Update on COVID-19 claims in the workers compensation system
7 October 2022
At the start of the COVID-19 pandemic in 2020 there was considerable uncertainty around the impact that COVID-19 claims would have on the workers compensation system in NSW.
A range of policy and service delivery changes were implemented in response to ensure that the system continued to provide the necessary support and protection for those who are injured at work.
Legislative changes introduced a presumption where workers in prescribed employment who contract COVID-19 are presumed to have contracted the disease in the course of their employment. This change made it easier for workers in numerous high-risk industries to access workers compensation when diagnosed with the virus.
Workers not in prescribed employment could continue to claim workers compensation entitlements if they test positive to COVID-19 and it was contracted at work. As it is a disease injury, employment must be the main contributing factor to the worker contracting the virus.
This article presents a summary of the volume, performance and cost of COVID-19 claims in the NSW workers compensation system from 2019/20 to 2021/22.
Volume of COVID-19 claims
From 2019/20 to 2021/22, COVID related claims made up 4.5 per cent of all claims, which represented one in every 22 new claims. The vast majority of those claims occurred in 2021/22.
Self insurers experienced the highest proportion of COVID-19 claims based on their total claim numbers.
Number of new claims from 2019/20 to 2021/22 | COVID-19 claims | Non-COVID-19 claims | Total all claims | Percentage of total claims that are for COVID-19 |
|---|---|---|---|---|
System-wide | 13,301 | 282,133 | 295,434 | 4.5% |
Nominal Insurer | 3,553 | 187,802 | 191,355 | 1.86% |
Treasury Managed Fund | 4,351 | 47,448 | 51,799 | 8.40% |
Self insurers | 3,922 | 24,304 | 28,226 | 13.89% |
Specialised insurers | 1,475 | 22,579 | 24,054 | 6.13% |
Industries most impacted by COVID-19 claims
The top five industries impacted by COVID-19 claims from 2019/20 to 2021/22 is below.
2019/20 | 2020/21 | 2021/22 | |||
|---|---|---|---|---|---|
Industries | COVID-19 Claims | Industries | COVID-19 Claims | Industries | COVID-19 Claims |
Air and Space Transport | 26 | Police Services | 68 | Supermarket and Grocery Stores | 1868 |
Hospitals (Except Psychiatric Hospitals) | 21 | Hospitals (Except Psychiatric Hospitals) | 14 | Correctional and Detention Services | 1135 |
Police Services | NP | Child Care Services | NP | Casino Operation | 1080 |
Travel Agency and Tour Arrangement Services | NP | General Practice Medical Services | NP | Combined Primary and Secondary Education | 963 |
General Practice Medical Services | NP | Wooden Structural Fitting and Component Manufacturing | NP | Hospitals (Except Psychiatric Hospitals) | 877 |
*Numbers below 10 have not been provided and have been marked as NP.
Cost of COVID-19 claims
From 2019/20 to 2021/22, total payments on COVID-19 claims represented 0.25% of all claims payments. The average cost of a COVID-19 claim is significantly lower than other claims.
The average COVID-19 claim cost has reduced significantly from the beginning of the pandemic, from $31,000 in 2019/20 to $4,820 in 2021/22.
Average claim cost from 2019/20 to 2021/22 | COVID-19 claims | Non-COVID-19 claims | All claims |
|---|---|---|---|
System-wide | $5,313 | $32,952 | $32,434 |
Treasury Managed Fund | $6,291 | $39,972 | $38,818 |
Nominal Insurer | $8,632 | $34,139 | $33,913 |
Self insurers | $2,910 | $20,407 | $19,330 |
Specialised insurers | $2,849 | $21,840 | $21,449 |
Performance of COVID-19 claims
Workers with COVID-19 have generally returned to work much sooner than workers with other injuries.
In 2021/22, 91 per cent of people with a COVID-19 claim returned to work within four weeks, compared to 62 per cent of people with non-COVID-19 related claims.
Return to work data 2021/22 | COVID-19 claims | Non-COVID-19 claims | All claims | |
|---|---|---|---|---|
4 weeks | Scheme-wide | 91% | 62% | 66% |
Treasury Managed Fund | 93% | 58% | 67% | |
Nominal Insurer | 96% | 62% | 64% | |
Self insurers | 82% | 65% | 68% | |
Specialised insurers | 95% | 71% | 77% | |
13 weeks | Scheme-wide | 94% | 78% | 80% |
Treasury Managed Fund | 97% | 73% | 77% | |
Nominal Insurer | 98% | 79% | 80% | |
Self insurers | 85% | 80% | 78% | |
Specialised insurers | 97% | 84% | 87% | |
26 weeks | Scheme-wide | 92% | 83% | 83% |
Treasury Managed Fund | 98% | 77% | 77% | |
Nominal Insurer | 97% | 84% | 84% | |
Self insurers | 80% | 84% | 84% | |
Specialised insurers | 99% | 87% | 87% | |
Data is as at 31 July 2022, excluding the All claims column which is as at 31 May 2022.
COVID-19 claim data is based on nature of injury disease codes 855, 945 and 952.