National Injury Insurance Scheme (NIIS) Return to Work Conference - - PowerPoint PPT Presentation

National Injury Insurance Scheme (NIIS)

Return to Work Conference 2017

Janene Hillhouse A/Senior Director – Workers’ Compensation Services Office of Industrial Relations

National Injury Insurance Scheme

• The National Injury Insurance Scheme (NIIS) is

a companion scheme to the National Disability Insurance Scheme

• Designed to ensure people who sustain the

most catastrophic personal injuries (serious personal injuries) have access to no-fault lifetime treatment, care and support.

National Injury Insurance Scheme

• The NIIS workplace and motor accident streams were

implemented in Queensland from 1 July 2016.

• Both NIIS streams are based on a consistent framework

and entitlements.

• National Injury Insurance Agency Queensland (NIISQ)

has been established to administer the scheme for motor accidents, and provides a service platform for the workplace accident stream.

NIIS - Workplace accidents stream

• The workers’ compensation scheme

already provided short-tail no-fault statutory compensation benefits

• NIIS provides lifetime treatment, care and

support payments for workers with serious personal injuries

• Interim and lifetime eligibility assessments
• Access to common law damages if

employer is at fault

• Insurers will engage NIISQ for claims

management

NIIS – Workplace accidents stream

• The workplace accident NIIS does not apply to:

– Journey claims – Ordinary recess claims – Serious and wilful misconduct – Claimants other than workers

Injuries covered by NIIS

Permanent spinal injury Serious brachial plexus injury High level or multiple amputations Traumatic brain injury Severe burns Permanent blindness

NIIS - Estimated injuries

• Motor vehicle accidents

– estimate 140 people in 2016-17

• Workplace accidents

– estimate 11 people per year

• Most common injuries estimated for workplace

accidents: – Brain injury – 78 per cent – Spinal cord injury – 14 per cent – Other – 8 per cent

NIIS - Entitlements

Medical treatment Rehabilitation Prostheses, aids Care; respite and appliances attendant and domestic assistance Ambulance transportation Dental Pharmaceuticals Educational and Home (Work)/ vocational training transport modifications

NIISQ - Guiding principles

How does it work?

Injured Worker (or Participant) 1.Hospitalised

• 2. Notification

and application

• 3. Eligibility

confirmed

• 4. Support

plan developed

• 5. Plan

funded, facilitated and delivered

• 6. Plan

monitoring and maintenance

Where are we at?

• New administrative arrangements between workers’

compensation insurers and NIISQ

• Workplace accidents stream - limited claims experience
• Motor accident stream - 43 accepted cases to date
• Key challenge for insurers is effectively managing dual

service delivery and dual liability where work-related motor vehicle accidents

NIISQ - Stakeholder Engagement

• medical and health services
• community service providers
• disability groups
• legal profession
• insurers (workers’

compensation/ CTP)

• researchers

Stakeholder Engagement in North QLD

• NIISQ is building relationships with:

– Townsville and Cairns Hospital Rehab Units – Primary health networks – Far North Queensland Allied Health Network

Further information

worksafe.qld.gov.au niis.qld.gov.au