Injured Worker Entitlements

Workers’ compensation coverage

Weekly compensation payments

An employer will commence payment of weekly compensation from the date the worker gives the employer notice of the injury.

If a worker makes a claim in relation to an injury, the insurer is liable to pay weekly compensation payments in relation to the injury from the date of the injury until the insurer rejects or settles the claim.

Compensation payments will end if the worker does not lodge a compensation claim within 7 days – unless the worker was unable to do so because of the injury.

Total incapacity

A worker is considered to be totally incapacitated if, due to functional impairment caused by the injury, there is no suitable paid work available.

While a worker is totally incapacitated by a work-related injury, the worker will receive their average pre-injury weekly earnings for the first 26 weeks from the date of the injury. Where there was a regular and established pattern of earnings, average earnings may take into account other employment and overtime.

After the first 26 weeks of incapacity, the injured worker receives an amount calculated in accordance with section 41 of the Workers Compensation Act 1951 (the Act).

The employer must immediately give the injured worker any payments from the insurer.

Payment may cease if the injured worker fails to participate and cooperate with their personal injury plan and any medical examinations that have been arranged.

An injured worker must make all reasonable efforts to return to work as soon as practicable.

Partial incapacity

A worker is partially incapacitated if they cannot do all the work tasks they did before the injury, but are not totally incapacitated (e.g. can perform ‘light duties’).

Partial incapacity payments are weekly compensation payments to an injured worker who commences duties in which they are earning less than before the injury. This occurs when the worker is not able to fully resume their former duties because of the injury.

Partial incapacity payments may be paid to make up the difference between the partial return to work earnings, and the injured worker's average pre-incapacity weekly earnings.

Medical treatment and related expenses

The cost of medical treatment and other expenses relating to a compensable injury are payable to the injured worker. Other expenses may include clothing that was damaged or lost as a result of the accident, the amount of wages lost by the worker whilst attending treatment, transport to and from the treatment, and the cost of accommodation (including meals) if required.

Medical & health provider fee schedules

In the ACT, workers’ compensation insurance is provided by licensed private insurers. As such, there are no prescribed fee schedules for medical and health providers.

Permanent injuries

A worker who has suffered a permanent injury listed in Schedule 1 of the Act, as the result of a compensable injury, may be entitled to receive a lump sum payment, as compensation for the permanent injury.

Schedule 1 of lists body parts and senses subject to compensation and assigns to each a percentage of a statutory maximum, the single loss amount. Workers who suffer loss of use of parts of the body mentioned in Schedule 1 of are entitled to compensation for the loss, based on the percentage of the single loss amount listed.

Proportionate loss of use

If a loss suffered by a worker consists of the loss of a proportion of a body part or sense as outlined in Schedule 1 of the Act, the compensation will be equal to the proportion lost by the worker, of the percentage of the single loss amount listed.

Previous injury or pre-existing condition

When working out compensation payable for losses, an amount must be deducted from the compensation for any proportion of the loss due to a previous injury or a pre-existing condition or abnormality. If it proves difficult or costly to work out the proportion of the loss, it is assumed that the proportion is 10% unless this assumption is contrary to the available evidence.

Compensation for hearing loss

In assessing loss of hearing due to specific noise related injuries such as boilermaker's deafness, no compensation will be paid if the total hearing loss is less than 6%. For example when working out the percentage hearing loss because of boilermaker's deafness, the loss is worked out as a proportionate loss of hearing of both ears, even if the loss of hearing is in one ear only. Loss of hearing attributed to age is taken to be 0.5 decibels for each complete year of a worker's age over the age of 55 years for a male and 65 years for a female.

If a work related injury results in the death of a worker, the dependents will be entitled to receive a single lump sum payment, funeral expenses and other benefits in accordance with the Act.

If a worker has received a compensable injury and dies within three months of receiving the injury, there are restrictions on compensation payable for losses relating to specific and other permanent injuries received at the same time.

Common law

The injured worker may also be entitled to seek common law damages if the injury was a result of the employer's negligence. Should the injured worker wish to pursue this option they must do so within three years and they would need to consult a lawyer.

Indexation benefits guide

Each year, the value of benefits paid under the Act are indexed in line with CPI. The most recent document is available to download here.

For the most up-to-date workers’ compensation indexation of benefits information, please read ACT Indexation Benefit Guide (PDF 435KB) or (WORD (122KB).

More information

Safe Work Australia’s Comparison of Workers’ Compensation Arrangements in Australia and New Zealand (the report) provides detailed information on the operation of workers’ compensation schemes in each of the jurisdictions in Australia and New Zealand – including the ACT private sector workers’ compensation scheme.

The report provides background information and discusses the way each scheme deals with key issues including coverage, benefits, return to work provisions, self-insurance, common law, dispute resolution and cross-border arrangements.