If you are hurt at work in
South Australia then you should notify your employer immediately
and complete a "WorkCover Claim Form" so that your employer can
forward the claim form to the appropriate compensating
The compensating authority (usually Employers Mutual Limited or
the employer if they are self-insured) will usually send you a
letter within 7 days confirming that they have received the claim
Unless there is good reason to think that the injury may not be
compensable the compensating authority should start paying what is
called WorkCover provisional liability payments to you. These
payments, in the first instance, may include income maintenance for
up to 13 weeks and medical expenses to the value of $5,000.00.
Provisional liability is not a formal determination of your
claim. If the claim is rejected then all payments will cease;
income maintenance and medical expenses. The payments already
made will not have to be paid back to the compensating authority,
unless you have committed fraud in relation to the claim.
If your claim is accepted then you will be entitled to receive
weekly payments of income maintenance calculated as the average of
your earnings over a period of twelve months prior to your
injury. For example, if you earned $52,000.00 over the twelve
month period leading up to your injury, then your average weekly
earnings would be calculated as being $1,000.00 per week. It
should, however be noted, that you may have received other benefits
as part of your "package" and these may be able to be considered
when calculating your average weekly earnings. For more
information, check out our blog "When is a non cash benefit a
"benefit" under the SA Workers Compensation Scheme?".
You are entitled to receive income maintenance for any periods
where you have a WorkCover Medical Certificate stating that you
have an incapacity for work.
For the first 13 weeks of incapacity you are entitled to receive
100% of your average weekly earnings. If you are able to
perform some work, you should be "topped up" to your average weekly
For the second 13 weeks you are entitled to receive 90% of your
average weekly earnings. If you are able to perform some work
you should be paid at your normal rate for the work actually
performed (actual earnings) and then "topped up" by income
maintenance at the rate of 90% of the difference between your
actual earnings and your average weekly earnings.
After 26 weeks you are entitled to receive 80% of your average
weekly earnings. If you are able to perform some work you should be
paid at your normal rate for the work actually performed (actual
earnings) and then "topped up" by income maintenance at the rate of
80% of the difference between your actual earnings and your average
If your WorkCover Medical Certificate states that you are able
to perform modified duties, then your employer is obliged to
provide you with suitable duties, and you are obliged to perform
them. If you do not do so, the compensating authority may
cease your weekly payments of income maintenance on the basis that
you have "breached mutuality".
If you have lodged a claim and it has not been formally accepted
then an application can be made at the SA Workers Compensation
Tribunal in order to force the compensating authority to make a
decision. Or, if your claim has been accepted but you
disagree with the rate of average weekly earnings a dispute can be
lodged in the Tribunal.
WorkCover claims can get complex but at Andersons we've got a great
team in Workers Compensation able to assist you with any of your
compo inquiries. Alternatively, you can get in direct contact
with our blog writer today, our Senior Associate Marion
Please note, this Blog is posted in Adelaide, South
Australia. It relates to South Australian legislation.