Understand the types of compensation you can receive through a WorkCover claim.
For time off work.
If your claim is accepted, WorkSafe can pay weekly payments until you can return to pre-injury work. There are statutory time limits – for example your payments are highest during the first 13 weeks. However many injured workers find they can return to work well before this time.
In most cases weekly payments are processed through your employer and paid in the same way as your usual wage.
Weekly payments are usually based on the average of your ordinary earnings from the last 52 weeks. These are referred to as pre-injury average weekly earnings or PIAWE.
For costs associated with your treatment.
If you have a work-related injury or illness, you may also be compensated for the cost of your treatment.
WorkSafe can pay reasonable costs of approved services but reasonable costs doesn’t always mean payment of the full costs. Sometimes there might be a difference or gap between what a healthcare provider charges and what WorkSafe can pay.
Some types of treatment can be accessed without a referral, however other treatment may require a referral or approval from your WorkSafe agent.
For workers with a mental injury claim.
If you have a mental injury claim, you may be able to access provisional payments to provide treatment and support while you await the outcome of your claim and for up to 13 weeks, even if your claim is rejected.
Provisional payments: support for mental injuries
Provisional payments will cover reasonable treatment and services as recommended by your general practitioner (GP) or other treating healthcare providers. This includes medication prescribed by your healthcare provider. Note that existing WorkSafe fee schedules apply.
How to claim for reimbursements
WorkSafe prefers that your healthcare provider invoices your WorkSafe agent directly for provisional payments. Talk to your WorkSafe agent to find out who your provider should invoice.
If you pay an account at the time of the service, then you should be reimbursed within 30 days from the day your WorkSafe agent receives your receipt. You need to send your receipts to your WorkSafe agent within six months of the treatment.
Mind the gap
Most providers charge the WorkSafe rate. If they charge more, you will need to pay the difference. You can discuss with a provider whether you will be charged a gap fee prior to booking an initial appointment.
Permanent impairment benefit
For people with permanent disabilities.
If you have a work-related injury or illness that has left you with a permanent impairment, you may also be entitled to a lump sum payment called an impairment benefit. Any entitlement cannot be established until any permanent injury has stabilised - generally at least 12 months after your injury.
An impairment benefit payment is separate to any payment for lost income and medical expenses, and you need to meet certain thresholds to be eligible. Examples of a permanent impairment can include:
reduced shoulder movement
a spinal cord injury
Your WorkSafe agent can help you with making a claim for an impairment benefit. As part of this process you’ll need to have a medical assessment by a WorkSafe approve doctor called an Independent Impairment Assessor.
Post-52 weeks to cover lost super.
If you're receiving weekly payments because of a work-related injury, you might also be eligible for the superannuation entitlement - a contribution paid on top of your weekly payment. Any entitlement will not be until after a period of 52 weeks, and only if your pre-injury employer has no legal obligation to continue superannuation payments.
Your WorkSafe agent will let you know if you are eligible for this entitlement and will organise for payment into your superannuation fund. You can nominate a fund by sending the choice of superannuation fund form to your WorkSafe agent.
Entitlements following a work-related death
For dependant partners.
WorkSafe provides support and financial compensation to the families of people who have died as a result of a work-related injury or illness. WorkSafe can cover expenses including medical services for the deceased person such as ambulance, hospital and treatment, burial or cremation and family counselling services.
Lump sum payments or weekly pensions may be available for dependent partners and children, and in some cases, non-dependent family members for reimbursement of expenses in cases of financial hardship.
Claim for damages
For workers who have a basis to sue their employer.
If you have a work-related injury or illness, you might also have an entitlement to sue for damages from your employer. You’ll need legal advice prior to going down this path.
To bring proceedings for damages to court, your injury has to meet the definition of 'serious' in Victorian workers’ compensation legislation. This means your legal practitioner will need to complete and submit a serious injury application to WorkSafe before any court proceedings can begin.