Does WorkCover back pay?

In some circumstances you, an injured worker, may be eligible to be paid back pay for weekly payments through the Victorian WorkCover scheme for your work related injury or illness.

It is important that you have already submitted a completed workers compensation claim form.

What is WorkCover back pay?

WorkCover back pay is for injured workers to receive weekly payments owed to them because they were not paid by an employer or insurer for previous pay periods.

Any outstanding amounts owed and paid in a future pay period is referred to as “back payment”.

Weekly Payments

There are three scenarios in which you may be entitled to back payment of weekly payments.

The first scenario is if your WorkCover claim for a work related injury or illness was initially rejected and later your claim is accepted.

The second scenario is your weekly payments of compensation have been terminated, and at a later stage you establish an entitlement to weekly payments.

The third scenario is where your claim for weekly payments of compensation has been accepted, but your pre-injury earnings were incorrectly calculated and paid for a period of time, and upon recalculation, it is determined that you are entitled to back payment of the difference.

How to apply for WorkCover back payment of weekly payments

In the first scenario where a claim is rejected then later accepted and entitlement to weekly payments is established, the WorkCover Insurer will calculate and pay the amount of back payment owed to you after deduction of taxation and any Centrelink repayment for any benefits received during the relevant period.

You will need to establish your work capacity for the time period in which you will receive back payment for. This requires providing the WorkCover Insurer with valid WorkCover certificates of capacity issued by your treating doctor covering the back pay period. Alternatively, you can submit a statutory declaration outlining incapacity and any work performed during the relevant period.

If an initial valid certificate of capacity cannot be provided, a referral can be lodged to the Workplace Injury Commission (WIC). If the WIC is satisfied that you have made all reasonable attempts to obtain a Certificate of Capacity, then you may apply to the County Court or the Magistrates' Court for a determination of your entitlement to weekly payments of compensation.

In the second scenario where a decision to reject a claim for weekly payments or to terminate weekly payments is set aside, you are not required to provide Certificates of Capacity for any period between the date the rejection or termination decision takes effect and the date the decision is set aside. A Statutory Declaration may be required outlining any work performed during the relevant period.

The setting aside of a decision to reject or terminate weekly payments applies in the following circumstances:

• The authorised Agent agrees to accept the WorkCover claim and to make weekly payments of compensation after a rejection or termination of weekly payments
• The authorised Agent withdraws a decision to reject or terminate weekly payments after an internal review
• The authorised Agent withdraws the notice to reject or terminate weekly payments during the conciliation process
• A Conciliation Officer issues a direction to set aside a decision to reject or terminate weekly payments
• The Workers Compensation Independent Review Service (WCIRS) issues a direction to an authorised Agent to overturn a decision to reject or terminate weekly payments
• The authorised Agent withdraws a decision to reject or terminate weekly payments during an independent review by WCIRS; or
• A Court sets aside a decision to reject or terminate weekly payments.

In the third scenario, where a PIAWE re-assessment has led to an entitlement to backpay, you will not require further certificates or statutory declarations.

Calculating WorkCover back payment of weekly payments

The authorised WorkCover insurer will calculate the amount of back payment you are entitled to.

Weekly payments are calculated based on your pre-injury average weekly earnings (PIAWE).

Pre-injury earnings are calculated on the average of your earnings over the 52 weeks prior to you suffering your injury. The calculation for the first 52 weeks of entitlement of workers compensation weekly payments, includes the following:

• Base rate of pay
• Overtime and shift allowances
• Piece rates
• Commissions
• Value of non-financial benefits including use of a motor vehicle and residential accommodation.

After the first 52 weeks of entitlement to weekly payments, your compensation will be calculated at your base rate of pay. However, you will also be entitled to superannuation payments after 52 weeks of weekly payments.

Superannuation will be payable if back payments exceed 52 weeks or encompass the period after 52 weeks of weekly payments have been received.

Weekly payments are paid at 95% of PIAWE for the initial 13 weeks of incapacity. From week 14 onwards, you will be paid at 80% of your PIAWE. (Subject to the statutory maximum currently $2,800, as at 1 July 2024).

If you have been injured at work and think you may be entitled to receive back payment of weekly payments, reach out to a member of our WorkCover team on (03) 9321 9988 or submit an online enquiry today.