NSW Sports Federation: Workers Compensation Reforms

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1 NSW Sports Federation: Workers Compensation Reforms Wednesday, 23 October 2013 Sonya Jenkins Manager Commercial Services Workers compensation insurance division 1

2 Outline Workers Compensation legislative reform Benefits reform Small employer policy reforms NSW Sporting Injuries insurance Summary of reform impacts

3 Why change the workers compensation scheme? The Scheme was in deficit of $4 billion The Scheme was financially unsustainable Funding it would have required a 28% increase in employer premiums Employers were already paying premiums between 20 and 60 percent higher than Victoria and Queensland The Workers Compensation Legislation Amendment Act 2012 implemented reforms designed to address all of these serious shortcomings and delivered a reduction in the Scheme deficit to $882 million as at December

4 Intent of the reforms 1. Enhance NSW workplace safety by preventing and reducing incidents and fatalities 2. Contribute to economic and jobs growth by ensuring premiums are comparable with other states and there are optimal insurance arrangements 3. Promote recovery and the health benefits of returning to work 4. Guarantee long-term medical and financial support for seriously injured workers 4

5 Intent of the reforms 5. Support less seriously injured workers to recover and regain their financial independence 6. Reduce the high regulatory burden and make it simple for injured workers, employers and service providers to navigate the system 7. Strongly discourage payments, treatments and services that do not contribute to recovery and return to work 5

6 Key changes 19 June 2012 Journey claims there must be a real and substantial connection between the employment and the incident out of which the injury arose Heart attack/stroke claims the nature of the employment must give rise to a significantly greater risk of the worker suffering the injury than had the worker not been employed in employment of that nature Disease injury claims compensable if the employment was the main contributing factor Nervous shock claims cannot be made when the nervous shock is not a work injury, and cannot be made by relatives of an injured or deceased worker (because their injuries are not work injuries) 6

7 Key changes work capacity The injured worker s capacity to return to work in suitable employment (not necessary pre-injury employment) The insurer will assess the worker s work capacity throughout the life of the claim Work capacity decisions by the insurer will be used to drive injury management and determine the worker s entitlement to weekly payments A new certificate of capacity replaced the WorkCover medical certificate to help doctors provide more advice on work capacity and focus on what the worker can rather than can t do CONFIDENTIAL 7

8 Key changes benefits The reforms provide incentive for the injured worker to return to work: stepping down weekly payments after 13 weeks (during which period 80% of workers currently return to work) tying eligibility for a higher rate of weekly payments after 13 weeks to working 15 hours or more (for those with some capacity to work) Weekly benefits cease after 5 years. Medical and related expenses are time limited to 12 months from when the worker ceases to be entitled to weekly benefits or from the date of the claim if not receiving weekly benefits. 8

9 Key changes retiring age Workers who continue to work past retiring age, and are subsequently injured at work, are entitled to weekly benefits for 12 months from the first date of incapacity arising from the injury In the event a worker is injured prior to reaching retiring age, they would be eligible for the appropriate workers compensation entitlements until they reach retiring age

10 Focus on return to work (RTW) The reforms are focused on encouraging and assisting early return to work Early return to work (or staying at work) is good for: NSW workers, with quick, safe and durable return to work shown to be good for the worker s recovery, health and wellbeing NSW employers, reducing the scheme deficit without increasing premiums, getting skilled workers back in the workplace faster, and reducing the costs of claims and related premium adjustments the NSW economy, with more workers working, and less strain on the Workers Compensation Scheme 10

11 Focus on return to work Employer obligations Employers continue to have obligations to assist their injured workers to return to work, including: having a plan for their injured workers to remain at work or return to work as soon as possible providing suitable employment if the worker has capacity to work (where reasonably practicable) making information about return to work available to all workers (have a return to work program in place) The reforms reinforce and support these obligations, with WorkCover inspectors able to issue improvement notices where employers contravene these obligations 11

