Weekly payments for workers injured before 21 October 2019
If you have been injured at work, you may be eligible to receive weekly payments depending on your capacity for work as a result of your work-related injury.
This page applies to workers injured before 21 October 2019.
The first step in claiming compensation for a work-related injury or illness is to notify your employer and the insurer of the injury. If you haven’t done this, please see What to do first.
After the insurer has been notified of the injury, they will contact you to discuss the notification and support available.
You may be entitled to weekly payments when a work-related injury has resulted in a loss of earnings because you have reduced capacity for work.
Exempt category of worker
To demonstrate this reduced capacity, you must provide a completed SIRA certificate of capacity to your employer or the insurer. Watch this short video to find out more about the certificate of capacity.
Once the insurer has received an initial notification of injury it must:
- start provisional payments within seven calendar days unless there is a reasonable excuse not to, or
- delay starting provisional weekly payments by issuing a reasonable excuse within seven days, or
- determine liability
Where the insurer has issued a reasonable excuse, they must give you the following information:
- what the reasonable excuse is;
- details of how you may make a claim for weekly payments.
If the insurer has issued a reasonable excuse, you may complete a claim form. Once the claim form is received by the insurer, they have 21 days to:
- details of the reasonable excuse,
- inform you that you may make a claim for compensation which will be determined within 21 days, and
- details of how you may make a claim for compensation
If the insurer disputes your claim, there’s help available. Our workers compensation disputes section has more information or you may contact the Independent Review Office (IRO) on 13 94 76.
If the insurer has accepted your claim for weekly payments, they must advise you of your weekly payment amount. The amount of your weekly payment is based on:
- your pre-injury average weekly earnings
- whether you have current work capacity or no current work capacity
- how long you have received weekly payments for
- whether you have been able to return to work
- your ability to earn in suitable employment
- whether your income includes non-pecuniary benefits from your employer
You may receive your weekly payments directly from your employer or the insurer within your usual pay cycle.
To help understand your weekly payment entitlements, see the Have you been injured at work? webapp. This resource provides a breakdown of your entitlements.
If you do not provide a completed SIRA certificate of capacity, the insurer may stop weekly payments within seven days of advising you that the document is required.
Pre-injury average weekly earnings
Pre-injury average weekly earnings are calculated by your insurer based on information provided by you and/or your employer. They reflect how much you were earning before your injury.
If you need help or advice, speak to the insurer or contact the Independent Review Office (IRO) on 13 94 76.
For more information on pre-injury average weekly earnings, see weekly payments in the claims management guide.
Note
Provisional payments
Provisional payments enable the insurer to start paying weekly payments (and medical expenses) to you while they fully assess your claim. The amount of the weekly payment will vary for each person.
Provisional payments can include weekly payments for up to 12 weeks, and payment of medical expenses up to $10,000. It also extends the time allowed for the insurer to make a decision on liability.
0-13 weeks: First entitlement period
In the first 13 weeks, the amount of your weekly payments is based on the lesser of:
- 95 per cent of your pre-injury average weekly earnings, minus:
- the value of any deductible amount if you have no capacity for work, or
- your current weekly earnings if you have capacity to work and are working.
- The maximum weekly compensation amount minus:
- the value of any deductible amount if you have no capacity for work, or
- any current weekly earnings and the value of any deductible amount if you have capacity for work and are working.
14-130 weeks: Second entitlement period
Working 15 hours or more a week
Where you have current work capacity and are working 15 hours or more per week, your weekly payments are based on the lesser of:
- 95 per cent of your pre-injury average weekly earnings minus your current weekly earnings, or the amount that you have been assessed as able to earn in suitable employment, and the value of any deductible amount, or
- the maximum weekly compensation amount minus any current weekly earnings or the amount that you have been assessed as able to earn in suitable employment, and the value of any deductible amount.
Working less than 15 hours a week
Where you have current work capacity and are working less than 15 hours per week, your weekly payments are based on the lesser of:
- 80 per cent of your pre-injury average weekly earnings minus your current weekly earnings or the amount that you have been assessed as able to earn in suitable employment and the value of any deductible amount, or
- the maximum weekly compensation amount minus any current weekly earnings or the amount that you have been assessed as able to earn in suitable employment, and the value of any deductible amount.
No capacity for work
Where you have no capacity for work, your weekly payment is based on the lesser of:
- 80 per cent of your pre-injury average weekly earnings, minus the value of any deductible amount, or
- the maximum weekly compensation amount minus the value of any deductible amount.
After 52 weeks
For injuries received before 26 October 2018, any overtime or shift allowance will no longer be included in the calculation of your average weekly earnings.
