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.
1) 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.
2) 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.
3) 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.
4) 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.
5) 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.