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Workers Compensation Weekly Payments

If you have sustained an injury during your employment and are unfit for work or fit for suitable work only then you are entitled to obtain weekly payments of compensation from your employer’s workers compensation insurer.

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Before you can receive weekly payments of compensation you must:

  • Have sustained an injury in the course of your employment.
  • Give notice of that injury to your employer within six months of the date of injury.
  • A notice of injury may be given orally or in writing.
  • The employer must then within 24 hours of such notice notify the workers compensation insurer of the injury.
  • A written claim form is not necessary.

Once the insurer has been notified of the injury, it must within 7 days do one of the following:

  • Accept provisional liability and commence payment of weekly compensation; or
  • Issue a “Reasonable Excuse Notice” outlining the reasons why provisional liability has not been accepted. If a reasonable excuse notice is provided the insurer has a further 21 days to determine whether they will provisionally accept the claim.

If a “Reasonable Excuse Notice” is provided, then you may be required to complete a written claim form.

How to claim weekly payments

If because of an injury sustained at work you are totally or partially unfit for work and are losing income, you have a right to make a claim for weekly payments.

To make a claim for weekly payments you need to attend your General Practitioner (known as the Nominated Treating Doctor) and obtain a WorkCover Certificate of Capacity. This certificate sets out whether you are totally or partially unfit for work and if partially unfit for work, what restrictions both in terms of the hours and the type of duties you can perform. The WorkCover Certificate of Capacity needs to be completed and provided to your employer as soon as possible.

If liability for your claim is declined, you need to contact an Accredited Specialist in Personal Injury Law immediately so this can be investigated and if necessary, challenged.

If the insurer accepts liability for your claim, then they will commence weekly payments of compensation.

The amount payable for weekly compensation varies depending on the following:

  • Whether you are totally or partially unfit for work.
  • Whether the employer has suitable work available for you.
  • The amount of your pre-injury average weekly earnings.

Payments when not able to work

If you are totally unfit for work as a result of a work place injury, then you are entitled to receive weekly benefits as follows:

Payments for the first 13 weeks

For the first 13 weeks, you have no current capacity for work, your weekly payment is based on the following:

  • 95% of your pre-injury average weekly earnings known as PIAWE.

Payments for 14 – 130 weeks

From 14 to 130 weeks of weekly payments, if you continue to have no current work capacity, your weekly payment is based on the following:

  • 80% of your pre-injury average weekly earnings

Payments for 131 – 260 weeks

Between 131 to 260 weeks, to continue to receive weekly payments of compensation, the following must have occurred:

1. The worker must have applied to the insurer in writing for continuation of weekly payments.

2. The insurer has made a work capacity decision that you continue to have no current capacity for work and that this is likely to continue indefinitely.

3. If so, then you continue to receive weekly payments as follows:

  • 80% of your pre-injury average weekly earnings

After 260 weeks (5 years) of weekly payments

Weekly payments will stop after 5 years unless your level of impairment is greater than 20% whole person impairment.

The insurer has made a work capacity decision that you continue to have no current capacity for work which is likely to continue indefinitely.

Weekly benefits are payable up to one year after your Commonwealth retirement age. Ongoing weekly benefits up to retirement age are subject to the insurer conducting a work capacity decision every 2 year.

If your assessment of whole person impairment cannot be determined as your injury has not stabilised, then weekly payments can continue as long as the insurer accepts that your injury has not stabilised and has made a work capacity decision that you have no current capacity which is likely to continue indefinitely.

If you have an assessment of whole person impairment of 20% or less, then weekly payments will stop.

Weekly payments if injury sustained after retirement age

If you sustained an injury at work after your Commonwealth statutory retirement age, then you are entitled to weekly compensation for a period of 52 weeks. At the end of 52 weeks, the weekly payments stop.

Payments when working

If following injury, you have some capacity to work and you return to work in suitable employment either with your pre-injury employer or another employer, you will earn income for the hours that you work.

Weekly payments will vary depending on the amount of income you are able to earn in this suitable employment.

Payments for the first 13 weeks

During the first 13 weeks of weekly compensation, if you are able to return to work in suitable employment then you will be paid weekly payments as follows:

  • 95% of your pre-injury average weekly earnings less your current weekly earnings (or the amount that you have been assessed as able to earn in some suitable employment).

