Described as landmark changes for injured workers, several reforms commenced on the 16 October 2015. These reforms are to benefit injured workers with the highest needs, those with injuries in returning to work and most importantly apply these benefits equitably for all injured workers. Changes are also being made to weekly benefits, Independent Medical Examinations (IME’s) and retiring age. We explain these changes in more below.
Injured Worker Reforms – The key changes effecting injured workers from the 16 October 2015 are as follows:
- Increased amount of lump sum compensation for permanent impairment
- Increased death benefit lump sum amount from $528,400 to $750,000
- Increased maximum for funeral expenses from $9000 to $15,000
Changes are also being made to weekly benefits and retiring age.
Injured workers are now entitled to up to 12 months of weekly payments of compensation after reaching retiring age, whether they were injured before or after 1 October 2012. When the weekly payments of compensation end, a further 12 months of medical benefits are available immediately.
Changes to IME’s for injured workers
iCare (previously WorkCover NSW) have made changes regarding the referral process for Independent Medical Examinations (IME’s).
The changes are effective from 26 October 2015 are in response to identified feedback from injured workers when requested to attend an IME.
Key changes include:
Choice of IME
The injured worker will now be provided with a choice of 3 examiners. The list of examiners will be provided to reduce unnecessary travel time and will provide injured workers with the opportunity to select their preference. Examiners will be allocated based on the injured workers residential address.
The below criteria will apply:
– Examiner location must be located within a 30 km radius from the worker in the first instance
– The radius is extended to 50 km, then 70km and finally to 100km if this is the nearest examiner that can be found
– Examiner is recommended as otherwise discussed with and agreed to by the worker
Existing IME protocol
– Referral criteria for IMEs continue to be based on a claim having inadequate or inconsistent medical information available. There must be documented evidence on which demonstrates attempts made to communicate with the treating Doctor and/or treating Specialist via phone call, fax or initiating case conferencing
– An injured worker is entitled to have a support person present with them at an IME appointment, providing the examiner is aware and consents. An injured worker is also entitled to have an interpreter present if this is necessary
– To prevent potential financial hardship, it is expected that reasonable out of pocket expenses are met by the insurer prior to the appointment or in conjunction with the appointment time frame. Reimbursements will be provided for relevant meals, transportation and accommodation (where applicable)
-The injured worker will be advised in writing at least 10 working days before the appointment. If less than 10 days is provided, the injured worker can refuse without impact on their entitlements