Compendium of OHS and Workers Compensation Statistics. December 2009 AUSTRALIA S SAFEST WORKPLACES

Transcription

1 Compendium of OHS and Workers Compensation Statistics December 2009 AUSTRALIA S SAFEST WORKPLACES

2 Disclaimer This Compendium has been developed by Comcare and all attempts have been made to incorporate accurate information and data. The data included in the Compendium has been compiled during October and November This Compendium is supplied on the terms and understanding that Comcare and the Safety Rehabilitation and Compensation Commission (SRCC) are not responsible for the results of any action taken on the basis of information in this publication, nor for any error or omission from this publication. Comcare and the SRCC expressly disclaim all and any liability and responsibility to any person, in respect of anything, and the consequences of anything, done or omitted to be done, by any such person in reliance, whether wholly or partially, upon the whole or any part of this publication. Copyright Published by Comcare ABN Commonwealth of Australia 2009 This work is copyright. Apart from any use as permitted under the Copyright Act 1968, no part may be reproduced by any process without prior written permission from the Australian Government available from the Department of Communications, Information Technology and the Arts. Requests and inquiries concerning reproduction and rights should be addressed to the Commonwealth Copyright Administration, Intellectual Property Branch, Department of Communications, Information Technology and the Arts, GPO Box 2154, Canberra ACT 2601 or posted at Contacts for further information To obtain further information about the contents of this report, contact: Comcare GPO Box 9905 CANBERRA ACT 2601 This publication is available on the Safety, Rehabilitation and Compensation Commission website at SRCC AUSTRALIA S SAFEST WORKPLACES Compendium of OHS & Workers Compensation Statistics 2

3 Contents 1 Introduction 5 2 Highlights 6 3 Coverage SRC scheme OHS scheme 9 4 Scheme profile Industry classification Australian and ACT government premium payers by industry classification Licensed self-insurers by industry classification Employer size Location 14 5 Occupational health and safety Workers compensation claims Incidence of accepted claims Frequency of claims with one day or more time lost (non-commuting) Incidence of claims with one week or more time lost (non-commuting) Breakdown of injury and disease Major claim drivers Body stressing Mental stress Accepted claims by mechanism of incident and gender Accepted claims by age group (Australian Government premium payers) Accepted claims by MOI and age group (Australian Government premium payers) Average total cost of claims by age (Australian Government premium payers) Prevention targets Claims with one week lost time (non-commuting) Deaths OHS incident notifications OHS notification incidence rate OHS notifications by mechanism of incident Investigations 33 6 Claims management Process Claims summary Claims determined Claims acceptance rate Determinations Reconsiderations AAT reviews 43 7 Rehabilitation and return-to-work Claim duration Median time lost injury and disease Durable return-to-work rate Return to Work Monitor 51 8 Scheme expenditure Revenue Premiums Payments Claim payments by type Performance Funding ratio Outstanding liabilities 55 9 Glossary 56 SRCC AUSTRALIA S SAFEST WORKPLACES Compendium of OHS & Workers Compensation Statistics 3

4 Tables and figures Figure 3.1 Comcare scheme Figure 3.2 SRC Act coverage 8 Figure 3.3 OHS Act coverage 9 Figure 4.1 SRC Act coverage by industry classification as at 30 June Table 4.1 Australian and ACT Government premium payers by industry as at 30 June Table 4.2 Licensed self-insurers by industry as at 30 June Table 4.3 SRC Act employers by size as at 30 June Table 4.4 Scheme FTE employees by location as at 30 June Figure 4.2 Scheme FTE employees by location as at 30 June Figure 5.1 Incidence of accepted claims 15 Figure 5.2 Frequency of claims with one day lost time 16 Figure 5.3 Incidence of claims with one week or more lost time 17 Figure 5.4 Accepted claims by injury/disease (premium payers) 18 Figure 5.5 Accepted claims by injury/disease (licensed self-insurers) 18 Figure 5.6 Accepted claims by mechanism of incident 12 months to 30 June Table 5.1 Accepted claims by mechanism of incident (premium payers) 20 Figure 5.7 Incidence of body stressing claims 21 Figure 5.8 Average total cost of body stressing claims (premium payers only) 21 Figure 5.9 Accepted body stressing claims by mechanism of incident 12 months to 30 June Figure 5.10 Accepted body stressing claims by occupation 12 months to 30 June Figure 5.11 Incidence of mental stress claims 23 Figure 5.12 Average total cost of mental stress claims (premium payers) 23 Figure 5.13 Accepted mental stress claims by mechanism of incident 12 months to 30 June Figure 5.14 Mental stress claims by occupation 12 months to 30 June Figure 5.15 Accepted claims by mechanism of incident and gender 12 months to 30 June Figure 5.16 Estimated incidence of claims (one week or more time lost) by age group (Australian Government premium payers) 26 Figure 5.17 Estimated incidence of claims (one week or more time lost) by mechanism of incident and age group (Australian Government premium payers) 12 months to 30 June Figure 5.18 Average total cost of claims by age (Australian Government premium payers) 12 months to 30 June Figure 5.19 Claims with one week lost time (premium payers and licensed self-insurers) 29 Table 5.2 Compensated deaths 30 Figure 5.20 OHS notifications incidence rate (scheme) 31 Table 5.3 OHS notifications by mechanism of incident (scheme) 12 months to 30 June Table 5.4 Number and ratio of field active investigators 33 Table 5.5 Investigations commenced 34 Figure 5.21 Rate of investigations commenced 35 Figure 6.1 Comcare claim lodgement and determination process 37 Figure 6.2 Claim reconsideration and review process 38 Figure 6.3 Incidence of claims determined 39 Figure 6.4 Claims acceptance rate 40 Table 6.1 Average time (calendar days) to determine claims 41 Table 6.2 Requests for reconsiderations decided 42 Table 6.3 Outcome of claimant applications to the AAT (premium payers) 43 Table 6.4 Outcome of claimant applications to the AAT (licensed self-insurers) 44 Figure 7.1 Steps in the return-to-work process 45 Figure 7.2 Incidence of claims with time lost (premium payers) 46 Figure 7.3 Incidence of claims with time lost (licensed self-insurers) 46 Figure 7.4 Time-lost-to-date to Table 7.1 Time-lost-to-date 48 Figure 7.5 Median lost time (premium payers) 49 Figure 7.6 Median time lost (licensed self-insurers) 49 Figure 7.7 Durable return-to-work (RTW) rate 50 Table 7.2 Return-to-work performance 51 Table 8.1 Scheme revenue 52 Figure 8.1 Australian Government and ACT Government premium rates 53 Figure 8.2 Workers compensation expenditure 54 Figure 8.3 Workers compensation payments 54 Table 8.2 Comcare funding ratio 55 Table 8.3 Outstanding liabilities 55 SRCC AUSTRALIA S SAFEST WORKPLACES Compendium of OHS & Workers Compensation Statistics 4

5 1 Introduction Comcare s Vision Australia s safest workplaces Achieving our Vision To achieve the vision, Comcare works in partnership with employers and employees to reduce the incidence and cost of workplace injuries and disease. Outcomes The outcomes for which Comcare is responsible are: Outcome 1: The protection of the health, safety and welfare at work of workers covered by the Comcare scheme through education, assurance and enforcement. Outcome 2: An early and safe return to work and access to compensation for injured workers covered by the Comcare scheme through working in partnership with employers to create best practice in rehabilitation and quick and accurate management of workers compensation claims. Outcome 3: Access to compensation for people with asbestos-related diseases where the Commonwealth has a liability through the management of claims. Comcare was established as a statutory authority under the Safety, Rehabilitation and Compensation Act 1988 (SRC Act) and reports to the responsible Minister (the Deputy Prime Minister as Minister for Education, Employment and Workplace Relations). Comcare is required to support the Safety, Rehabilitation and Compensation Commission (SRCC) in exercising its functions. In exercising its functions, the SRCC is responsible for the scheme s regulatory framework including occupational health and safety (OHS), rehabilitation and workers compensation. Comcare administers both the Commonwealth s statutory framework for rehabilitation and workers compensation under the SRC Act, and its OHS framework under the Occupational Health and Safety Act 1991 (OHS Act). The OHS Act prescribes employers and employees workplace health and safety responsibilities. Employers covered by the OHS Act pay an annual contribution for the regulatory, policy and advisory functions administered by Comcare. The SRC Act makes Commonwealth authorities and entities accountable for workers compensation injuries and diseases through the payment of annual premiums. Premium paying employers include Australian Government agencies and statutory authorities (excluding the Australian Defence Force) and the ACT Government. Under the SRC Act, certain Commonwealth authorities and eligible private corporations may apply for a licence to selfinsure. Licensed self-insurers meet the cost of their workers compensation liabilities and either manage their own workers compensation claims or have them managed by a third party claims manager. Licensed self-insurers are also covered by the OHS Act. Together, the two legislative Acts, the SRC Act and the OHS Act, are known as the Comcare scheme, which provides all scheme employers with an integrated safety, rehabilitation and compensation system, no matter what Australian state or territory an employer operates in or where its employees are located. Scheme performance information presented in this Compendium has been compiled from a variety of sources including workers compensation claims, OHS incident notifications, survey data and financial reports. Claims based data can be subject to development and performance information may therefore be updated when reported in future editions of this Compendium. SRCC AUSTRALIA S SAFEST WORKPLACES Compendium of OHS & Workers Compensation Statistics 5

