Why am I only being paid for 13 weeks? (Interim payments and PAWE delays)
A common NSW CTP problem is receiving interim weekly payments while the insurer says PAWE (pre-accident weekly earnings) is still not determined. In practice, this can leave claimants underpaid or stuck after the interim period. The key issue is usually evidence and insurer delay in making a formal PAWE decision. Quick answer: ask for the PAWE worksheet and written reasons now, submit one indexed earnings pack, and escalate quickly if no formal determination follows.
Quick answer
A common NSW CTP problem is receiving interim weekly payments while the insurer says PAWE (pre-accident weekly earnings) is still not determined. In practice, this can leave claimants underpaid or stuck after the interim period. The key issue is usually evidence and insurer delay in making a formal PAWE decision. Quick answer: ask for the PAWE worksheet and written reasons now, submit one indexed earnings pack, and escalate quickly if no formal determination follows.
Why this guide is structured this way
This page is written to help NSW CTP claimants understand deadlines, evidence, insurer decisions, and dispute pathways in plain language without overstating outcomes.
General information only. Your position depends on your facts, evidence, insurer response, and applicable time limits.
Official legal frame and public sources
These links are not a substitute for advice, but they are the main public-source anchors behind many NSW CTP questions on this page.
Top questions answered
Does interim payment mean my claim is denied?
Not necessarily. Interim payment usually means PAWE is not finalised yet. But if it drags on, it can still harm your weekly benefits unless challenged quickly.
Can the insurer just keep saying PAWE is not ready?
They must act reasonably and make determinations based on available evidence. If you have provided documents and there is ongoing delay, request written reasons and escalate.
What if I have irregular income or overtime?
Irregular earnings are often where PAWE errors happen. Provide full records and ask the insurer to show exactly what was included and excluded in the calculation.
What is usually happening
The insurer starts weekly payments on an interim basis because it says it does not yet have enough material to calculate your final PAWE. Interim payments are not meant to be a permanent position.
If PAWE is not properly determined, your weekly payments can remain too low, stop, or be adjusted late with avoidable dispute risk.
Why claimants hear “13 weeks”
Many claimants are told payments are only secure for an initial period (often around 13 weeks) while income evidence is gathered and checked. This is usually an administrative/evidence issue, not the final legal entitlement position.
The real priority is to push the insurer to make a clear PAWE determination as early as possible, with reasons and calculations in writing.
Documents to submit for PAWE calculation
To assist PAWE determination, claimants should provide a clean earnings bundle quickly. Common documents include:
- recent payslips and payroll summaries
- PAYG payment summaries / income statements
- employment contract and ordinary-hours/overtime evidence
- bank statements showing wage deposits
- for self-employed claimants: tax returns, BAS, P&L statements, invoices and contracts
Submit documents in one indexed pack where possible and keep proof of submission dates.
If documents were already provided
If you already provided what was requested, chase the insurer in writing and ask for:
- a formal PAWE determination date,
- the exact calculation methodology used, and
- any remaining document gaps (if they still allege gaps).
If the insurer delays or under-calculates earnings, escalate through internal review and then the PIC merit review pathway.
First 7 days when interim payments are reduced/stopped before PAWE is determined
If payments are cut or stopped before any clear PAWE decision is issued, move fast and keep the issues separated.
- Day 1: Request the exact decision relied on, legal basis, and PAWE worksheet/calculation notes in writing.
- Days 1–2: Send a short issue map splitting (a) interim-payment conduct and (b) PAWE-calculation dispute.
- Days 2–4: Lodge a rights-preserving internal review with your core indexed earnings bundle, even if some records are still pending.
- Days 4–7: File supplementary evidence with a dated addendum table so the insurer/PIC can track exactly what changed and why.
This structure prevents a mixed letter from freezing the whole claim and protects your deadline position.
Practical next steps
- Request the insurer’s PAWE worksheet and written reasons.
- Cross-check omissions (overtime, allowances, variable shifts, multiple employers).
- Diarise review deadlines immediately.
- If unresolved, file the dispute quickly with supporting earnings evidence.
Frequently asked questions
- Does interim payment mean my claim is denied?
- Not necessarily. Interim payment usually means PAWE is not finalised yet. But if it drags on, it can still harm your weekly benefits unless challenged quickly.
- Can the insurer just keep saying PAWE is not ready?
- They must act reasonably and make determinations based on available evidence. If you have provided documents and there is ongoing delay, request written reasons and escalate.
- What if I have irregular income or overtime?
- Irregular earnings are often where PAWE errors happen. Provide full records and ask the insurer to show exactly what was included and excluded in the calculation.
- What dispute pathway usually applies for PAWE issues?
- PAWE disputes commonly run as merit-review style disputes after internal review steps, depending on the exact decision and timing.
- What if the insurer combines PAWE, capacity, and treatment issues in one letter?
- Split the issues into separate tracks in your response so each decision has its own evidence and deadline. This avoids a single mixed letter delaying every part of your claim and makes internal review/PIC escalation cleaner.
- What should I do if a review deadline is under 7 days away?
- File a rights-preserving review application immediately with the decision letter and core earnings evidence, then provide supplementary records in an indexed addendum as soon as possible.
- How should I label my review filing so the insurer cannot misread the issue?
- Use a clear cover heading such as “Internal Review Request — PAWE Calculation Dispute (Decision Date: DD/MM/YYYY)” and list each disputed component (for example overtime, allowances, shift loadings, second employment) against evidence tab numbers.
- What if interim weekly payments are reduced or stopped before any clear PAWE decision is issued?
- Ask for the exact decision being relied on, the legal basis, and the calculation sheet immediately. In your written response, separate interim-payment conduct from the PAWE-calculation dispute, attach your indexed earnings evidence, and lodge a rights-preserving review without waiting for perfect records.
- If PAWE is later corrected upward, can I recover the shortfall from interim underpayment?
- Often yes, but only if the timeline and evidence are clean. Keep a dated record of what was paid, what should have been paid on your corrected calculation, and when each supporting document was provided. Ask for written arrears calculations and challenge any unexplained date cut-offs.
Route-specific public sources for PAWE delay disputes
If the insurer says your weekly payments are only interim because PAWE is still unresolved, these are the public sources most worth checking alongside your decision letter and wage records.
Motor Accident Injuries Act 2017
Check the Act for the weekly benefits framework, PAWE concepts, and the statutory basis for insurer decisions affecting earnings-based payments.
SIRA Motor Accident Guidelines
Useful for how insurers should handle claims, communicate decisions, and manage review steps when weekly benefits or earnings calculations are disputed.
Personal Injury Commission, lodge a dispute
Confirms the external dispute pathway if internal review does not fix the PAWE calculation or the insurer continues to delay a proper determination.
SIRA, what you can claim
A claimant-facing overview of weekly benefits and related entitlements, which helps you sense-check whether the insurer’s interim position matches the broader scheme.
Top questions answered on this route
These are the claimant questions this page is designed to answer quickly before you move into review or PIC escalation.
Why am I only getting 13 weeks of payments?
Usually because the insurer says PAWE has not been finalised yet, not because your whole claim has been lawfully rejected.
What documents usually unblock the insurer?
A single indexed earnings pack, including payslips, tax records, contract terms, and evidence of overtime, allowances, second jobs, or self-employment income.
What if the insurer has already had my documents for weeks?
Ask for the PAWE worksheet, written reasons, and the exact missing items they still rely on, then protect your review deadline instead of waiting indefinitely.
Where do I escalate if the insurer still delays or undercalculates PAWE?
Start with internal review and then move to the Personal Injury Commission if the issue remains unresolved.