If you’ve suffered awork-related injury or illness, this is the payout guide that sets out what you need to know. In NSW, you are entitled to claim workers compensation for lost wages while you’re unable to work, medical and rehabilitation expenses and travel costs for attending your treatment appointments.
Depending on the extent of your injury and its whole person impairment rating, you may also be entitled to receive a lump sum payment known as a lump sum claim. If your injuries are assessed at meeting the required threshold, you may also be entitled to a workers compensation settlement, known as a work injury damages or common law claim.
While there are numerous factors that determine the amount of compensation you may be entitled to claim, our specialised workers compensation lawyers can give you clear legal advice to help you understand your rights and access your entitlements to get your life back on track. You are not required and not liable to pay for any of our legal costs and disbursements for your workers compensation claim.
Is workers compensation the same as Workcover?
The old regulator in is NSW was called WorkCover, whereas now its regulated by the State Insurance Regulatory Authority (SIRA), however people still use the term WorkCover when referring to workers compensation. What you call it is not important in our view, but what is important, is knowing what compensation you are entitled to, the workers compensation claims process and next steps.
What is a workers compensation payout?
Workers’ compensation is a form of insurance payment to you (the employee) if you are injured at or in the course of work or become ill due to your work. Physical injuries and psychological injuries such as workplace bullying, and harassment are also considered as an illness. In NSW, every employee is covered under the Worker’s Compensation Scheme even if your employer was not insured.
When you make a workers compensation claim, you may be able to claim:
Entitlements:
- Weekly payments while you have a reduced capacity to work.
- Hospital, rehabilitation and medical expenses including travel expenses.
- Domestic assistance for help around the home
Lump Sum Payout:
- A permanent impairment payout -
If you are assessed as suffering at least 11% whole person impairment for physical injury (or 15% or greater for psychological injury). The lump sum is a separate additional entitlement to any other benefit. If you are an exempt worker, such as a police officer, paramedic or fire fighter, than you could still be entitled to lump sum payment even if your physical injuries are less than 11% whole person impairment. Our lawyers look after the assessment process by referring you to an Independent Medical Examiner who will assess your injuries and provide a whole person impairment which enables our lawyers to claim lump sum compensation based on the whole person impairment assessment.
Lump Sum Payout:
- Work injury damages payout – as mentioned previously, also known as a common law claim
If you are assessed as suffering at least 15% whole person impairment and your injury was caused by your employer’s negligence. Proving negligence is important however our lawyers will assist in obtaining evidence as to whether or not your employer was negligent.
Is workers compensation compulsory in NSW?
It is compulsory in New South Wales (NSW) that all employers have workers compensation insurance for employees in their workplace. There are penalties in place for employers that do not have workers compensation insurance. If your employer did not have workers compensation insurance, you should still be covered as it does not affect your entitlements. However, it is important you still notify the employer and our lawyers for assistance in that regard.
Am I eligible to make a workers compensation claim?
Depending as to whether you:
- Are a casual employee, permanent employee, full time employee, part-time employee or self-employed.
- Have been injured at work, as a result of work or during work activities.
You can claim workers compensation for physical or psychological injury, provided you sustained your injury or illness at work. Contact our workers compensation lawyers who will guide you more specifically to your situation on your eligibility to claim workers compensation and advise you on your entitlements.
Who pays for workers compensation?
Workers compensation insurance is paid by your employer.
When you make a workers compensation claim, you will be covered by your employer’s insurer which is managed by SIRA.
How much do I receive on workers compensation?
Your benefits are calculated based on various factors, such as:
- Your age and the age of retirement;
- The severity and complexity of your injury or illness;
- Your whole person impairment assessment;
- Your working conditions, including supervision provided and the level of training you received;
- Your prospects of rehabilitation;
- Whether your injury occurred as a result of your employers’ negligence
However, your weekly payments are as detailed below:
| Duration | Entitlement |
|---|---|
| Up to 13 weeks | Up to 95% pre injury average weekly earnings |
| Week 14-130 | Injured workers who have returned to work for at least 15 hours per week, are entitled to up to 95% of their pre-injury average weekly earnings. Injured workers who have no capacity to work, or are working less than 15 hours per week, may receive up to 80% of their pre-injury weekly earnings |
| Weeks 131-260 | For most, their weekly benefits stop here however, exceptions apply (as below). Injured workers who have no capacity to work can receive up to 80% of pre-injury weekly earnings if: – they’re assessed as likely to be off work indefinitely; or – their permanent impairment is greater than 20% |
| After 261 weeks (5 years) until retirement | Weekly payments are only available to injured workers with permanent impairment greater than 20%, subject to ongoing work capacity assessments |
If your permanent injury is assessed as being greater than 10% for a physical injury, or 15% or greater for a psychological injury, then you may make a claim for lump sum compensation.
