Weekly payments form a major part of the NSW workers compensation scheme and aim to compensate an injured worker for their loss of income over the course of recovery.
As an injured worker, the amount you can receive on a weekly basis and the period during which they are entitled to payments depends on a number of factors including the extent of your injury, your income before you got injured, as well as your ability to submit on time relevant documentation and applications to your insurer.
To help you better understand weekly compensation payments, this article covers:
- How to claim for weekly payments;
- When weekly payments can begin;
- How weekly payments are calculated;
- The maximum amount you can receive in weekly payments;
- How to claim weekly payments after 260 weeks (five years);
- Reasons why the insurer may cease payments; and
- How we can help with your claim for weekly payments.
How do I claim for weekly payments?
Under Section 33 of the Workers Compensation Act 1987 (NSW), you are entitled to weekly payments if you are partially or completely incapacitated as a result of your workplace injury.
You can access weekly payments by submitting a workers compensation claim or by notifying your employer of your injury. Either of these steps will trigger payments, even though you will eventually need to submit a formal workers compensation claim.
When you submit a workers compensation claim, you will need to provide evidence of your injury, including certification from a medical professional that you are injured as a result of your employment. It is therefore crucial at an early stage in the process to secure a medical assessment of your injury and a completed certificate of capacity from your nominated treating doctor.
To know more about lodging a workers compensation claim, make sure you visit our guide on How to Lodge a Workers Compensation Claim in NSW.
When do weekly payments begin?
As an injured worker, you can expect weekly payments to begin:
- Within 7 days of notifying your insurer and employer of your injury, triggering provisional liability payments;
- Within 21 days of submitting a completed compensation claim to your insurer along with medical evidence, or if provisional liability payments were delayed on account of a ‘reasonable excuse’; or
- Within the 12 weeks of provisional payments, upon accepting liability for the injury.
Weekly payments forming a part of provisional liability should commence within 7 days after you first notify your employer and insurer of your injury, and your insurer is satisfied upon an initial assessment that you should receive payments. You can receive provisional liability payments even when you have not yet submitted a complete formal claim for compensation.
Our guide Understanding Provisional Liability in Workers Compensation includes more information about how provisional payments work.
Please note that provisional weekly payments are not the same as weekly payments that form a part of your workers compensation package. Weekly workers compensation payments can only begin once the insurer formally accepts liability, i.e. after you have submitted a completed compensation claim and the insurer has properly assessed it.
Provisional weekly payments are available to injured workers for up to 12 weeks. The maximum time you can expect to wait before Workers Compensation Weekly payments formally begin should therefore be 112 days from the date of initial injury.
Once you submit a completed compensation claim to your employer, you can expect formal workers compensation payments to start within 21 days. You may also have to wait 21 days for provisional payments to start if your payments were previously delayed because of a ‘reasonable excuse’.
How are weekly payments calculated?
The amount you can receive in weekly payments depends on your pre-injury average weekly earnings (‘AWE’) and your work capacity (i.e. ability to return to work).
If you were injured before 21 October 2019, your AWE will include the monetary value of non-pecuniary benefits you received as a part of your work such as education fees, use of a motor vehicle, health insurance, and residential accommodation. If you were injured on or after this date, AWE is limited to pecuniary income, including shift and overtime.
Your insurer determines your work capacity using a certificate of capacity or a more in-depth work capacity assessment. Both require an assessment of your injury and completion of paperwork by your treating doctor.
You can download a blank certificate of capacity form from the SIRA site, and read more in our guide about Work Capacity Assessments for Workers Comp NSW.
The amount you receive in weekly payments will change each entitlement period. There are three entitlement periods (0 to 13 weeks, 14 to 130 weeks, and 131 to 260 weeks), each of which requires the insurer to apply a different formula using your AWE and work capacity to arrive at your weekly payment amount.
Below is a summary of the formulae according to each entitlement period and various capacities to return to work.
0 to 13 weeks of Weekly Compensation Payments
The relevant legal provision for this entitlement period is in section 36 of the Workers Compensation Act 1987 (NSW).
If you have no capacity to work during the first entitlement period, you are entitled to 95% of your AWE.
If you have some capacity to work during the first entitlement period, you will receive the lesser amount of either:
- 95% of your AWE, minus the amount you currently earn per week (‘CWE’); or
- The maximum allowable weekly payment amount, minus your CWE.
14 to 130 weeks of Weekly Compensation Payments
The relevant legal provision for this entitlement period is in section 37 of the Workers Compensation Act 1987 (NSW).
If you have no capacity to work during the second entitlement period, you are entitled to 80% of your AWE.
