*The contents in this blog relates to legislation in New South Wales.
For many people with serious injuries sustained at work, performing everyday tasks like cleaning, cooking, and mowing the lawns is daunting and sometimes simply impossible.
An injured worker can ask their employer’s workers compensation insurer (‘the insurer’) to provide domestic assistance, pursuant to section 60AA of the Workers Compensation Act 1987. It may include household tasks such as cleaning, doing the laundry, home repair and maintenance, car maintenance, and lawn and garden care etc.
An entitlement to domestic assistance arises where:
- A medical practitioner certifies it is reasonably necessary and that the need for domestic assistance arose as a direct result of the work injury;
- The assistance would not be provided ‘but for’ the injury;
- The worker’s injury has resulted in a degree of permanent impairment of at least 15%, or it is only to be provided on a temporary basis; and
- The assistance is provided in accordance with a care plan established by the insurer.
A worker’s degree of permanent impairment is assessed by a qualified specialist, and determined using the ‘NSW workers compensation guidelines for the evaluation of permanent impairment‘.[1] If a worker’s injury resulted in a degree of permanent impairment that is less than 15% but the injured worker still requires domestic assistance, the injured worker can receive assistance on a temporary basis but only if it is provided:
- For not more than 6 hours per week;
- During a period that is not longer than, or during periods that together are not longer than, 3 months; and
- It is provided pursuant to the requirements of the relevant injury management plan.[2]
Generally speaking, the insurer does not need to pay for ‘gratuitous domestic assistance’. That is, assistance provided for free, for example, by a family member or friend. However, they may be liable to pay for gratuitous domestic assistance in circumstances where the person providing the assistance has lost income or needs to forgo their employment to provide the assistance.
The insurer must make a decision regarding any claim for domestic/gratuitous assistance within 21 days. If they do not, a worker can make a complaint to the Independent Review Office, or lodge a dispute in the Personal Injury Commission.
If the insurer refuses to pay for domestic or gratuitous assistance, their decision is reviewable. We recommend contacting Turner Freeman Lawyers to speak with an experienced workers compensation lawyer to assist with challenging the dispute. We may request an internal review on the worker’s behalf, or commence proceedings and represent them in the Personal Injury Commission.
Most injured workers in NSW are entitled to receive funding to cover their legal fees through the Independent Review Office (IRO). At Turner Freeman, we have a number of IRO Approved Lawyers who would be pleased to assist.
If you are struggling with activities of daily living and general household tasks, contact Turner Freeman Lawyers on 13 43 63 to speak with one of our experienced workers compensation lawyers about claiming for domestic assistance, or challenging an insurer’s decision.
[1] State Insurance Regulatory Authority, NSW workers compensation guidelines for the evaluation of permanent impairment, (catalogue no. WC00970, 4th rev ed, 1 March 2021).
[2] see Larissa Pearson, ‘Injury Management Programs and Plans’, Turner Freeman Lawyers (Blog, 10 March 2021) <https://www.turnerfreeman.com.au/blog/injury-management-programs-and-plans/>.