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Workers compensation regulation bulletin - Issue 75 (November 2019)

Insurers: make sure your data is complete and on time

SIRA is reminding workers compensation insurers to submit data that’s complete and on time to avoid the risk of enforcement action.

Executive Director Darren Parker said SIRA’s compliance and enforcement officers were paying close attention to insurers’ monthly data submissions and timeliness in addressing suspect and critical errors.

‘Data is the cornerstone on which the performance of the scheme is reported and assessed,’ he said.

‘Data drives scheme design changes, supervision and compliance actions. That’s why it’s imperative that the data submitted to SIRA by insurers is timely and accurate.’

SIRA is also focusing over coming months on the requirement to report ‘date claim made’, particularly ‘test 3’, which is the number of days taken to determine claim liability from the date a claim is made, where the insurer had a reasonable excuse not to start provisional weekly payments. 

‘While these two areas are an immediate focus for SIRA, it does not take away or lessen insurers’ responsibilities to comply with the Workers Compensation Data Reporting Requirements and the relevant legislation, regulation or guidelines applicable to their role in the workers compensation scheme,’ Darren said.

‘SIRA will continue with transparently reporting the results of its compliance and enforcement actions, including any actions resulting from those activities.’

More uninsured employers put on notice

SIRA has been has been catching up with employers who tried to avoid workers compensation insurance this year.

Our compliance and enforcement operations made sure 10,000 more workers were covered, 2500 workers compensation policies were taken out and $4.6 million in additional premiums were paid.

SIRA targeted employers for not meeting their workers compensation obligations, particularly those who deliberately avoided paying workers compensation insurance.

Uninsured employers may be subject to fines and enforcement action ranging from $750 up to six months' imprisonment.

SIRA encourages all employers to take out appropriate workers compensation insurance and do the right thing by their workers.

Reminder: PIAWE for workers after 52 weeks

In late 2018, the NSW Government introduced changes to simplify and improve the way a worker’s pre-injury average weekly earnings (PIAWE) are calculated.

The first change took effect in relation to PIAWE relates to calculating PIAWE after 52 weeks of entitlement.

The change means that workers injured on or after 26 October 2018 who have received 52 weekly payments will continue to have shift and overtime amounts included in their PIAWE calculations from 25 October 2019.

Workers injured before 26 October 2018 only have overtime and shift allowances included in PIAWE calculations for the first 52 weeks.

More information about the PIAWE changes can be found in SIRA’s Claims management guide.

Consultation extended: Regulatory requirements for healthcare arrangements in the NSW workers compensation and CTP schemes

Consultation on healthcare arrangements in the NSW workers compensation and CTP schemes has been extended to Friday 29 November at 11:59 pm. 

The health care spend of these schemes accounts for over $1 billion annually. Scheme performance monitoring activity has highlighted escalating healthcare costs, particularly in the workers compensation scheme.  

We encourage you to provide feedback and participate in the consultation with a submission. 

In addition to the consultation paper, there is an EY report and consultation questions to support your submission.

The consultation can be accessed on SIRA's website.

Beware of underpayment risk during part-time return to work

We have heard that some employers may be inadvertently underpaying employees who have returned to work on a part-time basis while receiving workers compensation payments.

While we do not have specific examples of any underpaid employees, we advise that a worker who has returned to partial hours/duties should be paid the entirety of the wages earnt for time the worker actually worked. A worker’s actual earnings should not be reduced.

This ‘actual earnings’ amount may then be then ‘topped up’ by a workers compensation payment. The amount of the top-up depends on the worker’s weekly payment entitlements under the workers compensation legislation.

The top-up workers compensation payment will be sufficient to bring the worker’s total/aggregate income (i.e. actual earnings plus the top-up compensation payment) up to either 95 per cent or 80 per cent of their pre-injury average weekly earnings (PIAWE).

Whether the workers is entitled to 95 or 80 per cent of their PIAWE depends on the entitlement period applying to the worker and the extent to which the worker has returned or can return to work.

In summary, workers who return to work receive all of their actual earnings plus a top-up workers compensation payment to make up the difference between their earnings and the proportion of PIAWE to which they are entitled to under workers compensation legislation.

Return to work coordination training now available online

Return to work coordination training is now available online for free.

Fourteen online training modules explain what employers, small and large, must do to support recovery at work after a work-related injury.

The interactive training meets a variety of learning styles through the use of illustrations, animations, quizzes and engaging content.

Return to work coordinators can complete the training at their own pace and time. A certificate can also be obtained for completion of each module.

Modules cover:

  • the NSW workers compensation system
  • what employers need to know
  • understanding the role of the insurer
  • working with the support team
  • return to work programs
  • tailoring a return to work program
  • recover at work planning
  • developing a recover at work plan
  • understanding the claims process
  • worker entitlements and
  • what to do when things don’t go to plan.

Read more on the return to work coordination training page, including how to get started

For general enquiries, please call 13 10 50.

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