When your NSW workers compensation payments change or stop

If your weekly payments are being reduced or stopped, the decision behind that letter is a decision about one scheme. It is not a decision about insurance held inside your super: total and permanent disability cover and income protection cover.

Two systems, two tests, two decision-makers. One does not settle the other, and the super side does not announce itself.

This page sets out the schedule the New South Wales scheme runs on, and where the super side sits beside it. It explains a system. It cannot tell you what applies to your claim.

What dates does the NSW scheme run on?

Weekly payments in New South Wales run on the Workers Compensation Act 1987 (NSW). The dates below are set by the Act for every claim in the scheme, so reaching one is not a judgment about yours.

• Weeks 1 to 13. The first entitlement period. Payments run at 95% of pre-injury average weekly earnings (PIAWE), up to an indexed maximum (s 36).
• Weeks 14 to 130. The step-down. Payments drop to 80% of PIAWE for a worker not working, or working under 15 hours a week, and run at 95% of PIAWE less earnings for a worker who has returned to work 15 hours or more (s 37).
• Week 130. The second entitlement period runs an aggregate 117 weeks after the first 13, out to 130 weeks of payments (s 37, with the Schedule 3 definitions). Payments continue past it only under s 38: where the insurer assesses no current work capacity likely to continue indefinitely (s 38(1) and (2)); or where a worker with capacity applies in writing in the last 52 weeks of that period, has returned to work of at least 15 hours a week at or above an indexed earnings figure, and is assessed as likely to remain indefinitely incapable of work that would increase earnings (s 38(3)). A worker "with high needs", meaning whole person impairment (WPI) above 20%, need only apply (s 38(3A)).
• Week 260. No weekly payments after an aggregate 260 weeks, whether or not consecutive (s 39(1)), unless permanent impairment from the injury is more than 20% (s 39(2)). Payments that do continue past 260 weeks still run under the s 38 rules.
• Workers with highest needs. That is the Act's label for a worker whose permanent impairment is above 30%. These workers are not reassessed under s 38 unless they ask to be, and a minimum weekly payment applies (s 38A).
• A separate track for psychological injury. For a "primary psychological injury", s 39A caps payments at 130 weeks unless WPI is at least 25%, with up to 52 further weeks at 60% of PIAWE, on conditions, for the 21% to under 25% band (s 39B). Those rules reach only injuries first notified on or after 1 July 2026 (Schedule 6, Part 19R clause 4). Earlier notifications keep the older rules. Exempt workers (police officers, paramedics, firefighters), coal miners, dust diseases claims and emergency volunteers sit outside the changes (Part 19Q clauses 3 to 6, Part 19R clauses 5 to 8).
• Before payments stop. Each of these follows a "work capacity decision": an insurer decision about current work capacity, suitable employment, or what the worker can earn (s 43(1)). Written notice is required (s 78), with concise and readily understandable reasons (s 79(2)). The notice period is 3 months where the reassessment results from a work capacity decision (s 80(3)), otherwise 2 weeks under a year of payments or 6 weeks at a year or more (s 80(4)), and only where 12 continuous weeks have been paid (s 80(2)).

The figures behind s 38(3), the weekly maximum and the s 38A minimum are indexed each year, and the scheme regulator publishes the current amounts.

What does not stop when weekly payments stop?

Medical and related expenses run on their own clock (s 59A). How long depends on the permanent impairment figure: 2 years after weekly payments stop where impairment is 10% or less, or has not been assessed; 5 years where it is above 10% and up to 20%; and no time limit where it is above 20%. If weekly payments later restart, the medical entitlement revives for that period (s 59A(3)).

Some things are never time limited, including artificial aids, hearing aids, home and vehicle modifications, and approved secondary surgery (s 59A).

The psychological injury track changes this too. For a primary psychological injury first notified on or after 1 July 2026, medical expenses run for one year after weekly payments end, and only impairment above 30% removes the limit.

Is there a lump sum for permanent impairment?

Yes, and it is separate from weekly payments: s 66 provides a one-off lump sum where permanent impairment passes the thresholds the Act sets, with its own claim and assessment rules. It is its own entitlement, and this page does not cover it in full.

One date the legislation sets is worth writing down. A worker holding a whole person impairment assessment made under the rules as they stood before the scheme's recent reforms has until 1 July 2028 to claim the s 66 lump sum (Schedule 6, Part 19S, clause 5). That is a date in the Act, not an estimate, and a firm that works in this area can tell you whether it applies to your assessment.

Is this the same test a TPD policy uses?

No. The difference between these tests is not one of degree. It is a difference in kind.

The New South Wales tests sit inside one scheme. Section 38 turns on current work capacity, hours worked and earnings. Section 39 turns on a WPI figure above 20%.

