Can family be paid for care after a work injury in NSW?

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.

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.
• Diary entries from the family member or helper, with dates, times, and tasks.
• 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.