Tag Archives: WorkCover

Prescribed Amounts and other Workers’ Compensation payments for 2014/2015

WorkCover WA releases variations in Prescribed Amounts and other Workers’ Compensation payments for 2014/2015

WorkCover WA today announced the new limits payable under the Act.

Key elements of the revised Prescribed Amounts are:

  • Maximum payment: $212,980.00 (up from $206,742)
  • Medical and hospital expenses: $63,894.00 (up from $62,023)
  • Vocational rehabilitation expenses: $14,909.00 (up from $14,472)
  • Weekly payments: $2,594.20 (up from $2,448.50)

These increases are effective from 1st July, 2014.

Injured employees who are currently in receipt of the maximum weekly compensation of $2,448.50 may be entitled to an increase. You should seek advice from your insurer before making any changes to the approved weekly compensation rate.

The Recommended Prescribed Amount and other Workers’ Compensation Payments for 2014-2015 are available here from the WorkCover WA website.

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Proposed Changes to WA’s Workers’ Compensation Legislation

In Western Australia, the current Workers’ Compensation and Injury Management Act 1981 (the Act) has been amended a number of times and consequently is difficult to understand and apply. WorkCover WA recently published a discussion paper outlining proposals to re-draft the Act. The discussion paper was designed as the basis for consultation with a range of stakeholders in the WA workers’ compensation system, including insurers, rehabilitation providers, lawyers and industry groups.

As an employer advocate, Aurenda made a submission and our perspective on the Review focussed on changes that will particularly impact on the ability of employers to effectively manage their injured employees and the negative impact on claims costs, future premiums and the effective operation of their business.

The scope of the Review is wide and varied, with more than 160 recommendations to ‘improve’ the WA workers’ compensation system.

Some salient points we focussed on are:

  • The Act will not be amended, rather re written with a focus on “plain speech”. We fully support this recommendation.
  • Currently, an injured employee who is in receipt of weekly compensation and commences maternity leave continues to receive their full weekly compensation payments. We propose that weekly compensation should be suspended for the period of the applicable maternity leave period. This is an aspect of the current legislation that clearly contradicts the intent of the legislation, since the injured employee is not able to participate in the return to work process and therefore should not be entitled to compensation during that period. This was not contained within the recommendations – we have asked that this be addressed.
  • Failure to attend or participate in medical reviews arranged under s64 and s65 still requires focus. The Review proposes a consolidation of the sections but does not address any consequence for the non-attendance or participation in the medical reviews. These medical reviews are crucial to an employer in progressing their injury management obligations as well as the general management of the employee’s injury. We recommended an immediate suspension of weekly compensation where there is failure to attend or participate in a medical review that is scheduled under these sections of the Act.
  • The proposal to remove s92(f) as a mechanism to settle and resolve claims is not an option we support. It is crucial to allow both the employee and employer an opportunity to resolve the dispute over entitlement. This provides closure and certainty for the injured employee. It also allows the insurer to close the claim which provides certainty to the employer of impact on their insurance policy.
  • Removal of the common law election period under s93M is proposed. This is not supported as the election provides an understanding of the injured employees’ intentions in respect of their future entitlements (a statutory claim or a common law claim) and this invariably motivates their compliance and return to work motivation. The added benefit of an election is knowing the likely cost exposure of the claim which assists employers with premium negotiations.
  • It is proposed the twelve month time limit of notice of injury be removed (s178). We have not supported that change as the notification allows an employer to manage the injured employee in the workplace to ensure no further injury or aggravation, it also ensures that any changes to the system of work can occur or document the circumstances in the event a claim is made in the future and documentation is required by the insurer. Furthermore, if an employee believes they have a workplace injury why would they not want to report it to their employer within a reasonable timeframe and 12 months is not an onerous timeframe.
  • The proposal to allow people other than doctors to issue medical certificates is not a concept we support. The doctors (treating or second opinion) are key to providing an objective and evidence-based approach to determining an injured employee’s need for treatment and/or incapacity to work. Allowing other allied health providers the authority would diminish the integrity of the system as well as possibly expose the system to rort.
  • The recommendation to allow payment of small claims on a Without Admission of Liability basis to a cap of $750 is a good initiative but clarity will be required on the type of injuries and that it relates to medical expenses claims only.
  • Clarification and simplifying the rate of pay calculation is a welcome initiative. It is likely, however, that will mean there will be no step down rate after 13 weeks incapacity and the step down provides an incentive to motivate a return to work. We recommended an across the board reduction of 15% after 13 weeks incapacity. This is consistent with the approach taken in other jurisdictions.
  • It is proposed an injured employee can receive their permanent impairment lump sum entitlement and leave their claim open to receive the balance of their entitlements. This will increase the costs to the system and contribute to the longevity of claims.   We have opposed this recommendation.
  • Under s69 a Form 6 is required to be submitted if an injured employee is out of the State more than three months. The Review recommends weekly compensation to be suspended until the required form is submitted. We supported this amendment but further clarity on the frequency of the submission of the form is required as well as whether weekly compensation is backdated once there is compliance with the necessary forms evidencing an ongoing incapacity.
  • The proposed revisions of s84AA is pleasing as it addresses some of the ambiguity for an employer when they are terminating employment contracts which, invariably, are not related to the injury or claim process.

