How Long Can I Stay on WorkCover? A Guide to Recovery & Compensation

Understanding the duration of WorkCover benefits in New South Wales (NSW) is crucial for injured workers navigating their recovery and compensation journey. The length of time you can receive benefits depends on factors such as the severity of your injury, your capacity to work, and specific assessments conducted during your claim.

How Long Can I Stay on WorkCover?

Duration of Weekly Payments

In NSW, weekly compensation payments are generally available for up to 260 weeks (five years). However, this duration can vary based on your assessed level of permanent impairment and work capacity.

Up to 130 Weeks

• First 13 Weeks: You may receive up to 95% of your pre-injury average weekly earnings if you are unable to work.

• Weeks 14 to 130: Payments may adjust to 80-95% of your pre-injury earnings, depending on your capacity to return to work, even in a reduced capacity.

Beyond 130 Weeks

• Work Capacity Assessment: Before reaching 130 weeks, a work capacity assessment will determine your ability to engage in suitable employment.

• Continuation of Payments: If assessed with no current work capacity and it's unlikely to change, payments may continue. If you have some capacity to work, you might need to be employed for a minimum of 15 hours per week, earning at least a specified amount, to maintain benefits.

Beyond 260 Weeks (Five Years)

• Permanent Impairment Over 20%: If your Whole Person Impairment (WPI) is assessed above 20%, you may continue to receive weekly payments beyond 260 weeks.

• Permanent Impairment 20% or Less: For those with 20% WPI or less, weekly payments typically cease after five years.

Medical and Related Expenses

Coverage for medical treatments, hospitalizations, and rehabilitation services is also influenced by your level of permanent impairment:

• 10% WPI or Less: Expenses can be claimed for up to two years after weekly payments end or from the date of claim if no weekly payments were made.

• 11-20% WPI: Coverage extends up to five years post-weekly payments.

• Above 20% WPI: You may be eligible for lifetime coverage of reasonable medical and related expenses.

Permanent Impairment and Lump Sum Compensation

If your injury results in permanent impairment, you might be entitled to a lump sum compensation. The amount depends on the degree of impairment, as assessed by a qualified medical professional.

Key Considerations

• Regular Assessments: Ongoing medical and work capacity assessments are essential to determine the continuation of benefits.

• Engage with Your Case Manager: Maintain open communication with your insurer's case manager to stay informed about your entitlements and any necessary actions on your part.

• Seek Legal Advice if Needed: If you're uncertain about your rights or disagree with an assessment, consulting a legal professional experienced in workers' compensation can provide clarity and assistance.

This guide provides a general overview based on information from the State Insurance Regulatory Authority (SIRA) and icare NSW. Individual circumstances can vary, and it's advisable to consult directly with your case manager or legal advisor for personalised advice.

Sources:

• State Insurance Regulatory Authority (SIRA): Workers Compensation Benefits Guide

• icare NSW: Eligibility for Continuation of Wages and Medical Benefits

Disclaimer: This article is intended for informational purposes only and does not constitute legal advice. Workers' compensation laws and regulations are subject to change. For advice tailored to your specific situation, please consult with a qualified professional or the appropriate authorities.

Book Online