3.3 Entitlement periods & step-downs
3.3.1 Count weekly payments | 3.3.2 First entitlement period | 3.3.3 Second entitlement period | 3.3.4 Review of entitlement approaching the end of the second entitlement period | 3.3.5 After the second entitlement period | 3.3.6 Weekly payment rates
There are three entitlement periods for claims for weekly payments:
| Entitlement period | Claims received by the Agent before 1 January 2005 |
Claims received by the Agent on or after 1 January 2005 |
|---|---|---|
| First entitlement period | Weeks 0-13 | Weeks 0-13 |
| Second entitlement period | Weeks 14-104 | Weeks 14-130 |
| After second entitlement period | Weeks 105 + | Weeks 131 + |
Calculate the entitlement period
To calculate the entitlement period, a 'week' means a week in which any amount of compensation in the form of weekly payments or weekly payments of pension or superannuation contributions is paid or payable. It may be for all or part of that week.
First entitlement period
The first entitlement period is the first aggregate period of 13 weeks for which weekly payments are paid or payable.
The 13 weeks do not have to be consecutive.
See: Payments for periods from 13 November 2013
Second entitlement period
The length of the second entitlement period depends on when the claim for weekly payments was received by the Agent.
If the claim for weekly payments was received by the Agent:
- before 1 January 2005 the second entitlement period is a maximum of 91 weeks
- on or after 1 January 2005 the second entitlement period is a maximum of 117 weeks.
The weeks in the second entitlement period:
- exclude the first entitlement period
- are an aggregate period for which weekly payments is actually paid or payable
- do not have to be consecutive.
After second entitlement period
Weekly payments cease after the expiry of the second entitlement period unless:
-
the worker has no current work capacity Under the legislation, unless inconsistent with the context or subject-matter — current work capacity, in relation to a worker, means a present inability arising from an injury such that the worker is not able to return to his or her pre-injury employment but is able to return to work in suitable employment, declared training program and this is likely to continue indefinitely (NCI No Capacity Indefinitely); and
-
for claims reaching 130 weeks on or after 31 March 2024, the worker’s whole person impairment (WPI Whole person impairment) has been determined as 21% or more, based on all injuries and or illnesses arising from the same event or circumstance.
Subject to an ongoing entitlement, weekly payments will continue until the worker no longer meets one or more of the NCI criteria or attains retirement age.
Note: A worker's legal ability to work in Australia (i.e. VISA/convictions) has no relevance when applying the capacity test at 130 weeks.
See: NCI triage reference sheet | After the second entitlement period | Terminate or alter weekly payments
Where there has been a determination that the worker is not entitled to weekly payments after the expiry of the second entitlement period, a worker can apply to receive weekly payments after the second entitlement period in limited circumstances:
-
an incapacity following surgery
-
return to work subject to criteria
See: Weekly payments for surgery post 130 weeks | Application for weekly payments after second entitlement period