Wage Coverage

In New South Wales (NSW), navigating the complexities of Workcover wage coverage after an injury is vital for workers. Many individuals face unexpected challenges, and understanding your benefits can ease some of the stress during recovery. It can also help with financial planning for the future.

Workcover aims to support injured workers by delivering financial assistance throughout their recovery period. This article explains how payments are calculated, outlines entitlement periods, payment rates, and dives into calculating your Pre-Injury Average Weekly Earnings (PIAWE).

Understanding PIAWE: What’s it Based On?

Your wage coverage through Workcover is primarily determined by your Pre-Injury Average Weekly Earnings (PIAWE). This figure reflects your average weekly income before your injury.

PIAWE includes:

• Base pay

• Overtime hours

• Shift allowances

• Commissions

• Certain non-monetary benefits that may be unavailable post-injury

  
  

Accurately calculating your PIAWE is crucial, as it directly impacts your entitlement amounts and payment rates. For example, if your PIAWE is $1,000 per week, this will set the standard for your compensation calculations.

Entitlement Periods & Payment Rates

First 13 Weeks of Total Incapacity

During the initial 13 weeks following your injury, if you cannot work, you are entitled to receive the lesser of:

• 95% of your PIAWE, or

• The statutory maximum weekly amount, which is indexed regularly.

  
  

This early support is essential. It helps injured workers adjust and focus on recovery without worrying about bills. For instance, if your PIAWE is $1,000, you could receive $950 per week, significantly aiding in managing expenses during tough times.

Weeks 14 to 130: Continued Payments Based on Capacity

From weeks 14 to 130, payment amounts change depending on your work capacity:

• If you can’t work at all, you will receive the lesser of 80% of your PIAWE or the statutory maximum.

• If you can work and earn at least 15 hours per week, you may receive up to 95% of your PIAWE, minus any earnings from your job.

• If you can only work less than 15 hours, you will receive up to 80% of your PIAWE, with allowable earnings deducted.

  
  

Paying close attention to your capacity and maintaining proper communication with WorkCover during this time is critical. For instance, if you have a PIAWE of $1,000, and you work 10 hours earning $200, your payments would adjust to reflect that income.

Weeks 131 to 260: Extended Payments

For workers who still cannot return to work from weeks 131 to 260, support can continue, but you must meet certain criteria. You need to apply in writing before week 130, and a Work Capacity Assessment must confirm that you cannot work or that you're working 15 hours but cannot increase your earnings.

If approved, you can receive 80% of your PIAWE (up to the statutory maximum) minus any earnings. Timely applications and maintaining good communication with Workcover are necessary to avoid lapses in support.

Duration of Payments and Whole Person Impairment

Typically, payments last up to 260 weeks (5 years). However, if you have a whole person impairment (WPI) of over 20%, you may continue receiving payments until retirement age, pending ongoing assessments of your work capacity.

Keeping your documentation updated and engaging in health assessments is essential to maintain your eligibility for continued support. These assessments ensure that Workcover accurately considers your situation and that you receive the appropriate benefits.

Maximum Weekly Payment Caps

WorkCover weekly compensation payments are subject to a maximum cap, which is adjusted twice a year—on 1 April and 1 October—to reflect changes in the cost of living. This means there is an upper limit to how much you can receive each week, regardless of your pre-injury average weekly earnings (PIAWE).

If your PIAWE exceeds the current maximum cap, your weekly payments will be limited to that cap. For example, if your PIAWE is $3,000 per week but the current cap is lower, you’ll only receive up to the maximum allowed amount.

To find the most up-to-date maximum weekly cap, visit the SIRA NSW website or speak with your case manager.

Key Takeaways

Understanding wage coverage after an injury helps alleviate financial worries during recovery. With knowledge of PIAWE, entitlement periods, and payment limits, injured workers can better navigate their circumstances.

Familiarising yourself with these details not only improves your financial stability but also enables you to concentrate on healing. Whether it is your PIAWE entitlements or understanding payment structures, being informed plays a significant role in ensuring you receive the benefits you deserve. Stay engaged with your process and keep communication open with Workcover to optimise your recovery experience.

Dr Bishoy Marcus

Specialist GP