Needs and expenses

In all cases, when considering reducing an employee's section 19 payment, careful and objective consideration must be given to costs in relation to:

  • mortgages, loans, insurance and other budgetary expenses relating to major items owned by the employee, such as a house and car;

  • medical insurance;

  • membership fees to organisations;

  • clothing and toiletries;

  • books, magazines and periodicals;

  • entertainment/gifts; and

  • other personal needs.

It is a matter of balancing an individual case between those costs and needs an employee has:

  • as a long-term hospital patient, which do not fall into “maintenance”, but rather more “enjoyment of life” factors;

  • expenses the employee must continue to contribute to outside the hospital environment;

and the period the employee is expected to remain in hospital.  As a matter of course, circumstances will vary from employee to employee.

Example

A patient who will never recover from his compensable injuries has few needs that are not provided for by medical and hospital expenses, and no outstanding expenses.

Payment of half the employee's full NWE may be justified in this case.

However, medical evidence may indicate that an employee is improving in health, with a discharge from hospital likely at some stage in the future.

Reduction of payment in this circumstance is not justifiable.

Please note that, where an employee's entitlement is reduced, and it falls under the redemption threshold for weekly benefits, a lump sum payment under section 30 cannot be made.

A fortnightly payment to the employee under section 22 should continue to be made for as long as applicable.

Source URL: https://clik.dva.gov.au/military-compensation-reference-library/historical-information/comcare-operations-manual/volume-ten-incapacity-payments/part-eight-other-liability-issues/incapacity-employees-hospital-extended-period-section-22/things-consider-when-determining-payment-0