Table 5.8: Suspension and cessation of benefits | Safe Work Australia

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	Criteria for suspending payments
NSW	If a person recovers damages in respect of an injury from the employer liable to pay compensation under this Act then (except to the extent that ss(2), ss(3), or ss(4) covers the case): the person ceases to be entitled to any further compensation under this Act in respect of the injury concerned (including compensation claimed but not yet paid), and the amount of any weekly payments of compensation already paid in respect of the injury concerned is to be deducted from the damages (awarded or otherwise paid as a lump sum) and is to be paid to the person who paid the compensation, and the person ceases to be entitled to participate in any injury management program provided for under this Act or the 1998 Act — s151A, Workers Compensation Act 1987. If the worker fails to provide a certificate of capacity / medical certificate — The insurer may discontinue weekly payments of compensation if the worker fails to comply with a requirement under s270 1998 Act or s44B 1987 Act within 7 days after it is communicated to the worker by the insurer’ — s270(2) Workplace Injury Management and Workers Compensation Act 1998 / s44B(6) 1987 Act. A liability in respect of any of the following kinds of compensation under this Act or the former Act may be commuted to a lump sum as provided by this Division (and not otherwise): weekly payments of compensation, compensation under Division 3 (Compensation for medical, hospital and rehabilitation expenses etc.) of Part 3 of this Act or s 10 of the former Act. As part of a commutation agreement, a worker may agree that payment of a lump sum removes any liability to make a payment under Division 4 of Part 3 in respect of the injury concerned. This Division applies to the agreement for payment of that lump sum as if it were an agreement to commute the liability to pay that compensation to a lump sum. Payment of the lump sum removes any liability to which the agreement of the worker relates’ — s87F(8), 1998 Act If a worker has received 5 years of weekly payments and does not meet the threshold of at least 21% permanent impairment they cease to be entitled to weekly payments of compensation — s39, 1987 Act. [Does not apply to exempt workers – police officer, fire fighters, paramedics, volunteers under the Workers Compensation Bush Fire, Emergency and Rescue Services Act 1987 or workers employed in or about a coal mine.] Note: Workers who were in receipt of weekly payments immediately before 1 October 2012 (existing recipients) may continue to be entitled to weekly payments after 260 weeks if an assessment of the degree of permanent impairment is pending and has not been made because an approved medical specialist has declined to make the assessment on the basis that maximum medical improvement has not been reached and the degree of permanent impairment is not fully ascertainable, or the insurer is satisfied that the degree of permanent impairment is likely to be more than 20% (whether or not the degree of permanent impairment has previously been assessed). If a worker refuses to submit himself or herself for any examination under this section or in any way obstructs the examination: the worker’s right to recover compensation under this Act with respect to the injury, or the worker’s right to the weekly payments, is suspended until the examination has taken place — s119(3) and s120(2), 1998 Act If a worker refuses to attend an assessment (under s44A 1987 Act) or the assessment does not take place because of the worker’s failure to properly participate in it, the worker’s right to weekly payments is suspended until the assessment has taken place. [Does not apply to exempt workers — police officer, fire fighters, paramedics, volunteers under the Workers Compensation Bush Fire, Emergency and Rescue Services) Act 1987 or workers employed in or about a coal mine.] If a worker does not comply with an obligation imposed under s48 of 1998 Act [return to work obligations], the insurer may in accordance with this section: suspend the payment of compensation in the form of weekly payments to the worker, or terminate the payment of compensation in the form of weekly payments to the worker, or cease and determine the entitlement of the worker compensation in the form of weekly payments in respect of the injury under this Act. [Does not apply to exempt workers — police officer, fire fighters, paramedics, volunteers under the Workers Compensation Bush Fire, Emergency and Rescue Services Act 1987 or workers employed in or about a coal mine. — s52A, 1987 Act (as at 18 June 2012) [Only applies to exempt workers — police officer, fire fighters, and paramedics.] If a worker receiving, or entitled to receive, a weekly payment of compensation under an award ceases to reside in Australia, the worker shall thereupon cease to be entitled to receive any weekly payment, unless an approved medical specialist certifies, or the Workers Compensation Commission determines, that the incapacity for work resulting from the injury is likely to be of a permanent nature’ — s53(1), 1987 Act.
Vic	A worker’s entitlement to compensation and access to court proceedings may be suspended if the worker unreasonably refuses to have a medical examination or unreasonably obstructs a medical examination until the examination takes place and weekly payments are forfeited for the suspension period — s27 Workplace Injury Rehabilitation and Compensation Act 2013 Weekly payments may be suspended, terminated or ceased and determined if the worker fails to comply with a return to work obligation — s116 Entitlement to weekly payments ceases if the worker is absent from Australia — s175 No entitlement to weekly payments while worker serves a sentence of imprisonment — s177.