6 2 Highlights As at 30 June 2009, the Comcare scheme experienced: a 41 per cent reduction in the incidence of accepted claims since a 36 per cent reduction since in the frequency of claims with one day or more time lost from work a 45 per cent increase from 30 June 2005 in the number of full-time equivalent (FTE) employees covered by the SRC Act a 43 per cent increase from 30 June 2005 in the number of FTE employees covered by the OHS Act an increase in the number of licensed self-insurers from 8 in 2005 to 29 a 140 per cent increase from 30 June 2005 in the number of FTE employees in the licensed self-insurer sector covered by the OHS Act greater diversity in the industries and occupational groups being regulated an 88 per cent durable return-to-work rate (Australian Government employers) the highest in Australia and significantly above the Australian average of 72 per cent (Australian and New Zealand Return to Work Monitor ) a premium rate of 1.36 per cent in (Australian Government employers), which represents a 23 per cent reduction since the second lowest average standardised premium rate in Australia for (Comparative Performance Monitoring Report, December 2009) a positive funding ratio of 110 per cent as at 30 June SRCC AUSTRALIA S SAFEST WORKPLACES Compendium of OHS & Workers Compensation Statistics 6

7 3 Coverage Figure 3.1 provides an overview of the Comcare scheme and shows the differences in coverage between the SRC Act and the OHS Act. The OHS Act covers premium payers, licensed self-insurers and the Australian Defence Force (ADF). Since 2004, ADF members, while covered by the OHS Act, are covered for workers compensation by the Military Rehabilitation and Compensation Act 2004 (MRC Act). The SRC Act covers Australian Government and ACT Government premium payers and licensed self-insurers. ACT Government employees are covered by separate ACT Government OHS legislation. Figure 3.1 Comcare scheme 2009 OHS Act Duties of care Australian Defence Force Licensed self-insurers Australian Government premium payers ACT Government premium Employer protects health and safety of its employees at work Employer protects health and safety of its employees at work Employer manages claims Comcare manages claims Employer meets liabilities Comcare meets liabilities Employer manages rehabilitation Employer manages rehabilitation Discharging of liabilities SRC Act SRCC AUSTRALIA S SAFEST WORKPLACES Compendium of OHS & Workers Compensation Statistics 7

8 3.1 SRC scheme Figure 3.2 shows the number of full time equivalent (FTE) employees covered by the SRC Act between 30 June 2005 and 30 June The SRC scheme includes all Australian and ACT government premium payers and licensed self-insurers. In recent years the scheme has experienced considerable growth, largely attributable to a significant increase in the number of employers that have been granted a license to self-insure under the SRC Act. As at 30 June 2005 the scheme included eight licensed self-insurers, increasing to 29 as at 30 June The fact that the scheme applies in every Australian state and territory is an attractive feature to national employers who would otherwise operate in up to eight different OHS and workers compensation jurisdictions. As at 30 June 2009, there were approximately FTE employees covered by the SRC Act from premium payers (including the ACT Government) and from licensed self-insurers. This represents a 45 per cent increase in the number of FTE employees covered by the SRC Act since 30 June Notably, since 30 June 2005, there has been a 122 per cent increase in the number of FTE employees of licensed self-insurers, which reflects the significant growth in this sector of the scheme. Consequently, as at 30 June 2009, licensed self-insurers accounted for around 44 per cent of total FTE employees covered by the SRC Act, up from 29 per cent at 30 June During the same period the number of FTE employees within premium payers increased by 14 per cent. Figure 3.2 Figure 3.2 SRC Act coverage SRC Act coverage 400 Number of FTE employees ('000) % 71% 32% 68% 37% 63% 42% 58% 44% 56% 0 30 Jun Jun Jun Jun Jun 2009 Premium payers Licensed self-insurers SRCC AUSTRALIA S SAFEST WORKPLACES Compendium of OHS & Workers Compensation Statistics 8

9 3.2 OHS scheme Figure 3.3 shows the total number of FTE employees covered by the OHS Act between 30 June 2005 and 30 June Employers covered by the OHS Act include the Australian Government premium payers, licensed self-insurers and the ADF. Employers covered by the OHS Act pay an annual contribution for the regulatory, policy and advisory functions administered by Comcare. The total number of FTE employees covered by the OHS Act has steadily increased each year for the last three years. As at 30 June 2009, approximately FTE employees were covered under the OHS Act. This coverage consisted of FTE employees from premium payers, from licensed self-insurers and from the ADF, representing a 43 per cent increase in the number of FTE employees covered since 30 June The significant increase in the number of FTE employees covered by the OHS Act is largely due to legislative changes and the increased number of licensed self-insurers covered by the scheme. Legislative amendments in March 2007 extended the coverage of the OHS Act to previously ineligible licensed self-insurers. Since 30 June 2005, the number of employees of licensed self-insurers covered by the OHS Act has increased by 141 per cent, increasing the proportion of the licensed selfinsured sector of the scheme from 24 per cent to 40 per cent. The increase in the number of licensed self-insurers covered by the OHS Act has also led to an increase in the diversity of occupations and risk profiles within the scheme. Section 4, Scheme profile, has further detail on this topic. Figure 3.3 Figure 3.3 OHS Act coverage OHS Act coverage 450 Number of FTE employees ('000) % 14% 15% 18% 18% 38% 40% 33% 24% 23% 58% 59% 52% 48% 46% 30 Jun Jun Jun Jun Jun 2009 Premium payers Licensed self-insurers ADF SRCC AUSTRALIA S SAFEST WORKPLACES Compendium of OHS & Workers Compensation Statistics 9

10 4 Scheme profile This section summarises the demographics of the scheme including the industry classification, employer size and geographical location of employers covered by the SRC Act. 4.1 Industry classification Figure 4.1 provides a breakdown of FTE employees covered under the SRC Act by ANZSIC 1 industrial classification as at 30 June The data shows that approximately or 42 per cent of FTE employees were employed in the public administration and safety industry, (16 per cent) were employed in the financial and insurance services industry, (15 per cent) were employed in the transport, postal and warehousing industry and approximately (13 per cent) were employed in information, media and telecommunications industry. The increase in the number of FTE employees covered by the SRC Act, particularly those from licensed self-insurers, has resulted in the scheme covering a more diverse range of industries than previously. This has altered the risk profile of the scheme. Figure 4.1 SRC Act coverage by industry classification as at 30 June 2009 Public administration and safety Financial and isnurance services Transport, postal and warehousing Information media and telecommunications Professional, scientific and technical services Education and training Health care and social assistance Construction Electricty, gas, water and waste services Manufacturing Other industries Number of FTE employees ('000) 1. ANZSIC 2006 Australian & New Zealand Standard Industrial Classification (ANZSIC) 2006 (cat no ) SRCC AUSTRALIA S SAFEST WORKPLACES Compendium of OHS & Workers Compensation Statistics 10

11 4.1.1 Australian and ACT government premium payers by industry classification Table 4.1 provides a breakdown of Australian and ACT government premium payers by industry classification as at 30 June Of the 190 premium paying employers, 117 operated within the public administration and safety industry accounting for approximately FTE employees (74 per cent of premium payers). Public administration and safety covers the following sub-divisions: public administration (central government, state government, local government, justice and government representation) defence public order, safety and regulatory services. The remaining employees worked in a range of industries including: professional, scientific and technical services (six per cent) education and training (five per cent). Table 4.1 Australian and ACT Government premium payers by industry as at 30 June 2009 Industry Number of employers Total FTE employees % of total FTE employees Public administration and safety % Public administration % Defence* % Public order, safety and regulatory services % Professional, scientific and technical services % Education and training % Financial and insurance services % Health care and social assistance % Information media and telecommunications % Transport, postal and warehousing % All other industries % All industries % * This comprises Defence civilians and excludes ADF personnel who are not covered by the SRC Act. SRCC AUSTRALIA S SAFEST WORKPLACES Compendium of OHS & Workers Compensation Statistics 11

12 4.1.2 Licensed self-insurers by industry classification Table 4.2 provides a breakdown of licensed self-insurers by industry classification as at 30 June Approximately 88 per cent of licensed self-insurer employees worked in three major industry divisions including: financial and insurance services (32 per cent) transport, postal and warehousing (31 per cent) information media and telecommunications (25 per cent). Table 4.2 Licensed self-insurers by industry as at 30 June 2009 Industry Number of employers Total FTE employees % of total FTE employees Financial and insurance services % Transport, postal and warehousing % Information media and telecommunications % Construction % Manufacturing % All other industries % All industries % SRCC AUSTRALIA S SAFEST WORKPLACES Compendium of OHS & Workers Compensation Statistics 12

13 4.2 Employer size Table 4.3 provides a breakdown of employers covered by the SRC Act according to employer size (small, medium and large) as at 30 June Approximately 96 per cent of employees covered by the SRC Act worked for large employers consisting of 500 or more employees. Large employers represented approximately 39 per cent of the total number of employers in the scheme. While 39 per cent of premium payers were small employers (less than 100 employees) and 29 per cent were medium sized employers (100 to 499 employees), combined, these employed only seven per cent of all employees within premium payers. The remaining 93 per cent of employees work for large employers. Approximately 99 per cent of employees from licensed self-insurers worked for large employers. Table 4.3 SRC Act employers by size as at 30 June 2009 Employer size Premium payers Number % of total Licensed selfinsurers Number % of total Number Scheme % of total Small (less than 100 FTE employees) Medium (100 to 499 FTE employees) Large (500 or more FTE employees) All employers Employers FTE employees less than 1 Employers FTE employees Employers FTE employees Employers FTE employees SRCC AUSTRALIA S SAFEST WORKPLACES Compendium of OHS & Workers Compensation Statistics 13

14 4.3 Location Table 4.4 and Figure 4.2 show the geographic distribution of employees covered by the SRC Act across all Australian states and territories as at 30 June Comcare has offices in each capital city (except Hobart and Darwin) and in Newcastle to service the needs of the scheme. As at 30 June 2009, 27 per cent of employees covered by the SRC Act were employed in NSW, with approximately 23 per cent employed in Victoria. Approximately 23 per cent of employees were employed in the ACT; however this represents 40 per cent of all employees within premium payers. These figures reflect the presence of a large number of Australian Government entities based in Canberra. Table 4.4 Scheme FTE employees by location as at 30 June 2009 State Premium payers ( 000) Licensed selfinsurers ( 000) Total ( 000) % of Total NSW % Victoria % ACT % Queensland % WA % SA % Tasmania % NT % Total % Figure 4.2 Scheme FTE employees by location as at 30 June 2009 Comcare offices 1% 12% 6% Brisbane Perth 6% Adelaide 27% Newcastle 23% Sydney Canberra 23% Melbourne 2% SRCC AUSTRALIA S SAFEST WORKPLACES Compendium of OHS & Workers Compensation Statistics 14

