Referral Form

For Injured Workers

Thanks for referring us, we have a few tips to make this fairly easy for you.

Try to fill out this form as best as possible however if you do any questions please do not hesitate to contact us.

What happens next?

One of our friendly consultants will be in touch. We will then arrange a time to meet with you to discuss the background to your injury and plan for your recovery and return to work. We are committed to working together with you, your doctor, the insurer and your employer to ensure YOU get the support you need and the best possible return to work outcome.

1. Initial meeting

First we organise to have a meet and greet with you and your employer. If you’re not at work or have no capacity to work, that’s okay, we’ll ask you to pop down to our office.

On our first consultation, we discuss with you the background to your injury, your progress to date and any concerns you may have with your return to work and recovery.

2. What’s possible for you?

We then review the work that you usually do as well as the suitable duties or light duties your employer has available for you while you recover.

This process is very important in planning your return to work and guides the stages we would need to go through to assist you to return to your work in full capacity.

3. On doctor’s orders?

A meeting or case conference with your doctor occurs within a few days of us meeting with you. We discuss with you and your doctor your progress with treatment, your current work ability and hours of work.

We also help address any questions you may have about your recovery and return to work.

At this meeting we also explain to your doctor the duties we may have reviewed and discuss what may be suitable as light duties for you.

4. Review and check

A return to work plan is discussed and used as a reference for what you can do at work, until you have your next review with your doctor.

Often a staged return to work plan is discussed with your doctor that covers a six to eight week time to help you set some goals toward doing a little more at work while you recover.

Weekly Payments

Income replacement is dependent on:

  • The period for which you have been receiving weekly payments
  • Your capacity for work – as assessed by the insurer – and your work status.
  • Unless you have a permanent impairment above 30% you may be subjected to a work capacity decision at any time during the life of your claim. This may result in a reduction or
    cancellation of your weekly payment.
  • If you have a permanent impairment equal to or above 30% you will be entitled to $793 per week.
0 – 13 weeks95% of pre injury earnings* up to $2,058.10 – Minus current or potential weekly
earnings.
14 weeks – 2.5 years95% of pre injury earnings*
If you work 15+ hours per week
80% of pre injury earnings*
If you’re not working 15 or more hours per week
* Your take home pay & non-pecuniary benefits plus income replacement up to 95% of your pre injury average weekly earnings.

After 1 year, overtime and shift allowances are excluded

2.5 – 5 years80% of pre injury earnings
If your permanent impairment equal 20% or above and are not working 15+ hours or earning $176+ per week.
Your weekly payments cease
If you have some work capacity but are not working 15+ hours and earning $176+ per week, or if you could increase how much you work/earn.
95% of pre injury earnings
Your weekly payment may continue if: If you’re working 15+ hours and earning $176+ per week, and are unable to increase how much you work/earn indefinitely.
Your weekly payment may continue if:
You have applied in writing to your insurer to have them continue after passing the first 1 year (and before the 2.5 year mark) and this has been accepted.

There is some special compensation for incapacity resulting from injury-related surgery available from 144 weeks.

5+ years80% of pre injury earnings
Once you reach Commonwealth retirement age plus 12 months, you are no longer entitled to weekly payments.
Your weekly payments cease
If you have 20% or less permanent impairment

Once you reach Commonwealth retirement age plus 12 months, you are no longer entitled to weekly payments.

Health & Safety Factsheet

What is ‘Suitable’ Employment?

A worker’s capacity to earn in suitable employment (1987 Act: S.32A, S.35)

Determining a worker’s current work capacity and the amount they are able to earn in suitable employment are work capacity decisions that insurers may make.

Suitable duties in the workplace are duties identified that are able to accommodate an injured worker’s work restrictions due to their injury and to facilitate their return to work. These can be in an existing role or may be a role created by the employer to assist the worker in their efforts to rehabilitate and return to work.

Suitable employment however has a different meaning.

Suitable employment, in relation to a worker, is defined in Section 32A of the 1987 Act as:
“employment in work for which the worker is currently suited:

  1. having regard to:
    1. the nature of the worker’s incapacity and the details provided in medical information including, but not limited to, any certificate of capacity supplied by the worker (under section 44B), and
    2. the worker’s age, education, skills and work experience, and
    3. any plan or document prepared as part of the return to work planning process, including an injury management plan under Chapter 3 of the 1998 Act, and
    4. any occupational rehabilitation services that are being, or have been, provided to or for the worker, &
    5. such other matters as the Work Cover Guidelines may specify, and
  2. regardless of
    1. whether the work or employment is available, and
    2. whether the work or the employment is of a type or nature that is generally available in the employment market, and
    3. the nature of the worker’s pre-injury employment

If a worker is able to demonstrate they are fit for some type of work over a period of time (not necessarily their pre injury position) then the insurer has the ability to discontinue weekly payments and medicals.

Example of suitable employment extracted from WorkCover publication “Work Capacity Guidelines for insurers”: “A truck driver is provided with administrative duties to accommodate his physical restrictions. The worker has the transferrable skills to undertake these duties, as his previous employment and education history included managing his own business, which involved administrative tasks, and completing a MYOB and Certificate IV in Office Management. The employer advises they can no longer provide suitable duties. The worker has been compliant with all his injury management requirements under Section 48 of the 1987 Act. The worker has capacity to work, and has demonstrated this capacity for 6 months.”

According to the Guide there should be sufficient evidence in this situation for the insurer to deem an administrative role as suitable employment for the worker. The insurer can make a decision under Section 35 of the 1987 Act to reduce or discontinue the worker’s weekly payments accordingly on the basis he has capacity to perform some type of work.

In accordance with the new legislation this type of decision can be made regardless of:

  • whether the work or employment is available, and
  • whether the work or the employment is of a type or nature that is generally available in the employment market, and
  • the nature of the worker’s pre-injury employment, and
  • the worker’s place of residence

You can raise these as objections though if they apply to your situation.

For further information please contact:

Workers Health Centre on 02 9749 7666, admin@workershealth.com.au or www.workershealth.com.au

Your Union organiser or Unions NSW on 1800 688 919

Your legal representative Work Cover Claims Assistance Service on 131 050 or www.workcover.nsw.gov.au

Work Cover Independent Review Officer on 13 94 76 or wiro.nsw.gov.au