Payments for 14 – 130 weeks

During the period 14 to 130 weeks, if you have a capacity to work in suitable employment, then you are paid as follows:

  • If you are working 15 hours or more per week and being paid at least $176.00 per week you are paid as follows:
    • 95% of your pre-injury average weekly earnings minus your currently weekly earnings (or the amount that you have been assessed as able to earn in suitable employment).
  • If you are working less than 15 hours per week, your weekly payments are paid as follows:
    • 80% of your pre injury average weekly earnings minus your currently weekly earnings (or the amount that you have been assessed as able to earn in suitable employment).

Payments for 131 – 260 weeks

There is no entitlement to weekly payments of compensation if you are certified fit for suitable work after 130 weeks unless you satisfy the following:

  • You have completed an application for continued weekly payments after 130 weeks form and sent it to the insurer.
  • You are working at least 15 hours or more per week and are earning at least $176.00 per week.
  • The insurer has made a work capacity decision as indefinitely incapable of undertaking further employment to increase your earnings.

If you satisfy the above, then you are paid as follows:

  • 80% of your pre-injury average weekly earnings minus your currently weekly earnings (or the amount that you have been assessed in the work capacity decision as able to earn in suitable employment).

If you have some capacity to work but are not working 15 hours or more per week and are earning at least $176.00 per week weekly payments will stop.

After 260 weeks (5 years) of weekly payments

Weekly payments of compensation will cease after five years unless your level of whole person impairment is greater than 20%.

If you have an assessment of whole person impairment of greater than 20% whole person impairment, then you are entitled to continue to receive weekly payments of compensation as long as you continue to satisfy the following:

  • You are working at least 15 hours or more per week and earning at least $176.00 per week; and
  • You have been assessed by the insurer in a work capacity decision as indefinitely incapable of undertaking further employment to increase your earnings.
  • If you satisfy the above, then you are paid as follows:
    • 80% of your pre-injury average weekly earnings minus your currently weekly earnings (or the amount that you have been assessed as able to earn in suitable employment).

For all workers, weekly payments cease 12 months after they reach the Commonwealth retirement age.

Payments when work is not available

If you have some capacity to return to work in suitable employment but your employer fails to provide you with suitable employment, or you are unable to find any such suitable employment, then you are entitled to weekly compensation as follows:

Payment for the first 13 weeks

During the first 13 weeks if you continue to have a current work capacity and are not working because suitable employment is not available your weekly payments are calculated as follows:

  • 95% of your pre-injury average weekly earnings minus the amount that you have been assessed by the insurer as able to earn in suitable employment.

Payments for 14 – 130 weeks

During 14 – 130 weeks if you continue to have a current work capacity and are not working because suitable employment is not available your weekly payments are calculated as follows:

  • 80% of your pre-injury average weekly earnings minus the amount that you have been assessed by the insurer as able to earn in suitable employment.

Payments for 131 to 260 weeks

There is no entitlement to weekly payments of compensation if you are certified fit for suitable work after 130 weeks unless you satisfy the following:

  • You have completed an application for continued weekly payments after 130 weeks’ form and sent it to the insurer.
  • You are working at least 15 hours or more per week and are earning at least $176.00 per week.
  • The insurer has made a work capacity decision as indefinitely incapable of undertaking further employment to increase your earnings.

If you satisfy the above, then you are paid as follows:

  • 80% of your pre-injury average weekly earnings minus your currently weekly earnings (or the amount that you have been assessed in the work capacity decision as able to earn in suitable employment).

If you have some capacity to work but are not working 15 hours or more per week and are earning at least $176.00 per week weekly payments will stop.

After 260 weeks (5 years) of weekly payments

Weekly payments of compensation will cease after five years unless your level of whole person impairment is greater than 20%.

If you have an assessment of whole person impairment of greater than 20% whole person impairment, then you are entitled to continue to receive weekly payments of compensation as long as you continue to satisfy the following:

  • You are working at least 15 hours or more per week and earning at least $176.00 per week; and
  • You have been assessed by the insurer in a work capacity decision as indefinitely incapable of undertaking further employment to increase your earnings.

If you satisfy the above, then you are paid as follows:

  • 80% of your pre-injury average weekly earnings minus your currently weekly earnings (or the amount that you have been assessed as able to earn in suitable employment).

For all workers, weekly payments cease 12 months after they reach the Commonwealth retirement age.

Weekly payments stopped, suspended or reduced

The insurer may suspend, reduce or stop weekly payments of compensation if certain requirements are not met.