15 5 Occupational health and safety The data in this Section is sourced from claims lodged under the SRC Act with Comcare and licensed self-insurers and those OHS incidents required to be notified by employers under the OHS Act. 5.1 Workers compensation claims Comcare maintains a data warehouse on behalf of the SRCC which contains unit claims data supplied by licensed self-insurers and Comcare for all claims lodged under the SRC Act. The records incorporate occurrence details, incapacity determinations, claim payments, medical, rehabilitation and disputation data. While total claim costs and estimates of outstanding liability are available for claims managed by Comcare, only actual claim payments are recorded for all claims managed by licensed self-insurers. Accordingly, it is not possible to report aggregate scheme data relating to total claims costs within this Compendium Incidence of accepted claims Figure 5.1 shows the incidence of accepted claims for the period to for premium payers, licensed self-insurers and for the overall scheme. There has been a reduction of approximately 41 per cent in the incidence of claims accepted across the scheme since In the same period, the incidence of claims accepted by licensed self-insurers has remained approximately double that of the premium payers. In , licensed self-insurers accepted approximately 35 claims per 1000 FTE employees, compared to approximately 16 claims per 1000 FTE employees for premium payers. Significant reductions in the incidence of claims for both premium payers and licensed self-insurers occurred during This was, in part, attributable to changes to the SRC Act in April The changes removed workers compensation coverage for non-work related journeys and recess breaks and strengthened the required relationship with work for a disease claim to be compensable. Figure 5.1 Figure 5.1 Incidence of accepted claims Incidence of accepted claims 70 Claims per 1000 FTE employees Premium payers Licensed self-insurers Scheme SRCC AUSTRALIA S SAFEST WORKPLACES Compendium of OHS & Workers Compensation Statistics 15

16 5.1.2 Frequency of claims with one day or more time lost (non-commuting) Figure 5.2 shows the frequency rate for claims with one day or more time lost (excluding commuting claims). In , the scheme recorded 6.7 claims with one day lost time per million hours worked a 36 per cent reduction since The higher frequency rate recorded by licensed self-insurers reflects, in part, differences in risk profile between premium payers and licensed self-insurers. Figure 5.2 Figure 5.2 Frequency of claims with one day lost time 14 Accepted claims per million hours worked Premium payers Licensed self-insurers Scheme SRCC AUSTRALIA S SAFEST WORKPLACES Compendium of OHS & Workers Compensation Statistics 16

17 5.1.3 Incidence of claims with one week or more time lost (non-commuting) Figure 5.3 shows the incidence of claims with one week lost time (excluding commuting claims) for the period to Workers compensation claims vary in severity, including claims for medical treatment only, as well as claims involving extended time lost from work. During , 47 per cent of all new claims involved time lost from work and 36 per cent accumulated one week or more time lost. The data shows that since , the incidence of claims reaching one week or more time lost has decreased by 37 per cent for premium payers and by 28 per cent for licensed self-insurers. However, despite ongoing reductions being reported by the scheme between and , an increase in the incidence of these claims was recorded in This was due to an increase in the incidence of claims recorded by both premium payers and licensed self-insurers. Figure 5.3 Figure 5.3 Incidence of claims with one week or more lost time Incidence of claims with one week or more lost time 14 Claims per 1000 FTE employees Premium payers Licensed self-insurers Scheme SRCC AUSTRALIA S SAFEST WORKPLACES Compendium of OHS & Workers Compensation Statistics 17

18 5.1.4 Breakdown of injury and disease Figures 5.4 and 5.5 show the breakdown of accepted claims by injury and disease for premium payers and for licensed selfinsurers for the period to A decrease in the incidence of both accepted injury and disease claims was observed between and The most substantial reductions occurred in , which can be attributed, in part, to legislative changes implemented in April 2007 (see Section 5.1.1). Further, on 1 July 2005, licensed self-insurers implemented changes made to the Type of Occurrence Classification System (TOOCS), by the former Australian Safety and Compensation Council (ASCC). TOOCS is used to classify the circumstances surrounding the occurrence of injuries/diseases. Certain conditions classified as injuries under the previous version of TOOCS were re-classified as diseases under the new version. Since , there has been a general increase in the proportion of accepted disease claims for both premium payers and licensed self-insurers. However substantial differences were observed in the proportion of injury and disease claims between premium payers and licensed self-insurers. This can be attributed, in part, to the different risk profiles of each sector. Figure 5.4 Figure 5.4 Accepted claims by injury/disease (premium payers) Claims per 1000 FTE employees % 67% 34% 66% 39% 61% 36% 64% 49% 51% Injury Disease Figure 5.5 Figure 5.5 Accepted claims by injury/disease by injury/disease (licensed self-insurers) (licensed self-insurers) % Claims per 1000 FTE employees % 18% 82% 16% 84% 22% 78% 19% 81% Injury Disease SRCC AUSTRALIA S SAFEST WORKPLACES Compendium of OHS & Workers Compensation Statistics 18

19 5.1.5 Breakdown by mechanism of incident Figure 5.6 shows accepted claims by mechanism of incident for the 12 months to 30 June 2009 for both premium payers and licensed self-insurers. The mechanism of incident identifies the overall action, exposure or event that best describes the circumstances that resulted in the most serious injury or disease. Body stressing was the most prevalent mechanism of incident over the reporting period. In the 12 months to 30 June 2009 around half of all accepted claims for both premium payers and licensed self-insurers were due to body stressing. Falls, trips and slips also represented a significant proportion of claims, accounting for 20 per cent of premium payers claims and 16 per cent of licensed self-insurers claims. Being hit by moving objects accounted for eight per cent of premium payers and 13 per cent of licensed self-insurers claims. Mental stress was a significant cause of claims for premium payers, accounting for eight per cent of claims, compared to two per cent of claims for licensed self-insurers. Figure 5.6 Accepted claims by mechanism of incident 12 months to 30 Figure 5.6 Accepted claims by mechanism of incident 12 months to 30 June % 45% 40% 47% 44% Premium payers Licensed self-insurers Percentage of accepted claims 35% 30% 25% 20% 15% 10% 20% 16% 13% 14% 5% 0% Body Stressing Falls, trips and slips 8% 8% Hit by moving objects 2% Mental stress 6% 6% 7% 5% Vehicle incidents and other Hitting objects with body 5% All Other SRCC AUSTRALIA S SAFEST WORKPLACES Compendium of OHS & Workers Compensation Statistics 19

20 5.2 Major claim drivers Table 5.1 provides a summary of accepted claims by mechanism of incident for the period to The data covers premium payers only. For the period from to , body stressing injuries/diseases accounted for approximately 42 per cent of all claims for premium payers and 37 per cent of total claim costs with an average total cost* per claim of approximately $33K. In the 12 months to 30 June 2009 body stressing injuries/diseases represented 47 per cent of claims and 43 per cent of total claim costs, with an average total cost per claim of approximately $45K. Between and mental stress claims accounted for nine per cent of all claims, however these claims represented 34 per cent of total claim costs, with an average total cost per claim of approximately $149K. In the 12 months to 30 June 2009, mental stress claims accounted for eight per cent of all claims and 23 per cent of total claim costs, with an average total cost per claim of $140K. It should be noted that at this time the average total cost per claim is an estimate and may change as the claims mature. While not shown in this figure, the effect of the removal of coverage for non-work related journeys in April 2007 reduced the incidence of vehicle incidents within the scheme. Vehicle incidents and other accounted for six per cent of claims from premium payers in the 12 months to 30 June Table 5.1 Accepted claims by mechanism of incident (premium payers) Mechanism of incident % of all accepted claims to % of total claim costs* Average total cost per claim ($) Body stressing 42% 37% Falls, trips and slips of a person 20% 13% Vehicle incidents and other 11% 7% Mental stress 9% 34% Hit by moving objects 8% 4% Hitting objects with the body 5% 2% Chemicals and other substances 2% 2% Sound and pressure 2% 1% Heat, radiation and electricity 1% Less than 1% Biological factors Less than 1% Less than 1% All mechanisms of incident 100% 100% months to 30 June 2009 Body stressing 47% 43% Falls, trips and slips of a person 20% 18% Vehicle incidents and other 6% 5% Mental stress 8% 23% Hit by moving objects 8% 5% Hitting objects with the body 6% 2% Chemicals and other substances 2% 2% Sound and pressure 1% Less than 1% Heat, radiation and electricity 1% Less than 1% Biological factors Less than 1% 1% All mechanisms of incident 100% 100% * Average total cost is the cost to date plus estimated outstanding liability SRCC AUSTRALIA S SAFEST WORKPLACES Compendium of OHS & Workers Compensation Statistics 20

21 5.2.1 Body stressing Figure 5.7 shows the incidence of body stressing claims accepted over the period to The data shows that the incidence of these claims across the scheme declined during the period through , with the claims incidence being considerably lower for premium payers than for licensed self-insurers. The most recent data suggests further reductions may become more difficult to achieve. Figure Incidence of body stressing claims Incidence of body stressing claims Claims per 1000 FTE employees Premium payers Licensed self-insurers Scheme Figure 5.8 shows that since , despite an increase in the average total cost* of accepted body stressing claims, the average total cost of these claims remained below that of all other claims. The increase in the average total cost of body stressing claims, shown in Figure 5.6, may be due to the increased complexity of body stressing claims. Latest estimates indicate that the average total cost of body stressing claims is approximately $45K per claim. The data below covers premium payers only as total claim costs are not available for licensed self-insurers. Figure 5.8 Figure 5.8 Average total cost* of body stressing claims (premium payers only) Claims per 1000 FTE employees Body stressing claims All claims (excl. body stressing) * Average total cost is the cost to date plus estimated outstanding liability SRCC AUSTRALIA S SAFEST WORKPLACES Compendium of OHS & Workers Compensation Statistics 21

