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When you have been injured at work, compensation matters in general, including how you will continue to meet your normal living expenses, are usually a major concern for people.
That’s why getting back to work as soon as possible is the most important thing you can do for yourself. Find out which costs you will be covered for by clicking on the headings below.
If you have any doubt about what expenses you are covered for, please call WorkCover WA’s Advisory Service on 1300 794 744.
Claim entitlements
You are entitled to compensation payments if you are medically certified unfit for work. As there are some limits on the amount you are paid, you are encouraged to call WorkCover WA’s Advisory Service for further information on 1300 794 744.
Click on the links below to find answers to questions you may have.
- Who pays for my medical and allied health costs?
- What medical expenses am I entitled to?
- What about travelling costs and board and lodging expenses?
- What about other expenses?
- Weekly payments – how are payments calculated?
- Your rights and responsibilities – what do you need to know?
- Vocational rehabilitation – helping you back to work
- What is the process for settling my claim?
| Who pays for my medical and allied health costs? |
For claims where the employer/insurer has accepted or admitted liability:
If you receive treatment or services for an accepted work related injury from a doctor or allied health provider such as a physiotherapist or clinical psychologist, the workers’ compensation insurer will pay the account. However, an insurer is only obliged to pay at the ‘prescribed rate’ as published by WorkCover WA.
If your doctor or allied health provider charges more than the prescribed rate, you will be responsible for the extra portion (sometimes known as a ‘gap’) of the account. When making an appointment with your doctor or allied health provider, it is recommended that you ask whether that person only charges at the WorkCover WA prescribed rate. Click here for details of the prescribed ‘Rates, fees and payments’ for medical and allied health providers.
If your doctor or allied health provider advises that the charges will be above the prescribed rate, to avoid paying a ‘gap’, you may wish to obtain treatment or services from another person who only charges at the prescribed rate.
For claims that the employer/insurer has pended or not accepted:
If your workers’ compensation claim is not accepted you will be responsible for your medical and allied health provider accounts. If you disagree with the decision made by the insurance company you can apply to have the matter resolved by the Dispute Resolution Directorate.
If your claim is pended (the insurer delays the decision in order to seek further information) you will be responsible for your medical and allied health provider costs. It is important to keep a record of all your medical expenses as the insurance company may decide to accept your claim. If this occurs you may be reimbursed for reasonable hospital, medical and other expenses resulting from your injury. |
| What medical expenses am I entitled to? |
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You are entitled to payment of reasonable hospital, medical and other expenses resulting from your injury and to be treated by a doctor of your choice. Medical bills should be forwarded to your employer or insurer for payment.
Your entitlement to medical expenses is a separate prescribed amount (currently a maximum amount of $50,550* is available) in addition to the amount for weekly payments and vocational rehabilitation.
The insurer or self-insurer must notify you once 60 per cent of the maximum amount for medical expenses has been reached. In certain circumstances an application can then be made to the Dispute Resolution Directorate for an extension of medical expenses. Click here for further information.
Click here to access the Prescribed Amount which describes the amounts available for wages, medical treatments and vocational rehabilitation within a workers' compensation claim.
*Note: This amount varies annually in accordance with the prescribed amount published in the Government Gazette. |
| What about travelling costs? |
Where you are required by your employer, their insurer or a medical practitioner to travel from your home to a medical appointment or rehabilitation provider, you can claim the cost of reasonable travelling and board and lodgement expenses. Ask your employer or their insurer how to claim this entitlement.
Keep a record of your travel, by recording vehicle kilometrage, appointment times and dates and retain public transport receipts. The amount payable for travelling and board and lodging expenses is limited; currently 39 cents per kilometre for travelling expenses and $97 per day for meals and lodging.
Call Advisory Services for further details on 1300 794 744. |
| What about other expenses ? |
Reasonable vocational rehabilitation expenses are available under workers' compensation. To find out more about the role of approved vocational rehabilitation providers and how they can help you to return to work click here.
There are other benefits available for workers who meet certain criteria. For information about specialised retraining, exceptional circumstances medical payments and extensions in weekly and medical payments, click here.
