Workers frequently asked questions

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 to assist you to determine an individual's employee / contractor status.

The definition of a worker is:

A worker is someone who performs work or a service for another person under a contract and is an employee for PAYG purposes as defined by the Taxation Administration Act, even if the employer is not withholding tax when they should be.

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), immediate family members who live with those individuals are only covered if their personal details and their remuneration are disclosed to the insurer at the time the person commences employment, when a policy is obtained or at the renewal of a policy.

In the Northern Territory, a worker is entitled to compensation for any personal injury or disease, or an aggravation, acceleration, exacerbation, recurrence or deterioration of a pre-existing injury or disease that occurs:

• during the course of employment
• by an incident arising out of employment
• journeys to or from work that do not involve a motor vehicle. However there are exceptions to this – refer to bulletin, ‘Guidelines for the settling of journey claims’.
  • Injuries sustained involving a motor vehicle on a normal journey to or from work are covered by the Motor Accidents Compensation (MAC) scheme and therefore excluded from workers compensation.
• claims for diseases or injuries that occur by way of gradual process must be materially contributed to by your employment.

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. You can download a copy of the 'workers' compensation claim form'.

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 medical certificate of capacity - first certificate completed by your treating medical practitioner must be attached. If this medical certificate of capacity is not attached, the claim is not valid.

If the claim is for medical expenses only, the approved medical certificate of capacity is not required.

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.

Normal weekly earnings is based on a worker's gross remuneration immediately before they first become entitled to compensation. It includes remuneration from any other concurrent employment, provided the worker was employed by that other employer or employers for at least six weeks before they first become entitled to compensation.

For further information on the calculation of normal weekly earnings, refer to NT WorkSafe's Normal weekly earnings bulletin.

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.

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.

No. The Return to Work Act 1986 does not include superannuation contributions made by the workers employer.

The deferral gives the insurer up to 56 days to obtain further information to make a final decision to accept or dispute the claim.

During the period of deferral, the worker is entitled to weekly payments of compensation. This is paid by the employer within 3 working days after notification from the insurer. Payments are paid from the date of the insurers letter of deferral.

Other entitlements may include reasonable medical and rehabilitation expenses.

During the deferral, hospital inpatient and associated surgical costs as well as costs of interstate evacuations are excluded.

The processes available to resolve disputes include:

• direct discussions and negotiations between the worker 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.

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.

If the recurrence is a progression of an 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.

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

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 approved guidelines.

If either you or the insurer disagrees with the assessment, 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 NT WorkSafe Guideline for the Evaluation of Permanent Impairment. These guides adopt the "American Medical Association Guides to the Evaluation of Permanent Impairment (Fifth Edition)".

Journey claims are only covered by workers compensation for injuries that do not involve a motor vehicle, with the following exceptions:

• a journey to or from a workplace, other that the workers normal workplace at the request of an employer
• workers who are travelling from home to work as a result of a call out by an employer whether paid for the call out travel or not.

Injuries sustained involving a motor vehicle on a normal journey to or from work are covered by 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 refer to the 'guidelines for the settling of journey claims'.

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. This could include alternative duties or role, or 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 weekly compensation entitlements.

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.

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 as outlined in 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, to take an action against their employer or fellow worker under common law.

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.