NSW Legislative Amendments 2026 FAQs
Implementation and decision timelines
The psychological claim changes apply only to claims notified to the employer and lodged to insurer on or after 1 July 2026.
Excess changes apply to claims lodged against policies issued or renewed from 30 June 2026.
Changes to PIAWE decisions, Reasonable and Necessary treatment, and the WPI process will apply to all requests made on or after respective commencement dates.
Further detail can be found on the icare website: Workers Compensation Reform FAQs.
Employers must notify the insurer within 48 hours of becoming aware of the injury as required by Section 44 of the Workplace Injury Management and Workers Compensation Act 1998.
Further requirements can be found of the Safe Work Australia website: Table 3.4: Prescribed time periods for injury notification.
For psychological claims for a relevant conduct injury, the insurer has 42 days from the date the completed claim (signed claim form and certificate of capacity received). If the insurer does not decide within 42 days, the claims is taken to have been accepted. Trauma claims are subject to the existing Provisional Liability timeframes.
See SIRA’s website for more information: Psychological injuries – a guide for workers and employers.
Psychological claim eligibility and entitlements
Both pathways must be assessed, with all claimed relevant events investigated and a liability decision made within the required timeframes.
The worker will receive the highest entitlement available across the two claim pathways:
- If the trauma claim is accepted or placed under Provisional Liability (PL), the worker will receive 95% of PIAWE while both the trauma and conduct claims are being investigated.
- If the trauma claim is declined or placed under Reasonable Excuse (RE), the worker will receive 75% of PIAWE under the conduct pathway.
Regardless of the outcome, a full liability decision must still be made for both the trauma claim and the conduct claim.
More information on the psychological claim process is available on the SIRA website: Psychological injuries – a guide for workers and employers.
Yes, they can still make a claim. The CSPs will review the reported events to determine if they meet the statutory elements of the legislation. If the events do meet these statutory elements, the claim will be confirmed as compensable. If the statutory elements are not met, the claim will not be compensable.
This will be be determined on a case by case basis, but consideration for a factual investigation should be be undertaken prior to a claim being declined.
If a conduct claim is declined a written notice will be provided to the worker explaining the reasons for the decision and the information relied upon. The insurer must also give the worker two weeks’ notice, where they will continue to be entitled to weekly benefits and medical expenses.
QBE will discuss with employers and injured workers the types of evidence that may be required based on the circumstances upon lodgement of the claim being made with claim forms.
Employers should provide all available information and evidence as early as possible, along with an estimated timeframe for completion of any internal investigation. This enables the insurer to determine whether it is appropriate to await the investigation findings or engage an independent factual investigation to support timely liability decision-making.
Medical entitlements and employer case conferencing
The proposed Reasonable and Necessary changes introduce clearer criteria for approving treatment and services. To be covered, treatment must:
- Primarily relate to the work injury
- Be clinically appropriate and justified
- Represent value for money and be cost-effective.
When assessing value for money, consideration will be given to the benefits of the treatment compared with its cost and any alternative treatment options.
Some treatments and services are expressly excluded from employer liability, including certain alternative therapies, wellness services, unprescribed massage, and some general health or recreational activities unless prescribed by a medical practitioner.
While further guidance is expected regarding the practical application of the framework, the changes are intended to support greater consistency and evidence-based decision making when assessing treatment requests, while ensuring resources are directed towards interventions that effectively support recovery and return to work outcomes.
Further information can be found on the SIRA website: Key changes for employers – Workers compensation legislative reform 2026.
From 1 July 2026, employers and employer representatives (including workplace rehabilitation providers) cannot attend a worker’s medical treatment or examination unless the worker specifically requests their attendance.
This applies to all medical appointments held on or after 1 July 2026, regardless of when they were booked.
These restrictions do not apply to case conferences. Employers can continue to participate in case conferences to support recovery and return-to-work planning. Case conferences should be arranged separately from medical appointments unless the worker requests otherwise.
Further information can be found on the SIRA website: Employer not entitled to attend medical examination or treatment.
Weekly payments, excess and premium impacts
Yes, fixed excess is based on the first two weeks that a workers receives weekly payments. This includes:
- The first week the worker is entitled to weekly payments above $0, and
- The week immediately after.
The Excess amount is the total of these two weeks of weekly payments. The weekly benefits should still be paid to the worker and claimed from QBE as usual. A letter will be generated to advise you that a payment has been made and excess withheld.
