Workers Compensation Legislation Amendment Act 2018
Stakeholder Forum
November 2018
Workers Compensation Legislation Amendment Act 2018 Stakeholder - - PowerPoint PPT Presentation
Workers Compensation Legislation Amendment Act 2018 Stakeholder Forum November 2018 Agenda Welcome and Session Objectives SIRA 10:00 10:10 The Case for Change SIRA 10:10 10:15 Act Overview Dispute Resolution SIRA
Stakeholder Forum
November 2018
SIRA 10:00 – 10:10
SIRA 10:10 – 10:15
SIRA 10:15 – 10:40
SIRA 10:40 – 11:10
SIRA 11:10 – 11:30
11:30 – 11:40 40
SIRA 11:40 – 11:50
SIRA 11:50 – 12:00
SIRA 12:00 – 12:10
WIRO 12:10 – 12:40
WCC (SIRA) 12:40 – 12:50
SIRA 12:50 – 1:00
Please note this session is being recorded
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Legislation Amendment Act 2018
the Act
Workers Compensation Independent Review Officer regarding changes arising from the Act
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La Law and nd Ju Justice ce
workers compensation scheme’ made a number of recommendations regarding dispute resolution to the NSW Government. The report was released in March 2017
supported or supported in principle the recommendations
Dispu pute resolut ution revi view
compensation dispute resolution system in November 2017
February 2018
legislation would be introduced to Parliament to address the recommendations of the Law and Justice Committee
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accurate payments
unnecessarily complex
PIAWE
SIRA following additional stakeholder consultation
simplified definition of PIAWE – how this would be applied in practice was not addressed
the determination of PIAWE
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Mini nisterial ann nnoun unce cement nt – 4 May 201 018
introduced to Parliament to address the recommendations of the Law and Justice Committee
The reforms also include:
instance, will be directed to the Workers Compensation Independent Review Office (WIRO)
to the State Insurance Regulatory Authority (SIRA), and
resolution, removing these functions from SIRA and WIRO
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The following key outcomes were considered in developing the proposed amendments including Dispute Resolution and PIAWE:
mple – the process should be logical, easy to apply to a range of working
arrangements with fewer complexities than currently exist
Transpa parent – the process should be clearly articulated in a way in which insurers,
employers and workers can understand and explain
nd equ quitable – the process should provide consistent outcomes for injured
workers (where practicable)
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Schedule 1 – Amendme ments ts Relati ating to Dispute te Resoluti tion
Wo Work k ca capa paci city revi views
Ju Jurisdi dict ction n of the he Wo Worke kers Compe mpens nsation n Commi mmission (WC WCC)
WCC to award weekly payments when reviewing a work capacity decision
Funct ctions of SIRA & & WIRO
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Sche chedu dule 1 – Ame Amend ndment nts Relating g to Dispu pute Resolut ution Singl gle Deci cision Notice ce
Internal revi views
Commission
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Insurer fails to determine claim
decision on a compensation claim that a claimant disagrees with Section 54 Section 74 Work capacity decision Liability, medical & permanent impairment disputes Internal review by Insurer Merit review by SIRA Procedural review by WIRO Workers Compensation Commission Appeal to NSW Court of Appeal (point of law only)
(judicial review) depending on type
Current pathways for resolving a dispute
Insurer fails to determine claim
decision on a compensation claim that a claimant disagrees with Single Decision Notice Work capacity decision Liability, medical & permanent impairment disputes Optional Internal review by Insurer (mandatory if requested by claimant) Workers Compensation Commission Appeal to NSW Court of Appeal (point of law only)
(judicial review) depending on type
New pathway for resolving a dispute
Sche chedu dule 1 – Ame Amend ndment nts Relating g to Dispu pute Resolut ution Work k ca capa paci city stay
before the period of notice expires
Wo Work k ca capa paci city lega gal co costs
Commission
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Sche chedu dule 1 – Ame Amend ndment nts Relating g to Dispu pute Resolut ution Comme mmence ceme ment and d transition
dispute pathway
brought to the Workers Compensation Commission
new dispute pathway
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Sch chedu dule 2 – Ame mendm dments relating to me medi dica cal assessments for pe perma manent imp mpairme ment Referral to an App pprove ved Medi dica cal Spe peci cialist (AMS)
