Chapter 4: Coverage and eligibility for benefits

Coverage and eligibility

This chapter provides information about worker’s compensation coverage and eligibility for benefits in each jurisdiction. Workers’ compensation coverage differs between each jurisdiction. Determining whether a person is covered by workers’ compensation depends on the definitions of:

  • workers/employees
  • deemed workers/employees
  • injury, and
  • workplace.

Coverage of employees

To be eligible for compensation a person injured in the workplace must fall within the definition of worker/employee in their jurisdiction. Determining what types of workers are covered is very important, as penalties can apply if an employer does not insure its workers. A number of jurisdictions apply tests to determine if a worker requires coverage.

Definitions of deemed workers

A deemed worker for workers’ compensation purposes is a person who performs work for another in circumstances that fall outside of the general statutory definition of worker in a jurisdiction, but who is deemed by legislation to be a worker in order to receive a workers’ compensation benefit.

Over time there has been a decline of employment under traditional arrangements. As new working arrangements have emerged, jurisdictions have modified the definition of ‘worker’ to ensure that workers under these arrangements are properly covered by workers’ compensation. Table 4.2 provides a list of deemed workers in each jurisdiction.

Compensation coverage for volunteers

Table 4.3 provides a summary of workers’ compensation arrangements in each jurisdiction for volunteers such as firefighters, emergency service volunteers and persons performing community services or unpaid duties.

Treatment of sportspersons

All jurisdictions that cover sporting activities in their workers’ compensation legislation refer to the professional side of the sport only. Comcare, Seacare and DVA have no direct reference to sport-related injuries. As New Zealand’s scheme has much broader coverage, there is no distinction made between sport-related and any other injury — all receive the same cover.

In New South Wales, coverage for workers’ compensation depends on whether the person is within the definition of a ‘worker’, noting that persons who might otherwise be workers are excluded where they are covered by the Sporting Injuries Insurance Act 1978. A comparison of jurisdictions can be found in Table 4.4.

Workers’ compensation arrangements for government employers

Table 4.5 summarises the legislation, self-insurance, claims managers and premiums covering workers’ compensation for government employers in each of the jurisdictions.

Workers’ compensation arrangements for judges and members of parliament

Table 4.6 provides a summary of workers’ compensation arrangements for judges and members of parliament in each jurisdiction.