As every case is different, call WorkCover WA’s Advisory Services on 1300 794 744 to discuss your individual circumstances.
Click here for more information about lump sum settlements. |
| Weekly payments – how are payments calculated? |
Once your claim is accepted, your employer is required to pay your wages on the normal pay day and at the employer's usual place of payment of wages prior to the injury. There are two methods of calculating weekly workers' compensation payments, depending on your conditions of employment.
It is best to check with your employer if you are not sure about whether you work under an award agreement or not.
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If you work under an industrial award (including enterprise orders, collective agreements and enterprise bargaining agreements) your workers' compensation payments should include:
For the first 13 weeks you receive: the rate of weekly workers' compensation payments payable under your industrial award, plus any over-award or service payment paid to you on a regular basis, including overtime, bonuses and allowances. Your employer will average your overtime, bonuses and allowances over a 13 week period prior to your injury.
From week 14 onwards, your weekly workers' compensation payments will consist of:
the rate of weekly payments payable under the relevant industrial award, plus, any over award or service payments paid on a regular basis; plus any allowance paid on a regular basis as part of the workers’ earnings and related to the number or pattern of hours worked; plus, any other allowance prescribed by the regulations. Other allowances, overtime and bonuses are not paid from week 14 onwards.
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If you don’t work under an industrial agreement, your workers’ compensation payments should include: For the first 13 weeks: your weekly payments (including overtime, any bonus or allowance) are averaged over 12 months prior to the injury, and in the employment in which you were injured. If you have been employed for a period of less than one year, your earnings will be averaged over the lesser period.
From week 14 onwards, your weekly payments will 'step down' to consist of 85 per cent of your average weekly earnings up to the current cap. Important note: there is a limit that applies to your weekly payments while you are on workers’ compensation.
The maximum weekly amount you can receive is set at two times the ‘average weekly earnings’ as calculated by the Australian Bureau of Statistics. The maximum weekly amount for 2006/07 financial year is $1,904.40. The maximum amount is indexed on 1 July each year. and varies annually in accordance with the Prescribed Amount published in the Government Gazette.
Click here for variations in Prescribed Amounts. |
| Your rights and responsibilities – what do you need to know? |
| Click here to download important information for injured workers |
| Vocational rehabilitation – helping you back to work |
Rehabilitation is a crucial part of the return to work process. If there are problems for you in returning to the workplace, external assistance may be needed. Problems may include difficulty in identifying duties, determining your physical capacity, determining other services that will complement rehabilitation and fitness to return to work.
The nature and seriousness of your injury may also dictate the type of assistance you need to return to work.
An approved vocational rehabilitation provider (AVRP) may be used to deliver a professional program that meets your and your employers' needs, in consultation with the treating medical practitioner.
AVRPs are funded through your workers' compensation claim and you should speak to your GP and employer about assisting in your return to work. |
| What is the process for settling my claim? |
| Returning to work is the outcome your employer and doctor will help you work towards. In some cases, injured workers may be entitled to a lump sum payment in order to finalise their workers’ compensation claim. We encourage you to seek independent advice on your options and actions.
There are two types of settlements within the workers' compensation system - Schedule 1 or Schedule 2.
Schedule 1 is where you are assessed for the degree of your impairment and can negotiate with your employer’s insurer regarding the lump sum amount you receive. This type of settlement is also called a Redemption. To qualify you must have received weekly payments for at least six months and have a permanent total or permanent partial injury to be eligible for a Schedule 1 settlement.
You can proceed with a Schedule 2 settlement at any time. This is where you are medically assessed as having sustained a degree of impairment and receive a set amount for that impairment. There is no negotiation of your settlement if you go down the Schedule 2 path. The payment is calculated in accordance with Schedule 2, published in the Act and in the Annual Variation in Prescribed Amounts. The link to Schedule 2 can be found in the related links column on your right.
In some cases, you may be entitled to pursue common law damages against your employer. For further information about common law damages see the Guide in the Publications section to your right.
A workers' compensation settlement can affect your access to Centrelink payments, visit the Centrelink Website to find out further information.
For further details about the settlement process please call WorkCover WA’s Advisory Services on 1300 794 744. |
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