guidelines for work capacity decisions, for internal review by the insurers and the merit review by the authority which can be found on the Work Cover NSW website.

The NSW government has just recently allowed lawyers to assist in seeking a review either from the insurer or Work Cover. Workers can now seek the assistance of a lawyer if the work capacity decision was made after 16 December 2016.

Should you have any questions in relation to work capacity decisions please do not hesitate to contact us on (02) 8329 9500 or info@garlingandco.com.au.

Garling & Co Lawyers

Matthew Garling

Matthew Garling is an Accredited Specialist in Personal Injury Law approved by New South Wales Law Society. He is admitted to practice in the Supreme Court of NSW and the High Court of Australia. Matthew is also a member of...
Shaylee C.
09:54 27 Mar 24
I recently had the pleasure of working with Garling and Co on my case, and I must say that their service was truly outstanding. From the initial consultation to the resolution of my case, they... displayed unwavering dedication and professionalism.The outcome of my case exceeded my expectations, and I am incredibly grateful for the hard work and diligence exhibited by Garling and Co. I have no hesitation in recommending this law firm to my family and friends, knowing that they will receive the same level of exceptional service.- Traceyread more
Simona M.
05:11 26 Mar 24
Emma and Rebecca have looked after my husband's workers compensation claim over the last 3 years now. We have had positive outcomes from these claims and are now pursuing a work injury damages claim.... They have been amazing to deal with. They are genuine and empathetic over what has been a very stressful time for myself and my family over these last 3 years. Nothing is ever too much for Emma and Rebecca and they are always available to communicate with. We would highly recommend Garling and Co! Thank you Emma and Rebecca.read more
Donelle L.
01:16 26 Mar 24
So very happy with the service Garling has provided the care and help has eased a lot of worry I had when going through this process . Many thanks to the entire team
S R.
06:56 04 Mar 24
Thank you Garling and Co,For all your help and support, with myself and family going through a very tough process, physically and mentally. The compassion and comfort I've felt, with Garling and Co... representing me, has felt like family.I would highly recommend them, to anyone who is dealing with a Workers Comp issue. They have made a very tough road and process, a very reassuring and secure one, with great communication skills and negotiating to the highest level.Thank you to all the Garling and Co team, I'll be forever grateful, for all your assistance throughout this process.Kind regards, Scottread more
Kimberly B.
23:14 14 Feb 24
Mathew is very knowledgable and has been of great assistance to me. All the staff are friendly and helpful. I'm so happy I found this firm.Thank you Mathew and team for your great work in my case.... I am 100% happy with what you achieved for me.read more
Julie M.
10:16 16 Jan 24
My last stage of Workers compensation claim was managed by Emma Perkins, Natasha Stojanovic, Rebecca Dunshea and Kelli Robinson at Garling and Co. Lawyers who went the extra mile with their service... from the beginning to the end of 3 years of my case. I have become very anxious with almost everything after a workplace injury and a lot of times I probably ask more questions than I need to, but Emma Perkins always finds clear answers to my questions in a short time and explains to me patiently even using her mealtime or between her meeting and make me feel that I have been very well take care and supported. I am so grateful and extremely satisfied. The excellent service, attitude, and culture of Metthew Garling and his team are second to none with a very high success rate. If you going to battle with your workplace injury for a short or long period, you are better off with Garling and Co. lawyers who are able back you up every step of the way. I strongly recommend it to anybody who needs their service like me. Julieread more
patrick P.
01:46 19 Dec 23
I like to say that I had a very wonderful experience,And the support, and also understanding with all my requests,I could not ask for a better team!Thank you Emma and also her assistant Rebecca... thank youread more
Kazi H.
13:38 13 Dec 23
Work cover fund is GOVT’S money but insurer think that it is from their 14th generation. So only they can have it. Not only that, people from the work, IME doctor from insurer, back to work... coordinator from work, Rehab provider from any side push the worker as hard as possible that the worker (doesn’t matter how the workers mental or psychical condition) either go back to his pre injury duty or leave the job.More over on that very bumpy any difficult journey some of them only treat the worker as a MONEY MAKING MECHINE .in some point worker feels like, no rooms to breath. On that moment need someone to support legally, someone to care, someone to relive.On my case I believe that, somehow, I manage to make my God happy. That’s why God sends me to Matthew Gerling and his team Allison, Rebecca and Nathan, and all of GARLING & co Lawyers.I am not good enough in English, can’t express my gratitude.Matthew, Allison, Rebecca and Nathan, please accept my appreciation and pass it to others.read more
Carol L.
01:32 29 Nov 23
Professional, understanding and friendly
Sean G.
23:21 14 Nov 23
Matthew Garling and everyone I spoke to at Garling and Co were kind, caring and compassionate. They were sensitive to my psychological condition and were patient in explaining everything to me, so... that I clearly understood the legal process. I am exceptionally grateful for the settlement outcome that Garling and Co obtained for me. Many thanks.read more
READ ALL TESTIMONIALS

