The words in a Victorian WorkCover letter

Victorian letters are written out of two documents: the Workplace Injury Rehabilitation and Compensation Act 2013 and the WorkSafe Online Claims Manual, which is the operational instruction WorkSafe gives its agents. The manual is public, and it often says more about what the letter had to contain than the letter does.

Each phrase below gives three things: what it means in plain English, where it is defined so you can read the source yourself, and what it does not decide. That last line is the one that matters most, because most of the damage these letters do comes from reading a decision about one thing as a decision about everything.

This page describes published rules. It does not say anything about your claim. Nothing here means you have, or do not have, an entitlement. Only the scheme, an insurer or a court decides that, and a lawyer can tell you how the rules apply to your situation.

13 phrases, decoded

"second entitlement period" or "the 130 week review"

In plain EnglishThe second entitlement period is the block of 117 weeks of weekly payments that follows the first 13 weeks. Together they make 130 weeks. Payments stop at the end of it unless the conditions in the Act are met.

Where it is definedWorkplace Injury Rehabilitation and Compensation Act 2013 (Vic) s 163, and WorkSafe Victoria, second entitlement period FAQ, which defines it as "the period of 117 weeks that weekly payments are paid or payable following the first 13 weeks". For older claims the review requirement sits in s 93C of the Accident Compensation Act 1985.

What this does not decideMedical and like expenses. WorkSafe's own FAQ says the outcome "will not affect your entitlement to medical and like benefits including occupational rehabilitation services such as retraining and job-seeking assistance". It also decides nothing about any total and permanent disability (TPD) or income protection cover held inside superannuation, which is judged by an insurer under a policy, not by the scheme.

If a letter like this has arrivedOpen What happens next with this letter already ticked, and the scheme filled in.

"no current work capacity" and "current work capacity"

In plain English"No current work capacity" means a present inability, caused by the injury, such that the worker cannot return to work either in their pre-injury job or in suitable employment. "Current work capacity" means they cannot return to the pre-injury job but can return to some suitable employment.

Where it is definedWIRC Act 2013 (Vic) s 3 definitions. We have not reproduced the exact statutory wording here: the authorised Victorian text could not be retrieved in our last check, so nothing on this page is presented as a quotation from s 3.

What this does not decideWhether any job exists, or whether anyone is hiring. "Capacity" in this sense is a medical and vocational construct. It is not a statement that work is available near where the worker lives.

"likely to continue indefinitely" or "not likely to continue indefinitely"

In plain EnglishThe forward looking half of the 130 week test. A worker with no current work capacity keeps payments only if that state is likely to continue indefinitely.

Where it is definedWorkSafe Online Claims Manual 3.3.4.3, which instructs that the "not likely to continue indefinitely" ground should only be used where medical opinion confirms capacity will return in the foreseeable future, or the expected course of recovery says so, or "the duration of the worker's current incapacity can be defined and is proximate (e.g. < 9 months)", or there is a specific reason capacity will be gained.

What this does not decideIt is not a finding that the worker is fit for work. WorkSafe's own instruction puts a horizon of roughly nine months on the word "indefinitely". A decision on this ground with no defined and proximate recovery point sits outside the manual's own guidance.

"whole person impairment" (WPI) and "21% or more"

In plain EnglishA percentage score for permanent bodily and psychiatric impairment, assessed under the AMA Guides as adopted by the scheme. From 31 March 2024 it is a second, separate gate on payments past 130 weeks.

Where it is definedWorkSafe Victoria, second entitlement period FAQ: "For claims that reach 130 weeks after 31 March 2024, there is an additional requirement, that you have a permanent whole person impairment of 21% or more." How the figure is determined is set out at Claims Manual 3.3.4.1 to 3.3.4.9.

What this does not decideIt is not a measure of how much pain someone is in, what they earn, or whether they can work. It is also not the same number as a NSW or Commonwealth impairment figure, and it has nothing to do with a Centrelink impairment rating, which is scored in points on a different set of tables.

