Under the Workers’ Compensation Rehabilitation Act 2003, a worker’s entitlement to compensation stops when the first of the following happens:
- the incapacity because of your work related injury stops (you are no longer suffering from an incapacity); or
- you have received weekly payments for incapacity for 5 years; or
- compensation reaches the maximum amount of compensation (this calculation for this amount is prescribed under the legislation)
However, normally a workers compensation claim will close when your injuries are stable and stationary (have reached maximum medical improvement). The timeline is influenced by the nature of your injury, your recovery progress, and specific limits within Queensland's workers' compensation law:
- Initial 6 Months: WorkCover generally covers up to 85% of your normal weekly wage.
- 6 Months to 2 Years: Payments drop to 75% of your normal weekly wage.
- 2 Years Onward: After two years, you may remain entitled to payments (up to 75% of your normal weekly wage).
What if I Haven't Fully Recovered?
In cases where your injuries prevent a full recovery and return to work before certain time limits, WorkCover takes the following steps:
- Independent Medical Examination (IME): To assess the degree of permanent impairment (Whole Person Impairment or WPI), WorkCover arranges an independent medical examination with a qualified medical professional. This examines the long-term impacts and restrictions caused by your injury.
- Lump Sum Offer: Once your injuries are stable and stationary (not getting any better or getting any worse), you have received your Permanent Impairment Assessment with a degree of whole person impairment for your injuries, WorkCover will provide a lump-sum compensation offer.
If your degree of permanent impairment % is less than 20%, you may accept, reject or defer a decision. Your decision will be taken to be deferred if you do not advise the insurer within the “Decision Period”, which is currently 20 days.
However, if you fail to provide your decision before seeking common law damages for your injury, you are taken to have rejected the lump sum offer.
Importance of Legal Advice
Seeking legal advice from a personal injury lawyer specialising in WorkCover claims is crucial in these situations for several reasons:
- Fair WPI Assessment: Your lawyer helps ensure your degree of whole person impairment has been calculated fairly, maximising potential compensation.
- Common Law Claims: If anyone else’s negligence caused your injury (e.g., another driver, contractor, or your employer), you might be entitled to make a common law claim following your WorkCover statutory claim. Common law claims often result in much higher lump-sum payouts than what you would receive as a lump sum payment from WorkCover after your PI assessment.
- Challenging Offer Amounts: A lawyer can assist by negotiating or contesting any WorkCover offer that seemingly understates your needs and losses during your common law claim.
Also read: How Long Will My Common Law Claim Take to Resolve?
Can WorkCover Stop Payments?
Yes, WorkCover Queensland or your employer's self-insurer can increase, decrease or stop weekly payments under certain circumstances:
- Recovery and Return to Work: If you fully recover and your doctor clears you to resume work without restrictions.
- Refusing Suitable Employment: If you reject a suitable job offer within your capabilities with your pre-injury employer or elsewhere.
- Reaching Time Limits: Statutory time limits (5 years after your claim start date) can terminate ongoing wage replacement payments.
- Non-Compliance: Failure to attend medical appointments, IMEs, or participate in rehabilitation programs.
Note: WorkCover must give notice and a proper chance to respond before ending benefits. It's best to seek legal advice immediately if this happens.
Where to Find Help
- WorkCover Queensland: Provides specific information about entitlements and obligations: https://www.worksafe.qld.gov.au/
- Office of Industrial Relations (Queensland): Offers worker's compensation resources: https://www.oir.qld.gov.au/
If you've suffered a workplace injury in Queensland, Smith's Lawyers' workers compensation experts are here to help. We offer risk-free assistance across the entire state, including Brisbane, Gold Coast, Sunshine Coast, Logan, Ipswich, and regional cities like Cairns, Toowoomba, Townsville, Rockhampton, Bundaberg, and Mackay.
