Who Pays For Workers Compensation?
If you’ve been injured at work and are looking at your options, one of the questions that often comes up is: who pays for workers compensation? For many, especially if you work for a small business, it can be worrying to think you might be doing wrong by your employer. In Australia all businesses are required to have insurance for their workers, so they don’t pay for workers compensation (formerly known as Workcover) directly.
Worry about who pays for workers compensation should never deter you from making a claim that could help you recover. Workers compensation is designed to protect employees and can help you cover lost wages, pay for medical bills, and even provide a lump sum payout. Knowing what you’re entitled to – and who pays for it – gives you the best tools for recovery. Keep reading to find out more.
How does workers compensation work in Australia?
Workers compensation is a type of insurance that employers take out to protect their employees in case of a workplace injury. In Australia all employers must have some form of workers insurance policy which pays for any costs that an injured worker might face, like lost wages, medical and rehabilitation costs, and can even cover a lump sum payout in the case of permanent impairment. While many businesses use an external insurance provider, many large organisations are self insurers, like chain supermarkets or councils. You can see if your employer is on the SIRA list. Either way, businesses have a responsibility to have protection for their employees. They can be fined up to $55 000 if they don’t, so it’s in everyone’s best interests to have you covered.
Payments will come from one of three ways:
- Directly by the insurer
- From the insurer through your employer
- By the workers compensation regulator
It’s important to know that workers compensation covers you in any situation you’re in because of work. This includes work events where attendance is required, like an offsite meeting, as well as working from home. For more, see our working from home, your employer’s responsibilities article.
Do I get superannuation on workers compensation?
Typically, you’ll not receive superannuation payments while you’re on workers compensation. You may receive up to 95% of your regular earnings but it isn’t common to receive superannuation as well, however, there are some exceptions. Some industries, like hairdressing, or building and construction, offer up to 52 non-consecutive weeks of super to be paid while also receiving workers comp. Others don’t have any guidelines and will be dependent on your contract and your employer’s insurance.
The Australian Fair Work Ombudsman offers tailored information by industry if you’d like to check your eligibility. You can contact Law Partners for free, specialised advice specific to your industry and claim type.
What is accident pay?
Accident pay is the difference between your regular wage, and what you’re receiving as a workers compensation payment. It’s paid by your employer. Again, it depends on the industry you work in because not all awards cover accident pay. Builders and construction workers may be entitled to 26 weeks of accident pay, while a hospitality worker in a café or restaurant isn’t covered.
The Australian Fair Work Ombudsman also offers a calculator by industry.
What if my employer doesn’t pay the workers compensation?
Your employer has 48 hours to notify their insurer of any injuries or illnesses that happen to their workers, and it’s then up to the insurer to make a call about compensation. You’re allowed to contact the insurer directly to check that they’re aware of the claim, but your employer can’t deny you without alerting the insurer.
Workers compensation claims can be denied by the insurer for many reasons, like saying you have insufficient evidence that the injury was caused by work, or a that your claim isn’t reasonable in relation to your injuries. If they do deny your claim, they have to issue you with a Section 78 notice informing you of why the claim was denied, and what options you have to appeal the decision. For further information, see my workers compensation claim has been denied, now what?
For personal advice about your circumstances or assistance overturning a denied claim, tell us a bit about your claim and we’ll get back to you, or contact us directly via our website, or on 13 15 15.
Can I take leave while on workers compensation?
You’re allowed to both take and accrue annual leave while you’re on workers compensation as long as you remain an employee of the business. This includes maternity and paternity leave just like if you were still working normally, though your entitlements may change depending on how long you’re on workers compensation. You can’t take sick leave, however.
Does workers compensation pay full wages?
Short answer is no. Most workers compensation payments do not cover your full wages, however, as mentioned above, some industries do have accident pay which may make up the difference. For the first 13 weeks you’re entitled to up to 95% of your normal wages, and then 80% between week 14-130. Most payments stop after two and a half years if you’ve been able to return to work in some capacity but may be available for longer if your Whole Person Impairment is evaluated at over 20%. Our whole person impairment calculator and guide can help you to get started.
There are some factors which can impact the payments you receive as well. It’s in your employer’s best interests to get you back to work as soon as possible, and they have to give you appropriate tasks suitable for your abilities as you return to work. After the 14-week mark if you’re able to return to at least 15 hours a week, your payment can go from 80% back to 95%. For more information about potential compensation, see our workers compensation payout guide.
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How much can you claim for workers compensation?
The following table gives you some examples of what types of payment may be available to you, but in some cases, you might also be eligible for a lump sum payment, like if your employer was negligent in some way. In this situation you may access a Work Injury Damages payment and it’s available in circumstances of negligence. This might be because they failed to provide you with appropriate training which resulted in an injury, didn’t organise loose cables that created a tripping hazard, or didn’t complete adequate background checks on a new employee who then bullies or harasses others. If you think your employer may have been negligent, have a look at our workplace negligence claims guide.
|Weeks 0-13||Up to 95% of pre-accident earnings|
|Weeks 14-130 (no work capacity)||Up to 80% of pre-accident earnings|
|Weeks 14-130 (some work capacity*)||Up to 80% of pre-accident earnings (payments increase to 95% if working 15 hours per week and earning at least $200 per week)|
|Weeks 131-260 (no work capacity)||Up to 80% if no work capacity is likely to continue indefinitely|
|Weeks 131-260 (some work capacity*)||Weekly benefits stop for most, some exceptions apply|
|After 5 years||Weekly payments only available to people with WPI** >20%|
*Able to return to suitable employment but not pre-injury employment
**WPI is whole person impairment – a scale used to measure the extent of your injuries
The maximum weekly compensation amount is capped and indexed in April and October each year.
The maximum amount from 1 October 2022 to 31 March 2023 is $2,341.80.
Steps to making a successful claim
Making a claim can be a complicated process, following these steps can give you the best chance of success.
1. Seek medical treatment:
First and foremost, you should access appropriate treatment to make sure you’re safe and protected from further damage.
2. Report the injury:
Notify your employer or the manager on duty as soon as possible. It’s then their responsibility to let their insurer know within 38 hours, which can get the ball rolling on a successful claim.
3. Keep track of everything:
Having a written account of what took place is always useful to have, especially if an insurer denies your claim.
4. Ask the experts:
Having a specialist workers compensation lawyer on your side is the best way to make sure you’re aware of everything you may be entitled to and able to be proactive with your case, leading to a better chance of success. You can tell us a bit about your situation and one of our specialists will review it or send us a chat, or call to speak to someone directly.
To gain a better understanding of the best steps for a successful claim, see how do I make a successful workers compensation claim.
If you’ve been injured at work, your number one priority is recovery. This should never be impacted by worry about who pays for workers compensation claims. Insurance exists to protect both you and your employer, and you may be entitled to further benefits like accident pay, superannuation while on leave, and even a lump sum payment. Understanding your rights and how much you can claim on workers compensation, along with the support of a specialised personal injury lawyer, gives you the best chance to make a successful claim.
An accredited specialist in personal injury law, backed by over 15 years’ experience in assisting injured Australians receive everything they’re entitled to with their workers compensation claim.
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