22 Figure 5.9 provides a breakdown of accepted body stressing claims for both premium payers (1521 claims) and licensed self-insurers (2497 claims) for the 12 months to 30 June Significant differences in the mechanism of incident sub-groups for body stressing claims between premium payers and licensed self-insurers are apparent. Approximately 42 per cent of body stressing claims for premium payers were due to repetitive movement with low muscle loading, with a further 26 per cent due to muscular stress with no objects being handled. Repetitive movement with low muscle loading was less significant for licensed self-insurers, with only 11 per cent of body stressing claims attributed to this cause. The predominant cause of body stressing claims for licensed self-insurers was muscular stress while lifting, carrying or putting down objects and muscular stress while handling objects (other than lifting, carrying or putting down), which accounted for 42 per cent and 33 per cent respectively of all body stressing claims for licensed self-insurers. Figure 5.9 Figure 5.9 Accepted body stressing claims by mechanism of incident 12 months to 30 June 2009 Muscular stress while lifting, carrying or putting down objects 1374 Muscular stress while handling objects 991 Repetitive movement, low muscle loading 901 Muscular stress with no objects being handled Claims Premium payers Licensed self-insurers Figure 5.10 provides a breakdown by occupation group of body stressing claims accepted in the 12 months to 30 June Clerical and administration workers accounted for the largest number of accepted body stressing claims (approximately 49 per cent of all body stressing claims across the scheme). Licensed self-insurers also recorded a significant number of body stressing claims in the machinery operators and drivers and technicians and trades workers occupational groups. Figure 5.10 Figure 5.10 Accepted body stressing claims by occupation 12 months to 30 June 2009 Clerical and administration 1958 Machinery operators / drivers 800 Technicians / trade workers 451 Community / personal service Labourers Professionals Managers Sales workers Claims Premium payers Licensed self-insurers SRCC AUSTRALIA S SAFEST WORKPLACES Compendium of OHS & Workers Compensation Statistics 22

23 5.2.2 Mental stress Figure 5.11 shows the incidence of mental stress claims for the period to Since the incidence of accepted mental stress claims across the scheme has declined. The significant reduction during can, in part, be attributed to changes to the SRC Act introduced in April 2007, which strengthened the required connection between a disease and the claimant s employment for a claim to be accepted. The incidence of accepted mental stress claims has been consistently lower for licensed self-insurers than for premium payers in the scheme. Figure 5.11 Figure 5.11 Incidence of mental stress claims Claims per 1000 FTE employees Premium payers Licensed self-insurers Scheme Figure 5.12 shows that, despite the reduction in the incidence of accepted mental stress claims for the scheme, the average total cost* of these claims remained high compared to all other claims. Latest estimates indicate that the average total cost of mental stress claims was approximately $140K. The data below covers premium payers only as total claim costs are not available for licensed self-insurers. Figure Figure 5.12 Average total total cost* of cost* mental of stress mental claims (premium stress payers) claims (premium payers) Average total claim cost* $('000) Mental Stress All claims (excl. mental stress) * Average total cost is the cost to date plus estimated outstanding liability SRCC AUSTRALIA S SAFEST WORKPLACES Compendium of OHS & Workers Compensation Statistics 23

24 Figure 5.13 provides a breakdown of the number of accepted mental stress claims for both premium payers (258 claims in total) and licensed self-insurers (87 claims in total) in the 12 months to 30 June This figure shows the significant differences in the mechanism of incident sub-groups for mental stress claims between premium payers and licensed selfinsurers. For premium payers, the most significant sub-groups for mental stress claims were work pressure (44 per cent of claims) followed by work related harassment and/or bullying (34 per cent of claims). For licensed self-insurers, the most significant sub-group was exposure to workplace and/or occupational violence (29 per cent of claims) with an even distribution between all other sub-groups (excluding other mental stress factors ). The variability in the distribution of claims within the sub-groups illustrates, in part, the differences in risk profile between premium payers and licensed self-insurers. Figure 5.13 Figure 5.13 Accepted mental stress claims by mechanism of incident 12 months to 30 June 2009 Work pressure 132 Work related harassment and/or bullying 103 Exposure to workplace or occupational violence 39 Exposure to traumatic event 38 Other mental stress factors Claims Premium payers Licensed self-insurers Figure 5.14 shows the number of accepted mental stress claims by occupation group for the 12 months to 30 June The largest number of claims for premium payers was for employees classified as clerical and administration workers followed by professionals, community and personal service and managers workers. The largest number of mental stress claims for licensed self-insurers was also for clerical and administration workers with the second highest groups being community and personal service and machinery operators and drivers. Figure 5.14 Figure 5.14 Mental stress claims by occupation 12 months to 30 June 2009 Clerical and administration 201 Professionals 44 Community / personal service 36 Managers Machinery operators / drivers Technicians / trade workers Sales workers Labourers Claims Premium payers Licensed self-insurers SRCC AUSTRALIA S SAFEST WORKPLACES Compendium of OHS & Workers Compensation Statistics 24

25 Claims characteristics Accepted claims by mechanism of incident and gender Figure 5.15 shows the percentage distribution of accepted claims by mechanism of incident and gender for claims accepted during the 12 months ending 30 June For both premium payers and licensed self-insurers, males accounted for the majority of accepted claims for hitting objects with the body and hit by moving objects. Female premium payers accounted for the majority of accepted claims for mental stress, body stressing and falls, trips and slips. Significantly for premium payers, males accounted for approximately 40 per cent of all accepted claims for falls, trips and slips and body stressing and for licensed self-insurers, males accounted for approximately 80 per cent of accepted claims for falls, trips and slips and body stressing. The data presented in figure 5.14 is based on actual claim numbers and does not take into account the relative proportion of male and female workers employed by premium payers and licensed self-insurers. In general, there are a greater proportion of males employed within licensed self-insurers than within premium payers. Note: The category all other mechanisms of incidents includes biological factors, sound and pressure, heat, electricity and other environmental factors and chemicals and other substances. Figure 5.15 Figure 5.15 Accepted claims by mechanism of incident and gender 12 months to 30 June 2009 Hitting objects with the body All other mechanism of incidents Hit by moving objects Vehicle incidents and other Falls, trips and slips Body stressing Mental stress % 20% 40% 60% 80% 100% Premium payers, male Premium payers, female Licensed self-insurers, male Licensed self-insurers, female SRCC AUSTRALIA S SAFEST WORKPLACES Compendium of OHS & Workers Compensation Statistics 25

26 5.2.4 Accepted claims by age group (Australian Government premium payers) Figure 5.16 shows the estimated incidence of accepted claims involving incapacity of one week or more by age group over the period to The data covers claims for Australian Government premium payers only as age distribution data is not available for licensed self-insurers. The incidence rates shown below were estimated using age distribution data for the Australian Public Service 2 which accounts for approximately 80 per cent of workers employed within premium payers. The ACT Government has been excluded as age related data is unavailable and it is not included as part of the Australian Public Service. The data shows an overall reduction in the incidence of claims for all age groups over the period through Since , there has been a direct relationship observed between age and the incidence of claims, with successively older age groups evidencing higher claims incidence rates. If this pattern were to continue, this would represent a significant policy issue given the ageing workforce. Figure 5.16 Estimated incidence of claims (one week or more time lost) by age group (Australian Government premium payers) Figure Claims per 1000 FTE employees with one week or more incapacity < >55 2 Australian Public Service Commission, State of the Service Report SRCC AUSTRALIA S SAFEST WORKPLACES Compendium of OHS & Workers Compensation Statistics 26

27 5.2.5 Accepted claims by mechanism of incident and age group (Australian Government premium payers) Figure 5.17 shows the estimated incidence of accepted claims with one week or more time lost by mechanism of incident and age group for the 12 months to 30 June The data covers claims for Australian Government premium payers only as age distribution data is not available for licensed self-insurers. The incidence rates shown below were estimated using age distribution data for the Australian Public Service 3 which accounts for approximately 80 per cent of workers employed within premium payers. The ACT Government has been excluded as age related data is unavailable and it is not included as part of the Australian Public Service. The data shows that the incidence of claims for body stressing peaks in the years age group. The incidence of claims for falls, trips and slips and mental stress increases by age, with the over 55 age group having the highest incidence of claims in these two categories. Meanwhile workers in the under 25 and age groups have the highest incidence of claims for the hit by moving objects category. Figure 5.17 Estimated incidence of claims (one week or more time lost) by mechanism of incident and age group (Australian Government premium payers) 12 months to 30 June 2009 Figure Claims with one or more weeks incapcity per 1000 FTE employees Body Stressing Falls, trips and slips Hit by moving objects Mental stress Vehicle incidents and other Hitting objects with body All Other < >55 Average 3 Australian Public Service Commission, State of the Service Report SRCC AUSTRALIA S SAFEST WORKPLACES Compendium of OHS & Workers Compensation Statistics 27

28 5.2.6 Average total cost of claims by age (Australian Government premium payers) Figure 5.18 shows the average total cost* of accepted claims by age group for the 12 months to 30 June The data covers claims for Australian Government premium payers only as age distribution data is not available for licensed selfinsurers. The incidence rates shown below were estimated using age distribution data for the Australian Public Service 4 which accounts for approximately 80 per cent of workers employed within premium payers. The ACT Government has been excluded as age related data is unavailable and it is not included as part of the Australian Public Service. The data indicates that the age groups and years have the highest average total cost of claims. Figure 5.18 Average total cost* of claims by age (Australian Government premium payers) 12 months to 30 June 2009 Figure Average total claim cost*$ ('000) < >65 Average of all claims * Average total cost is the cost to date plus estimated outstanding liability 4 Australian Public Service Commission, State of the Service Report SRCC AUSTRALIA S SAFEST WORKPLACES Compendium of OHS & Workers Compensation Statistics 28

