Workers Compensation (AU) glossary
Workers compensation in Australia is administered state-by-state — NSW SIRA/icare, VIC WorkSafe, QLD WorkCover, and equivalents — each with its own Act, guidelines, and WPI methodology. This glossary focuses on the terms that appear across all schemes, with state-specific pointers where the meaning diverges.
This is a glossary of 40 key terms used across Australian workers compensation schemes. Each definition cites the controlling state Act, regulation, or leading authority. Use it for client briefings, applications, and junior lawyer training.
Definitions
Accepted claim
A claim the insurer has accepted liability for, triggering payment of statutory benefits.
Aggravation injury
An aggravation of a pre-existing injury or condition where employment was a significant contributing factor. Compensable under most schemes.
Casual worker
A non-permanent worker, still covered by workers compensation schemes if they meet the definition of worker.
Claim form
The prescribed scheme form lodged by the worker to initiate a claim for compensation.
Common law claim
A damages claim in negligence against the employer, available in some schemes once a WPI threshold is crossed.
Current work capacity
The worker's present ability to return to work in suitable employment, assessed by treating doctors and insurer assessments.
Deemed worker
A person deemed by statute to be a worker for scheme purposes — contractors, labour hire, and specified categories.
Dispute notice
The insurer's formal notice disputing all or part of a claim, triggering the worker's rights to review.
Domestic services
Household and care services reasonably required because of injury. Compensable subject to scheme limits.
Entitlement period
The statutory period during which a worker is entitled to weekly payments on specified terms — typically stepped down over time.
Exemption from step-downs
Exemption from reduced weekly payments — typically for high WPI or seriously injured workers.
Factual investigator
An insurer-engaged investigator who takes statements and gathers evidence about liability or work capacity.
Functional capacity evaluation
An objective assessment of a worker's physical and/or cognitive capacity for work, conducted by an occupational therapist or assessor.
High-needs worker
A worker with a WPI of 21% or more (NSW), attracting extended entitlements.
icare
Insurance and Care NSW — the statutory insurer for the NSW Nominal Insurer scheme.
Independent medical examination
An examination by a doctor engaged by the insurer, worker, or scheme to assess injury, capacity, or WPI.
Injury management plan
An individualised plan for managing a worker's injury and supporting return to work, prepared by the insurer.
Journey claim
A claim for an injury sustained travelling to or from work. Coverage varies between schemes.
Lump sum compensation
A one-off statutory payment for permanent impairment. Available above scheme WPI thresholds.
Main contributing factor
The test under s 4 of the NSW 1987 Act for disease injuries — employment must be the main contributing factor to contraction.
Medical expenses
Reasonably necessary medical, hospital, and rehabilitation expenses reimbursed by the insurer.
Merit review
Review of certain insurer work capacity and pre-injury earnings decisions by the regulator or PIC.
No current work capacity
A finding that the worker has no present capacity for any employment, activating the relevant benefit tier.
Nominal Insurer
The statutory insurer of last resort for scheme-covered employers — administered by icare in NSW.
Notice of injury
The worker's statutory notification to the employer of the injury, triggering scheme obligations.
Personal Injury Commission (PIC)
The NSW commission resolving workers compensation and motor accident disputes since March 2021.
Pre-injury average weekly earnings (PIAWE)
The statutory calculation of pre-injury earnings used to determine weekly payments under most schemes.
Provisional liability
The insurer's interim acceptance (within 7 days in NSW) allowing payments while liability is fully determined.
Reasonable excuse
A scheme-defined ground on which an insurer may refuse to commence provisional payments (e.g. dispute over worker status).
Reasonably necessary
The statutory test for recoverable medical and related expenses — the treatment must be reasonably necessary as a result of the injury.
Recess claim
A claim for injury during a work recess, such as a lunch break. Coverage is scheme-specific.
Return to work plan
A tailored plan for the worker's return to work, developed in consultation with treating doctors and the employer.
Section 39 cut-off
The NSW 260-week cap on weekly payments for workers with a WPI of 20% or less.
SIRA
State Insurance Regulatory Authority — the NSW regulator of the workers compensation and motor accident schemes.
Step-down
The reduction in weekly payments after the first entitlement period expires, typically at 13 weeks.
Suitable employment
Employment within the worker's current capacity, taking into account medical evidence, skills, and availability.
Weekly payments
Payments to compensate a worker for lost earnings due to injury, calculated by reference to PIAWE and current work capacity.
Work capacity decision
An insurer decision about a worker's current work capacity, suitable employment, or PIAWE — reviewable on merit.
Work injury damages
Negligence damages against the employer available in NSW where the worker has 15%+ WPI, limited to past and future economic loss.
Worker
A person who works under a contract of service. Deemed worker provisions extend coverage to certain contractors.
Research these terms in context
Quillio is built for Australian workers compensation practice. Use it to calculate PIAWE, check WPI thresholds across schemes, and draft disputes with live citations to the relevant state Act and SIRA/WorkSafe guidelines. See /practice-areas/workers-comp-lawyers or start a free trial.
These definitions are general explanations for educational purposes — not legal advice. Workers compensation rules vary significantly between Australian states and change frequently. Always verify against current legislation and scheme guidelines.
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