WorkCover Payments & Support    

How are WorkCover weekly payments calculated?

Your WorkCover weekly payments depend on the seriousness of your injury and the length of time you are off work. Weekly payments are calculated as a percentage of your pre-injury average weekly earnings (PIAWE) up to a set maximum.

The calculation of your pre-injury average weekly earnings is a complex matter. Normally it is your average weekly earnings for the twelve months before your injury. It may include some regular additional payments, for example ‘piecework’, or overtime worked in a regular pattern.

If you are partially incapacitated, WorkCover can reduce your payments by deducting ‘notional earnings’. Your notional earnings are the amount that WorkCover believes you could earn in a job suited to your current condition, even if you are not able to obtain that job.

If you are receiving weekly compensation payments and you return to work you must advise WorkCover. You must even advise WorkCover if you start any unpaid or voluntary work.

Possible WorkCover benefits

If you are injured at work, you could be entitled to a range of benefits, available irrespective of how the injury occurred. These benefits are paid by WorkCover insurers, and include:

• Payment of medical expenses
• Income loss payments when you are unable to work due to your injury
• A lump sum for any permanent injury

For more information regarding common law claims and maximum entitlements click here.

How does the date of my injury impact my level of WorkCover compensation?

If you are injured between 01/9/1985 – 11/11/1997:

First 6 months:

• 95% of pre-injury average weekly earnings (PIAWE)

• 90% if seriously injured
• 70% if totally incapacitated
• 60% if partially incapacitated

After 2 years:

• Continue at 90% or 70% only as above

First 13 weeks:

• 95% of pre-injury average weekly earnings (PIAWE)

• 75% if no current work capacity*
• 60% if currently able to work

After 2 years:

• Continue at 75% if no current work capacity* and this is likely to continue indefinitely
  OR
• Continue at 60% if you have returned to employment of at least 15 hours per week and earning at least $105 and this is likely to continue indefinitely

If you are injured between 01/01/2005 – to date:

First 13 weeks:

• 95% of pre-injury average weekly earnings PIAWE

• 75% if no current work capacity*
• 75% if currently able to work

After two and a half years:

• Continue at 75% if no current work capacity* and this is likely to continue indefinitely
  OR
• Continue at 60% if you have returned to employment of at least 15 hours per week and earning at least $105 and this is likely to continue indefinitely

* ‘No current work capacity’ means an inability to return to either your pre-injury employment or modified or restricted duties.

Will WorkCover affect superannuation payments?

Your employer is not obliged to continue to make contributions to your superannuation fund while you receive weekly payments of compensation. Accepting a superannuation payment can disqualify you from receiving weekly payments for a fixed period of time, unless the payment is rolled over. It is important, therefore, that you seek advice before accepting any superannuation payment.

If you do receive a superannuation payment, you are obliged to provide the details of the payment, and of any rollover, to the insurer within 14 days.

Can I still claim other insurance disability payments while under WorkCover?

In addition to WorkCover entitlements you may be entitled to extra benefits under your superannuation, insurance or consumer credit policy. These benefits depend on the terms of your policy and may include either a pension or a lump sum payment.

Generally, you will need to show that you are totally disabled for work either permanently or in some cases temporarily. However, precise requirements and time limits to make a claim from a superannuation fund or insurer vary.

Because payments made under your superannuation policy may affect your WorkCover claim, it is important to seek legal advice before agreeing to a settlement. Slater & Gordon’s experienced superannuation and insurance claims lawyers can help.

To find out more about your Superannuation entitlements, please click here

What medical and like expenses does WorkCover pay for?

At all times you have the right to choose your doctor. Many workplaces provide medical care through a company doctor. If you elect to be treated by a company doctor, it is important to realise that they have split responsibilities, to both the employer and to you.

WorkCover must pay the reasonable costs of:

• Doctors, specialists, physiotherapists, chiropractors, osteopaths, etc
• Investigative procedures, such as x-rays
• Chemist expenses
• Hospital and ambulance bills
• Remedial gym work and swimming, if approved by your doctor
• Home help, such as domestic cleaning assistance and lawn mowing
• Home modifications, such as hand rails; ergonomic beds, if approved in advance by WorkCover
• Reasonable travel expenses relating to medical treatment

You can still claim medical expenses while continuing to work and for at least 12 months after your weekly payments stop. Long-term medical expenses can be claimed if the treatment is necessary to ensure your health or condition does not deteriorate.

Are lump sum payments available through WorkCover?

WorkCover provides lump sum compensation for permanent impairment. Minimum impairment thresholds apply to some claims and pain and suffering compensation is only available in certain claims.

The amount of compensation payable is determined by a complex scheme and depends on the percentage level of impairment and extent of the loss of a body part.

• For injuries sustained between 01/09/1985 and 30/11/1992:
  You are entitled to compensation if you sustained a loss of use of prescribed body function. This includes largely injuries to limbs, the senses, the spine and psychological injuries. You are also able to claim for pain and suffering compensation.

• For injuries sustained between 01/12/1992 and 11/11/1997:
  You are entitled to compensation if you have sustained a loss of use of a prescribed body function, except you must pass monetary threshold before becoming entitled to additional compensation for pain and suffering. Psychological injuries are excluded.

• For injuries sustained from 12/11/1997 to date:
  You are entitled to a lump sum compensation if you are assessed as having suffered at least a 10% whole person impairment for physical injuries or 30% for psychological injuries. An exception applies to injuries sustained on or after 3.12.03 which involves a musculo-skeletal assessment, compensation is awarded where the whole person impairment is at least 5%.

The above mentioned WorkCover benefits are payable irrespective of fault.

If, however, you have a serious injury and it is established that your employer or another party was at fault, or partly at fault, you may be able to claim a further lump sum payment for damages as a result of negligence, for further details please see Negligence claims.