Existing NSW Workers Compensation Claims and the 1 July 2026 Reforms

A claim made before 1 July 2026 generally continues to be managed. Keep providing Certificates of Capacity where required, attend appropriate treatment, respond to insurer requests, record current earnings and work capacity, and keep copies of every decision. The reform date does not by itself cancel an accepted claim or remove an existing entitlement.

Different parts of the reforms have different commencement and transitional rules. A weekly-payment decision, treatment request, PIAWE dispute and permanent-impairment issue should therefore be checked separately rather than treated as one reform question.

• Keep the claim number, accepted-injury description and insurer contact details together.
• Retain Certificates of Capacity, work capacity decisions, treatment approvals and payment records.
• Record the date of every WPI assessment, agreement, offer and section 66 claim.
• Ask for the statutory and factual reasons if the insurer says a reform changes an entitlement.

SIRA describes an assessment or agreement made before 1 July 2026 as a pre-reform impairment assessment where it was relied upon to determine an entitlement to weekly payments, lump-sum compensation or work injury damages. Under the new arrangements, that assessment or agreement is taken to be the worker’s principal assessment for future compensation entitlements.

The principal assessment can affect weekly payments, medical and related expenses, section 66 lump-sum compensation, commutations and work injury damages. This is why an existing report should not be treated as relevant only to the payment originally being discussed.

A complying agreement entered into before 1 July 2026 can remain binding for the relevant statutory purposes. SIRA states that no new complying agreements under the former section 66A process can be entered into from 1 July 2026.

SIRA states that if a worker had a pre-reform permanent-impairment assessment before 1 July 2026 and had not yet claimed lump-sum compensation, the worker must make that claim before 1 July 2028. If the deadline applies and the claim is not made by then, SIRA says the worker will not be able to make the claim later.

The insurer or employer may contact workers who appear eligible, but a worker should not rely only on receiving a reminder. Check whether an assessment occurred, whether a section 66 claim was actually made, what injury and WPI the report covered, and whether a special scheme or exclusion applies.

This deadline is not a substitute for checking other limitation periods or procedural deadlines that may apply to the claim.

During the interim period from 1 July 2026 to mid-2027, a worker or insurer can arrange an assessment where the injury is thought to have a long-term impact. The assessor must be on the relevant SIRA list. The resulting agreed assessment becomes the principal assessment.

A worker must obtain independent legal advice before a permanent-impairment assessment and before entering a permanent-impairment agreement. That advice should address how the assessment may affect all relevant entitlements, not only a possible section 66 amount.

If the worker and insurer cannot agree on the degree of permanent impairment, the insurer must issue a written decision. The disagreement may then be referred to the Personal Injury Commission as a medical dispute.

From 1 July 2026, a further assessment is not available merely because symptoms continue or another doctor gives a different estimate. SIRA states that the worker and insurer must agree there has been an unexpected and material deterioration since the previous assessment.

SIRA describes that deterioration as one that was not expected at the earlier assessment and that increases permanent impairment by at least 10 percentage points. Age-related deterioration is not treated as unexpected. A request should be supported by medical evidence, and SIRA says the insurer should respond within 21 days.

• Updated treating reports explaining what changed and when.
• New imaging, operative records or test results linked to the deterioration.
• The earlier assessment and the clinical assumptions made at that time.
• A clear request to the insurer identifying the statutory further-assessment issue.

A short chronology and complete documents usually answer the transition question more reliably than a recollection of the percentage. Gather the original claim, accepted-injury notices, every permanent-impairment report, insurer assessment, offer, section 66 claim, complying or permanent-impairment agreement, and any Personal Injury Commission certificate.

Also retain current medical evidence, imaging and operative reports, because the accepted injury and the condition actually assessed may not be identical. If there are several injury dates or body systems, identify which report belongs to each injury.

The standard transition summary does not apply identically to every scheme. Exempt workers, coal miners, emergency volunteers, dust-disease claims and certain older injuries can be governed by different provisions. A worker with one of these categories should obtain scheme-specific advice rather than applying the general one-assessment summary.

The same caution applies where the worker has multiple injury dates, separate physical and primary psychological impairment, or an earlier assessment that was never relied upon for an entitlement. Those facts can change the analysis.

A worker obtained a WPI report in late 2025. The report was used when the insurer reviewed weekly-payment entitlement, but the worker cannot find a section 66 claim or insurer lump-sum response. The practical task is not to arrange another assessment immediately. The worker should retrieve the report and claim file, confirm whether a lump-sum claim was ever made, and obtain advice about the 1 July 2028 transition before taking further action.

This example illustrates document checking only. It does not establish that the worker is eligible for a lump sum or predict the result of a claim.