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WorkCover Claims – Weekly Benefits or Lost Wages – Your Rights and Entitlements Explained

In this blog article, we are looking at how WorkCover [and self-insurers] calculate the amount an injured worker is entitled to receive while receiving statutory benefits.

An injured worker’s entitlement to weekly benefits or lost wages is determined by the provisions of the Workers Compensation & Rehabilitation Act 2003 (“the WorkCover Act”).

Calculation of Weekly Benefits or Lost Wages

The calculation of the weekly benefits or lost wages depends on a few things including:-

  • How long your work capacity certificate or other medical opinion says you should be off work
  • The date you were injured
  • The date your doctor first assessed your injury
  • The length of time you’ve been receiving compensation
  • Thether your job has an award or workplace agreement in place
  • That your normal wage payments are each week (Normal Weekly Earnings or NWE)
  • Queensland full-time adult ordinary time earnings (QOTE)

What is QOTE?

QOTE is the amount of a Queensland full-time adult’s ordinary time earnings. These are adjusted year by year (usually on July 1) and are declared by the Australian Statistician. The current rate of QOTE is published in the Workers’ Compensation and Rehabilitation (QOTE) Notice and can be found on the Queensland Legislation website.

How does an injured worker get paid by WorkCover?

Your first week’s compensation will come directly from your employer.

After that, WorkCover will pay your weekly compensation into your bank account and, when possible, consistent with your employer’s payroll schedule.

Tax will be deducted from your payments in the same way as your normal wage. WorkCover doesn’t take deductions for employee benefits like your superannuation. Your employer might still have to pay your super while you’re receiving workers compensation. This will depend on your award or workplace agreement.

How long is an injured worker entitled to receive weekly benefits or lost wages?

How long will I be paid for?

Your weekly compensation will stop when the first of the following happens:

  • You go back to work and aren’t injured any more
  • You receive a lump-sum offer
  • You’ve been receiving weekly payments for five years
  • Your total weekly compensation reaches the maximum amount payable.

What information does WorkCover use to calculate weekly compensation?

WorkCover uses information from your employer, or from you, to calculate what you normally earn, known as Normal Weekly Earnings (NWE). When WorkCover is determining the claim, WorkCover will ask for:

  • An itemised payroll report from your employer for 12 months before the date of injury. The report must show each payment including wages, penalties and allowances, OR
  • Payslips from your employer, or from you, for 12 months before the date of injury (or from the date started, if less than 12 months), OR
  • If these aren’t available, we could accept other written wages evidence, such as tax invoices, or bank statements.

How is weekly compensation worked out?

  • Length of claim – up to 26 weeks
    • The greater of 85% NWE or amount under the industrial instrument.
    • For the people that are not covered by an Industrial Instrument, their entitlement is the greater of 85% of NWE or 80% of QOTE, however not more than a person’s normal weekly earnings.
  • Length of claim – between 26 weeks to 104 weeks
    • The greater of 75% NWE or 70% QOTE.
  • Length of claim – 104 weeks onwards
    • If worker is unfit for work after two years, compensation will depend on degree of impairment.

Options & Rights to Appeal if WorkCover suspends or terminates weekly benefits?

If an injured worker wishes to dispute the calculation of the weekly benefits or lost wages, it is possible to appeal the decision.

Also, if WorkCover suspends or ceases paying weekly benefits for any particular reason, it is also possible to appeal the decision.

Appealing any decision from WorkCover generally involves preparing an application for statutory review to the Workers Compensation Regulator.  An appeal to the regulator is ‘on the papers’ and there is no risk of an adverse costs order if an appeal to the regulator is unsuccessful.

Generally, an appeal to the Workers Compensation Regulator must be submitted within three months of WorkCover issuing a compliant statement of reasons for decision.

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State updated!
Your state has been updated to QLD. Practice areas on compensation law have been updated.