NSW workers compensation blog
Can family be paid for care after a work injury in NSW?
Family help after a serious work injury can be essential, but NSW workers compensation does not treat every helpful task as payable care. The safer question is whether the help is domestic assistance that is reasonably necessary, planned, verified, and within the legal limits.
Published by NSW Work Injury Claim, the workers compensation service of Stephen Young Lawyers · Published 3 May 2026 · Updated 21 July 2026
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Overview: can family care be paid?
Sometimes. Section 60AA requires a medical practitioner to certify, after a functional assessment, that the assistance is reasonably necessary as a direct result of the compensable injury. The assistance must also satisfy the but-for test: it would not otherwise have been provided because the worker performed the relevant domestic tasks before the injury. A care plan and proper verification are required. If a family member provides unpaid care, payment is available only if that person lost income or forewent employment to provide it.
- Do not assume ordinary family help is automatically reimbursable.
- Get medical support that explains what household tasks the injury prevents.
- Ask the insurer to establish or confirm the domestic assistance care plan.
- Keep a signed diary of the services, dates and hours.
- For unpaid family care, keep proof of the provider's lost income or employment foregone.
- If refused, ask for written reasons and check whether a section 78 notice or medical expense dispute pathway applies.
Sources
This guide is based on section 60AA of the Workers Compensation Act 1987 (NSW) and the current SIRA Workers Compensation Guidelines. It is general information only, not legal advice about your individual entitlement. Sources were reviewed on 21 July 2026.
Workers Compensation Act 1987 (NSW), section 60AA · SIRA Workers Compensation Guidelines
What counts as domestic assistance?
Domestic assistance is help with household tasks the worker can no longer do, or can only do with unsafe pain or risk, because of the compensable injury. SIRA describes examples such as household cleaning, laundry, lawn or garden care, and transport that is not covered as a medical, hospital or rehabilitation expense. The key is not whether the task is helpful in a general sense. The key is whether the work injury has created a task need that is reasonably necessary to meet.
That is why the evidence should connect the task to the injury. A shoulder injury may explain why hanging washing, vacuuming, or carrying groceries is unsafe. A back injury may explain why bending, lifting, lawn mowing, or prolonged driving is not realistic. A psychological injury may create different functional issues, but the claim still needs clear medical explanation rather than broad statements that the worker is struggling at home.
When the helper is a spouse, parent, child, or friend
Family-provided assistance is often called gratuitous domestic assistance because the worker has not paid for it and is not liable to pay for it before approval. That does not mean it is worthless. It means the insurer will usually require a stricter paper trail before payment is approved.
SIRA guidance indicates that once gratuitous domestic assistance is approved, the insurer pays the person providing the assistance, not the worker. Providers must submit a diary of what they have done before the insurer approves and pays compensation. In practice, a vague statement such as “my wife helps around the house” is usually too thin. A better record says who helped, the date, the task, time spent, why the worker could not safely do it, and whether the task appears in the care plan.
There is an additional condition for gratuitous assistance: the provider must have lost income or foregone employment to provide the help. The diary should be signed by the provider and the worker, if the worker is able, and record the date, services and hours. Family help without that financial consequence does not satisfy the statutory payment condition merely because it was valuable or time-consuming.
Important caution about limits
The temporary domestic assistance pathway is limited. SIRA states temporary assistance may be up to 6 hours per week for a total period of 3 months. Longer or more substantial assistance may depend on permanent impairment and other statutory requirements. Do not build a claim on assumed hours without checking the current legal basis and insurer reasons.
Temporary assistance must be provided under the relevant injury management plan. Outside that temporary pathway, section 60AA generally requires an assessed permanent impairment of at least 15%, along with the other conditions. The insurer's care plan should be established with the worker and medical practitioner within 21 days after the claim is received, based on the assistance accepted as reasonably necessary.
Practical request process before payment is expected
A domestic assistance request is easier to assess when it is framed as a practical support plan, not a general complaint that home life has become harder. The request should show the injury-related task need, the proposed helper, the expected hours, and how the need will be reviewed.