29 5.3 Prevention targets The Comcare scheme has a safety focus and regulatory philosophy that seeks to work with employers and their employees to prevent injuries in the workplace. The National OHS Strategy , endorsed by the Workplace Relations Ministers Council, outlines two national targets designed to create safer workplaces in Australia. The first target seeks a reduction in the incidence of work-related deaths, with a reduction of at least 20 per cent by 30 June The second national target seeks to reduce the incidence of workplace injury by at least 40 per cent by 30 June The SRCC adopted the national targets but went further by extending the injury target to include work-related disease and established an aspirational zero target for work-related injury deaths Claims with one week lost time (non-commuting) 5 Figure 5.19 shows that for the overall scheme (premium payers and licensed self-insurers) in , there were 8.8 claims per 1000 FTE employees a 29 per cent improvement since This result shows that the scheme is currently on track to meet the 40 per cent reduction target, which implies a 28 per cent improvement by 30 June Figure 5.19 Figure 5.19 Claims with one week lost time (premium payers and licensed self-insurers) Calims per 1000 FTE employees Result Target Commuting claims have been excluded from this measure since April 2007 due to changes to the SRC Act, which removed workers compensation coverage for journeys to and from work. SRCC AUSTRALIA S SAFEST WORKPLACES Compendium of OHS & Workers Compensation Statistics 29

30 5.3.2 Deaths The number of deaths reported in this section is based on claims lodged under the SRC Act (i.e. compensated deaths). The number of compensated deaths reported may not correlate with the number of notified deaths in each year. This is due to the different statutory definitions which apply to compensated deaths (claims under the SRC Act) compared to notifiable deaths (notified under the OHS Act). For example, incidents resulting in bystander deaths are included as notifiable deaths under the OHS Act, whereas compensated deaths only relate to employees under the SRC Act. Table 5.2 shows that four injury death claims were recorded by the scheme for The Commission s aspirational target of zero injury deaths was therefore not achieved. Two injury death claims were each reported by premium payers and licensed self-insurers. Two of these claims were the result of work-related transport accidents. Current data shows that the scheme has failed to meet the zero injury death target each year since its introduction in and it is likely that this target will remain difficult to achieve in future. While not contributing to performance against the scheme target, eight disease death claims were also reported by the scheme in These eight death claims were reported by premium payers, with six of these claims due to asbestos-related diseases. Table 5.2 Compensated deaths Premium payers Injury Disease Commuting Licensed self-insurers Injury Disease Commuting Total Injury Disease Commuting SRCC AUSTRALIA S SAFEST WORKPLACES Compendium of OHS & Workers Compensation Statistics 30

31 5.4 OHS incident notifications The OHS Act covers Australian Government premium payers, licensed self-insurers and members of the ADF. Under the OHS Act, employers are required to notify Comcare of incidents that result in a death, serious personal injury, specified incapacity or a dangerous occurrence. An incident is notifiable if it arose out of the conduct of the employer s undertaking, or out of work performed by an employee in connection with the undertaking. Death, serious personal injury and dangerous occurrence notifications relate to both employees and non-employees. As a result, these notifications are viewed as a risk arising from work undertaken, rather then a discrete risk to employees OHS notification incidence rate Figure 5.20 shows the incidence of OHS notifications between the period and , reported as a rate per 1000 FTE employees, with the exception of death notifications, which are reported per FTE employees. A 35 per cent decrease in the incidence of total notifications was reported for the scheme in , compared to the preceding four year period ( to ). This decrease was observed across all categories with the exception of deaths, which have increased since The majority of notifications over the five reporting periods relate to dangerous occurrences, which comprised approximately 79 per cent of the total notifications for Figure 5.20 Figure 5.20 OHS notifications incidence rate (scheme) Notifications (excl deaths) per 1,000 FTE employees Notified deaths per 100,000 FTE employees Employee incapacity Serious personal injury Dangerous occurrence Total Notifications Deaths SRCC AUSTRALIA S SAFEST WORKPLACES Compendium of OHS & Workers Compensation Statistics 31

32 5.4.2 OHS notifications by mechanism of incident Table 5.3 shows the number of OHS notifications by mechanism of incident for the 12 months ending 30 June 2009, for premium payers and licensed self-insurers. Vehicle incidents and other accounted for 31 per cent of total notifications, followed by being hit by moving objects (16 per cent), falls, strips and slips of a person (14 per cent) and chemicals and other substances (9 per cent). The largest number of notifications received by Comcare was for dangerous occurrences, with notifications in total. Dangerous occurrences are defined as incidents at a workplace that resulted from operations that could have caused (but did not cause) a death or serious personal injury to any person, or total incapacity of an employee for 30 or more consecutive shifts or days. Of these, 34 per cent related to vehicle incidents and other, 15 per cent related to being hit by moving objects and 12 per cent related to falls, trips and slips of a person. A serious personal injury is defined as an injury or disease caused in the course of work for which the injured person required emergency treatment by a registered medical practitioner (including psychologist), or treatment in a hospital, with or without being admitted to the hospital. Approximately 25 per cent of serious personal injury notifications related to falls, trips and slips of a person, 22 per cent related to being hit by moving objects and 20 per cent to vehicle incidents and other. An incident that is likely to result in work-related incapacity, leaving an employee unable to work for 30 or more successive shifts or 30 or more successive working days (depending on working arrangements), is notifiable under the OHS Act. Approximately 36 per cent of incapacity notifications related to mental stress, 24 per cent to body stressing and 22 per cent related to falls, trips and slips of a person. The number of notified deaths reported in this section is based on the number of notifications received under the OHS Act. The number of notified deaths reported may not correlate with the number of compensated deaths in each year. This is due to the different statutory definitions which apply to notifiable deaths (notified under the OHS Act) compared to compensated deaths (claims under the SRC Act). For example, incidents resulting in bystander deaths are included as notifiable deaths under the OHS Act. By comparison, compensated deaths only relate to employees under the SRC Act. Table 5.3 OHS notifications by mechanism of incident (scheme) 12 months to 30 June 2009 Incident Type Mechanism of incident Death Incapacity Dangerous occurrence Serious personal injury Total % of all notifications Vehicle incidents and other % Being hit by moving objects % Falls, trips and slips of a person % Chemicals and other substances % Heat, radiation and electricity % Body stressing % Hitting objects with part of the body % Mental stress % Sound and pressure % Biological factors % All mechanisms of incident % SRCC AUSTRALIA S SAFEST WORKPLACES Compendium of OHS & Workers Compensation Statistics 32

33 5.5 Investigations Over 90 per cent of employees covered by the OHS Act work in large organisations with more than 500 FTE employees. These employers generally have mature OHS systems in place. Comcare s broad-based approach to education and enforcement focuses on compliance with the OHS Act, including provision of compliance assistance, development and administration of safety policy, and enforcement of OHS legislation through its regulatory assurance program. Comcare may undertake two types of investigations under its regulatory assurance program: 1. A reactive investigation may be initiated in response to a particular incident that has occurred. These are most commonly undertaken in response to an accident or dangerous occurrence. Notifications of an accident or dangerous occurrence are a key trigger for Comcare to commence such an investigation. 2. A proactive investigation is programmed in advance by Comcare as part of an annual investigation program. These include both targeted and review investigations: Targeted investigations generally assess compliance with specific duties under the OHS Act or Regulations and are formulated in the annual compliance plan. Targeted investigations are scheduled in advance and run as a broader intervention campaign. These investigations may involve initiatives to develop awareness of a particular area of regulatory compliance being assessed, the conduct of investigations in a cross-section of organisations in the jurisdiction and the promulgation of results to both individual organisations and to the jurisdiction as a whole. Review investigations assess the effectiveness of an employer s actions in addressing recommendations of previous investigations. Table 5.4 sets out the number of Comcare field active investigators per FTE employees in the jurisdiction. Comcare currently employs 70 OHS field active investigators and brings in experts to assist in investigations where required. The ratio of field active investigators to employees covered by the Comcare scheme is comparable with the latest figures for other Australian state and territory OHS regulators. Table 5.4 Number and ratio of field active investigators Number of field active investigators Number of field active investigators per FTE employees SRCC AUSTRALIA S SAFEST WORKPLACES Compendium of OHS & Workers Compensation Statistics 33

34 Table 5.5 provides a breakdown of the total number of investigations commenced by Comcare in the years and The number of investigations decreased from 346 during to 295 during Over this period, the number of proactive investigations decreased from 82 to 35, while the number of reactive investigations decreased from 264 to 260. Comcare is currently reviewing the definitions relating to proactive and reactive investigations to provide more consistent reporting. Because of the nature of targeted investigation activities, care needs to be taken in making a direct comparison between this type of investigation and reactive investigations. That is, a proactive investigation may involve a range of interventions in a number of organisations as part of a broader program of activities. Table 5.5 Investigations commenced Investigation Type Premium payers Licensed selfinsurers ADF Scheme Premium payers Licensed selfinsurers ADF Scheme Proactive Investigations Review Targeted Total Reactive Investigations Dangerous occurrence Death report Disputed PIN Incapacity Serious personal injury Other Total SRCC AUSTRALIA S SAFEST WORKPLACES Compendium of OHS & Workers Compensation Statistics 34

35 Figure 5.21 provides the rate of proactive and reactive investigations per FTE employees that were commenced by Comcare in the period to The rate of proactive investigations declined between and , from approximately 31.3 investigations per FTE employees (90 investigations) in to 8.5 investigations per FTE employees (35 investigations) in The rate of reactive investigations increased significantly between and , but has declined in Figure 5.21 Figure 5.21 Rate of investigations commenced Completed investigations per 100,000 FTE employees Proactive investigations Reactive investigations SRCC AUSTRALIA S SAFEST WORKPLACES Compendium of OHS & Workers Compensation Statistics 35