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Shaylee C.
09:54 27 Mar 24
I recently had the pleasure of working with Garling and Co on my case, and I must say that their service was truly outstanding. From the initial consultation to the resolution of my case, they... displayed unwavering dedication and professionalism.The outcome of my case exceeded my expectations, and I am incredibly grateful for the hard work and diligence exhibited by Garling and Co. I have no hesitation in recommending this law firm to my family and friends, knowing that they will receive the same level of exceptional service.- Traceyread more
Simona M.
05:11 26 Mar 24
Emma and Rebecca have looked after my husband's workers compensation claim over the last 3 years now. We have had positive outcomes from these claims and are now pursuing a work injury damages claim.... They have been amazing to deal with. They are genuine and empathetic over what has been a very stressful time for myself and my family over these last 3 years. Nothing is ever too much for Emma and Rebecca and they are always available to communicate with. We would highly recommend Garling and Co! Thank you Emma and Rebecca.read more
Donelle L.
01:16 26 Mar 24
So very happy with the service Garling has provided the care and help has eased a lot of worry I had when going through this process . Many thanks to the entire team
S R.
06:56 04 Mar 24
Thank you Garling and Co,For all your help and support, with myself and family going through a very tough process, physically and mentally. The compassion and comfort I've felt, with Garling and Co... representing me, has felt like family.I would highly recommend them, to anyone who is dealing with a Workers Comp issue. They have made a very tough road and process, a very reassuring and secure one, with great communication skills and negotiating to the highest level.Thank you to all the Garling and Co team, I'll be forever grateful, for all your assistance throughout this process.Kind regards, Scottread more
Kimberly B.
23:14 14 Feb 24
Mathew is very knowledgable and has been of great assistance to me. All the staff are friendly and helpful. I'm so happy I found this firm.Thank you Mathew and team for your great work in my case.... I am 100% happy with what you achieved for me.read more
Julie M.
10:16 16 Jan 24
My last stage of Workers compensation claim was managed by Emma Perkins, Natasha Stojanovic, Rebecca Dunshea and Kelli Robinson at Garling and Co. Lawyers who went the extra mile with their service... from the beginning to the end of 3 years of my case. I have become very anxious with almost everything after a workplace injury and a lot of times I probably ask more questions than I need to, but Emma Perkins always finds clear answers to my questions in a short time and explains to me patiently even using her mealtime or between her meeting and make me feel that I have been very well take care and supported. I am so grateful and extremely satisfied. The excellent service, attitude, and culture of Metthew Garling and his team are second to none with a very high success rate. If you going to battle with your workplace injury for a short or long period, you are better off with Garling and Co. lawyers who are able back you up every step of the way. I strongly recommend it to anybody who needs their service like me. Julieread more
patrick P.
01:46 19 Dec 23
I like to say that I had a very wonderful experience,And the support, and also understanding with all my requests,I could not ask for a better team!Thank you Emma and also her assistant Rebecca... thank youread more
Kazi H.
13:38 13 Dec 23
Work cover fund is GOVT’S money but insurer think that it is from their 14th generation. So only they can have it. Not only that, people from the work, IME doctor from insurer, back to work... coordinator from work, Rehab provider from any side push the worker as hard as possible that the worker (doesn’t matter how the workers mental or psychical condition) either go back to his pre injury duty or leave the job.More over on that very bumpy any difficult journey some of them only treat the worker as a MONEY MAKING MECHINE .in some point worker feels like, no rooms to breath. On that moment need someone to support legally, someone to care, someone to relive.On my case I believe that, somehow, I manage to make my God happy. That’s why God sends me to Matthew Gerling and his team Allison, Rebecca and Nathan, and all of GARLING & co Lawyers.I am not good enough in English, can’t express my gratitude.Matthew, Allison, Rebecca and Nathan, please accept my appreciation and pass it to others.read more
Carol L.
01:32 29 Nov 23
Professional, understanding and friendly
Sean G.
23:21 14 Nov 23
Matthew Garling and everyone I spoke to at Garling and Co were kind, caring and compassionate. They were sensitive to my psychological condition and were patient in explaining everything to me, so... that I clearly understood the legal process. I am exceptionally grateful for the settlement outcome that Garling and Co obtained for me. Many thanks.read more
University of Technology, Sydney
Member of Law Society of New South Wales
Law Society of NSW Specialist Accreditation
University of Sydney
Legal Profession Admission Board of New South Wales
The law society of nsw professional standards scheme logo.
University of Technology, Sydney
Member of Law Society of New South Wales
Law Society of NSW Specialist Accreditation
University of Sydney
Legal Profession Admission Board of New South Wales
The law society of nsw professional standards scheme logo.
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