One ne assessment nt
‘one assessment’
App ppeals
appeal process
Comme mmence ceme ment and nd trans nsition
AMS
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Sch chedule 3 – Ame mendm dments relating g to pr pre-injury ave verage ge weekl kly earnings gs Simp mplifi fied me methodology y The amendments are designed to provide a simplified PIAWE methodology:
working arrangements
reflective of the worker’s actual pre-injury earnings
Struct cture
Guidelines
with the changes in the way workers earnings are determined (if required)
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Sche chedu dule 3 – Ame Amend ndment nts relating ng to pr pre-inj njury ave verage ge weekl kly earni nings gs Meaning g of pr pre-injury ave verage ge weekl kly earnings gs
injury earnings received by the worker for work in any employment in which the worker was engaged at the time of injury
prescribed by Regulation
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Sch chedu dule 3 – Ame mendm dments relating g to pr pre-injury ave verage ge weekl kly earnings gs Meaning g of pr pre-injury ave verage ge weekl kly earnings gs – releva vant earning pe period d
injury
for example:
unpaid leave within the relevant earning period
promotions, demotions, change in hours, change in role, or payment of bonuses
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Sch chedu dule 3 – Ame mendm dments relating g to pr pre-injury ave verage ge weekl kly earnings gs Ag Agreement nts relating g to PI PIAW AWE
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Sch chedu dule 3 – Ame mendm dments relating g to pr pre-injury ave verage ge weekl kly earnings gs Ind ndexation
Simpler approach:
injury is no longer required - repeal of s82A(3) of the 1987 Act
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Sche chedu dule 3 – Ame Amend ndment nts relating ng to pr pre-inj njury ave verage ge weekl kly earni nings gs PI PIAWE for short term m worke kers
weekly average of the earnings that the worker could reasonably have been expected to have earned during the period of 52 weeks after
purposes of determining earnings, for example:
the prospective earnings be used?
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Sch chedu dule 3 – Ame mendm dments relating g to pr pre-injury ave verage ge weekl kly earnings gs PI PIAW AWE for app pprent ntice ces, traine nees and nd youn ung g pe peopl ple
workers when they reach 21 years of age
and he / she continued in the employment concerned
3 of the Workers Compensation Act 1987)
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Sche chedu dule 3 – Ame Amend ndment nts relating ng to pr pre-inj njury ave verage ge weekl kly earni nings gs Earnings gs
the week, for example base rate of pay, allowances, piece rates, commissions, shift penalties and overtime loadings
benefit
benefit has been provided and whether the worker is entitled to it
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Sche chedu dule 3 – Ame Amend ndment nts relating ng to pr pre-inj njury ave verage ge weekl kly earni nings gs Monetary va value of non-mo monetary be benefi fits
payable’ where FBT does not apply
Meaning of ‘current weekly earnings’
employment
earnings plus shift and overtime
weekly payment formulae
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Sche chedu dule 3 – Ame Amend ndment nts relating ng to pr pre-inj njury ave verage ge weekl kly earni nings gs Current and d no cu current work k ca capa paci city
Sect ctions 36-38 - weekl kly payme ment nts
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Sche chedu dule 3 – Ame Amend ndment nts relating ng to pr pre-inj njury ave verage ge weekl kly earni nings gs In summa mmary, the Regu gulations ma may pr provi vide de for:
circumstances in the employment
earnings
weekly payment)
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Sche chedu dule 3 – Ame Amend ndment nts relating ng to pr pre-inj njury ave verage ge weekl kly earni nings gs In summa mmary, the Guide delines ma may ma make ke pr provi vision for:
with the PIAWE working group
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Sche chedu dule 3 – Ame Amend ndment nts relating ng to pr pre-inj njury ave verage ge weekl kly earni nings gs Comme mmence ceme ment and d transition
allowances removed after 52 weeks (based on date of injury)
confirmed
commencement (based on date of injury)
commencement
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Sch chedu dule 4 – Ame mendm dments relating g to information sharing Information sharing
including complaints
Data requ quired d to be be sup uppl plied d by by ins nsur urers
matters