The superannuation test asks something else. A trustee may release benefits on permanent incapacity where it is reasonably satisfied that the member's ill health, whether physical or mental, makes it unlikely the member will engage in gainful employment for which the member is reasonably qualified by education, training or experience (Superannuation Industry (Supervision) Regulations 1994 (Cth), reg 1.03C). No impairment percentage appears in reg 1.03C, and the cashing restriction for permanent incapacity, at Schedule 1 item 103, is "Nil".

So a section 38 or section 39 ending does not decide a TPD or income protection claim, and a termination under one does not decide the other. A TPD policy is assessed under its own definition, set out in the policy document, not under a scheme's whole person impairment percentage. Policy definitions vary again on top of that superannuation floor, which is why the policy wording matters more here than any scheme letter.

That runs in both directions. One door closing is not a decision about the other, and it does not mean a claim exists.

What may be sitting in the super account?

• Income protection held inside super arrives as periodic payments, not a lump sum. Schedule 1 item 109 restricts cashing to a non-commutable income stream, for no longer than the period of incapacity.
• Cover can lapse quietly. A trustee must stop insurance where no contributions or rollovers have arrived for 16 continuous months, unless the member elects in writing to keep it (Superannuation Industry (Supervision) Act 1993 (Cth), s 68AAA; the Australian Prudential Regulation Authority (APRA), Protecting your super package FAQ). The 1987 Act has no provision requiring superannuation contributions on weekly payments. Victoria has one (WIRC Act s 168). New South Wales does not, so contributions commonly stop when wages stop, and those 16 months can run without anyone mentioning it.

Whether a policy takes New South Wales weekly payments into account is a term of that policy, not something statute sets.

What can you do this week?

While a notice period runs, these two are open, and neither commits you to anything.

The file the insurer has to hand over

Where an insurer disputes liability, discontinues or reduces weekly payments, or confirms that decision on review, the Workers Compensation Regulation 2016 (NSW) requires it to give the worker copies of the relevant medical reports, certificates of capacity, clinical notes, investigators' reports, workplace rehabilitation provider reports and health service provider reports, "whether or not the report supports the reasons for the decision" (clause 41(4)).

The hook is s 73 of the Workplace Injury Management and Workers Compensation Act 1998 (NSW). A report that was not provided cannot be used to dispute liability, and is not admissible before the Personal Injury Commission (s 73(3)). This is a regulation, not a courtesy.

The super fund call

Four questions cover most of it. "I'm not sure" is a fine answer to anything they ask you.

• Do I hold total and permanent disability cover on this account, and is it active today?
• Do I hold income protection or salary continuance on this account?
• When did contributions or rollovers last arrive on this account?
• Please send me the insurance details and the policy wording that applied when I stopped working.

If you have worked more than one job, there may be more than one account, each with its own cover.

What costs nothing?

• Insurer review under s 287A of the 1987 Act, available any time before the matter reaches the Commission. The insurer must review and notify within 14 days.
• A complaint to the IRO, the standalone statutory office that investigates any act or omission of an insurer affecting a worker's entitlements and makes non-binding recommendations, ordinarily within 30 days (Personal Injury Commission Act 2020 (NSW), Schedule 5, clause 8). The same Schedule establishes ILARS, which funds workers' legal costs (clause 9).
• The Personal Injury Commission. Work capacity and PIAWE disputes can proceed there (1987 Act s 44BA), referred under s 288 of the 1998 Act.

One timing point is worth knowing. A referral lodged before the s 80 notice period expires stays the decision, so payments continue until the matter is determined, dismissed or discontinued (s 289B). The date on that notice matters for this reason.

ClaimsGuide does not run claims, assess entitlements, or tell you whether a policy will pay. We explain how these systems sit next to each other and, if you want it, introduce you to a firm on our panel that handles this type of claim. You never pay us. Panel firms do.

Check everything on this page

NSW scheme items checked 13 and 14 August 2026 against the sources below. Superannuation items read from the compilation noted.

• Workers Compensation Act 1987 (NSW). Sections 36, 37, 38, 38A, 39, 39A, 39B, 43, 44BA, 59A, 78, 79, 80 and 287A, with Schedule 3 for the entitlement period definitions and Schedule 6 Parts 19Q and 19R for the transitional rules.
• Workplace Injury Management and Workers Compensation Act 1998 (NSW). Sections 73, 288 and 289B.
• Workers Compensation Regulation 2016 (NSW). Clause 41.
• Personal Injury Commission Act 2020 (NSW). Schedule 5, clauses 8 and 9.
• Superannuation Industry (Supervision) Regulations 1994 (Cth), compilation as at 1 July 2024. Regulation 1.03C and Schedule 1 items 103 and 109.
• Superannuation Industry (Supervision) Act 1993 (Cth), section 68AAA.
• APRA, Protecting your super package frequently asked questions.
• Workplace Injury Rehabilitation and Compensation Act 2013 (Vic), section 168, cited for the contrast with New South Wales.
• SIRA, the New South Wales scheme regulator, on weekly payments, for the current indexed amounts.