According to the WorkCover Independent Review Office (WIRO), amendments made to WorkCover NSW in 2012 have left the program “overly complex and a source of confusion and frustration for all scheme participants”.
WorkCover NSW watchdog calls for simpler system
Amendments made to WorkCover NSW in 2012 have left the program “overly complex and a source of confusion and frustration for all scheme participants”, according to the WorkCover Independent Review Office (WIRO).
Two pieces of legislation that govern the scheme – the Workers’ Compensation Acts 1987 and 1998 – should be merged into one, it suggests in a discussion paper.
As part of an inquiry called the Parkes Project, WIRO is consulting employers, insurers, injured workers and lawyers about the changes made in 2012.
“What we are trying to say is that life should be simpler for a worker and it should not be so difficult for a worker to find their way through the system,” WorkCover Independent Review Officer Kim Garling told insuranceNEWS.com.au.
A final report will reach the State Government by the end of this month or early next month, he says.
The paper identifies problems including conflicting definitions of injury, complicated multiple claims processes and unclear explanations of employer return-to-work obligations.
It recommends simplifying multiple claims processes into one process, to bind all scheme participants and reduce confusion and unnecessary cost and delays.
Another option is to create a new pathway to resolve minor claims.
In cases of lump sum claims for permanent impairment, the restriction to one claim only must be reviewed, it says.
Mr Garling says determining how to calculate pre-injury earnings is another problematic area.
“Its interesting when you get a strong union and an insurer both agreeing that a particular area such as this needs further consideration, because it suits neither of them and does not work.”
The inquiry has received a number of submissions, including from the NSW Workers’ Compensation Self Insurers Association, which represents large employers such as Woolworths and Wesfarmers.
It calls for the calculation of pre-injury earnings to be simplified to exclude penalties and other loadings. “Currently the calculation is complex due to multiple employers and numerous allowances. [The] Victorian calculation is simpler and should be considered.”
The submission says it is “overly complex” and “extremely time-consuming” for employers to make a work capacity decision, then conduct an internal review and a WorkCover merit review, to which employers must provide a further reply in seven days, which then goes to WIRO for review – and which, if upheld, can result in an appeal process.
“The process needs complete revision,” the submission says.
The 2012 changes have created inconsistencies that are confusing even for lawyers.
The Law Society of NSW’s submission says insurers have avoided liability for medical treatment due to dispute resolution and other requirements, and these areas have proven unworkable, with delays often preventing prompt and effective treatment.
Injured workers are entitled to receive one lump sum payment only, but the society wants exceptions to this rule for workers whose conditions have deteriorated.
The three-stage review process is complex, cumbersome and time-consuming, the society says.[Source: http://www.insurancenews.com.au/regulatory-government/nsw-workcover-watchdog-calls-for-simpler-system]