Types of Workers Insurance payments
If you've been injured at work, there are various ways you can receive compensation depending on your circumstances.
Not being able to work after an injury can be stressful and leave you worrying about money, bills and taking care of your family. Workers compensation is designed to support you and reduce some of the financial stress following an injury at work.
Types of payments
Depending on your circumstances and the nature of your injury, you may be able to claim compensation.
Some of the different types of payments you may be eligible for are:
- weekly payments to cover loss of earnings
- medical, hospital and rehabilitation payments
- return to work assistance payments
- property damage payments
- lump sum payments for permanent impairment
- funeral expenses and support payments
- work injury damages.
Who is eligible to receive payments?
Most payments can only be made once your claim has been accepted by the insurer, except for provisional payments.
Provisional payments enable the insurer to start paying weekly and medical expenses to you while they fully assess your claim. Provisional payments can include weekly payments for up to 12 weeks, and payment of medical expenses up to $10,000.
If your work related injury has resulted in a loss of earnings, the insurer must commence provisional weekly payments within seven days from the day of notification, unless the insurer has a reasonable excuse not to commence the payments.
If provisional weekly payments do not start due to a reasonable excuse, the insurer must notify you in writing of the reason/s within seven days from the day of notification. The insurer will provide you with advice on how to make a claim and will be determined within 21 days of being received by the insurer.
Eligibility for Workers Insurance
Weekly payments provide you with some income during your recovery. There are certain types, depending on your circumstances and the nature of your injury.
Provisional payments involve the insurer paying you weekly payments within seven days of notification so as to minimise the disruption to your life while they fully assess your claim.
If the insurer does not accept your claim, you will not be required to pay back the provisional payments.
Changes to your weekly payments
icare is committed to providing support and transition services for all those who may be impacted by limits to weekly income replacement support relating to a workplace injury under Section 39 of the NSW Workers Compensation legislation.
Workers Assistance Program
Our Workers Assistance Program, operating since April 2016, ensures people affected will be afforded every opportunity for personalised transition support. Find out more below.
Workers Compensation income replacement benefits
icare is committed to providing support and transition services for all those who may be impacted by limits to weekly income replacement support relating to a workplace injury under Section 39 of the NSW Workers Compensation legislation. The limits commenced on 1 January 2013 and cap income support at 260 weeks (five years).
Medical support will continue for an additional two to five years based on each individual’s circumstances.
About the Workers Assistance Program
In 2012 there were legislative changes to the NSW workers compensation legislation.
icare’s role is to implement these changes for the Nominal Insurer (NI) and Treasury Managed Fund (TMF) schemes. In discharging its responsibilities, icare has undertaken to offer a tailored assistance program to support people transitioning from income replacement benefits for their workplace injury.
As an injured worker, you may have questions or concerns, or have been contacted by your insurer, and would like to know what support is available for you.
We are providing assistance through trusted transition support specialists who are tasked with providing care, understanding and respect to workers as they transition. (Note: we do not provide legal advice).
Community transition support services available
We understand how transitioning from income support may be a big change, and some people may require more tailored community support services and assistance.
Our Workers Assistance Program, operating since April 2016, ensures people affected will be afforded every opportunity for personalised transition support.
The program includes services that are tailored to the needs of the individual. Details of the Advisory & Assistance Service (AAS) and Community Support Service (CSS) are below.
The Community Support Services (CSS)
The Community Support Services (CSS) is a community transition program to help workers link in with the community, and other social services available to them when they exit the scheme. The program delivers tailored support services, through partnerships with experienced social services providers Uniting, St Vincent de Paul Society NSW and Interact.
Under the program, impacted claimants will be referred to a dedicated resource who develops a tailored plan to link them to the services most relevant to their needs.
Support services provided under CSS include:
- Phone-based or face-to-face sessions where professional case managers help facilitate access to community-based support services, such as government housing solutions, healthcare services, financial counselling and childcare.
- Assistance with engagement with other financial support institutions to minimise disruption and ensure they transition smoothly into other forms of support where necessary.
Workers can self-refer or be referred by their case manager to access this service by phoning: 13 47 15, (8:30am to 5pm, Monday to Friday).
Need to speak to a union representative?
Relevant union representatives:
Need more information?
To find out more on these changes, what they mean for injured workers, and the State Insurance Regulatory Authority’s (SIRA) additional support options available to impacted workers, visit SIRA's website.
Workers are also within their rights to seek legal representation or have their case reviewed by contacting:
Medical, hospital and rehabilitation payments
You may be eligible to claim the costs of medical treatment and services relating to your injury, including:
- medical and related treatment
- hospital treatment
- ambulance services
- workplace rehabilitation services
- travel expenses.
SIRA medical, hospital and rehabilitation expenses
Return to work assistance payments
These payments help eligible workers with some of the costs that can be associated with returning to work. There are programs, such as:
- New employment assistance - may be claimed by a worker in cases where they are unable to return to work with their pre-injury employer, due to their injury
- Education or training assistance - is designed to support workers in cases where additional skills are required to improve their readiness for work with the same employer, or a new employer.
Some payments may include:
- transport (eg public transport or motor vehicle registration)
- education or training (eg industry licences or certificates)
- equipment (eg tools of trade), or
- any similar service or assistance.
Property damage payments
If you’re a worker, you might be eligible for compensation for the cost of damage done to artificial aids and clothing in a work-related incident.
Lump sum payments for permanent impairment
If you have a permanent impairment as a result of a workplace injury or illness, you may be entitled to receive a lump sum payment as compensation.
This is in addition to weekly payments and medical and related expenses that may generally be available through the workers compensation system.
Funeral expenses and support payments
Payments for fully or partly dependent relatives can include funeral expenses, lump sum death benefits and weekly payments for each dependent child.
Payments for bereaved families
A commutation is an agreement to commute a liability for workers compensation to a lump sum amount that is made between you (the worker), your employer and the insurer.
If your commutation agreement is registered with the Personal Commission (PIC), you will no longer be entitled to future weekly payments, or to claim medical, hospital, rehabilitation expenses for any injury referred to in the agreement.
Work injury damages
If you have a work injury which resulted from your employer’s negligence and you have a permanent impairment of greater than 15 per cent, you may be able sue for modified common law damages These are known as ‘work injury damages’ claims.
A work injury damages settlement cancels all further entitlements to workers compensation benefits (including weekly payments, and medical, hospital and rehabilitation expenses, related to that injury).
The amount of weekly payments that have already been paid to the worker must be repaid out of the settlement amount.