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Community Connect program guidance material

This guidance material details the SIRA Community Connect program, with information on program principles, eligibility criteria and approval requirements.

Download a PDF of this information.

Introduction

The State Insurance Regulatory Authority (SIRA)’s Community Connect program is designed to help workers as they adjust to changing circumstances because their weekly workers compensation payments will or have ceased due to the operation of section 39 of the Workers Compensation Act 1987 (1987 Act).

The program provides workers with up to $3,000 in funding for services to help manage any barriers or needs that are preventing them from adjusting to these changed circumstances.

Under workers compensation legislation, weekly payments are available for a maximum (aggregate) period of five years (260 weeks). This applies unless the worker has been assessed as having a permanent impairment of more than 20 per cent.

The program can be used more than once provided total costs do not exceed $3,000 per worker.

Section 53 of the Workplace Injury Management and Workers Compensation Act 1998 (1998 Act) allows SIRA to develop, administer and coordinate vocational rehabilitation schemes for workers.

The SIRA help and support services webpage provides information regarding support services for workers.

Eligibility

A worker is eligible to access the Community Connect program if:

  • they have been notified by their insurer that they will cease to receive weekly compensation payments on a specific date prior to June 2018, due to the operation of section 39 of the 1987 Act, and
  • they are currently receiving weekly payments of compensation or their weekly payments have recently ceased (ie in the last 12 weeks) due to the operation of section 39 of the 1987 Act, and
  • they have not accepted a commutation or work injury damages settlement.

Principles

A request  for Community Connect should meet the following principles:

  1. The service or item supports a worker to help manage barriers or needs impacting them as a result of ceasing entitlement to weekly payments, and/or
  2. The service or item aims to support a worker to access a suitable community support service.

The service or item should not be reasonably necessary medical or related treatment.

A worker is entitled to medical treatment and workplace rehabilitation under section 60 of the 1987 Act for either two or five years after cessation of weekly payments depending on the assessed level of permanent impairment.

Using Community Connect

Community Connect provides flexible funding with consideration of each worker’s unique circumstances.

Participation in the program is voluntary and the worker can withdraw from a service at any time. A worker can recommence Community Connect  if they meet the program requirements.

The Community Connect program must be fully completed within two years, following the cessation of entitlement to weekly payments.

The following examples demonstrate how the program could be used to help a worker implement strategies to address short term barriers or needs that are preventing them from adjusting to changed circumstances.

Please be aware, the examples below are not exhaustive and serve as a guide only.

Financial counselling

Community Connect may be used for financial counselling or similar services if there is a reason a worker cannot access free, community-funded services.

Using Community Connect to plan a budget

Kate requests professional help to plan a budget given her weekly income will change.

Kate contacted a community organisation that offers financial counselling and was advised there was a four-week waiting list for free, face-to-face financial counselling and budgeting assistance.

Kate discusses her needs with her insurer and it is agreed that she would benefit from face-to-face assistance as soon as possible. A Community Connect payment provides support for Kate to access financial advice immediately.

Relocation and accommodation

Community Connect can be used to help a worker with relocation costs where a move is expected to improve job opportunities, the new suburb has higher employment rates, and it is beyond reasonable commuting distance from the original location.

Funding for short-term accommodation may also be considered, providing there is a sound strategy to support a worker with their longer term accommodation needs.

Using Community Connect to relocate to a larger labour market

Marieke was unable to secure a job in retail sales because of the limited labour market in her regional area. She wants to improve her job prospects by moving to a larger regional area with more employment opportunities, however she cannot afford the associated removalist costs or rental bond.

Marieke states she is able to maintain her longer term accommodation expenses after her weekly payments cease. Community Connect may be used to fund Marieke’s initial relocation expenses.

Transitional child care

Community Connect can be used to help with the costs of short-term child care where these expenses are a barrier to participating in SIRA funded or community vocational training programs, workplace rehabilitation or community services.

Using Community Connect to cover short-term child care costs while training

Jack has not returned to work since his injury. He is the primary carer for his children so that his wife can work.

Jack’s insurer has approved his participation in vocational training, but he needs help with casual child care costs while he is in training.

Community Connect may be used to fund out-of-pocket fees and the bond for his registered child care provider.

Travel

Community Connect can be used to pay for travel costs incurred when a worker is participating in a community program.

Workers should use public transport where available and appropriate. If it is necessary to use a private vehicle, the vehicle must have third-party property insurance1 as a minimum.

Private transport costs are reimbursed at 55 cents per kilometre2. Up to $300 may be paid in advance where appropriate, with a minimum of 10 days’ notice.

Please note, transport costs that are associated with worker entitlements or other vocational programs should be funded under the appropriate program.