12 Small employer reforms from 30 June 2013 Premium incentives and less red tape The following incentives were introduced: The discount for paying premiums in full by the due date increased to five percent A 10 per cent Employer Safety Incentive (ESI) premium discount at each policy renewal for small employers in the Scheme A Return to Work Incentive for employers who have an injury within the workplace whereby the ESI discount is retained if the injured worker returns to suitable employment (with the existing or another employer) within 13 weeks 25,000 employers reclassified as small so they no longer have their premiums adjusted based on their claims history. This means 96 per cent of the state s employers will have the certainty of having their premiums set before the policy renewal 12

13 Full payment discount Premium discount has increased from 3% to 5% for small employers who pay their premium in full by the due date Installments payment option is still available Wages return extended Timeframe to return actual wages declaration extended to 4 months past expiry Reduces financial pressure Aligns with ATO requirements for lodgement of tax returns 13

14 Easier policy renewals Estimated forms no longer required to renew policies for small employers Renewal premium will be automatically calculated by your Agent and sent out 4-6 weeks before expiry Premiums will be due 1 calendar month from the renewal date Renewal premium based on the current estimated wages details Eliminates red tape for employers 14

15 Employer safety return 10% discount from 30 June 2013 Discount removed if a claim is made and the worker is not returned to suitable employment within 4 weeks from date of injury Employer safety return Opportunity to retain a discount with the return to work incentive 10% discount made on adjustment if all injured workers return to suitable employment within 13 weeks, even with another employer ESI and RTWI will be reset for the next renewal to encourage employers to continue investing in safety and return to work 15

16 Impact of the reforms For injured workers Very positive feedback from 940 of the most seriously injured workers transitioned to the new legislation received around 70 per cent more than the previous statutory rate New claims are managed under the new legislation. More than 48,000 new claims have been made since 1 October, This is a 21 per cent reduction from the period 12 months earlier Transition nearly completed of 18,600 existing claims to the new legislation. For employers Average rate reduction of 7.5% with the NSW Government returning $204 million in premium rate reductions to employers as result of the reforms Additional incentives provided to small employers to encourage better return to work outcomes 16

17 Sporting participants insurance A paid sporting participant is considered to be a worker under NSW Workers Compensation legislation unless the participant is a registered participant of a sporting organisation which is insured by NSW Sporting Injuries NSW Sporting Injuries is a division of WorkCover NSW providing serious sports insurance to sporting organisations A twelve month policy can cost as little as a $1 and covers all authorised activities of a sporting organisation Significant lump sum benefits are paid for serious injuries in sport (where permanent loss of use is suffered) and death Benefits are paid depending on whether your injury meets the minimum disability threshold and how serious the injury is Benefits are paid regardless of fault or pre-existing conditions 17

18 Summary Large scale legislative and cultural reform to address systemic issues Implementation of reforms has resulted in: o Promotion of employer/worker engagement as part of an effective return to work program o Easier to understand premiums and cutting of red tape for small employers o Positive impact of reforms on scheme valuation to deliver better claims outcomes for workers and opportunities to improve insurance pricing for employers in NSW Paid sports participants are considered workers under NSW Workers Compensation legislation unless the sporting organisation has insurance with NSW Sporting Injuries.

19 Workers compensation insurance Name: Sonya Jenkins Position title: Manager Commercial Services Telephone: Websites: workcover.nsw.gov.au sportinginjuries.nsw.gov.au Copyright 19

20 Disclaimer This presentation may contain work health and safety and workers compensation information. It may include some of your obligations under the various legislation that WorkCover NSW administers. To ensure you comply with your legal obligations you must refer to the appropriate legislation in its most current form. Information on the latest laws can be checked by visiting the NSW legislation website (www.legislation.nsw.gov.au) or by contacting the free hotline service on This presentation does not represent a comprehensive statement of the law as it applies to particular problems or to individuals or as a substitute for legal advice. You should seek independent legal advice if you need assistance on the application of the law to your situation. Although all care has been taken to ensure that the information is correct at the time of publication, the laws change over time and you need to ensure that you are accessing the most current legislation to ensure that the information is up to date. The information contained in this presentation is provided as a guide and it does not necessarily represent the views of WorkCover. You may use this presentation for educational purposes in your organisation for internal training and development however, you are not permitted to edit, change or add to this presentation in any way. You are not allowed to remove this disclaimer from the presentation and you are not allowed to charge any fees for using this presentation. Copyright DRAF T WorkCover in confidence 20

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