There have been many changes in response to the COVID-19 pandemic that may affect you.
Detailed below is an outline of these changes:
SIRA aims to ensure that the insurance and support systems we steward are easy to deal with and deliver protection, recovery and restoration entitlements and good outcomes at an affordable price and in a sustainable way.
At this time, SIRA will significantly focus its regulatory efforts on adapting and responding to the impacts of COVID-19. SIRA is taking a common-sense approach to its advisory, compliance and enforcement activities. These activities will focus on matters that present potential or actual harm to injured people and policy holders or risks to scheme sustainability and integrity. All matters of non-compliance will be assessed using a risk-based approach.
For example, SIRA is proactively renewing or extending most workers compensation self and specialised insurer licences that are due for renewal up to the end of 2020 for a period of one year. This decision ensures business continuity and reduces regulatory burden. SIRA will increase supervision and regulatory action to mitigate any insurer risks at this time as required.
SIRA is committed to working constructively and pragmatically with scheme participants. SIRA will be working closely with its scheme participants over the coming weeks and months.
We have made various changes that were enabled by the COVID-19 Legislative Amendment (Emergency Measures) Act 2020. This Act made amendments to the Workers Compensation Act 1987 and the Motor Accident Injuries Act 2017 by providing Regulation and guideline making powers.
Motor accident guidelines updated
The Motor accident guidelines have been updated to:
- provide regulatory relief during COVID-19 to CTP insurers when complying with timeframes for electronic transition of eGreenSlips to Transport for NSW
- implement measures to allow treating physiotherapists or psychologists to issue certificates of fitness.
The amendments apply to Part 2 (Table 2.2: Timeframes for insurers electronically transmitting an eGreenSlip) and Part 4 (Evidence of fitness for work) of the guidelines and will be in place for 12 months, unless repealed earlier.
Workers compensation guidelines updated
The Workers compensation guidelines have been updated to:
Treating physiotherapists and psychologists can now provide certification of an injured person’s ability to work as a result of amendments to the Workers Compensation Regulation 2016 and Motor Accident Guidelines.
The amendments, which came into effect on 17 April 2020, are intended to relieve pressure on general practitioners and the overall health system during the COVID-19 pandemic. They will also make it easier for injured people to continue to receive their weekly benefits, without needing to visit their treating doctor.
A general practitioner must continue to issue the initial certificate of fitness or certificate of capacity to an injured road user or worker. This is important so that the person’s full health needs can be assessed.
Thereafter, the treating physiotherapist or psychologist can issue second and subsequent certificates to an injured person if the injury relates to their area of expertise.
The amendments will be in place for 12 months, unless repealed earlier.
The following Fees Orders have been updated to reflect changes to telehealth, certification of capacity and fitness by treating physiotherapists and psychologists, various definitions, payment classification coding and independent medical examinations.
- Workers Compensation (Medical Practitioner Fees) Order 2020 No.3
- Workers Compensation (Surgeon Fees) Order 2020 No.2
- Workers Compensation (Orthopaedic Surgeon Fees) Order 2020 No.2
- Workplace Injury Management and Workers Compensation (Medical Examinations and Reports Fees) Order 2020 No.2
- Workplace Injury Management and Workers Compensation (Injury Management Consultants Fees) Order 2020 No.2
- Workers Compensation (Physiotherapy, Chiropractic and Osteopathy Fees) Order 2020 No.3
- Workers Compensation (Psychology and Counselling Fees) Order 2020 No.3
- Workers Compensation (Accredited Exercise Physiology Fees) Order 2020 No.3
- Workplace Injury Management and Workers Compensation (Independent Consultants Fees) Order 2020 No.3
- Workers Compensation (Hearing Aid Fees) Order 2020 No.2
We recognise that COVID-19 may impact an injured person’s ability to attend face-to-face medical appointments.
So that we can minimise social contact and the demand on our health system, we have introduced new arrangements for telehealth services so that consultations between injured people and providers can occur over the telephone.
Insurers will need to consider the appropriateness of this service on a case-by-case basis. Insurers should also consider the use of video consultations at this time.
SIRA has issued guidance material for both referrers and examiners to consider for independent medical examinations and reports during the COVID-19 pandemic:
Recent amendments to the Workers Compensation Act 1987 introduced a presumption that workers in prescribed employment who contract COVID-19 contracted the virus in the course of their employment.
The presumption makes it easier for workers who contract COVID-19 to receive workers compensation entitlements to support their recovery.
The Workers Compensation Amendment (Consequential COVID-19 Matters) Regulation 2020 commenced on 24 July 2020. The Regulation sets out the medical tests and results for these workers, how the presumption applies and further types of prescribed employment.
The changes mean that workers in prescribed employment who are diagnosed with COVID-19 are automatically presumed to have contracted the disease in the course of their employment (unless the contrary is established). Eligible workers are presumed to be incapable of work until 21 days from the date of injury, or if the worker still has COVID-19 at this date, until the date marking the end of the worker’s incapacity on the worker’s certificate of capacity.
SIRA has also outlined expectations for insurers when applying the presumption in the new Standard of practice 32.
Further information regarding the COVID-19 presumption is available on SIRA’s Claims management guide.