Can weekly payments be stopped by the insurer?

Yes.

Weekly payments may be suspended, reduced or stopped by the insurer as a result of the following:

  1. Failure to provide documents
  2. If you fail to provide a WorkCover Medical Certificate of Capacity then the insurer will stop making weekly payments of compensation
  3. Comply with return to work obligations
  4. If you fail to comply with reasonable request to return to suitable employment, weekly payments may be suspended
  5. The insurer issues a work capacity decision
  6. The insurer can stop or reduce weekly payments if they disagree with your certificate of capacity and believe you have a greater capacity for work.
  7. The insurer declines liability for the claim
  8. The insurer can stop payments if they believe your injury is no longer work related.
  9. After 130 weeks of weekly payments
  10. A worker has no entitlement to weekly payments of compensation after 130 weeks unless:
    1. The insurer has assessed that the worker has no capacity for employment; or
    2. The worker has capacity for work and has applied to the insurer for continuation of weekly payments; and
    3. The worker is working 15 hours or more per week; and
    4. The worker is earning at least $173.00 per week; and
    5. The worker has been assessed by the insurer as incapable of undertaking further employment to increase their earnings.
    If you have a capacity to work and are not working at least 15 hours per week (and earning at least $173.00 per week) weekly payments will be stopped.
  11. After 260 weeks (5 years) of weekly payments:
  12. Weekly payments will stop for all workers after 5 years unless you have greater than 20% whole person impairment. If your impairment is greater than 20% then payments will continue if:
    • You are unable to work; or
    • You have some capacity for work and are working at least 15 hours or earning more per week and earning at least $173.00 per week
  13. Your entitlement ceases under the Workers Compensation Act due to your age.

Weekly payments of compensation will also cease on the anniversary of your statutory retirement age.

In each of these circumstances the insurer must notify you in writing as to the reasons why your payments have been stopped, reduced or suspended. They must provide you with all reports or other documents they rely upon in stopping, reducing or suspending the payments of weekly compensation.

Please see the following FAQs for further information:-

  • What weekly payments are payable by the insurer?
  • What do I do if my claim is declined?
  • What do I do if the insurer stops my weekly payments due to work capacity dispute?