Injuries include physical and psychological injury. It is important that your nominated treating doctor record all injuries on the workers compensation medical certificate (certificate of capacity).
To commence a claim against your employer you need to have your GP complete a certificate of capacity and provide a copy to your employer. The workers compensation insurer must make provisional payments within seven calendar days unless there is a reasonable excuse not to do so.
If a reasonable excuse is given, then you may make a claim for compensation which will be determined within 21 days.
Compensation payable
If liability is admitted, you will be entitled to claim the following:
- weekly payments of compensation for total and partial incapacity
- reasonably incurred medical and treatment expenses, which in some circumstances can include domestic assistance and care
- permanent impairment compensation if your physical injuries are greater than 10% whole person impairment (WPI) and psychiatric injuries greater than 15% WPI. (The assessment of physical injuries and psychological injuries cannot be added together.)
Weekly Payments
The amount of weekly payment of compensation you receive will be calculated on the basis of your preinjury average weekly earnings (PIAWE).
In the first 13 weeks your weekly payments of compensation are based on whichever are less:
- 95% of your PIAWE minus your current weekly earnings if you have capacity to work and are working.
- The maximum weekly compensation amount minus any current weekly earnings.
Note:
* Maximum weekly compensation amount:
From 1 October 2018 to 31 March 2019 $2,145.30
From 1 April 2019 to 30 September 2019 $2,177.40
From 1 October 2019 to 30 March 2020 $2,195.70
From 1 April 2020 to 30 September 2020 $2,224.00
From week 14 to week 130
If working 15 hours or more a week the weekly payments are the lesser of:
- 95% of your PIAWE minus your current weekly earnings or,
- The maximum weekly compensation amount minus your current weekly earnings
If working less than 15 hours a week the weekly payments are the lesser of:
- 80% of your PIAWE minus your current weekly earnings, or
- The maximum weekly compensation amount minus your current weekly earnings
If you have no capacity for work, your weekly payment is whichever less is:
- 80% of your PIAWE, or,
- The maximum weekly compensation amount
Payments will stop after 130 weeks unless:
- You have been assessed as having no current work capacity and likely to continue indefinitely, or
- You are working at least 15 hours per week and earning at least $200 (subject to indexation) and this is likely to continue indefinitely and you have completed an application for continued weekly payments after 130 weeks form and send it to the insurer.
131 to 260 weeks
You may continue to receive payments after 130 weeks where:
- You have been assessed as having no current work capacity and is likely to continue indefinitely, or
- You are working at least 15 hours per week and earning at least $200 (subject to indexation) and this is likely to continue indefinitely and you have completed an application for continued weekly payments after 130 weeks form and send it to the insurer.
Often there are disputes concerning the correct PIAWE. You should always include overtime in the calculation.
In order to continue receiving weekly benefits beyond 260 weeks (5 years), your injuries need to be agreed or assessed to be at or greater than 20% Whole Person Impairment.
Weekly benefits will continue until the age of retirement, generally at the age of 68. Benefits can continue if you can show that in your profession or industry the retirement age is later.
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