New South Wales paramedics have lost their battle with the State Government to maintain death and disability payouts.

The Industrial Relations Commission (IRC) has ruled that the expected cost of maintaining the existing scheme was significant.

The IRC said the refusal of the Australian Paramedics Association (APA) and the Health Services Union (HSU) to engage in any meaningful way in the arbitral process greatly assisted the NSW Ministry of Health in achieving its outcome.

The HSU said some paramedics stood to lose about $500,000 worth of entitlements, leaving a maximum payout of about $123,000 available to them.

HSU counsellor and paramedic Terry Savage said paramedics were not asking for anything extra.

"It's not something we were asking for, it's something we've had for many years," he said.

"If I went to work today and I was killed at work, there's a substantially less amount that my family would have to survive on," he said.

Mr Savage said there also needed to be more safety training and support for paramedics to help them deal with security risks.