"Impairment Specialist" and "estimated WPI"

In plain EnglishA person working inside the claims agent, not a treating doctor and not an examining specialist, who completes an Initial Eligibility Review and writes down an estimate of the worker's whole person impairment before anyone examines them. That estimate decides who gets examined.

Where it is definedWorkSafe Online Claims Manual 3.3.4.1. Minimum qualification is completed AMA4 Guides training. For physical injury, the manual's own table says that where the estimate is 12% or less, assessment by a scheme-appointed impairment assessor (IIA) is "not required, administrative determination can be made", and capacity assessment is "not required".

What this does not decideAnything about the worker's actual impairment. It is an estimate made in house before examination. Its practical effect is that a worker whose estimate is 12% or less can reach a termination decision without ever being examined by an impairment assessor and without a capacity assessment.

"administrative determination" and "interim determination"

In plain EnglishTwo ways of fixing a whole person impairment figure without an examination. An administrative determination is made on the papers. An interim determination is made when impairment cannot be assessed at all, usually because the injury has not stabilised, and the agent estimates what it would probably be.

Where it is definedWorkSafe Online Claims Manual 3.3.4.2 and 3.3.4.8, citing WIRC Act ss 167C and 167D(2). The manual requires the agent to consider "whether determining the degree of impairment of the worker without an IIA is likely to disadvantage the worker".

What this does not decideIt does not settle the impairment figure for other purposes. The manual calls an administrative determination "only an indicator" of an impairment benefit entitlement, and says a full assessment must be obtained if the worker later makes an impairment benefit claim. Interim determinations cannot be referred by the agent directly to the Medical Panel, so they carry the narrowest dispute path of the three.

"Statement of Injuries" or "List of Compensable Injuries and/or Illnesses"

In plain EnglishThe list, attached to the decision letter, of exactly which injuries and illnesses the agent treated as part of the claim when it did the review.

Where it is definedWorkSafe Online Claims Manual 3.3.4.4, citing WIRC Act ss 167B(3), 167C(5) and 167E(2). The same section instructs agents not to include the impairment percentage in notices that rely on interim or administrative determinations.

What this does not decideIt is not fixed and it is not the final word on what the claim covers. It is disputable in its own right, and it frames any later impairment benefit claim. A condition missing from the list has effectively been left out of the decision.

"13 weeks' notice" and "the period of notice"

In plain EnglishHow long payments must keep running after the letter arrives before they actually stop.

Where it is definedWorkSafe Online Claims Manual 3.9.9. For termination solely on expiry of the second entitlement period: "13 weeks (91 days) plus time for postage if the notice is sent by post", with a reminder letter 28 days before it takes effect. Other terminations and reductions run 0, 14 or 28 days plus postage depending on how long payments have run. "The period of notice starts from the date the worker receives the notice."

What this does not decideIt is not the deadline for disputing, and it is not a courtesy. Claims Manual 3.9.5 says a worker can recover compensation where payments were wrongfully terminated, including where the agent failed to give the required period of notice, with the amount being the compensation payable during the whole or the balance of the notice period.

If a letter like this has arrivedOpen What happens next with this letter already ticked, and the scheme filled in.

"grounds relied on" and "reasons"

In plain EnglishThe two things a Victorian notice has to contain, alongside the decision itself, the date payments stop, and appeal rights.

Where it is definedWorkSafe Online Claims Manual 3.9.7: the agent must quote the wording of the relevant section in the statement of reasons, and must "possess and summarise the evidence, factual and/or medical, which supports the grounds relied on". Verbatim: "It is not valid to make a decision based on lack of evidence." Manual 3.9.6 adds that a notice missing the necessary information "could be invalid", which "could result in the claim being deemed accepted or payments being reinstated from the date of the invalid notice".

What this does not decideWhether the notice is valid is not decided by the notice itself. The manual sets out what has to be in it, and treats a deficient notice as a live issue rather than a formality. Nothing on this page says whether any particular notice meets that standard.

If a letter like this has arrivedOpen What happens next with this letter already ticked, and the scheme filled in.

"stabilised" and "material change"

In plain English"Stabilised" means the injury has settled enough to be measured. "Material change" is the trigger that lets a decision be revisited.