The process of ‘reviewing the Review’, amending recommendations, seeking further feedback from stakeholders and drafting a completely new version of the Workers’ Compensation Act will take a great deal of time and commitment from WorkCover and the Government. We are pleased to represent employers’ interests in this significant project.

 

Footnote: Chris White, WorkCover CEO, stated that WorkCover received more than 70 submissions to the Review and that they are impressed with the constructive feedback that has been provided.

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Injury Management is our business

An interesting article was published in Australian newspapers last week. It was the story of a truck driver who works for a mining company in WA. It is a story about rights: the rights of the injured worker and the rights of the employer. Reading the article is seems that there is much confusion out there about the WA Workers’ Compensation legislation. And as the articles title goes to show, for the person who has never had to deal with it, it can be a quagmire of lawyers, committees, departments, insurers and doctors.

http://www.smh.com.au/comment/greg-ross-caught-up-in-work-cover-quagmire-20130827-2sn2c.html

The position we take at Aurenda is that the employer is a mining company. Their core business is mining. They have full intentions of keeping their employees and contractors safe and uninjured. Nobody wants the people who are doing work for them, to be hurt in anyway.

Some mining companies choose to keep their injury management entirely in-house with no reference to external specialists to assist them . As injury management specialists we believe this is toying with danger. As much as they have a human resources department to oversee it, the reality is that these are human resource specialists with a mining focus not injury management specialists.

We can see from this article that the people coordinating the injury management are attempting to do their best with good intentions. The reality is that they just don’t have the experience of a company like ours, where what we do is Workers’ Compensation and Injury Management day in, day out. We have seen just about every possible permeation of workplace injury and a library of case studies to guide us in times when the case is unusual.

A company we work with recently sent us some feedback for one of our injury management managers:

  • Timely communication – quick to notify of any issues (e.g. attendance, non-compliance, performance problems)
  • Quick return of requested documentation (e.g. within a few hours of request)
  • Effective management – takes on board our suggestions, open to feedback and eager and willing to cooperate with Injury Management strategies
  • Solutions-focused approach – rather than taking an obstructive approach re: what can’t be done or why that’s hard, he works with us to find a solution and how he can help

If all these points had been applied to the case highlighted in the newspaper, perhaps the conflict may not have arisen.

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WorkCover WA releases variations in Prescribed Amounts and other Workers’ Compensation payments for 2013/2014

WorkCover WA today announced the new limits payable under the Act.

Key elements of the revised Prescribed Amounts are:

  • Maximum payment: $206,742.00 (up from $198,365)
  • Medical and hospital expenses: $62,023.00 (up from $59,510)
  • Vocational rehabilitation expenses: $14,472.00 (up from $13,886)
  • Weekly payments: $2,448.50 (up from $2,351.80)

These increases are effective from 1st July, 2013.

Injured employees who are currently in receipt of the maximum weekly compensation of $2,351.80 may be entitled to an increase. You should seek advice from your insurer before making any changes to the approved weekly compensation rate.

The Recommended Prescribed Amount and other Workers’ Compensation Payments for 2013-2014 are available here from the WorkCover WA website.

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New workers’ compensation laws proclaimed – common law insurance

Following up from Aurenda‘s blog last year (Unintended Consequences of WA’s WC Amendments) the Governor in Executive Council proclaimed 1 August 2012 for the commencement of the Workers’ Compensation and Injury Management Amendment Act 2012.

The supporting Workers’ Compensation and Injury Management Amendment Regulations 2012 are also effective from 1 August 2012.

These legislative changes clarify common law insurance requirements under the Workers’ Compensation and Injury Management Act 1981 (the Act) as a result of legal uncertainty over the scope of the insurance obligation introduced on 1 October 2011 by the Workers’ Compensation and Injury Management Amendment Act 2011.

The legislative changes:

  • Clarify the definition of ‘damages’ for insurance purposes.
  • Provide that employers do not require common law insurance under the Act for ‘deemed workers’ – that is, workers of whom the employer would not be the employer but for being deemed an employer under sections 175 or 175AA for compensation purposes.
  • Retrospectively preserve insurance arrangements for employers of deemed workers insured under public liability insurance arrangements by preventing the denial of cover on the basis that the employer was required to be insured under the Act from from 1 October 2011 to 1 August 2012.
  • Limit, modify or exclude any requirement to hold insurance in respect of liabilities in prescribed circumstances or out of prescribed events. These are consistent with current employer indemnity arrangements and include:
    • a $50 million insurance limit on common law liabilities arising out of a single event.
    • an insurance exclusion regarding any liability to pay compensation or damages arising out of events such as war, military or usurped power.
    • an insurance exclusion regarding any liability to pay damages in respect of injuries occurring outside of Australia or in a jurisdiction outside of Australia.
    • an insurance exclusion regarding any liability to pay compensation or damages in respect of specified industrial diseases arising from employment in any mine or mining operation.
  • Preserve terms, conditions and exclusions in employer indemnity policies to the extent these comply with the corrective amendments in the Amendment Act and Regulations.

