How Much Compensation Can You Claim for a Work Injury?

Workers’ comp. Just hearing those words makes people tense up. On one hand, it’s a lifeline if you’ve been injured on the job. On the other hand, it can feel like a maze of rules, percentages, and forms. And then there’s the question everyone really wants answered: how much money am I actually going to get?

Thing is, there’s no single neat number. It’s not like someone can glance at your injury and say, “Right, that’ll be $50k, thanks very much.” The system just doesn’t work that way. It’s more like layers on a cake—weekly payments, medical bills, lump sums, maybe even future loss of earning capacity. Each case plays out differently.

But let’s slow it down and unpack it properly.

So, what does “workers’ compensation” even cover?

At its core, workers’ compensation is there to support people who get injured or sick because of work. That means if you hurt your back lifting boxes at the warehouse, or develop a repetitive strain injury from years of typing, the scheme’s designed to step in.

The main buckets of compensation usually look like this:

Weekly payments if you can’t work, or can only do reduced hours
Medical expenses like doctor visits, physio, surgery, medications
Travel expenses to and from treatment (yep, even parking sometimes)
Lump sum compensation for permanent impairment
Work injury damages claims in very limited situations (basically suing your employer for negligence)

That’s the rough outline. But each part has its own rules, timeframes, and caps. And here’s where most people get tripped up—just because someone you know got a big payout doesn’t mean you’ll get the same.

Weekly payments: the bit most people care about first

Alright, straight to the money side. If you can’t work, you’ll usually get a percentage of your pre-injury average weekly earnings. The actual percentage shifts depending on how long you’ve been off:

The first 13 weeks? Up to 95% of your pre-injury wages.
After that? Generally drops to 80%, unless you’re working some hours.
Long term? Well, the scheme starts tightening the tap after a certain point, with strict reviews at the 130-week and 260-week marks.

And yep, there’s a maximum cap—so higher earners might find the payments fall short of what they used to take home. Bit of a rude shock sometimes.

Medical bills: at least you’re not footing it yourself

The good news? Most reasonable and necessary medical expenses tied to your injury are covered. That means you’re not out of pocket for scans, specialist visits, or rehab.

But, worth noting: you usually need pre-approval for the bigger ticket items. Surgery, for example, won’t just get waved through. And the insurer can (and often does) argue about what’s “reasonable.” That’s where disputes creep in.

Lump sums: the part everyone whispers about

Now here’s where it gets interesting. If your injury leaves you with a permanent impairment, you might be entitled to a one-off lump sum. This isn’t automatic—you need to be assessed by a qualified medical specialist who gives you a percentage rating of impairment.

Here’s the kicker: you need to hit a threshold before lump sums even come into play. In NSW, that’s usually at least 11% whole person impairment for physical injuries (15% for psychological ones). The higher your rating, the bigger the payout.

And no, it’s not life-changing lottery money. More like recognition for the permanent impact on your body. Still, it can make a real difference down the line.

Work injury damages claims: rare but powerful

Sometimes—sometimes—you can step outside the normal system and sue your employer for negligence. That’s called a work injury damages claim. It’s not available to everyone. You need at least 15% whole person impairment and solid proof the employer dropped the ball on safety.

The upside? Bigger payouts covering future loss of earnings. The downside? Once you take it, your weekly payments and medical benefits under workers’ comp stop. It’s an all-or-nothing decision, so it has to be considered carefully.

So what’s the bottom line—how much could you get?

Here’s the frustrating bit. There isn’t a neat table that spits out “you’ll get $X.” Every case depends on:

How much you were earning before the injury
How severe and lasting the injury is
Whether you can get back to work, and in what capacity
Medical evidence (and whether the insurer disputes it)
Timeframes and caps in the legislation

For one worker, it might be weekly payments for six months and a few physio bills. For another, it could mean years of reduced wages plus a lump sum. For someone else entirely, it’s a fight over permanent impairment ratings.

And let’s be real—insurers don’t exactly make this process smooth sailing. Disputes, delays, endless forms… it can feel like they’re hoping you’ll just give up.

Common misconceptions that cause headaches

A few myths worth busting:

“Everyone gets a lump sum.” Nope. You need to meet thresholds, and many injuries don’t qualify.
“Compensation is tax-free.” Weekly benefits are treated differently to lump sums—so don’t assume everything’s tax-free.
“Once you’re on comp, you’re set for life.” Far from it. Payments reduce over time, and eligibility reviews can cut them off.
“The insurer decides everything.” Actually, decisions can be reviewed or challenged. You don’t have to just cop it.

Real world example (without the jargon)

Picture this. A tradie falls off scaffolding, smashes his ankle. Can’t work full-time for months. He gets weekly payments (95% of his old wages for the first 13 weeks, then 80% after that). His physio and surgery bills are covered.

But after a year, the ankle still won’t bend properly. He’s assessed at 12% whole person impairment. That crosses the threshold, so he gets a lump sum for permanent impairment. It’s not millions, but it recognises he’ll never be back to 100%.

Compare that to an office worker with carpal tunnel. Maybe surgery fixes it. She gets a few months of payments and medical expenses covered, but no lump sum because her impairment rating doesn’t hit the threshold.

Same system. Two completely different outcomes.

FAQs people actually ask

Do I have to go back to work if I’m not ready? Not if your doctor certifies you unfit. But insurers often push for “suitable duties,” so you might be asked to try light work.

Can I choose my own doctor? Yes, you can stick with your GP. The insurer might also send you to independent assessments, but your treating doctor’s opinion matters.

What if the insurer cuts me off? You can dispute the decision. Don’t assume it’s final. There are formal review and appeal processes.

Are psychological injuries covered? Yes—but the thresholds are higher for lump sums, and insurers often challenge these claims more heavily.

How long does all this take? Depends. Weekly payments can kick in fairly quickly. Lump sum claims can drag for months (or longer) because of assessments and disputes.

So, what should you do next?

Workers’ compensation is one of those areas where DIY can backfire. The rules are complicated, and the insurer’s not on your side. It’s worth talking to someone who knows the system inside-out. A specialist workers’ compensation lawyer can give clear advice based on your situation.

If you’re unsure where to start, firms like GC Law handle these matters every day. Even just getting proper guidance early can stop headaches later.

Disclaimer: This information is general only. It doesn’t replace tailored legal advice. Always get professional advice before making decisions about your own situation.

How Much Could You Actually Get From a Workers’ Compensation Claim?