WORKERS COMPENSATION: ARE YOUR WEEKLY PAYMENTS AT RISK?
May 23, 2017
If you’ve been receiving workers compensation weekly payments for up to 2 years, you need to be aware that 30 June 2017 is a significant date. Not only is it the end of the financial year, but for many people it also marks the cut-off point for these payments.
If you are currently receiving weekly payments, you need to know what’s happening and what you can do to clarify your financial and medical position.
What are weekly payments?
Weekly payments are also known as income maintenance payments. They are a form of workers compensation payments. The law says that:
- If a worker injures themselves because of or in the course of employment; and
- They are incapacitated (meaning that they are injured at work and can’t properly perform their job requirements because of the injury); and
- After the injury they can’t work and are earning less than their average weekly earnings; then
- They are entitled to weekly payments.
Average weekly earnings may include income from a second job and in some cases overtime payments.
On 1 July 2015, new workers compensation laws came into effect. The new laws say that anyone who was receiving weekly payments on or before this date will have their payments cut off from 30 June 2017, unless they’re a seriously injured worker.
Under the old law, workers compensation weekly payments could continue for as long as the worker was incapacitated for work.
But for these workers, the new limit gives no consideration to whether the worker was capable of returning to work or earning any sort of income. Weekly payments will be cut off from 30 June 2017 regardless of whether the worker has any capacity to work.
This has the potential to cause severe financial hardship to many workers who rely on the payments for their economic survival.
Whole Person Impairment
The exception to this is workers who are seriously injured. That is, they are assessed as having a whole person impairment of at least 30 percent.
All injuries arising from the original workplace trauma must be medically stable, meaning that they’re not going to get any better or any worse. Once this has happened, an accredited doctor (who can be chosen by the worker) will assess how much of the worker’s body has been permanently impaired (meaning damaged or injured). The doctor will make the assessment, and express the impairment as a percentage of the whole body, for example 30 percent whole person impairment.
30 percent is a very high hurdle. Typically this means that a person is impaired to the extent that they have suffered significant injury or amputation to one or more limbs.
For these workers, their workers compensation weekly payments could continue until retirement age, and they could receive payment of medical and other expenses until death. Also, they aren’t obliged to participate in rehabilitation or return to work plans.
What will happen to me?
Most people on weekly payments will not be assessed as 30 percent whole person impairment.
They will fall in the gap between being too incapacitated to resume their normal work and being “seriously injured.” For these workers, discontinuance of weekly payments may mean that they must rely on Centrelink payments to meet all of their financial obligations. If Centrelink payments are significantly lower than the weekly payments, this has the potential to cause severe financial hardship.
However, the law may allow an injured worker to make an application requiring their employer to give them work that suits their medical restrictions and abilities. Anyone considering this should seek legal advice before deciding what to do.
Injured workers may also be able to rely on the National Disability Insurance Scheme.
The NDIS has received much publicity over the past number of months.
It is a federal government scheme that provides assistance to people living with a disability, including:
- Access to medical and educational support services.
- Access to community support services.
- Support for the people who care for them.
- Financial support.
From 1 July 2017, the NDIS will apply to South Australian adults aged 18 to 64. It is to be rolled out region by region.
As part of the 2017 Budget, the federal government announced an increase in the Medicare levy to ensure adequate funding for the NDIS. There remains significant speculation about whether the public purse is capable of funding the NDIS because the forecast costs are huge.
Medical treatment expenses
Of further concern for workers on weekly payments is that from 1 July 2018, medical treatment expenses will be stopped for anyone who received workers compensation weekly payments but were not assessed as having 30 percent or more whole person impairment. Again, the consequences of this may be incredibly serious for incapacitated workers who rely on payment of the expenses to maintain a reasonable lifestyle. For example, just think of the hardship that may be caused if a person could no longer access expensive but vital prescription medication.
Redemption of medical expenses
As a claim comes to an end, there may be a possibility of redemption of medical expenses.
This is a one-off lump sum payment to buy off any future entitlements that a person may have to reasonably and necessarily incurred medical and other expenses. As the payment is usually calculated by the case manager, it might be worth talking to a lawyer about whether the offer is reasonable in consideration of what future medical treatment or surgery you might require.
Income protection claims
Many superannuation policies include an insurance policy for income protection or total and permanent disablement. As each insurance policy is different, we recommend getting legal advice about whether these entitlements can be claimed.
If a person’s doctor has told them that they might need future surgery in relation to workplace injuries, they must make an application to the case manager before their entitlements to medical and other expenses run out. If the application isn’t made or isn’t successful, they will not be entitled to the cost of the future surgery, or any time off work that they have had because of the surgery.
This doesn’t apply to knee replacements, hearing aids and other therapeutic appliances and prostheses. You should seek legal advice for further information in respect of these things.
What should I do?
Workers compensation is a complex legal area and if you are receiving weekly payments, you really need to know your rights so that you can act to protect your interests. Getting good legal advice is essential to this.
If you have any concerns or questions about the upcoming deadline, Websters Lawyers can help. We have an outstanding team of highly experienced workers compensation lawyers who can discuss your options and help you to identify what entitlements you may be able to pursue. Contact us today for a free first interview. Because the sooner you act, often the better off you’ll be.