S7. Interim pre-injury average weekly earnings calculation
Commencement date: 21 October 2019
Providing for interim pre-injury average weekly earnings (PIAWE) enables workers to be supported by the commencement of weekly payments when the insurer has insufficient information to make a complete calculation.
Principle
Weekly payments to workers will commence as soon as possible. Workers will not be disadvantaged if the insurer has not been able to obtain all information required to calculate PIAWE.
Application
This standard does not apply to exempt workers.
Note: any reference in this Standard to an 'agreement' only relates to injuries on or after 21 October 2019.
Expectations
Benchmarks
S7.1
For claims where weekly payments may be payable, as soon as possible after notification, insurers are to advise the worker and employer:
that a worker's pre-injury average weekly earnings (PIAWE), to be used for the calculation of weekly payments, may be determined:
by agreement between the worker and employer, or
by the insurer using the prescribed methodology to make a work capacity decision
what information and evidence is to be supplied and applicable timeframes for each approach.
Communication with the employer and worker within three working days from receipt of an initial notification
S7.2
For claims where the employer and worker do not make an application for approval of a PIAWE agreement to the insurer, and the insurer does not have sufficient information to make a complete PIAWE calculation, the insurer is to:
commence weekly payments using an interim PIAWE, calculated based on the best available information, and communicated via a work capacity decision
inform the employer and the worker that all of the information required to undertake a complete PIAWE calculation should be provided to the insurer, as soon as possible, following which PIAWE will be determined.
Evidence on claim file of communication with the worker and employer before commencing weekly payments
S7.3
For claims where an interim PIAWE work capacity decision has been made, insurers are to recalculate a worker's PIAWE as soon as possible following receipt of the necessary information. If the amount determined differs to the interim PIAWE amount, a new work capacity decision is to be made.
Note: Insurers should have regard to the requirements of clause 8N of the Workers Compensation Regulation 2016 and Standard of practice S.23 Recovery of payments due to insurer error in managing adjustments to weekly payments
PIAWE to be recalculated within five working days from receipt of required information
Providing for an interim pre-injury average weekly earnings (PIAWE) calculation enables workers to be supported by commencement of weekly payments, even when the insurer has insufficient information to make a complete calculation. This ensures workers are not disadvantaged or experience delays in receiving weekly payments where the employer has not provided the required information to the insurer for the purposes of calculating pre-injury average weekly earnings (PIAWE).
One of the key system objectives is to provide workers with income support during incapacity.
Sometimes insurers are unable to determine PIAWE within the required timeframe for the first weekly payment as they have insufficient information to correctly determine it. In such instances insurers are to calculate an interim PIAWE or make an interim payment decision to commence payments without delay.
Where there is an interim PIAWE, and the employer does not respond to insurer requests for information, the insurer can contact SIRA on 13 10 50.
