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members. Many of our victories are legal ones which have a huge impact on our members and their

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The NSW workers compensation system

The NSW workers compensation system

The NSW workers compensation system provides support to people injured at work, including assistance with recovering and returning to work wherever possible.

The State Insurance Regulatory Authority (SIRA) is the NSW Government agency responsible for regulating the NSW workers compensation system.

Nominated Treating Doctor

The Nominated Treating Doctor (NTD) plays a key role in the recovery and rehabilitation of people who are injured at work.

GPs are often the first point of contact with a person who has been injured at work, and are the entry point to the rest of the health care system.

Your GP may also have contact with your employer to discuss your capacity for work and discuss suitable work options. Many employers are able to offer modified hours or duties to support their recovery at work.

A completed and up-to-date certificate of capacity is essential for you to receive the best care, and to ensure you receive a wage reimbursement and any other types of payment you are entitled to. The certificate of capacity is also required for any additional service providers to receive payment.

The claims process

Date of injury

Your GP (or other NTD) will be required to provide you with a certificate of capacity.

You will be encouraged to report your injury to your employer as soon as possible. You can also notify the insurer directly online.

The USU recommends reporting an injury to your employer on the day that it occurs, or within the first 24 hours of injury.

48 hours

The employer must notify the insurer of the injury within 48 hours. You should provide your employer with a copy of your certificate of capacity.

7 days

Within 7 days, the insurer will determine whether your claim has been approved to receive provisional payments. 

This may include up to 12 weeks of weekly payments, as well as reasonably necessary medical and related treatment up to $7500 whilst liability is being determined.  You will continue to be eligible for medical and related treatment during this time.

4 to 12 weeks

During this time, your GP (or NTD) will work with the insurer and other service providers to assist with your return to, and recovery at, work.

This may include participating in the development of an injury management plan by the insurer, and ensuring you are receiving the right intervention to assist you with achieving their recovery and return to work goals.

Psychosocial concerns are best addressed as soon as they are identified. 

130 weeks

After 130 weeks of receiving payments, a decision will be made about your capacity for work. The outcome of this decision will determine whether you will continue to receive weekly payments. 

5 years

Workers that continue to receive payments beyond 130 weeks will cease to receive these payments at 5 years, unless they have whole person impairment of 21% or greater.  These patients may continue to receive weekly payments until retirement age (plus one year).

Access to reasonably necessary medical treatment will extend for up to 2 years after weekly benefits have ceased. This may extend further in certain situations depending on your level of whole person impairment.

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