Providing documents

To receive weekly payments, you must provide to the insurer at all times a WorkCover Certificate of Capacity. The insurer will not pay you for periods during which a doctor has not certified that you are totally or partially unfit for work.

Not complying with return to work obligations

If your WorkCover Certificate of Capacity certifies that you are fit to return to suitable work, then you must, if available, undertake the following:

  • Return to work with your employer in suitable employment.
  • Return to suitable work at another place of employment.

If you fail to comply with your return to work obligations then the insurer may suspend or terminate your weekly payments.

If your employer offers you suitable employment, then you must accept such an offer or your weekly payments may be suspended or terminated.

If your employer is unable to provide you with suitable duties, then you have an obligation to look for suitable employment on the open labour market. If you fail to prove to the insurer that you are looking for suitable employment, then your weekly payments may be suspended or terminated.

After 130 weeks of weekly payments

The insurer is required prior to 130 weeks of weekly payments conduct a work capacity assessment and make a work capacity decision.

The insurer assesses your capacity for work based on your functional, vocational and medical status. The insurer relies on medical evidence available to it from your treating doctors and from its own independent medical examination.

The insurer then makes a work capacity decision in which they decide whether you are:

  1. Fit to return to your pre-injury employment.
  2. Fit to return to suitable employment with your pre-injury employer or at another place of employment.
  3. Totally unfit for work.

Following a work capacity decision there is no entitlement to weekly payments unless:

  • The work capacity decision has assessed that you have no capacity for work and this is likely to continue indefinitely; or
  • You have applied to the insurer for continuing weekly payments and:
    • You are working 15 hours or more per week; and
    • Earning at least $176.00 per week; and
    • You have been assessed as being indefinitely incapable of undertaking further employment or additional work to increase your earnings.

If you have been assessed as having some current capacity for work but are not working or are working less than 15 hours or earning less than $176.00 per week, your weekly payments will stop.

After 260 weeks (5 years) of weekly payments

All weekly payments stop after 5 years unless you have a permanent impairment greater than 20%.

If the assessment of whole person impairment is between 21-30% then you continue to receive weekly benefits as you would for the period between 130-260 weeks however you are subject to the insurer conducting a work capacity decision every 2 year. Such payments are made until 12 months after your Commonwealth statutory retirement age.

Payments however may be reduced or stopped at any time subject to the work capacity decision and whether the insurer is of the view that you remain partially or totally unfit for work.

If you have an assessment of whole person impairment of 31% or greater, then the insurer is not allowed to conduct a work capacity assessment or make a work capacity decision without your consent. The effect of this is that the insurer will not be able to make a work capacity decision and you should continue to receive weekly benefits until 12 months following your Commonwealth retirement age.

Complaints about weekly compensation

If at any time you are unsure about your entitlements, dissatisfied with the insurer’s response or wish to make a complaint about the insurer, you should contact the Workers Compensation Independent Review Office (WIRO) at www.wiro.nsw.gov.au or call them on 13 94 76. WIRO is responsible for:

  • Investigating complaints made by workers about insurer where their entitlements, rights or obligations are effected and making recommendations for action to be taken by the insurer.
  • Reviewing work capacity decisions by insurers.
  • Encouraging high quality complaint resolution by insurers and employers.
  • Administering the independent legal assistance and review service.

WIRO should be able to assist you in determining whether the insurer is correctly paying weekly payments of compensation.

WIRO can also assist you with reviewing a work capacity decision by an insurer.

Injured workers exempt from weekly payments amendments

The Workers Compensation Act was amended on 1 October 2012. Some workers were exempt from these reforms. Injuries sustained to police officers, paramedics, fire fighters, volunteer bush fire fighters, emergency service volunteers, coal miners or those making a dust diseases claim are exempt from the weekly compensation benefits as outlined above.

Such workers continue to be entitled to weekly payments of compensation as was payable under the Workers Compensation Act prior to the amendments on 1 October 2012.

Legal costs and disbursements

Under the Workers Compensation Act, insurers are no longer required to pay a worker’s legal costs and disbursements.

A worker’s legal costs and disbursements are now paid through the Independent Legal Assistance and Review Service (ILARS) which is a function of WIRO. ILARS approves Lawyers to be able to act for injured workers.