and other services or the detection of fraudulent claims
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Sche chedu dule 4 – Ame Amend ndment nts relating g to inf nformation sha haring ng Manda datory notifica cation
Comme mmence ceme ment
Regulatory framework to developed following commencement
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Sch chedule 5 – Ame Amend ndment nts relating ng to ind ndexation Indexa xation
by regulation
Comm mmencemen cement and transition
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Sche chedu dule 6 6 – Ame Amend ndme ments relating ng to mo motor acci ccide dent nts sche cheme me Reco cove veries
to entitlements payable under each scheme
Medi dica cal be benefi fits
the life time medical benefits that they are entitled to under the CTP scheme
Comme mmence ceme ment and nd trans nsition
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Sch chedu dule 7 – Misce cellaneous Ame mendm dments SIRA A Board
Clarify tha hat the he NS NSW W legi gislation is co cons nsistent nt with h the he Na Nationa nal Inj njur ury Ins nsur urance nce Sch cheme me (NIIS)
‘catastrophic injuries’ have access to lifetime compensation for medical, hospital and rehabilitation.
Workp kplace ce Rehabi bilitation
regarding return to work programs
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Sch chedu dule 7 – Misce cellaneous Ame mendm dments Summa mmary of the Act ct
regarding the summary of the Act (if you are injured at work poster)
available
Comme mmence ceme ment and d transition
and apply from 1 July 2018
apply from that date
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Dispu pute resolution steering g co commi mmittee
Pl Planned d co comme mmence cement
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Regu gulation n cha chang nges
Regu gulation co consultation
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Gui uide deline ne cha chang nges
Guide deline co consultation
be held on 5 November 2018
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Othe her cha chang nges
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Pr Propo posed d ch change ges
Injured d worke kers
insurer in the first instance will be directed to the WIRO
Emp mployers
referred to SIRA
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Enqu quiries and d co comp mplaints – SIRA’s role
Information pr provi vision and d regu gulation – SIRA’s role
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Enq nqui uiries and nd co compl mplaint nts – WIRO’s role
relating to their insurer
Inde depend pendent Le Lega gal Aid d and d Revi view Servi vice ce (ILA LARS)– WIRO’s role
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Dispu pute resolut ution steering g co commi mmittee
Impl mplement ntation act ctivi vities
Imp mplementation
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Dispu pute resolut ution steering g co commi mmittee
PI PIAW AWE worki king ng gr group up
Pl Planned d co comme mmence cement
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Regu gulation ch change ges
Regu gulation n co cons nsul ultation
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Guide deline ch change ges
Guide deline co consultation
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Other ch change ges
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Amendments relating to dispute resolution (Schedule 1)
Workers Compensation Legislation Amendment Bill 2018
Worke kers Comp mpen ensa sation ion Comm mmissio ission
iagin ing Work k Capacit acity y Disput utes es
WCD – TRIAGE
WCD + LIABILITY WCD ONLY REGISTRAR’S DELEGATE REPLY
(Optional)
TELE CONFERENCE DECISION
7 Days 14 Days
ARBITRATOR SERVICE REPLY CON/ARB
7 Days 14 Days 14 Days 7 Days
TELE CONFERENCE
21 Days
COD
Where ca can I find d mo more information?
Any questions regarding the Act email SIRA at: disputereforms@sira.nsw.gov.au
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This presentation may contain information that relates to the regulation of workers compensation insurance, motor accident third party (CTP) insurance and home building compensation in NSW. It may include details of some of your obligations under the various schemes that the State Insurance Regulatory Authority (SIRA)
found at the NSW Legislation website legislation.nsw.gov.au. This presentation does not represent a comprehensive statement of the law as it applies to particular problems or to individuals, or as a substitute for legal advice. You should seek independent legal advice if you need assistance on the application of the law to your situation. This material may be displayed, printed and reproduced without amendment for personal, in-house or non-commercial use.