36 6 Claims management The Comcare workers compensation scheme is a no fault scheme with limited access to common law. This means that an injured employee does not have to prove negligence on behalf of the employer to be eligible to receive compensation for a work-related injury/disease. The scheme provides employees who have an accepted claim for work-related injury or illness access to: compensation for time off work for 45 weeks at one hundred per cent of their pre injury salary level (normal weekly earnings) and a reduced rate thereafter until age 65 (or 104 weeks if injured after 63 years of age), if their injury precludes them from working payment of reasonably required medical and related costs associated with treatment until their injuries resolve reasonable rehabilitation support /return-to-work assistance at no cost to the individual payment by way of lump sum for any permanent impairment death and funeral benefits for dependents and weekly benefits for dependent children. 6.1 Process For compensation to be payable under the SRC Act, Comcare must find that liability exists for an employee s injury or illness. An injury can be a disease, a physical or mental injury, or an aggravation of a physical or mental injury that arose out of, or in the course of employment. Comcare considers the following factors in determining liability for compensation: Compliance with certain conditions specified in the SRC Act, including submission of a written claim on the approved form and provision of a medical certificate identifying an injury or disease. In circumstances where the claim is not compliant, further information may be sought by Comcare. Employment relationship. Whether the injury arose out of or in the course of employment, or if a disease, a significant contribution by employment. Medical evidence. Exclusionary provisions specified in the SRC Act including that compensation is not payable where the injury, disease or aggravation: was suffered as a result of reasonable administrative action was self-inflicted was as a result of serious and wilfull misconduct occurred during a break or when commuting to and from work. Compensation is payable in those circumstances where the injury results in permanent impairment or death. SRCC AUSTRALIA S SAFEST WORKPLACES Compendium of OHS & Workers Compensation Statistics 36

37 Figure 6.1 provides an overview of the Comcare claims lodgement and determination process. Note that this is an abridged version for general guidance purposes only. Figure 6.1 Comcare claim lodgement and determination process Claimant injured or ill Claim lodged with Comcare Is claim compliant? NO Further information sought YES Claim rejected NO Have the required factors been met? YES Claim accepted Benefits paid SRCC AUSTRALIA S SAFEST WORKPLACES Compendium of OHS & Workers Compensation Statistics 37

38 Figure 6.2 provides an overview of the review and reconsideration process. The SRC Act provides employees and employers with access to a two-tiered review process. Employees or employers may choose to request a review if they are dissatisfied with a decision on claim liability made by a determining authority (Comcare or a licensed self-insurer). An employee may also request a review of a decision made by their rehabilitation authority (employer) in relation to rehabilitation. The first tier involves a request for reconsideration by the determining authority. This requires the decision to be reconsidered by a person within that authority who was not involved in making the original decision. Comcare may also reconsider a matter of its own motion where it considers the original determination was incorrect or if it receives information that changes its view of the original determination. Once a reconsideration has been completed, that decision then becomes a reviewable decision and either the employee or the employer may choose to apply to the Administrative Appeals Tribunal (AAT) for an external review. Once the AAT has undertaken a review, the reviewable decision is either affirmed, revoked or varied. If a party to an AAT review disagrees with the AAT s decision, that party can appeal to the Federal Court in respect of an error of law (for example misapplication of the law). If the Federal Court finds that such an error has been made, the Court may order that the matter be remitted back to the AAT to be reheard with directions. Decisions of the Federal Court may be further appealed on points of law to the Full Court of the Federal Court (consisting usually of 3 judges), and to the High Court by way of an application for special leave to appeal. Figure 6.2 Claim reconsideration and review process Claim determined Claimant/employer satisfied? NO Determining authority reconsideration Reviewable decision External Review AAT Appeal affirmed/revoked/varied Federal Court Appeal allowed/disallowed High Court Appeal allowed/disallowed SRCC AUSTRALIA S SAFEST WORKPLACES Compendium of OHS & Workers Compensation Statistics 38

39 6.2 Claims summary Claims determined Figure 6.3 shows the incidence of claims determined (i.e. claims accepted and rejected) for the period to The data shows there has been a reduction of approximately 37 per cent in the incidence (number of claims per 1000 FTE employees) determined across the scheme. Comcare premium payers experienced a 46 per cent decrease in claims determined, from approximately 36 claims per 1000 FTE employees in to approximately 20 claims per 1000 FTE employees determined in The data shows that licensed self-insurers had a 42 per cent decrease in the incidence of claims determined from approximately 70 claims per 1000 FTE employees in to 41 claims per 1000 FTE employees in Since , the incidence of claims determined for licensed self-insurers has remained almost double that for Comcare premium paying employers. Figure 6.3 Figure 6.3 Incidence of claims determined 80 Calims determined per 1000 FTE employees Premium payers Licensed self-insurers Scheme SRCC AUSTRALIA S SAFEST WORKPLACES Compendium of OHS & Workers Compensation Statistics 39

40 6.2.2 Claims acceptance rate Figure 6.4 shows the claims acceptance rate from to for premium payers, licensed self-insurers and for the scheme. In , 84 per cent of claims determined were accepted by the scheme. These included claims that were accepted following reconsideration or review. Since , licensed self-insurers have accepted a higher proportion of claims than Comcare (i.e. for premium paying employers). In 2008 an investigation into factors contributing to the decrease in Comcare s claims acceptance rate was undertaken. It was found that a higher proportion of disease claims were received in recent years and the associated complexity of these claims had contributed to the decreasing claims acceptance rate. The amendments to the SRC Act introduced in April 2007 also had a more substantial impact on the claim profile and associated complexity for premium payers, which is evident in the decline in the claims acceptance rate from 87 per cent in to 80 per cent in As licensed self-insurers have a lower proportion of disease claims compared to premium paying employers, the SRC Act amendments have had less impact on their claims acceptance rate. Figure 6.4 Figure 6.4 Claims acceptance rate 100 Percentage of determined claims % 89% 89% 87% 87% 84% 80% 84% 81% 86% Premium payers Licensed self-insurers Scheme SRCC AUSTRALIA S SAFEST WORKPLACES Compendium of OHS & Workers Compensation Statistics 40

41 6.3 Determinations Table 6.1 shows the average time taken in calendar days to determine new claims from date of receipt for the period to The data shows significant differences in the claim determination time between Comcare and licensed self-insurers. Disease claims take longer to determine than injury claims due to their complexity,. Table 6.1 Average time (calendar days) to determine claims Nature of claim Comcare (premium payers) Licensed selfinsurers Scheme Injury Disease Injury Disease Injury Disease SRCC AUSTRALIA S SAFEST WORKPLACES Compendium of OHS & Workers Compensation Statistics 41

42 6.4 Reconsiderations Table 6.2 provides data relating to reconsiderations decided in each year from to The data excludes reconsiderations of own motion initiated by determining authorities, decided in each year from to The data comprises reconsiderations requested by claimants and includes matters which were affirmed, varied or revoked. The data indicates that the average time taken to decide requests for reconsideration increased in , but has generally reduced since then, particularly for licensed self-insurers. Table 6.2 also shows the affirmation rate for requests for reconsideration decided in each year from to The data shows the percentage of determining authorities original decisions which are upheld following a request for a reconsideration. The data indicates that the affirmation rate for Comcare has increased from 62 per cent in to 72 per cent in The affirmation rate for licensed self-insurers has remained relatively stable between 77 per cent and 80 per cent over the period to Table 6.2 Requests for reconsiderations decided Number of requests decided Comcare (premium payers) Licensed self-insurers Scheme Average time (calendar days) to decide requests for reconsideration Comcare (premium payers) * Licensed self-insurers Scheme Injury Disease Injury Disease Injury Disease Affirmation rate at reconsideration Comcare (premium payers) 62% 67% 71% 72% 72% Licensed self-insurers 77% 78% 78% 77% 80% Scheme 69% 72% 75% 74% 76% * Based on the number of calendar days from the date of commencement of the reconsideration to the decision date for a reviewable decision. A delay between receipt and commencement of a review may occur when the claimant has indicated they will follow-up their request for reconsideration at a later date with further evidence (e.g. additional medical report) to support their claim. SRCC AUSTRALIA S SAFEST WORKPLACES Compendium of OHS & Workers Compensation Statistics 42

43 6.5 AAT reviews The number of Administrative Appeals Tribunal (AAT) appeals received for the Comcare Scheme decreased by 18 per cent from to Tables 6.3 and 6.4 show the number of AAT applications finalised during and for premium payers and licensed self-insurers. The data only includes requests for review lodged by claimants. Requests for review lodged by employers, which represent less than 0.1 per cent of all requests for review, are excluded. The data in Table 6.3 shows that the number of claimant applications to the AAT that have been finalised increased by 48 per cent for premium payers from 457 during to 675 during The affirmation rate shows the percentage of Comcare s original decisions that were affirmed without variation. Table 6.3 Outcome of claimant applications to the AAT (premium payers)* Outcome of claimant applications No. of applications finalised No. of original decisions affirmed No. of original decisions set aside or varied Affirmation rate Applications heard and determined by the Tribunal % Applications finalised by consent % Applications dismissed by consent 2 2 n/a n/a Applications withdrawn by applicant n/a n/a Other applications dismissed, etc n/a n/a Outcome of all applications % Applications heard and determined by the Tribunal % Applications finalised by consent % Applications dismissed by consent 4 4 n/a n/a Applications withdrawn by applicant n/a n/a Other applications dismissed, etc 7 7 n/a n/a Outcome of all applications % * Based on data supplied by the Administrative Appeals Tribunal SRCC AUSTRALIA S SAFEST WORKPLACES Compendium of OHS & Workers Compensation Statistics 43

44 Table 6.4 shows the outcome of claimant applications to the AAT for licensed self-insurers. The number of claimant applications finalised increased by 13 per cent from 528 during to 596 during Table 6.4 Outcome of claimant applications to the AAT (licensed self-insurers)* Outcome of claimant applications No. of applications finalised No. of original decisions affirmed No. of original decisions set aside or varied Affirmation rate Applications heard and determined by the Tribunal % Applications finalised by consent % Applications dismissed by consent 7 7 n/a n/a Applications withdrawn by applicant n/a n/a Other applications dismissed, etc n/a n/a Outcome of all applications % Applications heard and determined by the Tribunal % Applications finalised by consent % Applications dismissed by consent 7 7 n/a n/a Applications withdrawn by applicant n/a n/a Other applications dismissed, etc 5 5 n/a n/a Outcome of all applications % * Based on data supplied by the Administrative Appeals Tribunal SRCC AUSTRALIA S SAFEST WORKPLACES Compendium of OHS & Workers Compensation Statistics 44

