Scheme overview

Scheme coverage

Anybody considered to be a 'worker' under the WorkCover legislation is entitled to compensation if they are injured in the course of their work. It doesn't matter if the work is full-time, permanent, part-time, casual or on a fixed-term contract, the worker is covered.

To be entitled to compensation, a worker's injury must come from their work or happen in the course of their work. There is no need for the employer to be at fault. If someone contracts a work-related disease or illness, they are entitled to compensation if the employment contributed to the disease or illness. This is also the case for mental disabilities.

If someone aggravates a pre-existing disability at work, they are also entitled to compensation but only if the employment contributed to the aggravation.

The Scheme covers disabilities that are connected to South Australia. There are matching 'cross-border' laws in every state and territory, which set the rules for connecting disabilities to a state or territory. In general, workers are covered by the South Australian Scheme if they usually work or are usually based in South Australia. This is so even if the injury happens outside the state. There is a four-point test for employers to determine where their workers are covered. For more information please see the Guide to Cross-Border Workers Compensation Provisions.

Scheme entitlements

Depending on the nature of the injury, a worker's entitlements can include:

• weekly payments of income maintenance
• medical and associated costs related to the injury or illness
• lump sum compensation for non-economic loss (permanent impairment).

If Employers Mutual cannot determine a claim within seven days, a worker will receive provisional weekly payments for up to 13 weeks, and/or provisional medical expense payments.

The Scheme also covers medical and related costs due to the need to diagnose and treat workplace injuries and illnesses. The specific services required will depend on the type of injury, and what is considered 'reasonable' treatment by the worker’s case manager and doctor.

The Scheme also offers rehabilitation programs and rehabilitation and return to work plans. These assist workers and employers in managing workers' safe return to work, and preventing further aggravation or recurrence of injuries.

Rehabilitation services are directly provided by workplace rehabilitation specialists and may be considered by the worker's case manager as part of rehabilitation and recovery.

Scheme funding

The Scheme is funded by levies collected from South Australia's employers. WorkCoverSA generates additional revenue by investing levy funds.

The average annual levy rate is reviewed each year by the WorkCover Board and management. An external actuary assists this process by providing an independent estimate of long-term claim-related liabilities.

For more information on how the levy rate is set, see the registered employers section.