Step 1
Describe the injury-related household task need
List the domestic tasks the worker did before the injury, what has changed, and why the compensable injury now prevents or restricts those tasks.
Step 2
Get medical practitioner certification
Ask a medical practitioner to record the functional assessment and certify why the assistance is reasonably necessary as a direct result of the compensable injury.
Step 3
Confirm the care plan and provider details
Ask the insurer to confirm the domestic assistance care plan, including task types, expected frequency, hours, review dates, and whether the helper is a family member or commercial provider.
Step 4
Keep diary records before payment is expected
The helper should record the date, service, hours and injury-related reason. The provider and worker, if able, should sign the diary. Keep copies of what is sent to the insurer.
Step 5
Respond to written insurer reasons if refused
If the insurer refuses payment, compare the reasons with the medical evidence, care plan, diary entries, section 60AA requirements, SIRA guidance, and any section 78 notice.
The worker should also keep the broader claim pathway in mind. If the care request depends on permanent impairment evidence, review the WPI assessment guide. If the insurer issues a formal liability dispute, read the section 78 response timeline before deadlines or review options are missed.
Evidence checklist before asking the insurer to pay
The strongest domestic assistance requests are practical and task-specific. They do not simply say the worker is injured. They show what changed at home because of the injury, how often the task is needed, and why the requested assistance is proportionate.
- Current certificate of capacity and treating doctor notes showing functional restrictions.
- A short list of household tasks the worker did before injury and cannot safely do now.
- Medical explanation linking those restrictions to the accepted work injury.
- Care plan details, including tasks, frequency, hours, review dates, and provider details.
- A diary signed by the provider and worker, if able, recording dates, services and hours.
- For gratuitous care, wage records or employer evidence showing income lost or employment foregone by the provider.
- Photos or practical evidence where useful, such as stairs, lawn size, laundry access, or mobility barriers.
- Written insurer approval before assuming payment will be made, unless urgent circumstances require advice about the risk of proceeding.
If treatment, equipment, travel, or home help are all being disputed together, keep the categories separate. Domestic assistance is not the same as section 60 medical treatment, and treatment travel can raise different evidence issues. Mixing categories can make it easier for an insurer to refuse everything as unclear.
What if the insurer refuses family care or domestic assistance?
Ask for the refusal in writing. The reasons matter. The insurer may say the assistance is not reasonably necessary, not injury-related, outside the temporary limit, unsupported by a care plan, not verified by diary records, or affected by a WPI threshold issue. Each reason needs a different response.
If the dispute is really about medical support, speak to your nominated treating doctor about a clearer report. If the dispute is about the care plan, ask the insurer what part of the SIRA guideline process it says has not been met. If the dispute is about WPI, check whether a permanent impairment assessment or section 66 claim strategy is relevant. If the refusal arrives with a liability dispute, use the PIC disputes process guide to understand escalation.
FAQ: family care and domestic assistance in NSW workers compensation
Can my family be paid for care after a work injury?
Possibly, but only if all applicable conditions are met. These include medical practitioner certification, the but-for test, a care plan and verification. If care is gratuitous, the provider must also have lost income or foregone employment.
Is there a time or hour limit?
For temporary domestic assistance, SIRA states up to 6 hours per week for a total period of 3 months. Ongoing assistance may require different threshold analysis, including permanent impairment.
Who should keep the diary?
The provider should keep the diary and the worker should keep copies. The provider and worker, if able, should sign it. Record the date, services and hours.
Should I wait for insurer approval?
Usually, get the request and care plan clarified before assuming payment. If the situation is urgent, get advice because later reimbursement is not guaranteed.
What if the family member already helped before the injury?
Section 60AA requires the claimed assistance to be something that would not otherwise have been provided because the worker performed the relevant task before the injury. Pre-injury family help with the same task may therefore fail that test. A different or additional task may still need separate assessment if the worker performed it before injury and the compensable injury now prevents that.
Need help with a care expense refusal?
If the insurer has refused domestic assistance, family care payment, treatment, or a WPI-related support issue, get the reasons checked before the evidence window closes.