45 7 Rehabilitation and return-to-work A key objective of the Comcare scheme is the early and safe return to work of injured employees covered by the scheme. While employers are responsible for managing the rehabilitation and return to work of their injured or ill employees, Comcare provides support and advice to employers on how to manage their responsibilities. Rehabilitation and return-to-work programs are based on the principles that intervention should occur as soon as practical after injury or disease and that the employer can enable a coordinated return to work. An employer providing early intervention and rehabilitation sends a strong message that the workplace values the employee s contribution and sets an expectation of early return to work. Figure 7.1 sets out the steps in the return-to-work (RTW) process. Figure 7.1 Steps in the return-to-work process Supervisor becomes aware of injury and meets with the employee to discuss prevention of further injury Supervisor notifies case manager Case manager decides if further assessment needs to be undertaken (s.36) YES assessment required Case manager refers to an approved rehab provider (ARP), legally qualified medical practitioner or panel for assessment NO assessment not required Case manager initiates RTW planning based on medical advice and in consultation with the employee and supervisor (s.37) RTW program developed to assist injured employee to RTW quickly and safely Case manager, ARP and doctor monitor and review implementation of RTW plan When employee returns to work case manager closes plan SRCC AUSTRALIA S SAFEST WORKPLACES Compendium of OHS & Workers Compensation Statistics 45

46 7.1 Claim duration Figures 7.2 and 7.3 show the incidence of claims with one, 12, 26 and 52 weeks or more time lost (non-commuting) for the period to for premium payers and licensed self-insurers. Premium payers experienced an overall reduction in the incidence of claims across each time lost category from to However, the incidence of claims involving one and 12 weeks time lost increased during Licensed self-insurers also recorded an overall reduction in time lost during the period to , despite an increase in the incidence of claims with one, 12 and 26 weeks lost time during Figure 7.2 Figure 7.2 Incidence of claims with time lost (premium payers) Calims per 1000 FTE employees week 12 weeks 26 weeks 52 weeks Figure 7.3 Figure 7.3 Incidence of claims with time lost (licensed self-insurers) Calims per 1000 FTE employees week 12 weeks 26 weeks 52 weeks SRCC AUSTRALIA S SAFEST WORKPLACES Compendium of OHS & Workers Compensation Statistics 46

47 Figure 7.4 shows the time-lost-to-date for injury and disease claims. The data includes all accepted claims between and , for both premium payers and licensed self-insurers. The figure shows that approximately 11 per cent of injury claims and 25 per cent of disease claims reached six weeks or more time lost. It also shows that disease claims tend to be of longer duration than injury claims. Figure 7.4 Time-lost-to-date to Figure 7.4 % of all accepted claims 6 weeks 12 weeks 26 weeks Time-lost-to-date (weeks) Disease Injury SRCC AUSTRALIA S SAFEST WORKPLACES Compendium of OHS & Workers Compensation Statistics 47

48 Table 7.1 shows the percentage of accepted claims reaching selected incapacity thresholds. The data shows that premium payers have a higher proportion of accepted injury and disease claims that incur one week or more time lost compared to licensed self-insurers. In addition, licensed self-insurers have less disparity in time-lost-to-date between accepted injury and disease claims compared to premium payers. It should be noted that these figures may change as claims mature, in particular for the most recent reporting periods. Table 7.1 Time-lost-to-date Claims accepted in the period Time-lost-to-date Premium payers injury Accepted claims Less than one week 59% 60% 61% 64% 62% One week or more 41% 40% 39% 36% 38% Six or more weeks 15% 16% 15% 14% 15% 12 or more weeks 10% 9% 9% 8% 8% 26 or more weeks 5% 5% 5% 4% 3% Premium payers disease Accepted claims Less than one week 39% 43% 45% 45% 50% One week or more 61% 57% 55% 55% 50% Six or more weeks 36% 35% 32% 32% 26% 12 or more weeks 26% 26% 23% 23% 18% 26 or more weeks 16% 16% 14% 13% 8% Licensed self insurers injury Accepted claims Less than one week 78% 76% 77% 75% 76% One week or more 22% 24% 23% 25% 24% Six or more weeks 8% 9% 8% 8% 8% 12 or more weeks 4% 5% 4% 4% 3% 26 or more weeks 2% 2% 2% 2% 1% Licensed self insurers disease Accepted claims Less than one week 73% 73% 71% 67% 67% One week or more 27% 27% 29% 33% 33% Six or more weeks 11% 10% 11% 14% 12% 12 or more weeks 7% 6% 6% 9% 6% 26 or more weeks 4% 3% 3% 4% 3% SRCC AUSTRALIA S SAFEST WORKPLACES Compendium of OHS & Workers Compensation Statistics 48

49 7.2 Median time lost injury and disease Figure 7.5 shows that since for premium payers, the median duration of incapacity for accepted injury claims has remained at approximately 1.9 weeks. Between and , the median duration for accepted disease claims was more than five weeks. While it appears that there has been a significant improvement during , data for this period is relatively immature, and the median duration of accepted disease claims in particular is expected to increase with further claim development. Figure Median lost time (premium payers) 7 Time lost from work (weeks) Injury Disease Figure 7.6 shows that over the period to , the median duration of incapacity for accepted injury claims for licensed self-insurers was approximately 1.4 weeks slightly lower than the result for premium payers. The median duration of incapacity for accepted disease claims was also lower for licensed self-insurers compared to premium payers. This is despite a doubling in the median duration of licensed self-insurers accepted disease claims between and It should be noted that data for is relatively immature and the median duration of accepted disease claims in particular is expected to increase. Figure Median time lost (licensed self-insurers) 5 Time lost from work (weeks) Injury Disease SRCC AUSTRALIA S SAFEST WORKPLACES Compendium of OHS & Workers Compensation Statistics 49

50 7.2.1 Durable return-to-work rate Figure 7.7 shows the proportion of injured employees who had returned to work and were still working seven to nine months after lodging their claim (durable return-to-work (RTW) rate). The RTW performance reported is from the National RTW Monitor 6, a national survey of injured employees designed to measure RTW outcomes. The RTW performance of both premium payers and licensed self-insurers has remained at a consistently high level over the five periods reported. Noting that the RTW performance is based on a survey of claimants, and may be influenced to some extent by the survey sample, these results show only minor differences in the performance of licensed self-insurers compared to the premium payers. The durable RTW rate reported in the RTW Monitor for injured employees in the Comcare scheme (88 per cent) was higher than the Australian national average (72 per cent) during In addition the durable RTW rate is higher for licensed self-insurers than for premium payers. Figure 7.7 Figure 7.7 Durable return-to-work (RTW) rate 100% 90% 80% 85% 97% 89% 88% 85% 87% 84% 94% 88% 91% 70% Percentage (%) 60% 50% 40% 30% 20% 10% 0% Premium payers Licensed self-insurers Scheme /08 Australia & New Zealand Return to Work Monitor Report (RTW Monitor), SRCC AUSTRALIA S SAFEST WORKPLACES Compendium of OHS & Workers Compensation Statistics 50

51 7.2.2 Return to Work Monitor Table 7.2 provides a summary of further RTW Monitor 7 results for the period to The data shows that the performance of licensed self-insurers has been slightly better than the performance of premium payers across three indicators: RTW rate, durable RTW rate and RTW with original employer. The RTW performance of licensed self-insurers has generally been better than premium payers. Performance for the scheme has remained relatively stable over the five years from to Table 7.2 Return-to-work performance Measure Injured employees who: Returned to work for some period since injury (RTW rate %) Were working 6 to 9 months post injury (durable RTW rate %) Returned to work with their original employer (%) Returned to work on original duties (%) Premium payers 91% 92% 92% 90% 93% Licensed self-insurers 99% 97% 96% 99% 95% Scheme 92% 93% 93% 93% 94% Premium payers 85% 89% 85% 84% 88% Licensed self-insurers 97% 88% 87% 94% 91% Scheme 87% 88% 86% 87% 89% Premium payers 93% 94% 93% 96% 96% Licensed self-insurers 98% 96% 97% 97% 97% Scheme 94% 95% 94% 96% 97% Premium payers 78% 78% 78% 78% 72% Licensed self-insurers 77% 82% 68% 71% 72% Scheme 78% 78% 76% 75% 72% /08 Australia & New Zealand Return to Work Monitor Report (RTW Monitor), SRCC AUSTRALIA S SAFEST WORKPLACES Compendium of OHS & Workers Compensation Statistics 51

52 8 Scheme expenditure 8.1 Revenue The Comcare scheme revenue sources include a combination of premiums, licence fees and regulatory contributions under the SRC and the OHS Acts. Premium payers pay a workers compensation premium and a regulatory contribution, while licensed self-insurers pay a licence fee. Under the SRC Act, Comcare managed workers compensation liabilities of $1.60 billion and held assets of $1.865 billion (as at 30 June 2009) on behalf of Commonwealth premium payers. Comcare does not manage such liabilities or hold assets for the self-insured component of the scheme, which has estimated workers compensation liabilities of $341 million (June 2009). Each licensed self-insurer is required to make provisions in its audited accounts for these liabilities. In addition, these liabilities are backed by bank guarantees of some $650 million as well as other prudential safeguards. In , some 70 per cent of Comcare s revenue was derived from Australian Government employers, the ACT Government and private sector organisations through workers compensation premiums, regulatory contributions and licence fees. The remaining revenue was provided through Australian Government appropriations. The revenue from premiums in was $207 million, compared to $222 million in Revenue from licence fees has increased since as a consequence of the increase in the total number of licensed self-insurers and their employees covered by the scheme. Table 8.1 Scheme revenue Premium revenue $M Licence fee revenue $M Government appropriations $M Goods and services $M (Inc. regulatory contribution) SRCC AUSTRALIA S SAFEST WORKPLACES Compendium of OHS & Workers Compensation Statistics 52

