If you’re recovering from a work injury and relying on workers’ compensation payments to get by, one of the most pressing questions on your mind is probably: how long can this actually continue? It’s a fair question, and the answer depends on a few things that are worth understanding clearly.

A note on terminology: throughout this article, “WorkCover” is used as a general reference to Queensland’s workers’ compensation insurers, including WorkCover Queensland and licensed self-insurers. Both operate under the same legislative framework, the Workers Compensation and Rehabilitation Act 2003 (Qld).

The Three Things That Can Stop Your WorkCover Payments

Under section 144A of the Workers Compensation and Rehabilitation Act 2003, your entitlement to weekly payments stops when the first of the following happens:

1. Your incapacity stops. If you recover to the point where you can return to work, even in a modified or reduced capacity, your weekly payments may reduce or stop. You don’t need to be fully recovered. It simply means your incapacity arising from the work-related injury is no longer ongoing.
2. You’ve received five years of weekly payments. This is the hard legislative cap. Once five years of weekly payments have been paid for the same incapacity, your entitlement to further weekly payments for that injury stops entirely. Most claims never reach this point. The more common pathway is the IME and DPI process explained in the next section.
3. You reach the maximum compensation amount. Under section 140 of the Act, the maximum weekly payment entitlement for one injury or multiple injuries from the same event is 216.15 times QOTE (Queensland Ordinary Time Earnings). Once payments reach that ceiling, they stop.

Why Most Claims End Before Five Years: The IME and DPI Process

The five-year limit is the legal boundary, but it is rarely what ends a claim. The more common pathway is this.

At some point during your claim, WorkCover may form the view that your injury could have reached maximum medical improvement. This means WorkCover believes your condition may have stabilised and may be unlikely to improve significantly with further treatment. WorkCover is not a medical professional and cannot make that determination itself. Instead, WorkCover will refer you to an independent medical examiner (an IME) to assess whether that is actually the case.

If the IME confirms that your injury has reached maximum medical improvement, you will then be assessed for your Degree of Permanent Impairment (DPI). A doctor measures the extent of any lasting impairment from your injury and assigns a percentage. That percentage determines whether you are entitled to lump sum compensation and, if so, how much.

Once a Notice of Assessment is issued, weekly payments typically stop 20 business days after you receive it. If your DPI is greater than 0%, the notice will include an offer of lump sum compensation. You will have a decision period to accept, defer or take other steps, depending on the percentage and your circumstances. Getting legal advice before you respond to that notice is worth considering, because the decisions you make at that point can have lasting consequences.

Do Medical Expenses Stop at the Same Time as Weekly Payments?

Not necessarily. Your weekly payments and your medical treatment entitlements do not always end at the same moment.

Under section 144B of the Act, your entitlement to payment of medical treatment, hospitalisation and expenses stops when two things are both true: your weekly payments have stopped, and medical treatment is no longer required to manage the injury because it is unlikely to improve with further treatment.

In practical terms, WorkCover may continue covering medical expenses after weekly payments stop, as long as ongoing treatment is still genuinely needed. If you have questions about whether your treatment entitlements are continuing correctly, that is worth clarifying with a lawyer who handles workers’ compensation claims.

What to Do If Your WorkCover Payments Are Reduced or Stopped

WorkCover can review your claim at any point. If WorkCover forms the view that your incapacity has resolved, that you can return to work, or that your injury may have reached maximum medical improvement, WorkCover can move to reduce or stop your weekly payments well before five years.

If that happens and you believe the decision is wrong, you have the right to dispute it. Under section 542 of the Act, an application for review must generally be made within three months of receiving the written decision. If the notice did not include reasons, the three-month period runs from when you receive those reasons. Act quickly if you receive a decision you disagree with.

A lawyer experienced in Queensland’s workers’ compensation scheme can help you understand whether a decision to stop your payments is legally sound and guide you through the review process if it isn’t.

Not every claim needs a lawyer. If your injury is minor, your recovery is straightforward and WorkCover is handling things without problems, you may not need legal representation. Engaging a lawyer on a modest claim can sometimes mean legal costs erode what you receive. But if your payments have been stopped or reduced, your claim has been disputed, you’ve received a Notice of Assessment you’re unsure about, or you believe negligence played a role in your injury, getting advice early is worth it.

At AX Compensation Lawyers, we work on a No Win, No Fee* basis for workers’ compensation claims. That means you don’t pay legal fees unless your claim is settled.

Not sure where you stand after a decision about your WorkCover payments? Book an obligation free consultation with our team. It takes about 15 minutes, and there is no obligation to proceed.

Frequently Asked Questions

How long can you be on WorkCover in Queensland?

Weekly workers’ compensation payments can continue for up to five years under section 144A of the Workers Compensation and Rehabilitation Act 2003. In practice, most claims end earlier, when an independent medical examiner confirms the injury has stabilised and a DPI assessment follows. Payments can also stop if your incapacity resolves or the statutory compensation cap is reached.

Can WorkCover stop my payments before five years?

Yes. WorkCover can review your claim at any time. If WorkCover believes your injury may have reached maximum medical improvement, they will refer you to an independent medical examiner. If that is confirmed, a DPI assessment follows and weekly payments typically stop 20 business days after a Notice of Assessment is issued. Payments can also stop earlier if your incapacity resolves or the maximum compensation amount is reached.

What is a DPI assessment?

A DPI (Degree of Permanent Impairment) assessment measures the extent of any lasting impairment from your work injury. It happens after an independent medical examiner confirms the injury has stabilised. The percentage result determines whether you are entitled to lump sum compensation and, if so, how much.

Can I challenge a decision to stop my WorkCover payments?

Yes. Under section 542 of the Workers Compensation and Rehabilitation Act 2003, an application for review must generally be made within three months of receiving the written decision. If the decision notice did not include reasons, the three-month period runs from when you receive those reasons. Act quickly if you receive a decision you disagree with.

Have questions about your legal rights after a workplace injury in Queensland? Book an obligation free consultation with AX Compensation Lawyers. Our team can explain how the workers’ compensation process works and what your options are. There is no obligation to proceed.

This article was written by the team at AX Compensation Lawyers, personal injury lawyers helping Queenslanders understand their rights after an injury.