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Understand Your Rights

A Warning for long term Workers Compensation recipients

By Tonya Longmore – Solicitor, Workers Compensation

11 November 2016

If you or a member of your family has been injured at work and has been receiving weekly benefits payments from a workers compensation insurer, the new regulation in relation to the 260 week limit may soon affect you.

Insurance & Care NSW (icare) delivers insurance and care services to people with injuries under the NSW Workers Compensation Scheme, the Lifetime Care and Support Authority, the Dust Diseases Authority, the NSW Self Insurance Corporation (SICorp) and NSW Sporting Injuries Compensation Authority.

We’ve received reports that some icare scheme agents have been contacting injured workers who may reach the 260 week limit for weekly payments.

The agents have then been writing to the injured workers, informing them that they have to be assessed to determine whether they have a degree of permanent impairment of more than 20% to be eligible for continuing to receive weekly payments beyond that limit.

The brochure they send out contains information which may be misleading. If the appropriate action is not taken you may have your weekly payments terminated even if you exceed the 20% whole person impairment threshold which could allow your benefits to continue.

Under the new guidelines for claiming workers compensation which came into effect on 1 August 2016, weekly payments will cease unless you have a permanent impairment greater than 20% and have been assessed as having no 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.

Worker with high needs may continue after 260 weeks but require a work capacity assessment to be done at least once every two years. Workers with highest needs (having a whole person impairment in excess of 30%) continue to be entitled to weekly payments without the requirement for a work capacity assessment.

There is no reference in the brochure from the icare scheme agent to your ability to seek independent legal advice, but we strongly encourage you to do so to ensure you understand your rights and also the difficulties that may affect you from the assessment process.

For more details and assistance, please contact us on 1800 643 779.