All You Need to Know about Workcover WA Schemes and Claims: Workers Compensation Benefits, Coverage and Examples

If you have been injured on the job, it is important to know that workers’ compensation benefits can help. In this blog post, we will discuss what workers’ compensation is in Western Australia and how workers are eligible for these benefits. The goal of this article is to provide you with all you need to know about the WorkCover Scheme and claims in WA.

Types of workers compensation claims

The first thing to know about workers compensation in Western Australia is that there are many types of injuries that qualify for workers’ comp. This includes physical injuries such as back pain or a broken arm, mental injuries such as PTSD from an assault at work or anxiety brought on by traumatic events at work like shootings or other violence, and psychological trauma caused by bullying or harassment while working.

How much does WorkCover pay?

WorkCover WA usually does not pay compensation directly to injured workers. In most accepted workers compensation claims, payments are made by the employer’s workers compensation insurer or, in some cases, by a self-insured employer.

WorkCover WA’s role is different. It regulates the workers compensation scheme, provides information about the scheme, and deals with disputes through its dispute resolution process. If a claim is disputed, WorkCover WA may have power to make orders about whether compensation should be paid.

Once a workers compensation claim is accepted, an injured worker may be entitled to:

• income compensation, sometimes called weekly payments;
• reasonable medical and health expenses;
• reasonable workplace rehabilitation expenses;
• travel and other claim-related expenses; and
• permanent impairment compensation, if there is a permanent impairment assessment.

Current limits (2026/27 financial year — effective 1 July 2026):

• General Maximum Amount / Income Compensation General Limit: $284,448.
• Medical and health expenses general limit: $170,669.
• Workplace rehabilitation expenses compensation limit: $19,911.

Income compensation and permanent impairment compensation are subject to the General Maximum Amount/ income compensation general limit; medical and rehab have separate limits.

These limits can sometimes be increased in limited circumstances. For example, an extension may be relevant where a worker has permanent total incapacity, significant ongoing medical needs, or a claim where the ordinary statutory limits may not be enough. Whether an extension is available depends on the worker’s circumstances, medical evidence and the requirements of the Workers Compensation and Injury Management Act 2023 (WA).

Is superannuation paid on workers compensation?

Workers on workers’ compensation are not entitled to superannuation under the workers’ compensation legislation, but they may be able to receive such benefits if there is a specific provision in their award or contract of employment.

There has been some ambiguity about this point and whether it was an oversight when originally drafting the workers’ compensation legislation is unclear.

Who is eligible for workers compensation laws benefits?

In general terms, a person may be eligible for workers compensation in Western Australia if they are a worker who suffers an injury arising out of or in the course of their employment.

This can include physical injuries, psychological injuries, diseases, and aggravations of pre-existing conditions, depending on the circumstances. Some contractors and workers in non-standard arrangements may also be covered, but this can be legally complex and should be assessed carefully.

The 2 most common myths about who is eligible for workers compensation benefits are:

Myth #1 – an injured person must show their employer is at fault in order to claim workers’ compensation

In WA, the workers compensation and injury management scheme is a no-fault system. This means the injured person does not have to show that his or her employer was at fault in causing the injury as they would if the claim was a negligence claim. Foyle Legal’s free online worker’s compensation claim checker can help you to establish if you meet the injury requirement to make a workers comp claim in WA.

Myth #2 – all workers meet the definition of “worker”

Most employees in Western Australia will be treated as workers for the purpose of the workers compensation scheme. However, the issue can be more complicated for contractors, subcontractors, labour-hire workers, family work arrangements, farm workers and other non-standard working arrangements.

In general terms, a person may be covered if they perform work under an employment relationship or another working arrangement recognised by the Workers Compensation and Injury Management Act 2023 (WA). Whether a person is a “worker” depends on the circumstances of the working relationship, not just the label used by the employer or in the contract.

If an insurer disputes that you are a worker, or says you are an independent contractor rather than an employee, you should get legal advice before accepting that decision.

What qualifies as a work-related injury?

A work-related injury in Western Australia can include a physical injury, psychological injury, disease, or an aggravation of a pre-existing condition, depending on the circumstances.

In general terms, the injury must have a sufficient connection with the worker’s employment. This may include an accident at work, an injury suffered while carrying out work duties, a disease contributed to by employment, or a pre-existing condition that is made worse by work.

Psychological injury claims can be more complex, especially where the injury is connected with stress, bullying, performance management, disciplinary action or other workplace conflict. In some cases, an insurer may dispute a psychological injury claim on the basis that it arose from reasonable administrative action or ordinary workplace management. If your claim involves psychological injury, it is usually worth getting legal advice early.

Examples of Workers Compensation Claims in Western Australia

Below are three examples of workers compensation claims but the names and other identifying features have been changed. It is very important to note that every worker’s compensation claim is different. In some cases, the accident may be the same but you are never just dealing with an injury, you’re also dealing with a specific person who has sustained it. The amount of workers compensation payout you received will also be variant depending on how your worker’s compensation claim is managed and progressed.

Unlawfully Ceased Weekly Payments

James worked as a nurse in rural Western Australia. He worked on a fly in fly out basis. On his way home he experienced barotrauma (which is physical damage to body tissues caused by a difference in pressure between a gas space inside, or in contact with, the body, and the surrounding gas or fluid) whilst on the aeroplane.

James made a claim for workers compensation by completing a claim form and first medical certificate and his claim was accepted. The insurer stopped paying weekly payments of compensation. James engaged Foyle Legal which made an application to WorkCover on the basis that the insurer unlawfully ceased weekly payments of compensation. The insurer essentially argued that James needed to show his claim should be accepted again. WorkCover ruled that was not the case and Foyle Legal helped James to settle his claim.

