Receiving compensation

If your workers compensation claim is accepted, you are entitled to be compensated for loss of wages, reasonable medical and allied health treatment expenses, reasonable workplace rehabilitation expenses, and travel and other expenses.

If your claim has not been accepted, you are responsible for your expenses. While your claim is being considered keep all receipts and records of payments made, in case the insurer accepts liability – in which case you will be reimbursed for payments.

If your claim has been deferred and you are eligible for provisional payments, you will be paid provisional payments of income compensation and medical and health expenses. For further information see Provisional payments.

Loss of earnings

Once your claim is accepted and if you are unable to work due to your incapacity, your employer is required to pay weekly compensation payments on the employer’s usual pay day and in the normal pay manner. Penalties apply when employers do not make payments on the regular pay day.

For information about the calculation and receipt of your weekly payments, contact your employer’s insurer.

For more information about your entitlements, contact our Advice and Assistance Service on 1300 794 744.

Calculating income compensation payments

The Workers Compensation and Injury Management Act 2023, clarifies and simplifies the methodology for calculating income compensation.

Income compensation payments are calculated based on a worker’s pre-injury average earnings over a 12-month period for award and non-award workers (or period employed if less than one year).

Any period you have taken as leave without pay is excluded from the calculation of your average earnings.

Part-time workers will be paid a minimum amount (base award rate component) to which the worker would have been entitled (if not injured) to be paid in a week for working.

Step-down after 26 weeks

A step-down to 85% of your pre-injury weekly rate of income will apply after 26 weeks of payments.

Maximum and minimum payments

A step down to 85% of your pre-injury weekly rate of earnings applies after 26 weeks of payments, but this is subject to a minimum safety net.

A safety net minimum weekly rate of income compensation applies if the step down to 85% of your pre-injury weekly rate of earnings would otherwise result in income compensation falling below:

  • the base award rate under provisions of an industrial instrument to which you would be entitled to be paid in a week (plus any regular additional earnings – over award payments, overtime and allowances)
  • if you are not covered by an industrial instrument, the minimum amount to which you would be entitled under the Minimum Conditions of Employment Act 1993 to be paid in a week.

A limit is applied to the amount of compensation you can receive in total. The maximum amount of compensation you can receive during the life of your claim, in terms of income compensation payments for loss of earnings, is called the income compensation general limit amount.

Status of leave

The Act clarifies the status of sick leave, annual leave and long service leave when on income compensation.

When on income compensation you:

  • are entitled to take annual leave or long service leave (income compensation is not affected by this use of leave, the entitlements run concurrently)
  • accrue all your normal leave entitlements (annual leave, long service leave and sick leave)
  • may not take sick leave.

If you take leave prior to your claim being accepted, that leave is to be reinstated where the claim is accepted.

When weekly payments stop

It is a fundamental principle of workers compensation that once an entitlement to income compensation is established and payments commence the payments cannot be reduced, suspended or discontinued, except in accordance with the Act.

When can your income compensation be reduced or ceased?

Your income compensation can be reduced or ceased when in compliance with the Act (e.g. step-down after 26 weeks or where the General Maximum Amount has been reached), when in compliance with a direction of a conciliator or an order of an arbitrator, or for one of the following reasons:

With consent:

  • you may consent to reduce or discontinue income compensation payments
  • your consent must be given in written notice in the approved form – Intention to reduce or discontinue income compensation – consent
  • the form must include details as to whether income compensation is to be reduced or discontinued, the date of the action and the reason.

Return to work:

  • you must be given written notice by your employer in the approved form – Intention to reduce or discontinue income compensation – return to work
  • the form must include details as to whether income compensation is to be reduced or discontinued, the date of the action and the return-to-work details
  • if you do not agree with your employer’s decision to reduce or cease your income compensation payments you may make an application to WorkCover WA’s Conciliation and Arbitration Services.

Medical evidence:

  • your income compensation is reduced or ceased based on medical certificate (evidence) indicating you have total or partial capacity for work, or the incapacity is no longer a result of the injury
  • you must be given written notice by your employer in the approved form – Intention to reduce or discontinue income compensation – medical evidence
  • you must be given a copy of the medical evidence relied upon your employer to reduce or discontinue income compensation payments
  • you will have 21 days after receiving the form and medical evidence to make an application to WorkCover WA’s Conciliation and Arbitration Services if you do not agree with your employer’s decision to reduce or cease your income compensation payments
  • if you make an application to WorkCover WA’s Conciliation and Arbitration Services within 21 days your employer cannot reduce or discontinue income compensation payments until the dispute is finalised
  • if you do not make an application to WorkCover WA’s Conciliation and Arbitration Services within 21 days your employer may proceed to reduce or discontinue income compensation payments.

