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, or an application for agreement between the worker and employer as to PIAWE has not yet been approved.

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, or if an insurer has not yet approved a PIAWE agreement.

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.

ExpectationsBenchmarks
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 complete information required. If the amount determined differs to the interim PIAWE amount, a new work capacity decision is to be made.

PIAWE to be recalculated within five working days from receipt of required information

S7.4

If the insurer makes a work capacity decision, and the PIAWE is more than

  • the rate in the application for approval of the PIAWE agreement which was refused to be approved by the insurer after weekly payments commenced, or
  • the interim PIAWE,

the insurer is to pay any adjustment payment due to the worker as soon as possible.

If the insurer makes a work capacity decision, and the PIAWE is less than:

  • the rate in the application for approval of the PIAWE agreement which was refused to be approved by the insurer after weekly payments commenced, or
  • the interim PIAWE,

any overpayment made to the worker is to be dealt with in accordance with Standard 23.

Adjustment payment to the worker paid no later than 14 days from the work capacity decision

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.

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