Weekly payments for workers insurance

If you're injured at work, you may be entitled to weekly payments.

Find out when and how long weekly workers’ insurance payments might be paid, and the reasons why they could be stopped.

Provisional payments

Provisional payments enable the insurer to start paying weekly payments (and medical expenses) to you while they fully assess your claim.

However, if the insurer does not accept your claim, you will not be required to pay back the provisional payments.

Duration of provisional payments

Provisional payments can include weekly payments for up to 12 weeks, and payment of medical expenses up to $7,500. It also extends the time allowed for the insurer to make a decision on liability.

When do I receive them?
Where there has been a loss of earnings leading to an entitlement to weekly payments, the insurer will commence provisional weekly payments within seven days of being notified of the injury. This is unless there is a reasonable excuse to not 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. They must also provide you with advice on how to make a claim, which will be determined within 21 days of being received by the insurer.

Part A of the 2016 Guidelines for claiming workers compensation sets out the procedures for initial notifications and provisional payments.

To learn more, see Part A of the 2016 Guidelines for claiming workers compensation.

Visit the SIRA website

Weekly payments

If you’ve been injured in the workplace or through the course of your employment there are various reasons why you may receive weekly payments.

You may not be able to work at all because of your injury, or you may be back at work part-time or in a role that isn’t at the same pay grade as your previous one.

Or, perhaps, you have some capacity for work but your employer can’t offer you work that is suitable for your injury.

Weekly payments can be paid for each of these different situations.

How weekly payments work

If your injury means you can’t work for a period of time, you could be paid up to 95 per cent of your pre-injury average weekly earnings (PIAWE) for a set period of time.

The amount you receive is either based on your weekly earnings and received non-monetary benefits before the injury – including any overtime and shift allowances for the first 52 weeks – or a maximum weekly compensation amount.

Currently that amount is capped at $2,128.50 per week, and is indexed every 1 April and 1 October.

The value of any non-monetary benefits you receive as part of your employment will be deducted whichever way your weekly payment is calculated if they are retained following your injury. Non-monetary benefits may include residential accommodation, education fees, health insurance or use of a motor vehicle for example.

This is called the ‘deductible amount’.

Why payments can be reduced or stopped

There are a number of reasons you may stop receiving payments including:

  • No certificate of capacity and/or the declaration has not been signed by you declaring that you not engaged in other employment. If this isn’t done seven days after being notified, the insurer may discontinue payments.
  • You haven’t complied with your return to work obligations despite receiving notice from the insurer to do so. Your payments can be suspended after 14 days.
  • If the insurer assesses you as having some capacity to work, they may reduce or stop your payments based on what they believe you can earn in suitable employment.
  • Not attending a medical appointment arranged for you by the insurer, they may suspend your payments until the examination takes place.
  • Refusing or not participating in an assessment of your work capacity may lead to a suspension of payments until the assessment takes place.

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. 

John Nagle, Group Executive, Workers Insurance discusses icare's commitment to those affected by the changes and how icare is providing continuity of support services.

Our Workers Assistance Program, operating since April 2016, ensures people affected will be afforded every opportunity for personalised transition support.

    Find out more about the Workers Assistance Program

  • 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). 

  • 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.

  • 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 Advisory & Assistance Service (AAS)

    The Advisory & Assistance Service (AAS) is a face-to-face and phone-based information and advisory service designed to assist those people requiring more intensive support and tailored intervention.

    The service is staffed by psychologists and mental health nurses, available by phone to support workers in understanding how they will be impacted by the change.

    The aim is to provide workers with information to help them understand how changes to workers compensation may impact their entitlement to income replacement payments. The service ensures that workers are fully aware of their rights and options, including potential avenues for recourse.

    The professional staff can also liaise with an injured worker’s case manager when additional intervention is required.

    Workers can self-refer or be referred by their case manager to access this service by phoning 13 90 53 (9am- 5pm, Monday to Saturday). 

  • 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-5pm, Monday to Friday).

  • 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:

    • WIRO (Workers Compensation Independent Review Office) 
    • WCC (Workers Compensation Commission)
    • SIRA (State Insurance Regulatory Authority) 
  • Need to speak to a union representative?

Your payments and retirement

If you receive an injury before reaching the retiring age, you may be entitled to weekly payments for up 12 months following reaching the retiring age.

If you receive an injury on or after retiring age, you will be entitled to up to 12 months of weekly payments from the date of your first incapacity.

You will need to provide the insurer with a certificate of capacity for the period you are claiming weekly payments.

This does not apply to weekly payments for injuries claimed before 30th June 1985.

