Am I covered for workers' compensation?

The pay as you go (PAYG) test applied under the Australian Taxation Office (ATO) laws is used to determine who is required to be covered for workers compensation in the Northern Territory. The ATO website has guidelines and online tools to assist you to determine an individual's employee / contractor status.

The definition of a worker is:

An individual who performs work or a service under contract and is in relation to the contract, an employee for the purpose of assessment for PAYG withholding under the 'Tax Administration Act 1953 (Cth), Schedule 1, Parts 2-5.'

If you are a director of a company, you are only covered if your company has taken out a workers' compensation policy with an approved insurer and your personal details and your remuneration have been disclosed to the insurer.

If the business is owned by an individual or partnership (not a company) family members of those individuals are only covered if their personal details and their remuneration are disclosed to the insurer.

When is a worker covered for workers' compensation?

In the Northern Territory a worker is entitled to compensation for any personal injury or disease, or an aggravation of an injury or disease that occurs:

  • during the course of employment
  • by an incident arising out of employment
  • on journeys to and from work are excluded. Exceptions to this are where the journey is to or from a workplace other than the worker’s normal workplace at the request of the employer, or where the worker is required to work outside their normal hours of work and is paid for the time taken for the journey to or from work.
  • claims for diseases or injuries that occur by way of gradual process must be materially contributed to by your employment.

How do I make a claim?

If you believe you have suffered a work related injury or disease, tell your employer or supervisor as soon as you can. This can be done either verbally or in writing.

You have up to six months to lodge a claim for workers' compensation from the date of the injury or when you first became aware of the injury or disease, however, in some circumstances a claim can be made later.

The NT WorkSafe 'workers' compensation claim form' is the only approved form for lodging a workers' compensation claim in the Northern Territory. In the event of a work related injury or disease, an employer or worker should download this form. The form may be completed by typing into the online form or printed out and hand written. In both cases, the form will need to be printed so the worker and the employer can sign the form as required. Download a copy of the 'workers' compensation claim form' below.

You must complete Part 1, numbers 1 to 9 of the NT WorkSafe approved claim form and submit the form to your employer. If the claim is for lost time, a ‘statement of fitness for work - first certificate’ completed by your treating medical practitioner must be attached. If this 'statement of fitness for work' is not attached, the claim is not valid.

If the claim is for medical expenses only, the approved ‘statement of fitness for work - first certificate’ is not required.

How much will I be paid?

You are entitled to receive your normal weekly earnings for the first 26 weeks of total or partial incapacity, less any amount you actually earn.

If after the first 26 weeks you are still incapacitated you will normally be paid at 75% of your loss of earning capacity. Minimum and maximum provisions may apply.

Will my weekly benefits reduce at any time?

Weekly benefits automatically reduce after 26 weeks to 75% of your loss of earning capacity.

For most people the maximum period that they can stay on weekly benefits is for 260 weeks, being the equivalent of five years. Plus another 12 months of medical and associated benefits.

This does not apply to workers who have suffered a more serious injury and are assessed as having a permanent impairment of 15% or more. These workers are not time limited and depending on work capacity may be entitled to compensation payments until pension age.

For older aged workers who are injured within two years of their pension age or after their pension age, the maximum period on weekly benefits is 104 weeks, ie, 2 years. Their entitlement to medical and associated benefits could go on for a further four years.

What are my other workers' compensation entitlements?

Other workers' compensation entitlements you maybe eligible for include:

  • reasonable costs for medical, surgical and rehabilitation treatment
  • hospitalisation and hospital treatment
  • pharmaceutical expense
  • travel or transportation costs to attend treatment or hospitalisation (including kilometre allowance)
  • upskilling or training for a different career, if your injury prohibits you working in your pre-injury position
  • payment for a permanent impairment.

The above list is not complete as the needs of individual workers are different and your insurer will consider each request for service on its merits.

Are employer contributions to my superannuation included in the calculation for weekly workers' compensation entitlements?

No.

What happens when a decision on a claim gets deferred?

The deferral gives the insurer up to 56 days to obtain further information, however, the insurer must make a final decision to accept or dispute the claim before 56 days have expired from the date of the decision to defer.

During the period of the deferral the worker is entitled to weekly payments of compensation as well as reasonable medical and rehabilitation expenses.

This benefit excludes hospital inpatient and associated surgical costs as well as costs of interstate evacuations.

What do I do if I disagree with a decision made on my claim or if my claim is disputed, or my benefits are cancelled or reduced?

The processes available to resolve disputes include:

  • direct discussions and negotiations between the claimant and the representatives of the insurer or self-insurer.
  • use of the insurers or self-insurers internal dispute resolution process.
  • the mediation service available through NT WorkSafe.

