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 10:15 – 10:40 • Act Overview – PIAWE SIRA 10:40 – 11:10 • Act Overview – Other Amendments SIRA 11:10 – 11:30 • Break 11:30 – 11:40 40 • Implementation Overview – Dispute Resolution SIRA 11:40 – 11:50 • Implementation Overview – Enquiries and Complaints SIRA 11:50 – 12:00 • Implementation Overview – PIAWE SIRA 12:00 – 12:10 • WIRO Update WIRO 12:10 – 12:40 • Workers Compensation Commission Update WCC (SIRA) 12:40 – 12:50 • Next Steps and Close SIRA 12:50 – 1:00 Please note this session is being recorded 2
Session Objectives • Provide information on the objectives and application of the Workers Compensation Legislation Amendment Act 2018 • Provide on overview of the implementation and commencement of the provisions of the Act • Provide an opportunity to hear from the Workers Compensation Commission and the Workers Compensation Independent Review Officer regarding changes arising from the Act 3
The Case for Change La Law and nd Ju Justice ce • The Legislative Council Law and Justice Committee in its 2016 ‘ first review of the workers compensation scheme ’ made a number of recommendations regarding dispute resolution to the NSW Government. The report was released in March 2017 • The NSW Government in its response to the report in October 2017 indicated that it supported or supported in principle the recommendations Dispu pute resolut ution revi view • Central Policy Office commenced an independent review of the workers compensation dispute resolution system in November 2017 • A discussion paper was issued with responses received and consultation closing in February 2018 • On 4 May 2018 Minister Victor Dominello announced that as result of that review legislation would be introduced to Parliament to address the recommendations of the Law and Justice Committee 4
The Case for Change • The calculation of a worker’s PIAWE is fundamental to ensuring that workers receive accurate payments • Consistent feedback from stakeholders was that the current methodology was unnecessarily complex • SIRA has undertaken extensive consultation in relation to the current arrangements for PIAWE • SIRA engaged independent expert Professor Tania Sourdin who provided a report to SIRA following additional stakeholder consultation • Professor Sourdin’s report recommended legislative amendment to achieve a single, simplified definition of PIAWE – how this would be applied in practice was not addressed • Government response was to amend the Workers Compensation Act 1987 to simplify the determination of PIAWE 5
The Case for Change Mini nisterial ann nnoun unce cement nt – 4 May 201 018 • Minister Dominello announced that as result of that review, legislation would be introduced to Parliament to address the recommendations of the Law and Justice Committee • Minister Dominello said we will: • improve support services, simply claims processes and remove duplication • deliver a one-stop shop for resolving disputes, enabling faster resolution The reforms also include: • all injured worker enquiries and complaints, not resolved by the insurer in the first instance, will be directed to the Workers Compensation Independent Review Office (WIRO) • all employer and other system participants enquires and complaints will be referred to the State Insurance Regulatory Authority (SIRA), and • the Workers Compensation Commission (WCC) will undertake all dispute resolution, removing these functions from SIRA and WIRO 6
The Case for Change The following key outcomes were considered in developing the proposed amendments including Dispute Resolution and PIAWE: • Simp mple – the process should be logical, easy to apply to a range of working arrangements with fewer complexities than currently exist • Transpa Tr parent – the process should be clearly articulated in a way in which insurers, employers and workers can understand and explain • Fair and nd equ quitable – the process should provide consistent outcomes for injured workers (where practicable) 7
Act Overview – Dispute Resolution Schedule 1 – Amendme ments ts Relati ating to Dispute te Resoluti tion Wo Work k ca capa paci city revi views • Repeals Part 3, Division2, Subdivision 3A, Reviews of Work Capacity Decisions Ju Jurisdi dict ction n of the he Wo Worke kers Compe mpens nsation n Commi mmission (WC WCC) • Amends section 43 (1) • Repeals section 43(3) • Deletes the note under section 105 • Ensures that for Work Capacity Decisions there is no limitation on the powers of the WCC to award weekly payments when reviewing a work capacity decision Funct ctions of SIRA & & WIRO • Repeals all functions related to Work Capacity Decision disputes 8
Act Overview – Dispute Resolution Sche chedu dule 1 – Ame Amend ndment nts Relating g to Dispu pute Resolut ution Singl gle Deci cision Notice ce • Repeals section 54 and section 74 • Introduces a Division 3 (sections 76 – 85) Internal revi views • Internal review is now optional • Requirements have been aligned with the existing optional review requirements • Regulations can prescribe how internal reviews are to be conducted • Regulations can prescribe how notice may be given of an internal review • Regulations may require an insurer to conduct a review if a dispute is lodged in the Commission 9
Act Overview – Dispute Resolution Current pathways for resolving a dispute Internal review Merit review by Procedural Insurer fails to Work capacity Section 54 by Insurer SIRA review by WIRO determine claim decision or makes a decision on a compensation Appeal to NSW Liability, medical & claim that a Court of Appeal permanent claimant Section 74 (point of law only) impairment disputes disagrees with Workers Compensation Commission or Supreme Court (judicial review) depending on type of dispute New pathway for resolving a dispute Insurer fails to Work capacity Appeal to NSW determine claim decision Optional Internal Court of Appeal or makes a Single review by Insurer Workers (point of law only) decision on a Decision (mandatory if Compensation or Supreme Court compensation Notice requested by Commission (judicial review) claim that a Liability, medical & claimant) depending on type claimant permanent of dispute disagrees with impairment disputes 10
Act Overview – Dispute Resolution Sche chedu dule 1 – Ame Amend ndment nts Relating g to Dispu pute Resolut ution Work k ca capa paci city stay • Stay does not apply to internal reviews • Stay will only apply if application for dispute has been lodged in the Commission before the period of notice expires Wo Work k ca capa paci city lega gal co costs • Repeals section 44BF • Legal costs will be prescribed in schedule 6 as per other legal activities in the Commission • Will allow legal costs to be paid for both Claimant and Insurer • Claimant legal costs will be paid through ILARS as administered by WIRO 11
Act Overview – Dispute Resolution Sche chedu dule 1 – Ame Amend ndment nts Relating g to Dispu pute Resolut ution Comme mmence ceme ment and d transition • To be commenced on a date to be proclaimed – proposed for 1 January 2019 • All work capacity decisions from Commencement will use the new dispute pathway • All work capacity decisions prior to Commencement will continue to use the existing dispute pathway • Any work capacity disputes resolved under the exiting review process cannot be brought to the Workers Compensation Commission • After a 6 month “Transitional Review Period’ all work capacity disputes will use the new dispute pathway 12
Act Overview – Dispute Resolution 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) • Repeal section 65(3) • Introduce regulation making power regarding referrals to an AMS One ne assessment nt • Clarifies for the purpose of section 322A that a determination by an Arbitrator is a ‘one assessment’ App ppeals • Clarifies that appeals of a determination are to be heard as per the normal Arbitrator appeal process Comme mmence ceme ment and nd trans nsition • Upon commencement the Commission will be able to determine any referrals to an AMS • It is expected that matters already in progress will continue as normal 13
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