If you sustained an injury on or after the 26 October 2018, any overtime or shift allowance entitlement will continue to be included in the calculation of your average weekly earnings after 52 weeks.
Note: Payments after 130 weeks will stop unless:
- you have been assessed as having no current work capacity, and this is likely to continue indefinitely, or
- you are working at least 15 hours per week and earning at least $155 (indexed annually), and this is likely to continue indefinitely, AND
- you have completed an application for continued weekly payments after 130 weeks form and sent it to the insurer or
- you are a worker with high needs.
131-260 weeks
You may continue to receive payments after 130 weeks where:
- you have been assessed by the insurer as having no current work capacity, and this is likely to continue indefinitely, or
- you are working at least 15 hours per week and earning at least $155 (as indexed), and this is likely to continue indefinitely, AND
- you completed an application for continued weekly payments after 130 weeks form and this has been confirmed by the insurer, or
- you are a worker with high needs.
Working 15 or more hours a week
If you have current work capacity, are working at least 15 hours per week and earning at least $155 a week (as indexed), and have been assessed by the insurer as being likely to continue in this capacity indefinitely, weekly payments are based on the lesser of:
- 80 per cent of your pre-injury average weekly earnings, minus your current weekly earnings or the amount that you have been assessed as able to earn in suitable employment, and the value of any deductible amount, or
- the maximum weekly compensation amount minus any current weekly earnings or the amount that you have been assessed as able to earn in suitable employment, and the value of any deductible amount.
No capacity for work
If you have been assessed as having no current work capacity and this is expected to continue indefinitely, you will continue to be eligible for weekly payments after 130 weeks.
If this is the case, your weekly payment is based on the lesser of:
- 80 per cent of your pre-injury average weekly earnings, minus the value of any deductible amount, or
- the maximum weekly compensation amount minus the value of any deductible amount.
Workers with permanent impairment of more than 20 per cent
If you have been assessed or are likely to be assessed to have a permanent impairment more than 20 per cent, you will continue to receive weekly payments if you are working less than 15 hours a week or earning less than the minimum $155 a week (as indexed).
Your weekly payment will be based on the lesser of:
- 80 per cent of your pre-injury average weekly earnings, minus your current weekly earnings or the amount that you have been assessed as able to earn in suitable employment, and the value of any deductible amount, or
- the maximum weekly compensation amount minus any current weekly earnings or the amount that you have been assessed as able to earn in suitable employment, and the value of any deductible amount.
After 260 weeks (five years)
Weekly payments will cease unless you have been assessed as having an agreed permanent impairment of more than 20 per cent.
Where you continue to be entitled to weekly payments, the insurer will determine your weekly payment in accordance with section 38 of the 1987 Act.
Weekly payments are calculated based on the lesser of:
- 80 per cent of your pre-injury average weekly earnings, minus your current weekly earnings or the amount that you have been assessed as able to earn in suitable employment, and the value of any deductible amount, or
- the maximum weekly compensation amount minus any current weekly earnings or the amount that you have been assessed as able to earn in suitable employment, and the value of any deductible amount.
Further information
Workers who have an unresolved enquiry or complaint about their weekly payment entitlements with their insurer should contact IRO by phoning 13 94 76, or visit their website for further information.
To learn more about workers compensation in NSW – including information about weekly payments – see Understanding the claims journey in the claims management guide.
Stopping weekly payments
Your ongoing entitlement to weekly payments is dependent on:
- you meeting your return to work obligations
- work capacity decisions made by the insurer
- your assessed degree of permanent impairment
- whether or not you have exceeded the entitlement period of 130 weeks, and
- whether or not you have exceeded the entitlement period of 260 weeks.
Work capacity assessment/decision
The insurer assesses your capacity for work based on your functional, vocational and medical status.
They use this information to make a decision about your ability to return to your pre-injury employment, or to return to suitable employment with the pre-injury employer or at another place of employment.
If they determine you have some capacity to work, then your weekly payments may be reduced or stopped according to the amount that you could earn in that capacity.
These decisions can be reviewed and/or disputed. See work capacity decision disputes for more information.
Retirement
If you're receiving weekly payments and reach retirement age, you may be entitled to receive weekly payments for a further period of 12 months.
If you receive an injury on or after retiring age, you may be entitled to weekly payments during the 12-month period that starts from the date of your first incapacity.
The retiring age is defined as the age a person is eligible to receive the age pension.
You will need to provide the insurer with a SIRA certificate of capacity for the period you are claiming weekly payments.
For injuries received before 30 June 1985, your entitlement to weekly payments is not affected by the retiring age.
Maximum weekly compensation amount
The maximum weekly compensation amount is capped and indexed in April and October each year. The maximum amount from 1 April 2024 to 30 September 2024 is $2,497.70.