Where it is definedWorkSafe Online Claims Manual 3.3.4.5: "Stability is not a medical question capable of referral to the Medical Panel. If stability is in dispute, the question to be referred is the worker's WPI". Manual 3.9.12 says material change has no statutory definition, and "needs to be one that is real and quantifiable to the degree that it can easily be demonstrated to have positively (or negatively) impacted the worker's condition".

What this does not decide"Not stabilised" is not a finding that the injury is minor. It is a statement that the impairment question cannot be answered yet. Manual 3.3.4.9 says that where the Medical Panel finds an injury unstable, the termination stands, because the impairment question has not been answered.

"vocational assessment"

In plain EnglishAn assessment arranged during the 130 week review to identify types of work the worker might have capacity for.

Where it is definedWorkSafe Online Claims Manual 3.3.4.3. The agent must give the worker a list of at least three occupational rehabilitation providers to choose from, must explain that the purpose is "to identify suitable jobs that the worker has a capacity to perform", and must advise the worker "that the outcome could affect the worker's ongoing entitlement to weekly payments".

What this does not decideIt does not find a job and it does not offer one. It identifies job types. It is also not the decision: it produces material the agent then weighs.

"an examination the agent arranged"

In plain EnglishAn examination by a doctor the claims agent chose and paid, to give an opinion for the file. It is not treatment, and the examiner is not the worker's own doctor.

Where it is definedWorkSafe Online Claims Manual 2.7.2 and 2.7.3. The agent must give at least seven days' notice, confirm in writing, remind the worker at least 48 hours before, and provide an interpreter where one is needed rather than relying on the worker's family or friends. All psychiatric and psychological examinations are booked centrally by WorkSafe. Manual 2.7.3 lists reasonable grounds for non-attendance and requires the agent to obtain the worker's explanation before suspending payments.

What this does not decideNothing by itself. It produces an opinion the agent then weighs. It is not a treating relationship, and manual 2.7.2.5 says the examiner should not be asked for an opinion on matters outside their area of medical expertise.

"refer to a Medical Panel" and "request for conciliation"

In plain EnglishThe two roads out of a Victorian decision. Which one applies depends on what is being disputed, not on how strongly it is felt.

Where it is definedWorkSafe Online Claims Manual 3.3.4.5 and book 7. If the worker disputes impairment only, the agent must refer medical questions to the Medical Panels within 14 days. If the worker disputes anything else, or several things at once, the dispute goes to internal review or conciliation, and the manual says: "If a worker is unsure which issues they want to dispute, they should lodge a request for conciliation." A Medical Panel's opinion on a medical question referred to it is binding: under WIRC Act s 313(4) it "is to be adopted and applied by any court, body or person" and "must be accepted as final and conclusive by any court, body or person". Section 53A is the separate rule about impairment assessments, and it is not absolute: s 53A(1) makes an assessment final "for the purposes of this Act" but is expressly subject to s 53A(2), which allows a reassessment where the worker has had surgery for that injury and is being assessed for a claim under s 164A.

What this does not decideOne letter can carry two limbs with two completely different roads. Capacity can go to senior review, conciliation, WCIRS, arbitration and court. The 21% limb routes only to the Medical Panel and ends there. WCIRS review is expressly not available for a decision to stop weekly payments because impairment is not 21% or more, and not available for self-insurer decisions at all. A Panel opinion being binding also does not mean an impairment percentage can never be assessed again. Section 53A(2) of the Act expressly allows a reassessment where the worker has had surgery for that injury and is being assessed for a claim under s 164A.

Where this fits

• What happens at 130 weeks in Victoria: the payment schedule, with section numbers
• When your WorkCover payments change: the Victorian timetable, and what it does not decide
• The Letter Decoder: all five senders

Every phrase, section number and quotation on this page was checked against the sources linked above on 14 August 2026. Corrected 28 August 2026: the Medical Panel entry cited WIRC Act s 53A for a Panel opinion being binding. The binding provision is s 313(4), and s 53A allows a reassessment after surgery in the case it names. Both were read against the authorised text of the Act. If something has changed since, tell us and we will fix it: contact.