Using Community Connect to pay for travel to and from a community program

Karim wants to attend a community support group that will help improve his self-management and organisational capabilities with the aim of starting to look for work.

Karim requests Community Connect assistance from his insurer in order to pay bus fares to and from the community centre for four weeks.

Planning and support

Community Connect may be used to pay for a support service to help a worker to connect with community services.

Using Community Connect to access a support service

Anh has expressed difficulty in knowing how to access services in the community to support him once his payments cease.

The insurer helped Anh select an appropriate service provider with experience helping people access community services.

The provider was engaged and supported Anh with his application for Centrelink payments and put him in touch with a social support group.

Using Community Connect to engage with local organisations

Hannah would like to try volunteering in her local community however she doesn’t know where to start.

Hannah’s insurer referred her to a community organisation for assistance. The community organisation helped Hannah identify her interests, skills, goals and provided information about volunteering.

With this support, Hannah started volunteer work and was able to build up her confidence and connect with people in a comfortable environment.

Planning and support may include:

  • helping a worker identify issues and needs that they wish to address
  • identifying a worker’s strengths and support systems to help them manage issues
  • planning and setting personal goals
  • identifying and providing information
  • helping a worker to access appropriate services including specialist disability, mainstream or community services.

Support should be provided on a one-on-one basis to ensure that the service is personalised and provides a worker with intervention(s) appropriate to their needs.

Who can provide planning and support services?

Organisations that have a quality management system and can provide evidence that they conform to the NSW Disability Service Standards can deliver planning and support services.

Organisations:

  • may offer face-to-face contact, website or telephone services depending on the specific issue and needs of a worker including the worker’s location
  • should not be providing treatment or return to work services to the worker.

The worker or the insurer should identify the most appropriate service provider to support the worker’s needs and goals.

The provider organisation should ensure that the person providing services to the worker has the appropriate skills, knowledge and experience to achieve the best possible outcome(s) for the worker.

Insurer endorsement

Either the worker, provider or insurer may identify that Community Connect could benefit the worker. The worker or provider should discuss this with the insurer and advise the insurer of the supplier or service provider details and related costs. The insurer will:

  • consider the request against the Community Connect principles and eligibility criteria
  • provide advice on whether the worker is eligible for the program within 14 days of receiving the request
  • advise the worker in writing of the SIRA appeal process if the request is not approved.

Community Connect funding should be agreed to by the insurer before costs are incurred.

Payment

The insurer managing the claim is responsible for administering payment.

Reimbursement from SIRA

When the claim is with a SICorp insurance agent, self-insurer or specialised insurer and they are seeking reimbursement for expenses, the insurer should submit a vocational program claim for payment and relevant receipts to SIRA within six months from the date the expenses were incurred.

Monitoring

The insurer is responsible for ensuring Community Connect is used effectively to address a worker’s barriers or needs. The insurer should make sure that the services provided help a worker to access community funded program(s) if support is required beyond Community Connect.

Change in circumstances

If an extension or amendment to Community Connect is required, a request for amendment should be made to the insurer.

Appeal process

If there is disagreement about eligibility or use of the Community Connect program prior to submission of a request, the worker should try to resolve the matter directly with the insurer in the first instance. If the problem cannot be resolved, contact SIRA on 13 10 50 or email contact@sira.nsw.gov.au.

Where an insurer has not agreed to the program, the worker can request an internal review by the insurer.

If agreement is not obtained following an internal insurer review, the insurer should notify the worker in writing that an appeal can be lodged with SIRA by writing to: Director, Claimant Outcomes, State Insurance Regulatory Authority (SIRA), Locked Bag 2906, Lisarow NSW 2250 or vocprograms@sira.nsw.gov.au.

An appeal must outline the reasons a review is requested and provide information/evidence to support the request. SIRA may ask for additional information from the worker, person submitting the application, and/or the insurer.

SIRA will notify the worker and the insurer of the appeal outcome within 10 working days of receiving it and all the necessary supporting information.

Further information

Learn more about SIRA, workers compensation, Community Connect and our vocational programs at our website. Get started by checking out the links below:

SIRA vocational programs

If you are interested in one of our vocational programs, the links below will help you take the next steps:

Legislation and detailed guidelines

If you’d like further information, please read the related NSW legislation and detailed guidelines for claiming workers compensation:

The SIRA vocational programs and return to work assistance benefit operate in addition to and separately from the Community Connect program. Contact the SIRA Customer Service Centre on 13 10 50 or email contact@sira.nsw.gov.au if you have any questions or require assistance.

Footnotes

1 Third party property insurance is different to third party personal (CTP ‘green slip’) insurance, which does not meet the minimum insurance requirement.
2 These rates are correct at time of publication. Please refer to the current Workers compensation benefits guide for the current rate for car travel expenses.