If you have returned to work for 15 hours or more per week during the second entitlement period, you will receive lesser amount of either:
- 95% of your AWE, minus your CWE; or
- The maximum allowable weekly payment amount, minus your CWE.
If you have returned to work for less than 15 hours per week during the second entitlement period, you will receive the lesser amount of either:
- 80% of your AWE, minus your CWE; or
- The maximum allowable weekly compensation amount, minus your CWE.
131 to 260 weeks of Weekly Compensation Payments
The relevant legal provision for this entitlement period in section 38 of the Workers Compensation Act 1987 (NSW).
In the third entitlement period, you can receive the lesser amount of either:
- 80% of your AWE, minus your CWE; or
- The maximum allowable weekly payment amount, minus your CWE.
You can access these payments if you fit one of the following categories:
- You have no capacity to work during the third entitlement period
- You have returned to work for 15 hours or more per week during the entitlement period and:
- Earn at least $155 per week (as indexed in the Workers compensation benefits guide);
- Proved to your insurer that you cannot work more hours per week; and
- Submitted to your insurer a ‘Continuation of weekly payments after 130 weeks form’
- You are a “high needs” worker, i.e. you have the capacity to work but can prove that you are 20 to 30 percent permanently impaired from your injury, and you have submitted to your insurer a ‘Continuation of weekly payments after 130 weeks form’.
Exempt Workers
Please note that your insurer will apply different formulae to calculate your payments if you are an exempt worker, that is, a class of worker for whom various provisions in the NSW Workers Compensation Acts do not apply. Exempt workers include police officers, paramedics, and fire fighters.
Among the differences in the provision of weekly payments to exempt workers is the ability to:
- Receive 100% of your pre-injury earnings in the first 26 weeks and a fixed statutory rate or 90% of earnings after 26 weeks if you have no work capacity; or
- Receive the full difference between your current and previous earnings if you have some capacity to work.
You can find out more about exempt worker weekly workers compensation payments on the relevant SIRA webpage.
What is the maximum weekly compensation I can receive?
The maximum weekly payment amount any injured worker in NSW can receive per week is $2,497.70 as of 1 April to 30 September 2024.
The cap on weekly payments is adjusted in April and October every year according to indexation, i.e. according to the average values of wages every year.
SIRA’s Workers compensation benefits guide provides at all times detailed information on the indexation and the scaling of workers compensations payments.
What happens to weekly payments after 260 weeks?
Your weekly payments will end after 260 weeks unless you can demonstrate to your insurer that you suffer from more than 20 percent permanent impairment. In that case, the amount in weekly payments you will receive will be assessed according to the same rules that apply to the third entitlement period (or under section 38 of the Workers Compensation Act 1987 (NSW)).
If the insurer plans to end your payments after 260 weeks, they will inform you in writing at least 13 weeks before the end of the payment period. If you are unsure about when weekly payments will end, you can contact your insurer to find out.
Why have my weekly payments been stopped or changed?
Your insurer may stop or alter the amount of your weekly payments for several reasons:
Work Capacity Decisions from the Insurer
Throughout the entitlement periods, your insurer will assess your work capacity. Your payments may stop if the insurer determines you are capable of a complete return to work, or they may decrease according to how much you earn each week if you have partially returned to work.
You can find out more in our guide on Work Capacity Decisions in NSW.
Complying with return to work obligations
Your insurer may end your weekly payments if you do not demonstrate that you are following your employer’s return to work program.
Complying with your employer’s return to work program may involve attending regular meetings with your employer over the course of your recovery, providing your employer with updates on your recovery, and even accepting alternative work from your employer.
You can contact your employer to confirm what your return to work obligations are.
Exceeding the entitlement period of 130 weeks or 260 weeks
In many cases, an injured worker is only entitled to receive weekly payments for two or three entitlement periods.
Whether you continue to receive weekly payments will depend on your capacity to return to work and whether you have followed the relevant administrative steps to prolong your workers compensation payments.
As discussed above, unless you are completely incapable of returning to work, you will need to submit additional documentation to your insurer to prove either that you can only return to work in a limited capacity or are a ‘high needs’ worker (see “How are weekly payments calculated?”).
How can Alliance Compensation & Litigation Lawyers help?
Claiming weekly workers compensation payments can be a complex and daunting experience. You may encounter, for instance, difficulties with explaining the seriousness of your injury or dissatisfaction with the amount you receive for your recovery.
Alliance Compensation & Litigation Lawyers are focused on supporting you through the claims process. We are experienced with helping clients receive the most they can when it comes to compensation payments.
If you wish to claim workers compensation or dispute an aspect of your payments, we invite you to book a no obligations consultation with us.
Call us on 02 8764 1776 or email us at refer@alliancecomplawyers.com.au.
