The role of a RTW Coordinator is vital to achieving cost effective and durable return to work’s for people suffering from a work related injury or illness. Every state or territory has different requirements, so what happens in the ACT?
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.
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.
Independent
research shows Mental Illness is the fastest growing workplace injury and is
costing hundreds of billions per year.
The
Australian Council of Trade Unions has welcomed some recommendations from the
Productivity Commission, including no-liability treatment for mental health
injuries and claims.
Psychological
health and safety should be treated with the same importance as physical health
and safety and WHS in the workplace.
ACTU conducted
a survey this year and I was found that over 60% of respondents had experienced
mental illness due to their employer failing to manage psycho-social hazards in
the workplace. It was also found in this survey that nearly half of
participants felt their employers were not prepared to support workers
experiencing mental illness in the workplace.
For all NSW workers compensation policy holders with a 30 June 2018 Renewal date, the deadline to submit Declaration of Actual Wages was 31 October 2018. If you have missed this date, your submission is now overdue. icare has advised that the policy adjustment process will soon commence for those submitted before this date.