    How weekly payments are calculated

  • Weekly payments for the first 13 weeks

    If you aren’t able to work, you’ll get whichever is the smaller amount out of:

    • 95 per cent of your pre-injury average weekly earnings, minus the value of any deductible amount
    • Maximum weekly compensation amount (currently $2084.90) minus the value of any deductible amount

    If you are working in some capacity, or cannot find suitable work due to your injury, you’ll get the smaller amount out of:

    • 95 per cent of your pre-injury average weekly earnings, minus the amount that you are earning in suitable employment or have been assessed as able to earn in suitable employment, and the value of any deductible amount
    • Maximum weekly compensation amount (currently $2084.90), minus the amount that you are earning in suitable employment or have been assessed as able to earn in suitable employment, and the value of any deductible amount
  • Weekly payments for 14 to 130 weeks

    If you still can’t work due to your injury your weekly payment will be the smaller amount out of:

    • 80 per cent of your pre-injury average weekly earnings, minus the value of any deductible amount, or
    • The maximum weekly compensation amount (currently $2084.90) minus the value of any deductible amount

    If you can work 15 hours or more a week and are working 15 hours of more a week, your weekly payment will be the smaller amount of:

    • 95 per cent of your pre-injury average weekly earnings, minus the amount that you are earning in suitable employment or have been assessed as able to earn in suitable employment, and the value of any deductible amount
    • Maximum weekly compensation amount (currently $2084.90), minus the amount that you are earning in suitable employment or have been assessed as able to earn in suitable employment, and the value of any deductible amount

    If you can only work less than 15 hours a week or are able to but are working for less than 15 hours a week, your payment will be the smaller amount of:

    • 80 per cent of your pre-injury average weekly earnings, minus the amount that you are earning in suitable employment or have been assessed as able to earn in suitable employment, and the value of any deductible amount, or
    • The maximum weekly compensation amount (currently $2084.90) minus the amount that you are earning in suitable employment or have been assessed as able to earn in suitable employment, and the value of any deductible amount
  • Weekly payments for 131 to 260 weeks

    If you still can’t work, your payments will cease unless you are assessed as likely to be off work indefinitely. Then your weekly payments will be the smaller amount out of:

    • 80 per cent of your pre-injury average weekly earnings, minus the value of any deductible amount, or
      The maximum weekly compensation amount (currently $2084.90) minus the value of any deductible amount

    If you are working or have some capacity to work but nothing suitable is available due to your injury, then weekly payments will cease after 130 weeks unless:

    • You’ve applied to your insurer for continued weekly payments
    • You’re working at least 15 hours a week and earn a minimum of $183 per week (indexed annually) and have been assessed as unable to do additional employment or work in any capacity to increase your weekly earnings

    Note that if you’re a worker with high needs (your degree of permanent impairment is greater than 20 per cent), the 15 hours and $183 (currently) per week requirements are waivered.

    If you are entitled to payments after 130 weeks they will be the lesser of:

    • 80 per cent of your pre-injury average weekly earnings, minus the amount you are currently earning or have been assessed as able to earn if suitable employment were available, and the value of any deductible amount, or
    • The maximum weekly compensation amount (currently $2084.90) minus the amount you are currently earning or have been assessed as able to earn if suitable employment were available, and the value of any deductible amount
  • Weekly payments after 260 weeks

    Unless your level of impairment from your injury has been assessed as greater than 20 per cent, payments stop after five years.

    If you’re still working in some capacity, or can’t find suitable work due to your injury, and have been assessed as having an impairment greater than 20 per cent, you’ll receive the lesser of:

    • 80 per cent of your pre-injury average weekly earnings, minus the amount you are currently earning or have been assessed as able to earn if suitable employment were available, and the value of any deductible amount, or
    • The maximum weekly compensation amount (currently $2084.90) minus the amount you are currently earning or have been assessed as able to earn if suitable employment were available, and the value of any deductible amount
  • Exempt workers

    Exempt workers including police officers, paramedics, firefighters, volunteer bush firefighters and rescue volunteers have different rules.

    If you have been injured in the course of employment but can return part time to work, you’ll be paid for those hours. If that means you are earning less than before your injury, you may receive ‘make up’ pay. 

    This is calculated based on the difference between your pre-injury earnings (including overtime, shifts, special expenses, penalty rates) minus what you can earn afterwards.

    However, your make up pay can’t be more than the compensation you would receive if you were completely incapacitated.

    If you are unable to work at all, the first 26 weeks will be calculated based on your current weekly wage. After 26 weeks, it is based on the statutory rate.

    Current weekly wage rate is:

    • 100 per cent of the rate of remuneration for one week of work (excluding overtime, shift work, payments for special expenses and penalty rates) if you are paid under an award, industrial or enterprise agreement, or if there is a relevant award that can be applied to your pre-injury position
    • 80 per cent of your average weekly earnings (including regular overtime and allowances) if you are not employed under an award, industrial or enterprise agreement and there is no relevant award that can be applied to your pre-injury position

    If your current weekly wage rate is more than $2084.90, your insurer will use that amount to calculate what you’re entitled to. This amount is indexed every 1 April and 1 October. The statutory rate for a single worker is $490.40 and is indexed every 1 April and 1 October. There are additional weekly payments for dependents, please see the benefits guide for those additional payments