Suspension of Weekly Payments

Tim was employed as a labourer near Bunbury, WA. He suffered a back injury in the course of his employment. He made a workers compensation and liability was accepted.

The pain from Tim’s back injury was terrible. Tim used prescription medication but it did not prove enough from him. He started taking illegal drugs. Tim had a girlfriend and young child but the relationship broke down and his girlfriend left him, and he did not see his young child anymore. He tried rehabilitation for his drug addiction, but he was unable to complete it.

The workers compensation insurer said Tim was not engaging in vocational rehabilitation and applied for a suspension of his weekly payments of compensation and he had failed to attend an independent medical review. Tim continued to struggle with his drug addiction and his ability to commit to anything was very limited.

Foyle Legal helped Tim to organise another review with the independent medical review arranged by the insurer so that was no longer an issue. Close to the arbitration date, Foyle Legal helped Tim organize a return to work with a relative. Tim managed to settle his case on favourable terms just before the Arbitration hearing.

Disputed WorkCover Stress Claim

Paula was an administrative assistant and she was subject to continuing and constant bullying by her manager. She made a workers compensation claim and like most psychological claims liability for her claim was not accepted. Paula did not know what to do and came to Foyle Legal to help her with her claim.

Foyle Legal helped with the cost of obtaining medical reports regarding Paula’s claim and brought an application through WorkCover WA. The insurer offered Paula a lump sum at Conciliation but it was not enough for her. Foyle Legal helped Paula get more records (medical notes and a Psychiatrist report) regarding her case and Paula settled her claim on favourable terms at a pre-arbitration conference.

Un-disputed Workers Compensation Claims

1) John is a crane operator who was injured while at the work site. He sustained a work-related injury to his back and arm which meant he had limited movement in both areas. The workers compensation claim involved specialist medical reports, hospital records, rehabilitation documents and other assessments including psychological evaluation of John’s limitations.

2) Mary is a retail assistant who was injured when she fell from the ladder while working in her store. The workers compensation claim involved medical reports that showed Mary had sustained an injury to her back which meant she would not be able to return to work.

3) Tony is a construction worker, fell from a ladder and sustained fractures to his right arm. He was treated in hospital for the fracture and then released home with workers compensation benefits covering all of his medical expenses.

4) Nina slipped on some wet tiles at work while carrying groceries. She suffered severe lower back pain and a sprained wrist, for which she was prescribed medication.  The worker’s compensation claim for Nina involved a report from the treating doctor, and also from an independent Medical Practitioner. Foyle Legal helped Nina to successfully settle her claim for her permanent impairment

Workers Compensation Common Law Claim

Tom is a painter who sustained a work related injury to his shoulder when he slipped and fell on the floor while carrying paint in his bucket. Tom had surgery which helped with some pain but not all of it and he also developed anxiety and depression due to his injury. The worker’s compensation claim involved an internal investigation which showed Tom was exposed to a dangerous set of circumstances at the workplace and that he had been unsafely using equipment on site. We were able to settle the worker’s compensation claim for workers’ compensation benefits.

Management of WorkCover Claims

To make a workers compensation claim in Western Australia, you usually need to give your employer a completed workers compensation claim form and a first certificate of capacity from your doctor.

Your employer is then required to provide the claim documents to its workers compensation insurer. The insurer will assess the claim and decide whether liability is accepted, disputed, or deferred while further information is obtained.

Strict timeframes apply to the employer and insurer when dealing with a workers compensation claim. If the claim is accepted, the insurer will usually start paying compensation benefits. If the claim is disputed or deferred, you should be told the reason and may need legal advice about your options.

Workcover Management Plan

After a workers compensation claim is accepted, the employer and insurer may become involved in injury management and return to work planning. This can include suitable duties, medical reviews, workplace rehabilitation provider involvement and return to work goals.

A return to work plan should be realistic and based on the worker’s certified medical capacity. If the proposed duties do not match your restrictions, or if you feel pressured to return to work before you are ready, you should raise this with your treating doctor and consider getting legal advice.

Disputes can arise when an insurer says a worker is not cooperating with injury management or suitable duties. These disputes can affect weekly payments, so it is important to respond carefully and keep medical evidence up to date.

Legal Assistance for Claiming WorkCover – No Win, No Fee

Foyle Legal is one of the leading worker’s compensation lawyers in Perth. We have been helping injured workers in WA for years to maximize their claims. We have the team and expertise to help you win your workcover claim, as well as other types of personal injury benefits you may be entitled to. If you or a loved one are facing a worker’s compensation claim in Western Australia, we can provide all of the resources necessary to ensure that you get what is rightfully due from your employer. From medical care reviews to negotiations with employers and insurance companies, our legal team will be there every step of the way to make sure that you receive fair treatment in line with Western Australian laws on Workers Compensation claims. If you have made a personal injury claim in WA? Contact Foyle Legal today at 1300 300 966.

More Information about Personal Injury Law

For more information about the personal injury claim process and what to expect from your injury compensation claim, please check out of Workers Compensation FAQ and Personal Injury FAQ page.

Change of Workers Compensation Law

This article has been updated to reflect the Western Australian workers compensation scheme under the Workers Compensation and Injury Management Act 2023 (WA), which commenced on 1 July 2024. Some older resources may still refer to the “prescribed amount”. Under the current scheme, the equivalent term is generally the General Maximum Amount.

The information in this article is general in nature and does not constitute legal advice. It does not take into account your personal circumstances, medical evidence, employment history or the specific facts of your workers compensation claim. Workers compensation laws and benefit limits can change over time. If you have been injured at work and want advice about your rights, you should seek legal advice about your individual situation.