If your weekly benefits are cancelled or reduced, you will receive formal notification by the insurer with a 'notice of decision' and 'rights of appeal form'. This process will inform you of your rights to appeal the decision by applying to NT WorkSafe for mediation.

Mediation may help solve disputes by sharing information, identifying the issues in dispute, discussing them and trying to reach a mutually acceptable agreement.

Mediation is a free service.

If the matter is not resolved at mediation, you can also apply to the Work Health Court for a resolution to the dispute.

Can I make an application directly to the Work Health Court?

Before you can make an application to the Work Health Court, you must first apply for and complete the mediation process. Once the process is completed, a mediation certificate will be issued to you and you are required to lodge the certificate with your application to the Work Health Court.

You have 28 days from the date you receive the certificate of mediation to make an application to the Court. If the 28 days has passed, you may apply to the Court for an extension to make an application. The granting of such extension is at the discretion of the Court.

What happens if I suffer a recurrence or an aggravation of an injury or disease when I am back at work

If the recurrence is a progression of the original injury with no new contributing incident or aggravation, then it will form part of your original claim.

If the recurrence or aggravation is caused by a new work related incident, you will need to submit a new claim.

Can I claim for a stress related condition under workers' compensation?

You can make a claim for psychological injuries if there is medical evidence to support that your employment was a materially contributing factor. You are not entitled to compensation if the psychological injury was a result of:

  • management action taken on reasonable grounds and in a reasonable manner by or on behalf of the worker's employer
  • a decision of the worker's employer, on reasonable grounds, to take, or not to take, any management action
  • any expectation by the worker that any management action would, or would not, be taken or any decision made to take, or not to take, any management action.

How do I make a claim for a permanent impairment?

If you are left with a permanent impairment as a result of a work related injury or illness, there is provision under the Return to Work Act 1986 for you to receive compensation once a medical assessment has been conducted to determine the level of impact the impairment has on you.

If you believe that you have a permanent impairment and your condition is stable, you can ask your insurance company to have you assessed. The insurer will arrange for you to be examined by a medical practitioner, who will assess your impairment in accordance with approved guidelines*.

Alternatively you could ask your own medical practitioner or specialist to do the assessment, but you will have to ensure that the assessment is done in accordance with the prescribed guidelines.

If either you or the insurer disagrees with the assessment made, an application can be made to NT WorkSafe for a permanent impairment reassessment.

The cost of carrying out a permanent impairment assessment or reassessment is paid by your employer (insurer).

* The approved guidelines are American Medical Association Guides to the Evaluation of Permanent Impairment (Fourth Edition)

If I am injured on my way to work, am I covered by workers' compensation?

Injuries while traveling to and from work are generally not covered under the 'Return to Work Act 1986', however, may be claimed under the 'Motor Accidents Compensation scheme (MAC)', which is administered by Allianz Insurance, trading as the Territory Insurance Office (TIO) on behalf of the NT Motor Accidents Compensation Commission.

For further information on journey claims see the 'guidelines for the settling of journey claims' below.

What steps do I need to take to return to work?

If rehabilitation is recommended, you must cooperate with reasonable treatment, rehabilitation and return to work programs.

If your employer is unable to provide you with suitable duties, you must participate in a reasonable return to work program, with another employer.

You are also required to inform your employer if you commence employment elsewhere or circumstances change in a way which may affect your entitlements.

Can I visit my family doctor or do I have to see the doctor specified by my employer?

Some employers do have arrangements with certain medical practitioners to treat their employees; however you are entitled to be treated by the doctor of your choice.

If you have made a claim for workers' compensation, you may be required by an insurer or your employer to undergo an examination by another medical practitioner for the purpose of obtaining a second opinion.

Can a claim be made for a death which resulted from work related injury?

Yes, a single lump sum payment can be claimed by the dependants of a worker who has died as a result of work related injuries. The claim may also include funeral expenses and other benefits outlined in the 'Return to Work Act 1986'.

Is there common law under the 'Return to Work Act 1986'?

No. The Northern Territory Workers' Compensation Scheme is a no fault scheme. The 'Return to Work Act 1986' removes the ability of a worker, as defined by the Act, to take an action against their employer or fellow worker under common law.

Are there best practice guidelines and service standards?

Workers' compensation 'best practice guidelines' have been developed in consultation with approved insurers and self-insurers with the objective of setting service standards and achieving consistency.

The 'best practice guidelines' contain a Schedule of Performance Indicators which sets out the service standards that insurers and self-insurers have agreed to.

These guidelines and service standards are not rules but rather a framework within which approved insurers and self-insurers will work. They are intended as minimum standards which approved insurers and self-insurers are encouraged to improve upon. 

Best practice guidelines for approved insurers and self-insurers (pdf 185 kb)

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