Qld	Insurer may suspend compensation if worker: is serving a term of imprisonment — s137 Workers’ Compensation and Rehabilitation Act 2003 fails to participate in an independent medical examination — s135 fails to participate in rehabilitation — s232, or fails to participate in an examination by the medical assessment tribunal — s510. If compensation payments are suspended, no compensation is payable for the period of suspension — s138.
WA	Reduction or discontinuance Restrictions on reduction, suspension or discontinuation of income compensation -s62 Reducing or discontinuing income compensation on basis of worker’s return to work -s63 Reducing or discontinuing income compensation on basis of medical evidence -s64 Suspension Suspension of payments for failure to provide declaration in the approved form if worker not residing in State –s65 Suspension of payments during custody — s66 Suspension or cessation of payments for failure to undergo medical examination — s181 Suspension or cessation of payments for failure to participate in return to work program — s164 An Arbitrator has powers to suspend weekly payments under — s68(2) In the event that compensation is suspended, no compensation is payable during the suspension period unless an arbitrator otherwise orders — s67 A conciliator may direct that payments of income compensation be suspended or reduced if the conciliator considers that it would be reasonable to expect that the resolution or determination of a dispute would result in the payments being suspended, reduced or discontinued –s323
SA	Reduction or discontinuance of weekly payments is covered by s48 (Return to Work Act 2014) and covers the following circumstances: Discontinued if dismissed from employment for serious and willful misconduct — s48(2)(e) Discontinued for breach of mutuality — s48(2)(f), including: failure to submit to a medical examination where required by notice — s48(3)(a) failure to supply a medical certificate where required by notice — s48(3)(b) refusal or failure to submit to proper medical treatment — s48(3)(c) refusal or failure to participate in a recovery/return to work program or — s48(3)(d)(i) failure to comply with obligations under a recover/return to work program — s48(3)(d)(ii) refusal or failure to undertake work offered and capable of performing, taking reasonable steps to obtain suitable employment or having obtained suitable employment, unreasonably discontinues the employment — 48(3)(e) refusal or failure to participate in assessments of worker’s capacity, return to work progress or future employment prospects (including failure to attend) — s48(3)(f),and anything else recognised as a breach of the obligation of mutuality — s48(3)(g) Payments are suspended whilst a worker is in prison — s193 Payments are suspended under s46(7) if a worker fails to comply with a requirement under s46(6) (submit to medical examination or furnish evidence of earnings). Payments can be suspended during absence of a worker from Australia under certain circumstances — s51.
Tas	A worker’s entitlement to compensation may be suspended if the worker unreasonably refuses to submit to a medical examination or undertake any treatment (with the exception of surgical treatment) — s90C Workers Rehabilitation and Compensation Act 1988 An employer may, subject to certain conditions such as providing written notice, terminate or reduce weekly payments where: the payment is in respect of total incapacity and the worker has returned to work the worker is in receipt of the weekly payment in respect of partial incapacity and is receiving weekly earnings in excess of the amount upon which the amount of such weekly payment was determined an accredited medical practitioner who has examined the worker has certified that in their opinion the worker has wholly or substantially recovered from the effects of the injury or that the worker’s incapacity is no longer wholly or substantially due to that injury, or a worker’s entitlement to weekly payments has expired as provided by s69B(2E) — s86(1) If a worker does not comply with the requirements of a return to work plan or injury management plan, the matter can be referred to the Tribunal which has the power to suspend compensation — s143E(7) and s143Q(7) A worker is not entitled to weekly compensation whilst serving a term of imprisonment — s82.
ACT	A worker’s entitlement to compensation may be suspended under s113 (compliance by workers), s44 (living outside Australia) or s83 (no compensation while imprisoned) of the Workers Compensation Act 1951.
NT	s75B(2) (Return to Work Act 1986): provides that where a worker unreasonably fails to undertake medical, surgical and rehabilitation treatment or to participate in rehabilitation training or a workplace based return to work program which could enable him or her to undertake more profitable employment, he or she shall be deemed to be able to undertake such employment and their compensation for incapacity benefits may, subject to s69, be reduced or cancelled accordingly. Where under s75B(3) a worker so required under ss(1) unreasonably refuses to present himself or herself for assessment of their employment prospects, he or she shall be deemed to be able to undertake the most profitable employment that would be reasonably possible for a willing worker with their experience and skill and who has sustained a similar injury and is in similar circumstances, having regard to the matters referred to in s68, and their incapacity benefits may, subject to s69, be reduced or cancelled accordingly. s91(2) provides that subject to s69, where a worker unreasonably refuses to have, or unreasonably obstructs, an examination by a medical practitioner, provided and paid for by the employer the employer may cancel or reduce the incapacity compensation payable to the worker until the examination takes place. Imprisonment s65A — a person is not entitled to receive incapacity benefits for periods of incarceration. Residing outside Australia unless the claimant provides, at intervals of not less than 3 months, a declaration, in the approved form (reg 6A) of continued incapacity – s65B. A maximum of 104 weeks is payable if a claimant resides outside Australia — s65B – unless the Court orders otherwise (maximum - a further 104 weeks) - s65B(4). s69 the worker ceases to be incapacitated for work.
