Australia Day 2019
Wishing you a happy & safe Australia Day. With best wishes from ABILITY GROUP
Dispute Resolution Reforms
Injury Management
Beginning 1 January 2019, the State Insurance Regulatory Authority (SIRA) are applying new reforms to the workers compensation dispute resolution process to align with the Workers Compensation legislation Amendment Act 2018.
The goal of these changes is to minimise dispute by streamlining the system, making it easier and more effective for claims processing and support services.
5 key changes which bring positive effects to the injury management process:
- The Workers Compensation Commission (WCC) will now resolve all disputes, as they now have mandatory internal reviews for injured workers.
- The option to apply for an internal review of the insurer’s decision is still available.
- For a work capacity decision or review of liability, the insurer is required to respond within 14 days. Worker legal costs for reviews of work capacity decisions will be met by Independent Legal Assistance & Review Service (ILARS).
- Notice of insurer decision
- Existing notice templates will need to identify information received from the employer and considered in addition to information received from workers and insurer.
- The insurer is the first point of contact workers compensation complaints and enquiries in the first instance. Injured workers, employers and service providers also have the option to also call the iCare Complaints & Enquiries team on 13 99 22.
- Unresolved complaints and enquires for employers will be directed to SIRA on 13 10 50 or contact@sira.nsw.gov.au.
- Unresolved complaints and enquires for workers will be directed to Workers Compensation Independent Review Office (WIRO) on 13 94 76 or contact@wiro.nsw.gov.au.
- If a worker has a complaint about their employer or provider, they are advised to contact SIRA.
- Permanent impairment compensation without referral to an Approved Medical Specialist may be awarded by the WCC in certain circumstances.
Other smaller changes include:
- The mandatory electronic delivery of workers compensation information to employees
- Changes to the definition of PIAWE to include shift and overtime allowances, and ability to settle on PIAWE rate in certain circumstances.
- Injured workers who receive workers compensation benefits as well as CTP damages for the same injury will only need to repay to the workers compensation insurer the amount of weekly payments received.
- Injured workers who were identified to be in the ‘catastrophic injury’ category will continue to receive medical benefits under the workers compensation scheme, even if they commute their weekly benefit entitlements.
If you would liek to discuss or need help, please contact us to discuss.
The state of the Workers’ Compensation reform
In recent years, the reforms surrounding NSW Workers Compensation have received criticisms of poor practices from employers. The 2015 changes divided the workers compensation system into the State Insurance Regulatory Authority (SIRA), Insurance and Care NSW (iCare) and SafeWork NSW in an effort to produce a more effective and dedicated response to claims.
The NSW Business chamber highlights inefficiencies in the system which are inflating insurance expenses and negatively impacting both employers and employees. These proposed inefficiencies include poor claims management practices, causing delays to medical and rehabilitation services to workers – which ultimately cause a rise in premium costs. Moreover, inappropriate approval of claims, poor advice and low levels of support for employers and employees have also been blamed.
However, despite the complaints and calls for an urgent review of the system, a spokesman for NSW Treasurer Mr Perrottet mentioned it has brought about massive improvements. Since 2015, they have boasted reduced business premiums, increased worker support and elimination of the scheme debt, which compared to the old scheme, is a huge improvement. The predicted $4.1 billion deficit, premium increases of 28% and failure to help injured workers have supposedly been rectified by these reforms.
The business chamber have scheduled meetings with a number of workers’ compensation stakeholders to address these criticisms.
Further information:
Source: Insurance News
Title: NSW Treasurer hits back after workers’ comp criticism
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