If you require a lawyer to assist you in a dispute with an insurer, then the lawyer applies to ILARS for payment of legal costs and disbursements. ILARS will generally approve payment of legal costs and disbursements and your lawyer will be paid directly by ILARS at the conclusion of your claim.

You are therefore not responsible for payment of any legal costs and disbursements as long as ILARS approves funding.

If you have any question at all please contact us as follows;

  1. Complete our FREE case assessment form HERE
  2. Email us at info@garlingandco.com.au
  3. Give us a call on (02) 8518 1120

Further Articles on Worker Compensation can be found HERE

Definitions

Pre Injury Average Weekly Earnings (PIAWE) – Definition

Pre injury average weekly earnings are calculated by the insurer based on the information provided by both you and your employer and are designed to reflect how much you were earning prior to the injury. The insurer is required to calculate pre injury average weekly earnings based on the average of your ordinary earnings including overtime and shift allowance payments for the 52 weeks prior to your injury.

If you were employed for less than 52 weeks, then you use the average the weeks you did work up to injury.

PIAWE does not include any non-pecuniary benefits such as a car, phone or accommodation allowance.

After 52 weeks of receiving weekly payments the PIAWE is recalculated by removing earnings from overtime or shift allowance, so it becomes the average of ordinary earnings only.

The maximum amount you can claim for the PIAWE is currently $2,042.80 gross per week.

Work Capacity Decision – Definition

A 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 will normally be made just prior to weekly benefits having been paid for a period of 130 weeks.

A work capacity decision will find you:

  • Have no current capacity for work or;
  • Have a current capacity for work and list the hours and type of work you are fit to perform including how much you could earn in that suitable employment.

A work capacity decision can be appealed however you are not entitled to receive the assistance of a lawyer in appealing the work capacity decision. 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. Legal Costs are now payable for assistance with lodging a Merit Review with the WorkCover Authority.

Commonwealth statutory retirement age table
To be eligible for Age Pension you must be 65 years of age or older.

From 1 July 2017, the qualifying age for Age Pension will increase from 65 years to 65 years and 6 months.

The qualifying age will then increase by 6 months every 2 years, reaching 67 years by 1 July 2023.

If you were born between You qualify for Age Pension at a
1 July 1952 to 31 December 1953 65 years and 6 months
1 January 1954 to 30 June 1955 66 years
1 July 1955 to 31 December 1956 66 years and 6 months
From 1 January 1957 67 years

Would you like assistance with your claim?

Complete our free, no obligation confidential case assessment form and we’ll get back to you within 24 hours.

Alternatively, we are available to talk by phone and email. Please contact our experienced accredited specialist personal injury lawyers to find out how we can help.

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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
waqas A.
08:33 13 Nov 23
Great Experience with Garling & Co. Matthew explained everything in detail during the first appointment. Allison, Nathan, Rebecca and the staff have been extremely helpful. Thank You to the team and... lawyers at Garling & Co. for making the long process easy for me and getting an excellent outcome for my compensation claim.I would highly recommend Garling & Co. Lawyersread more
Saskia L.
21:42 08 Nov 23
The world of workers compensation is long, hard and confusing, but Emma and Rebecca at Garling & Co always treated my case with kindness, respect and understanding. No question was ever silly and... they always had time to make sure I knew what would happen next and how we could best prepare. I am so thankful for their expertise and could not have chosen anyone better to represent me.read more
Antonio P.
08:46 06 Nov 23
Thank you Matthew and his team for taking care of my case couldn’t ask for a better results and couldn’t have better team to do that thank you

Frequently Asked Questions

1. 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:

i. Failure to provide documents
If you fail to provide a WorkCover Medical Certificate of Capacity then the insurer will stop making weekly payments of compensation

ii. Comply with return to work obligations
If you fail to comply with reasonable request to return to suitable employment, weekly payments may be suspended

iii. The insurer issues a work capacity decision
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.

iv. The insurer declines liability for the claim
The insurer can stop payments if they believe your injury is no longer work related.

v. After 130 weeks of weekly payments
A worker has no entitlement to weekly payments of compensation after 130 weeks unless:

  • The insurer has assessed that the worker has no capacity for employment; or
  • The worker has capacity for work and has applied to the insurer for continuation of weekly payments; and
  • The worker is working 15 hours or more per week; and
  • The worker is earning at least $173.00 per week; and
  • 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.

vi. After 260 weeks (5 years) of weekly payments:
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

vii. 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?
More Faqs

Find out more about Workers Compensation

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