When can the TAC stop income payments?
If you have an accepted TAC claim and you are in receipt of income payments, there are a few instances when TAC can stop your payments.
In each of these instances, the TAC must give you written reasons as to why your payments have stopped as well as provide you with adequate notice so you can make alternative arrangements for income support once your payments have stopped.
When you can return to work on an unrestricted basis
If you recover from your injury (or injuries) to the extent that it is no longer impacting your ability to work, then you will not be entitled to receive income payments from the TAC.
Here is an example:
Jonathan suffered injury to his neck and shoulder in a motor vehicle accident.
Jonathan is employed at an aged care facility and as a consequence of the injuries, his doctor certified that he was not to perform any heavy lifting for a period of three months after the accident.
During this three month period Jonathan was able to return to work but working in a modified capacity and reduced hours.
He was getting certified fit for modified duties only and was avoiding any heavy lifting or any work that might aggravate his injuries.
After three months, Jonathan’s GP certified him fit for a full return to work on an unrestricted basis.
The GP provided him with a certificate of capacity that he could return to work full time and as a consequence the TAC terminated his entitlement to ongoing weekly payments.
Reaching the end of the three year period
When a person that has been injured in a motor vehicle accident has received loss of earnings payments as well as loss of earning capacity benefits for three years post accident, in most cases their entitlement to income payments will then cease.
This is because the TAC legislation requires the TAC to pay income replacement benefits to a person for up to three years post accident.
In some cases however loss of earning capacity benefits do not cease after that three year period.
They do not cease if you have been assessed as having a 50% or more whole person impairment rating in relation to your impairment claim
Keep in mind however that only very serious injuries, or a collection of a number of injuries, ever get assessed as being 50% or greater whole person impairment.
Reaching 18 months post accident
A person may be entitled to loss of earnings benefits after an accident, which cease 18 months post accident.
However, at the 18 month mark the income benefits then become what’s called loss of earning capacity benefits.
Many people are entitled to loss of earnings benefits but not loss of earning capacity benefits as the assessment criteria is different.
The injury is no longer materially contributed to by the motor vehicle accident
Let’s say that you suffered an injury to your shoulder in a motor vehicle accident. And lets say also that you had, before the accident, a pre existing injury to your shoulder.
The TAC could say that the impact and restrictions of the shoulder injury that you suffered in the motor vehicle accident has ceased and that any residual incapacity is caused by the pre-existing shoulder injury that you had.
This is not something that is commonly done by the TAC but can happen.
Non-compliance with obligations
The TAC may suspend income payments for a period of time or even terminate them if a person does not comply with reasonable requirements.
This occurs for example when a person won’t return phone calls or correspondence from the TAC over a period of time, or doesn’t attend medical assessments that the TAC may have arranged, or does not appropriately engage in return to work or rehabilitation programs.
If the TAC believes that you’ve engaged in fraud, then obviously this would disentitle you to the payment of income replacement benefits as well as the termination of your payments which will likely take affect immediately.
The most common example would be if someone is obtaining income replacement benefits from the TAC and declaring that they are not working at all when in fact they are.
On each certificate of capacity that a person completes and sends off to the TAC, they must declare whether or not they are working.
If they declare that they are working, they must note the hours worked as well as other details relevant to their employment.
There are very significant financial penalties that a person who is made a false declaration in this regard may have to pay.
If you are in receipt of income replacement benefits and you were sentenced to a term of imprisonment, your entitlement to these benefits will cease while you serve the term of imprisonment.