How does workers compensation work in NSW?
If you have suffered an injury or illness at work, you can make a workers compensation claim by:
1. Reporting your injury or illness to your employer as soon as possible. If you don’t report your injuries how can we prove it happened?
2. Visiting your doctor and seeking medical treatment. You will also need to obtain a certificate of capacity to be completed by your doctor. Same question as above applies here too!
3. Contacting our team of workers compensation lawyers to seek advice about your eligibility to claim, how much you can claim and when you can expect to receive a response or payments from the insurer.
4. Completing and lodging a Worker’s Compensation Claim form. In addition to your form, you will be required to provide your employer with a Certificate of Capacity completed by your doctor and you before lodging your claim.
There is a 6 month time limit to lodge a workers compensation claim form, for workers so we recommend that you act as soon as possible.
How long can you stay on workers compensation?
It depends on your whole person impairment assessment. For example, In NSW, injured workers with a permanent impairment of greater than 20% are eligible to claim weekly payments until reaching the commonwealth retirement age plus one year, subject to ongoing capacity assessments.
If your permanent impairment is assessed as 20% or less, your weekly payments are limited to 5 years. You may not want to stay on workers compensation and if your injury is assessed at 15% or more then you have the option to close your claim by making a work injury damages claim.
What is the maximum payout for workers compensation in NSW?
The maximum weekly workers compensation payments change April and October each year. Therefore, the maximum you may earn will differ depending on when you make a claim.
In addition to weekly payments, you may also be entitled to hospital, rehabilitation and medical expenses as well as lump sum payout for permanent impairment or damages.
Contact our workers compensation lawyers on 1800 952 901 on to discuss your circumstances.
Can you get a pain and suffering payout under workers compensation in NSW?
In short, no, unless you’re an exempt worker. In NSW most workers cannot claim pain and suffering payouts under workers compensation. In addition to weekly payments and medical expenses, workers compensation entitlements include lump sum payouts for permanent impairment and work injury damages which are in addition to weekly payments.
To be entitled to permanent impairment payout you must meet the 11% threshold for physical injury or 15% threshold for psychological injury. You may claim work injury damages if you’re assessed as having a 15% permanent impairment and your injury was caused by your employer’s negligence.
What is a Work injury damages claim/common law claim?
A work injury damages claim is a common law claim for workplace injuries where the employee sustains an injury at work as a result of their employer’s negligence.
The workplace injury must meet the threshold of at least 15% and this assessment must either be accepted by the insurer or determined by the Personal Injuries Commission.
To make a successful work injury damages claim you need to establish that:Your employer owed you a duty of care; and
- 1. Your employer failed to exercise that duty of care; and
- 2. Your permanent impairment resulted from your employer’s negligence.
Both physical or psychological injuries are able to make a work injury damages/common law claim if they meet the above.
What happens if my workers compensation claim is denied?
If your claim is denied, the insurer must notify you of the reasons for their denial, in writing and provide information about the next steps available to you.
After receiving the denial, you have the following options to challenge the decision:
- Request an internal review by the insurer.
- Lodge a dispute directly with the Personal Injury Commission (PIC), the central body for resolving all workers compensation disputes in NSW.
- Contact us on 1800 952 901 for advice on challenging the decision and if we disagree with the insurer we will act on your behalf in seeking to challenge the decision and obtaining evidence in support of your claim. Once we have the required evidence we will then put the insurer on notice of our claim and depending on the insurers response, refer your claim for conciliation/arbitration at the Personal Injuries Comission.
How much will a workers compensation lawyer cost me?
Our workers compensation lawyers will provide you with free legal advice about your claim and if you decide to instruct us, we will apply to the Independent Review Office (IRO) for funding. This means there’s no cost to you!
If you are eligible for lump sum payments, we’ll work on a ‘no win no fee’ basis, so you will only need to pay us when you win.
Issa Rabaya
• Bachelor of Laws
• Graduate Diploma in Legal Practice
• Approved Legal Service Provider to the Work Cover Independent Review Office
• Member of the Law Society