Comcare	An employee’s right to compensation is suspended for unreasonable refusal to: undergo (or for obstructing) a rehabilitation assessment examination — s36(4) Safety, Rehabilitation and Compensation Act 1988 undertake a rehabilitation program — s37 (7), or undergo (or for obstructing) a medical examination — s57(2) Note: for suspensions under s36 or s37, rights to compensation for medical expenses under s16 continue where the suspension commenced on or after 7 December 2011. An employee’s right to compensation is suspended for failure to comply with any reasonable requirement of Comcare or the licensee where Comcare or the licensee takes over or initiates a 3rd party recovery action — s50(5) Should an employee fail to comply with a notice to give information or a copy of a document, Comcare or the licensee may refuse to deal with the claim — s58. Suspension of incapacity payments for periods of imprisonment for conviction of an offence — s23(2).
Seacare	An employee’s right to compensation is suspended for unreasonable refusal to: undergo (or for obstructing) a rehabilitation assessment examination — s49(4) Seafarers Rehabilitation and Compensation Act 1992 undertake a rehabilitation program — s50(5), or undergo (or for obstructing) a medical examination — s66(2) An employee’s right to compensation is suspended for failure to comply with any reasonable requirement of the employer where the employer takes over or initiates a third party recovery action — s59(9). The employer may refuse to deal with the claim if an employee fails to comply with a notice to give information or a copy of a document — s67(3).
DVA	Military Rehabilitation and Compensation Act 2004 (MRCA) Failure to undertake a rehabilitation assessment or program or a medical examination where required, or to comply in relation to third party proceedings, compensation (other than treatment) may be suspended — ss50, 52, 329 and 397. Suspension of incapacity payments and Special Rate Disability Pension for periods of imprisonment for conviction of an offence — s122. Failure to provide certain information may result in refusal to deal with claim — s330. Safety, Rehabilitation and Compensation (Defence-related Claims) Act 1988 (DRCA) An employee’s right to compensation is suspended for unreasonable refusal to: undergo (or for obstructing) a rehabilitation assessment examination — s36, undertake a rehabilitation program — s37, undergo (or for obstructing) a medical examination — s57, or comply with a notice to provide information – s58. For common law claims against third parties, an employee’s right to compensation is suspended for failure to comply with any reasonable requirement of Comcare or the licensee where Comcare or the licensee takes over or initiates a 3rd party recovery action — s50. Suspension of incapacity payments for periods of imprisonment for conviction of an offence — s23(2). Note: for suspensions under s36 or s37, rights to compensation for medical expenses under s16 continue where the suspension commenced on or after 7 December 2011.
NZ	The Corporation may decline to provide any entitlement for as long as the claimant unreasonably refuses or unreasonably fails to: comply with any requirement of the Act relating to the claimant’s claim; or undergo medical or surgical treatment for their personal injury, being treatment that the claimant is entitled to receive; or agree to, or comply with, an individual rehabilitation plan — s 117(3), Accident Compensation Act 2001 Corporation may suspend, cancel, or decline entitlements: The Corporation may suspend or cancel an entitlement if it is not satisfied, on the basis of the information in its possession, that a claimant is entitled to continue to receive the entitlement. The Corporation must give the claimant written notice of the proposed suspension or cancellation within a reasonable period before the proposed starting date. The Corporation may decline to provide any entitlement for as long as the claimant unreasonably refuses or unreasonably fails to: comply with any requirement of this Act relating to the claimant’s claim; or undergo medical or surgical treatment for their personal injury, being treatment that the claimant is entitled to receive; or agree to, or comply with, an individual rehabilitation plan. (3A) If the Corporation declines, under subsection (3), to provide an entitlement for any period, the Corporation must start providing the entitlement again if satisfied that: subsection (3) no longer applies to the claimant; and the claimant is eligible to the entitlement. (3B) The Corporation is not required to make any payment of the entitlement for the period during which it was declined under subsection (3), even though it may have started providing the entitlement again under subsection (3A). However, the Corporation may make such payment if the Corporation believes that — exceptional circumstances exist; and it would be inequitable to refuse to do so. (3C) An entitlement that has been declined for any period under subsection (3) must be provided by the Corporation, with effect from the beginning of that period, if: the Corporation’s decision to decline to provide the entitlement for that period is: revised under section 65; or quashed on review or appeal; and the claimant was otherwise entitled to receive the entitlement for that period.