The specific entitlements available under each workers compensation scheme differ, but generally speaking, they fall into three categories:
- income maintenance, usually in the form of weekly payments;
- payment of medical expenses;
- lump sum compensation based on permanent impairment.
Under the South Australian Return to Work scheme, if you require time off from work as a result of a work injury, or are restricted in the hours you can work, you may be able to claim weekly payments based the average of your weekly earnings for the 12 months prior to the injury. These payments are usually limited to a maximum period of two years, paid at 100% of the average weekly earnings for the first year, and then at 80% for the second year. If you actually work during these periods and receive a wage, then you can claim "top-up" weekly payments for the period when you are not working.
You may also be entitled claim reasonable expenses associated with medical treatment. You can claim these expenses for 12 months, or if you receive weekly payments, for 12 months after your last weekly payment. You may also be able to claim travel expenses to and from medical and rehabilitation appointment, and in some cases you may be able to claim help at home while recovering from an injury.
There is an exception to the usual time limits on the above entitlements if you qualify as a seriously injured worker. In order to do so, you need to need to be assessed as having a 30% whole person impairment, by an accredited assessor, under the Impairment Assessment Guidelines. There are special rules which apply to these types of assessments. If you reach the 30% threshold, you are entitled to claim weekly payments until retirement age (as defined by the Act) and medical expenses indefinitely.
If you are assessed as having at least a 5% whole person impairment as a result of your physical injuries, then you may also entitled to claim lump sum payments for non-economic loss (similar to "pain and suffering") and future loss of earning capacity.
There are special transitional rules which apply to workers who were injured before the current legislation commenced on 1 July 2015.
Where a worker dies as a result of a work related injury, family members may be able to claim a lump sum death benefit, some funeral expenses and possibly a weekly dependency entitlement.
We invite you to make first no-obligation interview with one of our experienced workers compensation lawyers to receive advice on preparing an initial claim and for advice in relation to how best to access your entitlements.