3.3.1 Count weekly payments

A week count as opposed to a day count is required to calculate a worker’s entitlement to weekly payments. A ‘week’ is deemed to be the period Saturday to Friday.

Each 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, whether for all or part of that week and whether consecutive or not, should be counted as one week to calculate 13 weeks, 26 weeks, 52 weeks, 104 weeks and 130 weeks.

First 10 days needs to be included

The legislation provides that where the entitlement to compensation has been established, the employer is required to pay the first 10 days of time lost. This period is included in the week count, on the same basis as above.


3.3.2 First entitlement period

For claims received after 11 November 1997 the first entitlement period First entitlement period, in relation to a claim for compensation in the form of weekly payments made by a worker means an aggregate period not exceeding 13 weeks (whether or not consecutive) in respect of which a weekly payment has been paid or is payable to the worker means an aggregate period not exceeding 13 weeks (whether or not consecutive) for which a weekly payment has been paid or is payable.

For claims received before 12 November 1997 the first entitlement period means an aggregate period of 26 weeks (whether or not consecutive) after the worker became entitled to compensation in the form of weekly payments.

3.3.3 Second entitlement period

For claims received on or after 1 January 2005

Means an aggregate period of 117 weeks (whether or not consecutive) after the expiry of the first entitlement period (total of 130 weeks).

For claims made on or after 12 November 1997 but received before 1 January 2005

Means an aggregate period of 91 weeks (whether or not consecutive) after the expiry of the first entitlement period (total of 104 weeks).

For claims made for an injury before 12 November 1997

An aggregate period of 78 weeks (whether or not consecutive) after the expiry of the first entitlement period (total of 104 weeks).

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3.3.4 Review of entitlement at the end of the second entitlement period

Before the end of the second entitlement period the Agent must review the claim to determine if the worker will have an entitlement once the second entitlement period has expired.

See: After the second entitlement period


Timing of review

The review should take place to allow the required notice period under the legislation if the worker's weekly payments are to be terminated.

Eligibility criteria is addressed

The Agent needs to assess if the worker will have 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 (NCWC No 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 work, either in the worker's pre-injury employment or in suitable employment) indefinitely.

If a worker is not assessed as having NCWC indefinitely, the Agent must ensure that the eligibility criteria are addressed before weekly payments are terminated.

This includes workers who:


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Evidence required

Agents need to obtain evidence including medical reports specifically commenting on the worker’s capacity for work.

This includes:

See: After the second entitlement period


The ‘not likely to continue indefinitely’ ground

The ‘not likely to continue indefinitely’ ground (the worker has no current work capacity but this is not likely to continue indefinitely) should only be used where:

  • medical opinion confirms that the worker will have a capacity for suitable employment in the foreseeable future
  • the normal or expected course of recovery is that the worker will have a capacity for suitable employment based on evidence-based clinical practice and/or previous experience
  • the duration of the worker's current incapacity can be defined and is proximate, eg < 9 months
  • there are reasons why the worker will gain a capacity for suitable employment, eg surgery recovery, gaining a qualification etc and
  • there is consistent information supporting the change of capacity.
Vocational assessments

The worker must be provided with a list of at least three OR Occupational Rehabilitation providers and can select their preferred provider.

When Agents arrange a vocational assessment as part of the assessment of a worker’s entitlement after the second entitlement period to weekly payments, the Agent must advise the worker that the:

  • purpose of the assessment is to obtain an opinion of the worker’s CWC and their ability to undertake suitable employment
  • assessment report may provide an opinion that could lead to a review or termination of the worker’s entitlement to weekly payments.

See: Approve occupational rehabilitation services


Worker advised of entitlement

When the Agent has made a determination of whether the worker will have an entitlement to weekly payments once the second entitlement period has ended the Agent must send a notice to the worker and employer.


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