For further information on the legislative changes please contact Mr Kevin Gillingham, Manager Policy and Legislative Services at WorkCover WA, on 9388 5640.

Source of this article is Workcover WA

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WOP/WOL Payment of Wages while a Claim is Pended

In the Western Australian workers’ compensation system, it is generally accepted that entitlements such as medical investigations and treatment, and even vocational rehabilitation, can be funded on a Without Prejudice/ Without Admission of Liability (WOP/WOL) basis while liability on a claim is being determined.

A recent situation experienced by one of our clients has caused us to consider WOP/WOL issues in greater depth.

An insurer advised an employer – a client of both Aurenda and the insurer – to pay wages to an injured worker on a WOP/WOL basis even though the claim was pended and the worker was not at work.

When queried on this advice, the insurer stated that they sometimes advise employers to pay wages when in all probability the claim will be accepted. The insurer believes that paying wages will negate the need for the employee to lodge an application at Conciliation and Arbitration Services (CAS), where an order to pay wages may be granted anyway. The insurer also feels that by paying wages in these circumstances, the employee may be deterred from seeking legal advice.

In our experienced opinion, under NO circumstances should wages be paid – even on a WOP/WOL basis – until the claim has been accepted.

Our reasons for this are as follows:

  • If you’re going to pay wages – why pend the claim?
  • If you think in all probability the claim will be accepted – why not just accept the claim, why bother with the investigations?
  • Paying the wages gives no incentive for the employee to make any attempt to return to work – especially in circumstances when the workers’ compensation rate of pay is greater than their base rate of pay.
  • There is no evidence that the employee will not seek legal advice while the claim remains pended.
  • If an application is made at WorkCover for wages to be paid (when the claim is pended) an order is not always granted in favour of the employee.
  • Once wages payments have commenced, it is difficult to stop them – this would no doubt require a visit to CAS at WorkCover in any case. This could also be an incentive for workers to drag out the resolution process.
  • A worker could justifiably assume their employer has accepted liability for their injury if wages are paid prior to investigations taking place.
  • It doesn’t set a great precedent for other workers if everyone who lodges a claim is paid, regardless of whether their claim is accepted.
  • If the claim is accepted, the employer will be obliged to back-pay wages. If the claim is declined, however, and the employer has paid wages on a WOP/WOL basis, it is not possible to recoup these wages from the worker.

We believe that all workers who suffer a legitimate workplace injury are entitled to fair compensation for their injury. Sometimes, however, claims are pended because more information is required to assess the injury and determine liability – and sometimes injuries are not compensable. A very small percentage of workers fall into this situation. The fact that the employer has identified significant cause for concern, in our opinion, means that they should not bear the additional onus of paying wages when there is no legal obligation to do so. The best interests of all parties are served by everyone, including the worker, focusing on a fast determination of liability. A focus on a solution is always Aurenda’s preference.

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May 6, 2012 · 6:55 am

Workers’ Compensation systems around Australia

Australia has 10 different Workers’ Compensation systems, each with its own method of calculating funding requirements to meet anticipated compensation entitlements for injured workers under each unique model. Judging by recent coverage in the media, not all states have got this right.
Here is the state of affairs at the moment
New South Wales
NSW WorkCover deficit will be $4.1 billion – a $1.7 billion slide in six months. Premier O’Farrell will be slashed workers’ compensation rights and payouts to rein in a $4 billion WorkCover deficit and encourage employers to employ more staff.
An article in the Daily Telegraph says “Workers compensation premiums in NSW are double those in Victoria – and the government says employers will end up facing premiums four to five times higher if the scheme is not reformed. A NSW cleaning company paying $150,000 in annual wages currently forks out $10,681 as a base premium. Similar firms in Melbourne and Brisbane would pay $3709 and $4901 respectively.”

From the daily telegraph

South Australia
A $222 million blowout in the unfunded liability of the South Australian scheme has created more headaches for the government and businesses struggling to pay growing premiums. The latest actual figures to December 31 show the unfunded liability has grown from $952m to $1.174bn in just six months. The unfunded liability was $55m in June 2001.
Victoria
Victorian Premier Mr Baillieu plans to use funds ($471.5 million over the next four years) from Victoria Workcover Authority (which is in the black) to plug holes in the Victorian budget. He plans to take the funds from the Victorian WorkCover Authority over the next four years.
Western Australia
In Western Australia the system of workers’ compensation payments is completely different. WA’s workers compensation is run privately and insurers are responsible for the WC liabilities. Other than their own government agencies, the WA government does not have any payment responsibility.

At Aurenda we work with companies to in all these states to reduce their workers’ compensation costs.

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