Excess examples can be found on the SIRA website: Employer Excess Guidance.
Yes, Excess will be deducted from the cost of claims for premium calculation from 27/28 premium calculations.
Where there is an entitlement, wage benefits are paid from the date claim is made not back dated to a DOI prior. Therefore associated claim costs impact premium for the policy period wages were paid in.
Whole Person Impairment
From 1 July 2026 until mid-2027, the worker and/ or the insurer can arrange a permanent impairment assessment if they think that the worker’s injury will have a long term (or lifelong) impact. The assessor that undertakes this assessment, must be on the list of assessors regulated by SIRA.
The worker must obtain independent legal advice prior to the permanent impairment assessment. This is important, so the worker understands the effect of having this assessment on their future rights and entitlements under workers compensation law.
More information on the changes to Permanent Impairment can be found on the SIRA website: Assessment of permanent impairment.
Yes. The Whole Person Impairment (WPI) threshold for psychological Work Injury Damages (WID) claims is increasing in stages:
- 25% WPI from 1 July 2026
- 27% WPI from 1 July 2027
- 28% WPI from 1 July 2029
These changes apply only to injuries reported on or after the relevant commencement date. If an injury was reported before the change takes effect, the previous threshold will continue to apply, even if a WID claim is lodged later.
Further information can be found on the SIRA website: Psychological injuries – a guide for workers and employers.
Summary of entitlements
| Percentage of WPI | Weekly payments | Medical and related treatment | Work injury damages |
|---|---|---|---|
| 0 to 20% | Weekly benefits cease at 130 weeks. | 1 year after cessation of weekly payments (or from date of claim if no weekly payments). | No entitlement |
| 21 to 24% | Up to 130 weeks
Weeks 131-182 an additional 52 weeks at 60% of PIAWE where:
|
1 year after cessation of weekly payments (or from date of claim if no weekly payments) Access to return-to-work intensive support program for no more than 12 months (post 130 weeks). |
No entitlement |
| 25 to 30% | Entitled to receive weekly payments to retiring age. | 1 year after cessation of weekly payments (or from date of claim if no weekly payments). | May be entitled to bring a work injury damages claim. |
| 31% or more | Entitled to receive weekly payments to retiring age. | Lifetime access | May be entitled to bring a work injury damages claim. |
To be eligible for compensation under section 66:
- Permanent physical injuries must have a degree of permanent impairment over 10% percent (including hearing loss claims)
- Permanent primary psychological or psychiatric injuries must have a degree of permanent impairment over 15%.
Dispute and review process
Insurers are currently awaiting further information on the IRC process, as SIRA has not yet released the relevant guidelines.
The IRC will try to resolve the dispute through conciliation. If this is unsuccessful, it can make a binding determination on whether the conduct meets the definition of relevant conduct.
If the insurer disputes liability for other reasons – such as whether the conduct caused the injury, whether it was the main contributing factor, or whether the person is a worker – the dispute may still need to be determined by the Personal Injury Commission (PIC).
The IRC determines whether the conduct was relevant conduct, while the PIC may deal with any remaining liability disputes.
Yes, a worker may still be able to lodge a workers compensation claim after an FWC settlement, depending on the circumstances.
However, a worker cannot be compensated twice for the same workplace conduct or injury. Any compensation already received through the FWC or IRC will be considered when assessing the workers compensation claim.
Training & resources
Discover a range of resources to help you prepare for the NSW legislative amendments, including webinars featuring insights from our legal partner Turks, and access to QBE’s Customer Solutions Panel for workplace wellbeing and psychological injury support.
For further assistance, please contact our QBE Team on [email protected]
NSW Workers Compensation Legislative Reforms – Psychological claims eligibility pathways
Join QBE and our law partner, Turks, for an exclusive webinar exploring the upcoming NSW legislative reforms and what they mean for psychological injury claims. Designed for employers and broker partners, this session will help you understand the potential impacts on your business and how to prepare for the changes ahead.
NSW Workers Compensation Legislative Reforms – Overview of Key Changes
Join QBE and our law partner, Turks, for a follow-up webinar exploring the broader impacts of the NSW legislative reforms for NSW policy holders. Designed for employers and broker partners, this session will help you understand how the reforms may affect your business and how to prepare for the changes ahead.
Customer Solutions Panel
To support psychological wellbeing and workplace safety, access QBE’s Risk Solutions Panel, connecting customers with specialist providers focused on mental health, injury prevention and workplace wellbeing.