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Workers’ Compensation Payout Guide in Victoria, Australia

What is Workers’ Compensation?

Workers’ compensation provides wage replacement, medical treatment, and other benefits to workers suffering from work-related injuries or illnesses. In Victoria, Australia, it is governed by the Workplace Injury Rehabilitation and Compensation Act 2013 and administered by WorkSafe Victoria.

Who is Eligible for Workers’ Compensation?

Most workers in Victoria are covered by workers’ comp, including full-time, part-time, casual, labour hire and contract workers. However, self-employed individuals and some volunteers are not automatically covered.

Injuries and illnesses that can be claimed include physical injuries, musculoskeletal disorders, occupational diseases, psychological injuries, and aggravations of pre-existing conditions due to work.

Workers’ Compensation Benefits

In Victoria, the workers’ compensation system is designed to assist employees who have been injured or become ill due to their employment. Below are the essential benefits provided under Victorian Workers’ Compensation to ensure you’re fully informed of your entitlements.

Weekly Payments for Lost Income

Life doesn’t pause when you’re unable to work due to an injury or illness. Workers’ compensation provides weekly payments to help replace your lost income. These payments act as a financial lifeline, allowing you to focus on your recovery without the added stress of lost wages.

Medical and Hospital Expenses Coverage

The road to recovery may require various medical treatments and hospital visits. Under workers’ Compensation, you’re covered for reasonable medical and hospital expenses. This benefit ensures that the cost of essential healthcare services, from consultations to surgeries, does not become a barrier to your recovery.

Rehabilitation and Return to Work Assistance

Returning to work after an illness or injury can be a challenging process. That’s why workers’ compensation includes rehabilitation and return-to-work assistance. This benefit is designed to provide you with the support and resources needed to make a safe and sustainable return to your job, or to transition to new employment if necessary.

Lump Sum Impairment Benefits

Injuries can sometimes result in permanent disabilities. When this occurs, eligible individuals may receive a lump sum impairment benefit. This one-time payment acknowledges the lasting impact of your injury and is determined based on the severity of your impairment.

Death Benefits for Dependents

In the unfortunate event of any worker’s death due to work-related illness or injury, the individuals’ dependents are entitled to death benefits. These benefits provide financial support during a profoundly difficult time, helping cover expenses and lost income.

Workers’ Compensation Claim Process

1. Report the injury/illness to your employer as soon as possible

2. Seek medical treatment and obtain a certificate of capacity

3. Your employer will forward the claim to their WorkSafe agent 

4. The agent assesses and determines acceptance or denial

5. You can dispute denied claims through conciliation and court proceedings

Legal Representation

Workers can engage injury and compensation lawyers or union advisors to assist with claims, disputes, or severe injury proceedings. In some cases, workers can avail of a no-win, no-fee arrangement. 

Understanding Workers Compensation Payouts in Victoria

To help you out, we have created a friendly guide to workers’ compensation payout, designed to support you financially while you recover.

If you have an injury from your workplace, you will need to let your employer know and get a medical certificate from your doctor. Once your claim is approved by WorkSafe, you will start receiving weekly payments to help cover your lost wages while you are recovering.

These payments are up to a maximum of $2,660 per week. Here’s how it breaks down depending on how long you’re off work:

  • First 13 weeks: You will get 95% of what you usually earn.
  • Weeks 14 to 130: Your payment goes to 80% of your pre-injury earnings.
  • Beyond 130 weeks: If it looks like your condition won’t improve, you could receive 80% of your earnings until you turn 67.

However, there is more to it than just your weekly wage. WorkSafe also covers your medical bills related to your work injury. This includes doctor visits, medication, treatments, and medical devices like glasses or hearing aids. Just remember to get these expenses approved by WorkSafe before you rack them up, or keep receipts if you hope to be reimbursed for costs you have already incurred.

And if your injury is severe, there are also lump sum payments you might be eligible for:

  • Impairment benefit: This is a one-off payment for permanent injuries.
  • Damages claim: Also known as a common law claim, this is for severe injuries caused by someone else’s negligence.

How Much Shall I Receive for my Workers Compensation Payout?

The amount you receive from a workers compensation impairment benefit in Victoria is directly tied to the level of Whole Person Impairment (WPI) you’re assessed at, following your injury. This assessment is important as it determines the range of lump sum payment you’re eligible for. 

