Second entitlement period frequently asked questions

What is the second entitlement period?

It is the period of 117 weeks that weekly payments are paid or payable following the first 13 weeks of weekly payments (first entitlement period). This means that at the expiration of the first and second entitlement periods, 130 weeks of weekly payments would have been paid or payable. This explains why this review is also known as a 130-week review.

The legislation sets out conditions you have to meet to continue receiving weekly payments after a total of 130 weeks.

As the end of this period approaches, your agent or self-insurer will review your ongoing entitlement to weekly payments under your claim. Your case manager will be there to support you throughout the review process, will continue to manage your claim and will be available to answer any questions along the way.

Which legislation calls for this review?

Section 163 of the Workplace Injury Rehabilitation and Compensation Act 2013 (WIRC Act) and section 93C of the Accident Compensation Act 1985 outline the requirement for your ongoing entitlement to weekly payments to be reviewed when your claim nears 130 weeks of paid weekly payments.

The requirements are that because of your injury/ies, you have no current work capacity and you are likely to continue to have no current work capacity.

For claims that reach 130 weeks after 31 March 2024, there is an additional requirement – that you have a permanent whole person impairment of 21% or more.

The WIRC Act also allows for capacity reviews to happen periodically after the initial second entitlement period review.

What happens during this review?

Your agent or self-insurer will work proactively with you, your treating health practitioners, and (where appropriate) your employer together with your occupational rehabilitation provider. All parties involved will provide information relating to your claim to assist in the second entitlement review process.

Your agent or self-insurer will arrange appointments with independent medical examiners (including any independent impairment assessors (IIAs)) and vocational assessors.

If needed, occupational rehabilitation services are available to assist you with returning to work during the next phase. Depending on the individual, this may include training or re-skilling, help with job seeking or employment services.

Things to expect during the review

• Your agent or self-insurer will work with you and your treating health practitioners to:
  • ensure you are getting the right medical treatment to help you recover from your injury
  • provide you with occupational rehabilitation services, including a review of your transferable skills, training or re-skilling and finding suitable employment options
  • assess your ongoing capacity for work and where relevant, your level of whole person impairment
• Your agent or self-insurer will arrange appointments with one or more independent medical examiners (IME) or IIAs that specialise in your type of injury or illness. This is to get independent medical opinions to help with the review.
• Your case manager will be in touch regularly to keep you up to date with the review progress.
• Your case manager will notify you of the outcome of the review.
• If the outcome of the review is that you are not entitled to ongoing weekly payments, your weekly payments will cease but you will receive 13 weeks' notice. This review outcome will not affect your entitlement to medical and like benefits including occupational rehabilitation services such as retraining and job-seeking assistance.
• During this transition time, you can access WorkSafe's transition support services that can help you plan for the future.

What do I need to do during the review?

You don't have to do anything. Your case manager will be in touch after you've received 52 weeks of weekly payments. They will start coordinating the review when you near the end of your second entitlement period.