Weekly payments may be suspended, reduced or stopped if certain requirements are not met.
You must provide to the insurer a Certificate of capacity with the "Worker's declaration" section completed.
Weekly payments may be discontinued by the insurer within seven days of the insurer communicating to you that the document must be provided.
The information below is general in nature and the payments you receive may vary based on your circumstances.
Work capacity assessments and decisions
The insurer assesses your capacity for work based on your functional, vocational and medical status. This is used to inform the decision about your ability to return to your pre injury employment or suitable employment with the pre injury employer or at another place of employment.
A work capacity decision could result in weekly payments being reduced or terminated. The decisions can be reviewed.
Not complying with return to work obligations
If you have capacity to work, then you are required to return to work. This could be:
- with your employer in suitable employment, or
- in pre injury employment at your place of employment, or
- at another place of employment.
Weekly payments may be suspended or terminated at a date at least 14 days but no more than 60 days from when notice is given by the insurer communicating to you that you must comply with your return to work obligations.
After 130 weeks of weekly payments
There is no entitlement to weekly payments after receiving weekly payments for 130 weeks unless:
- the insurer has assessed that you have no capacity to work and this is likely to continue indefinitely, or
- you have been assessed as having a current capacity to work and have applied to the insurer for continuation of weekly payments, and
- you are working 15 hours or more per week, and
- earning at least $176 per week and
- have been assessed as being (and likely to continue to be) indefinitely incapable of undertaking further employment or additional work to increase your earnings.
If you have been assessed as having some current capacity to work but are not working 15 hours or more and earning at least $176 per week (indexed annually), you will cease to receive weekly payments.
Note: the amount earned is indexed annually on 1 July.
After 260 weeks (five years) of weekly payments
Weekly payments will cease, unless you have a permanent impairment greater than 20% and have no assessed current work capacity (which is likely to continue indefinitely), or you have an assessed current work capacity, and you:
- are working 15 hours or more per week; and
- are earning at least $176 per week and
- have been assessed as indefinitely incapable of undertaking further employment to increase your earnings.
Complaints to the Workers Compensation Independent Review Office
If you are dissatisfied at any stage with the management of your injury, you can contact the Workers Compensation Independent Review Office (WIRO) at www.wiro.nsw.gov.au or call them on 13 94 76.
The Workers Compensation Independent Review Office fact sheet contains general information about workers compensation entitlements and procedures. This fact sheet is not a detailed explanation of the law as it applies to claims made by individual workers.
Payments for exempt claimants
This section only relates to those exempt from the 2012 reforms.
If you have been receiving weekly benefits for partial incapacity for more than two years, your weekly payments can be discontinued if you:
- are not suitably employed and are not seeking suitable employment or participating in rehabilitation/retraining
- are not suitably employed and have previously unreasonably rejected suitable employment
- have sought but failed to obtain suitable employment primarily because of the labour market.
If you fail to comply with your return to work obligations, weekly payments may be suspended or terminated within 14 days of the insurer communicating the requirement to you.
Entitlements after retiring age
Entitlements for exempt workers may continue until one year after you reach retiring age.