Due to a shared moral and commitment to a company, a common question that arises amongst the majority of injured workers is, “who pays for workers’ compensation?”
In this article, we will cover everything regarding workers’ compensation, from what it is to who pays it and the main stages of the process.
Understanding Workers Compensation in Australia
In Australia, there are both state and federal funded workers compensation schemes. This article will focus on the NSW workers compensation scheme.
Workers compensation insurance ensures support for workers who have suffered an injury or illness arising out of or in the course of their employment. The key supports in workers compensation insurance include wage payments, medical benefits, domestic assistance and in some circumstances lump sum compensation for whole person impairment.
Basic Principles of Workers Compensation
In NSW, the workers compensation scheme is ‘no-fault’. This means that you do not need to establish fault on the part of the employer in order to claim statutory workers compensation benefits.
In NSW, an employer with employees will generally require a workers insurance policy. This policy will provide the employer and the employee with important coverage in the event that a worker suffers from an injury or illness.
What does Workers’ Compensation Cover?
Before moving on to the next part, let’s briefly overview what workers' compensation covers.
Under the NSW statutory scheme, workers compensation benefits can include:
- Weekly compensation benefits if you have a partial or total incapacity as a result of your work injury.
- Medical and treatment related costs (appointments, surgery, medication, etc.) that are reasonably necessary as a result of the work injury.
- Lump sum payments for permanent impairment or death
Workers’ compensation insurance can also cover return-to-work assistance expenses, travel expenses if necessary for receiving medical treatment and domestic assistance.
Employer Responsibilities Regarding Workers’ Compensation
Employers have a responsibility to ensure that they have the appropriate insurance for their business. Employers should contact their insurer for specific guidance on their obligations under the insurance policy.
Under section 248 of the Workers Compensation Act 1987, an employer must not dismiss a worker within the first six months from then the worker first became unfit as a result of the injury.
Does Workers’ Compensation Pay Full Salaries?
A common question asked by injured workers is whether or not they will be compensated full wages in respect of any incapacity that arises as a result of a work injury.
If a worker experiences a total or partial incapacity as a result of their work injury, they may be entitled to claim weekly payments during the period of incapacity.
Weekly payments compensate for the lost income of a worker as a result of a work injury. From weeks 0 to 13, workers with no current work capacity are entitled to claim 95% of their paycheck (pre-injury earnings). If a worker has a current work capacity in this period, then they may be entitled to claim the lesser of 95% of their pre-injury earnings, less the current weekly earnings, or the maximum weekly compensation amount, less the current weekly earnings.
From weeks 14 to 130, workers with no current work capacity are entitled to claim 80% of pre-injury earnings. If a worker has a current work capacity in this period, and they are working at least 15 hours per week, then they may be entitled to claim the lesser of 95% of their pre-injury earnings, less the current weekly earnings, or the maximum weekly compensation amount, less the current weekly earnings. If a worker has a current work capacity and has not returned to work, or has returned to work but for less than 15 hours per week, hen they may be entitled to claim the lesser of 80% of their pre-injury earnings, less the current weekly earnings, or the maximum weekly compensation amount, less the current weekly earnings.
To continue receiving weekly payments between weeks 130 to 260, a new worker assessment is required to determine the ability to return to work. If the worker is able to work, the weekly benefits will stop. If the employee cannot return to work, then they will continue to receive 80% of their pre-injury earnings.
Suppose the worker cannot return to work for over 260 weeks (beyond 5 years). In that case, they may be entitled to continue to claim weekly benefits if their WPI is agreed or determined to be greater than 20%, and they continue to meet the eligibility conditions.
Contact professional lawyers to discuss your particular circumstances.
Who Pays for Workers’ Compensation?
Most workers injured in NSW are able to obtain free legal advice in relation to their workers compensation claim. Funding in these matters is granted by the Independent Review Office (IRO), which is a NSW Government Agency established to assist injured workers with receiving free legal advice about their workers compensation entitlements. At Walker Law Group, we have a team of Approved Lawyers who are able to provide advice, assistance and representation to eligible injured workers at no cost to the injured worker.
There are some NSW injured workers such as Police Offices, Paramedics and Firefighters, who fall within a category known as ‘exempt workers’. Although exempt workers are not eligible to have their case funded by the IRO, at Walker Law Group, we are able to conduct most workers compensation claims on a no-win-no-fee basis. This is also the case for workers injured in the course of their employment under the federal scheme.
Thus, companies are not paying for the compensation, but the insurer is. However, no matter the case, if you were injured in the workplace, you are highly encouraged to take appropriate measures and apply for workers' compensation.
Main Stages of Workers Compensation Claims in Australia
To file a worker's compensation claim, you must follow these steps:
- Step 1: Report the injury to the employer as soon as possible.
- Step 2: Access healthcare services and seek medical attention.
- Step 3: Document the injury and obtain medical records.
- Step 4: Obtain a workers’ compensation claim form from the employer/insurer/relevant authority.
- Step 5: Start to fill out the form and gather the necessary documentation as well as supporting evidence.
- Step 6: Submit the claim.
At Walker Law Group, our team of Approved Lawyers are here to assist you with the lodgment of your workers compensation claim. Contact us today for further advice.