Not residing in Western Australia:

  • you must provide a declaration about your incapacity for work to your employer’s insurer or self-insurer at prescribed intervals (3 months)
  • if you fail to provide a declaration in time, your employer’s insurer or self-insurer may suspend your income compensation payments subject to:
    • you being given a written warning notice reminding you of your obligations to provide the required declaration before the due date Non-resident worker – declaration warning notice
    • the notice must also warn you that the payment of income compensation will be suspended from a specific date if you fail to provide a declaration
    • the warning notice cannot be issued to you earlier than 14 days before the last day the worker has to provide a declaration
    • the date specified as the suspension date must be at least 14 days after the warning notice is given to the worker can cannot be earlier than the last day the worker must provide the declaration
  • if suspended, your income compensation payments must recommence from the date you provide the required declaration
  • if you believe your income compensation payments were unlawfully stopped, you may apply to have the matter determined by an arbitrator.

Worker in custody:

  • payments of income compensation are suspended if you are in custody under a law of WA, or another state, or the Commonwealth, or you are otherwise serving a term of imprisonment
  • your employer must have written confirmation from the relevant government authority of the facts relevant to you being in custody or serving a term of imprisonment and this must be provided in the approve form Custody or imprisonment notice
  • if suspended, your income compensation payments will be required to recommence from the date you are no longer in custody or serving a term of imprisonment
  • if you believe your income compensation payments were unlawfully stopped, you may apply to have the matter determined by an arbitrator.
Expenses

If you are injured at work, you may claim for a range of reasonable medical and health expenses, including:

  • first aid and ambulance
  • medicines
  • medical and surgical attendance
  • treatment by specialists
  • dental
  • physiotherapy
  • chiropractic
  • charges for hospital treatment
  • other approved treatment, including acupuncture, clinical psychology, counselling psychology, exercise program, mental health social work, occupational therapy, osteopathy, psychology and speech pathology.

If you require treatment from an alternative health provider, for example a naturopath, you should check with your employer’s insurer to ensure that the cost will be reimbursed prior to commencing treatment.

Miscellaneous expenses

Miscellaneous expenses are additional to medical and health expenses, include:

  • first aid and emergency transport (e.g. medical evacuation costs)
  • wheelchair or similar appliance
  • surgical appliance or artificial limb
  • repair or replacement of clothing damaged or destroyed
  • repair or replacement of an artificial aid damaged or destroyed
  • travel
  • assessment of degree of permanent impairment.

Right to choose

You have the right to be treated by a doctor or allied health provider of your choice.

Reimbursement of medical expenses

It’s important to check with your employer’s insurer before commencing any treatment to ensure it will be reimbursed.

Generally, you will need to pay for your medical invoices after a consultation or treatment and be reimbursed by your employer’s insurer. However, arrangements can be made for treatment invoices to be issued directly to your employer’s insurer.

Gap payments liability

The insurer will only pay medical accounts up to the medical and allied health provider rates set by WorkCover WA. If your provider charges more than this rate, you will be responsible for the extra portion of the account (the ‘gap’).

Check the charges with the provider before making an appointment.

Limits on total payments for medical and health expenses

The amount you can receive to cover your medical and health expenses over the life of your claim is limited to 60% of the General Maximum Amount, unless a determination has been made to extend the limit.

For more information see the Indexation of Workers Compensation Payments Schedule.

Increase in medical and health expenses limit

In certain circumstances, you may lodge an application with WorkCover WA’s Conciliation and Arbitration Services for an extension of the medical and health expenses general limit amount.

An additional amount of up to 40% of the medical and health expenses general limit amount may be ordered by an arbitrator where a worker’s social and financial circumstances justify it.

A further additional amount of up to 190% of the medical and health expenses general limit amount may be ordered by an arbitrator in the circumstances described in section 78 of the Act.

Workplace rehabilitation expenses

You are entitled to claim payments to cover the cost of workplace rehabilitation services if you need assistance with staying in or returning to work following an injury. The amount you can receive to cover workplace rehabilitation expenses is limited to 7 % of the General Maximum Amount. For more information see the Indexation of Workers Compensation Payments Schedule.

Travel, board & lodging expenses

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 travel expenses.

Travel expenses incurred by a worker in obtaining an assessment by an approved medical specialist can also be claimed.

Regional workers

For workers in regional areas, reasonable costs may also include reasonable meals and accommodation expenses.

What you should do

Payment of travel costs is best arranged through your employer or their insurer. Keep a record of your travel by recording vehicle kilometres, appointment dates and times, and any public transport tickets or receipts.

Insurers will only pay the rates set by WorkCover WA for travel, board and lodging expenses. See the Indexation of Workers Compensation Payments Schedule 2024/25 for more details on these rates and expenses.