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Guidance for workers reaching the end of their medical entitlement period

Guidance for workers reaching the end of their medical entitlement period

Some workers will soon reach the end of their entitlement period to claim medical benefits through the NSW workers compensation system.

Under section 59A of the Workers Compensation Act 1987, workers can claim medical, hospital, and rehabilitation expenses for:

  • two years after weekly payments stop, where their degree of permanent impairment is 10 per cent or less
  • five years after weekly payments stop, where their degree of permanent impairment is 11 to 20 per cent.

Workers with greater than 20 per cent permanent impairment are entitled to medical treatment, service or assistance for life.

Workers are expected to start reaching their medical entitlement limits from September 2019.

The State Insurance Regulatory Authority has developed information and resources to encourage workers, health providers and insurers to work together to plan smooth transitions to alternative treatments and supports.

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