Here is a breakdown of what you might expect based on your WPI percentage for physical injuries, with figures relevant for musculoskeletal injuries assessed in the 2023/24 period as of March 6, 2024.

Whole Person Impairment (WPI) %Lump Sum Payment Range*
5-9%$14,980 – $25,188
10-19%$27,740 – $58,847
20-29%$62,295 – $93,332
30-39%$96,780 – $151,200
40-49%$157,250 – $211,700
50-59%$217,750 – $272,200
60-69%$278,250 – $332,700
70-79%$338,750 – $676,130

How do I qualify for a Workers Compensation Payout?

There are two primary ways to qualify for a lump sum payout:

Impairment Benefit for Permanent Impairment

If your injuries are considered to be a permanent impairment, you might be eligible for this benefit. However, your injuries need to be stabilised, which typically takes about 12 months post-injury. After this period, a doctor will assess your injuries to determine if you qualify.

The eligibility criteria depend on the type of injury:

  • For musculoskeletal injuries, you need a minimum of 5% Whole Person Impairment (WPI).
  • For physical injuries (other than musculoskeletal), the threshold is at least 10% WPI.
  • For psychological injuries, you need to have suffered at least 30% WPI.

Damages Claim for Serious Injuries

This applies if your injury is serious and was caused or significantly contributed to by someone else’s negligence.

To pursue this, you will need a serious injury certificate, which is obtained by having your lawyer lodge a Serious Injury Application on your behalf. WorkSafe then has up to 120 days to make a decision on granting the certificate.

If WorkSafe does not grant the certificate, you have the option to take your case to the County Court to seek it through a Judge’s decision.

Notably, if you’re assessed as having a WPI rating of 30% or more during the impairment benefits assessment, you’re automatically considered to have a serious injury. This means WorkSafe must accept your Serious Injury Application.

Both ways aim to provide financial support to those who have been significantly affected by workplace injuries, helping cover ongoing costs and losses due to the injury.

How to Claim a Lump Sum Payout?

For Impairment Benefit

Claiming a lump sum payout for an impairment benefit involves a structured process. Here’s a simplified guide to help you navigate it:

  • Wait for Injury Stabilisation: Give your injuries about 12 months to stabilise. This waiting period ensures that the full extent of your injuries can be accurately assessed.
  • Submit an Application: Next, fill out and submit the necessary application form to start the claim process.
  • Medical Assessment: Have your injuries evaluated by a doctor who is specially trained to conduct these assessments. This step is important as it determines the severity of your impairment.
  • Decision Notification: After your assessment, you’ll receive a written notice of the decision within 120 days. This document will detail whether your claim was approved and the amount of benefit you’re entitled to.
  • Dispute Process: If you disagree with the decision or the amount of the impairment benefit, there is a process in place to dispute it.

For a Damages Claim

Claiming damages requires a different approach, primarily focused on establishing the serious nature of your injury due to negligence. Here’s what you need to know:

  • Lodge a Serious Injury Application: This includes preparing an affidavit detailing the impact of your injury on your life, a draft Statement of Claim for negligence, a medical authority form, your tax records, and relevant medical reports and notes.
  • Attend a Conference: A meeting with WorkSafe or the self-insurer is necessary to discuss your claim. This step aims for an amicable resolution without going to court.
  • Statutory Offer Process: If the case is not resolved in the conference, WorkSafe or the self-insurer will make a written offer (statutory offer). If you’re not satisfied with it, you can make a written counteroffer (statutory counteroffer).
  • Court Proceedings: Should the claim not be settled through the statutory offer process, you then have the option to initiate court proceedings for damages. However, most claims are settled before reaching this stage.

What to Do If Your Lump Sum Claim Is Denied

Do not worry if your lump sum claim is denied; this is not the final say! We are here to support you every step of the way.

Sometimes, the initial medical assessment might not fully capture how your injuries affect your life. If that happens, we’re ready to step in. Call us at 1800 KARLOS  and let’s discuss the possibility of challenging the assessment and bring forward additional evidence to support your case. Most often, we can reverse the denial.

Consult our Injury Compensation Lawyers

If you are in Victoria and in need of reliable injury compensation lawyers, our team is here to help. Specialising in lump sum claims, our experienced workers’ compensation lawyers have a solid history of securing payouts for our clients.

Call us at 1800 KARLOS for a FREE initial consultation

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