53 8.2 Premiums Figure 8.1 shows the average premium rates for Australian Government employers and the ACT Government. Employers are financially accountable for the cost of work-related injury and disease through the payment of an annual premium. The premium rate that Comcare sets for each employer reflects that employer s claim frequency and average claim cost as a percentage of their payroll. In the period to there has been a reduction in the average premium rate for workers compensation for premium payers in the Comcare scheme. The Australian Government premium payers have seen a reduction of 23 per cent, with the ACT Government experiencing a reduction of 14 per cent. This reduction is attributed to the decline in the incidence of claims as a result of improved prevention by employers as well as Comcare s focus on prevention. In addition, the CPM Report 8 states that in the standardised Australian average premium rate was 1.59 per cent of payroll, with the Australian Government scheme recording the second lowest standardised premium rate of all jurisdictions at 1.15 per cent of payroll (excluding ACT Government). Figure 8.1 Figure 8.1 Australian Government and ACT Government premium rates 3.50% 3.00% Premium rate (% of payroll) 2.50% 2.00% 1.50% 1.00% 0.50% 0.00% Australian Government 1.43% 1.67% 1.77% 1.77% 1.55% 1.36% ACT Government 3.13% 3.07% 3.08% 3.03% 2.74% 2.66% 8 Comparative Performance Monitoring Report (CPM Report), December 2009, Note that these data are different from Comcare published rates due to the adjustments made to the data to enable more accurate jurisdictional comparisons. SRCC AUSTRALIA S SAFEST WORKPLACES Compendium of OHS & Workers Compensation Statistics 53

54 8.3 Payments Figure 8.2 shows total payments made by Comcare for workers compensation claims for the financial years to These figures include payments to claimants and payments for medical, rehabilitation, legal, administrative and regulatory costs. The total payments for workers compensation claims in was $285.3 million, which represents an increase of approximately 11 per cent from Figure 8.2 Figure 8.2 Workers compensation expenditure Total expenditure $(M) Financial year Claim payments by type Figure 8.3 provides a breakdown of claim payments by payment type for the financial years to Figure 8.3 Figure % Workers compensation payments Per cent of all payments 80% 60% 40% 20% % Paid in the financial year Paid to claimant Medical and rehabilitation Legal, administrative and regulatory costs SRCC AUSTRALIA S SAFEST WORKPLACES Compendium of OHS & Workers Compensation Statistics 54

55 8.4 Performance Funding ratio Table 8.2 sets out the funding ratio of assets to net outstanding claim liabilities. The measure indicates Comcare s ability to meet future claim payments. As illustrated, Comcare s funding ratio has consistently been above 100 per cent, which indicates the scheme has sufficient assets to meet its predicted future liabilities. Table 8.2 Comcare funding ratio 30 June June June June June 2009 Funding ratio 113% 114% 110% 113% 110% Outstanding liabilities Table 8.3 shows outstanding liabilities for the period 30 June 2005 to 30 June The increases each year seen below are due to inflation and the addition of liabilities for an extra injury year. Table 8.3 Outstanding liabilities 30 June June June June June 2009 Premium payers $M $858m $902m $1035m $1083m $1154m SRCC AUSTRALIA S SAFEST WORKPLACES Compendium of OHS & Workers Compensation Statistics 55

56 9 Glossary AAT Accepted claim ACT ADF Administrative Appeals Tribunal Affirmation rate (appeals) Affirmation rate (reconsiderations) ANZSIC 2006 ARP ASCC Average claim cost-to-date Average time lost-to-date Case manager Claim Claim received Claimant Claims acceptance rate Claims management Comcare scheme Commission Administrative Appeals Tribunal, which can on request, review administrative decisions by most Australian and ACT Government departments and authorities. This includes reviewing reconsideration decisions made by Comcare. Either an employee or an employer may request a review of a decision. A claim for compensation where liability has been accepted under the SRC Act. Australian Capital Territory Australian Defence Force See AAT The percentage of the AAT s affirmation of a determining authority s original decisions following an appeal. The percentage of the determining authority s affirmation of its original decisions following a reconsideration. The industry in which an occupational injury or disease occurred is classified in accordance with the Australian and New Zealand Standard Industrial Classification 2006 (ANZSIC) (cat no ). Approved Rehabilitation Provider under the SRC Act. Employers may only engage rehabilitation providers that have been approved by Comcare. Rehabilitation providers assist the employer s case manager to identify medically suitable duties as part of the return-to-work plan (RTWP). Australian Safety and Compensation Council now Safe Work Australia. Average cost per claim (for a defined period of time) as at a specified date. Average amount of time lost accumulated per claim as at a specified date for a defined period of time. Responsible for workplace-based management of an injured employee s return-to-work plan, including initiating, coordinating and monitoring the rehabilitation process. The employer is responsible for providing case managers, who are usually employees of the organisation. Any compliant claim for compensation, for example, the initial liability claim, claim for payment of medical expenses, claim for impairment payments, claim for cost of services rendered or claim for incapacity benefits. A claim for compensation where liability has not yet been determined under the SRC Act. An employee, or a dependant of a deceased employee, who makes a claim for compensation benefits in accordance with the SRC Act. Accepted claims expressed as a percentage of determined claims. The management of an injured person s claim, including registration of a claim, decision making, benefit payment and return-to-work planning. For a claim lodged with Comcare, a Comcare employee manages the claim. The Commonwealth occupational health and safety, rehabilitation and workers compensation scheme. See Safety, Rehabilitation and Compensation Commission SRCC AUSTRALIA S SAFEST WORKPLACES Compendium of OHS & Workers Compensation Statistics 56

57 CPM Report Commuting Dangerous occurrence Date of determination Date of injury or date of disease Date of receipt Determination Disease Frequency rate Full-time equivalent (FTE) employees HWCA Impairment Incapacity Incapacity benefit Incapacity (notifiable) Incidence rate Injury Liability Licensed self-insurers Comparative Performance Monitoring report, which is produced annually and provides a comparison of occupational health and safety and workers compensation schemes in Australia and New Zealand. Travel to or from work as defined in section 6 of the SRC Act. This does not include travel associated with employment. That is where the travel is part of an employee s duties or where the cost of travel is met by the employer. Under the Occupational Health and Safety (Safety Arrangements) Regulations 1991, r.3 dangerous occurrence is a work-related occurrence that resulted from operations that arose from an undertaking conducted by an employer and could have caused (but did not cause) the: death of a person serious personal injury to any person total incapacity of any employee for 30 or more consecutive shifts or days. The date upon which a decision was made regarding liability to pay a claim or to provide rehabilitation. For a new claim the date of determination means the date upon which the first decision was made to either accept or deny liability. Date when medical treatment was first sought, or first resulted in incapacity or impairment (disease) as defined by s.7(4) of the SRC Act. Refers to the date on which a new claim or request for reconsideration, being compliant with legislative requirements, was received in the area responsible for determining claims. A decision regarding liability for compensation or rehabilitation under the SRC Act. For a new claim, determination means the initial decision regarding liability. From 13 April 2007 any ailment suffered by an employee, or the aggravation of such an ailment, that is contributed to, to a significant degree, by the employee s employment. Disease is defined by the Nature of Injury classification in TOOCS. The number of cases expressed as a rate per million hours worked by employees. The total hours worked by all employees in the reporting period divided by the average/standard hours worked in full-time jobs. Heads of Workers Compensation Authorities The loss, the loss of use, or the damage or malfunction, of any bodily system or function or part of such system or function. A permanent impairment is one that is likely to continue indefinitely. A diminished ability to earn. A payment made by Comcare, directly or indirectly, by way of income maintenance. Under the Occupational Health and Safety (Safety Arrangements) Regulations 1991, r.36a incapacity is a work-related incapacity that leaves an employee unable to work: in the case of an employee who performs work in shifts 30 or more successive shifts workable by the employee in any other case 30 or more successive working days. The number of cases expressed as a rate per 1000 FTE employees. Incidence rates for deaths are expressed as a rate per FTE employees. Refers to either an injury or disease (unless otherwise specified). An injury can be a physical or mental injury and includes aggravation of a pre-existing ailment. The effect of a determination. Where liability is accepted a legal obligation is created to pay compensation under the SRC Act. A Commonwealth authority or a corporation that is a holder of a license under Part VIII of the SRC Act. SRCC AUSTRALIA S SAFEST WORKPLACES Compendium of OHS & Workers Compensation Statistics 57

58 Lost time claims Mechanism of incident All accepted claims which have resulted in one day or more time lost from work excluding deaths and including those with a lump sum payment. TOOCS classification that identifies the overall action, exposure or event that best describes the circumstances that resulted in the most serious injury or disease. Median The median is a measure of central tendency of a sample and is the value for which one half (50 per cent) of the observations when ranked will lie above that value and one half will lie below that value. MOI See mechanism of incident MRC Act Military Rehabilitation and Compensation Act 2004 Non-commuting injury Occupational Health and Safety Act 1991 (OHS Act) Occupational rehabilitation OHS An injury sustained other than when travelling to or from work, as defined in s.6 of the SRC Act. This includes travel associated with employment. That is where the travel is part of an employee s duties or where the cost of travel is met by the employer. (see commuting). Provides for the health, safety and welfare at work of employees of Australian Government departments and authorities, and licensed self-insurers. A managed process involving early intervention with appropriate, adequate and timely services based on assessed needs, and which is aimed at maintaining injured or ill employees in, or returning them to, suitable employment. Occupational health and safety OHS Act Occupational Health and Safety Act 1991 OHS Code 2008 Occupational Health and Safety Code of Practice 2008 Premises Premium Under s.5 of the OHS Act, premises refers to any place (whether enclosed or built or not) including a place situated under ground or under water. This includes: a building, aircraft, vehicle or vessel any structure, whether a fixed or moveable structure, and whether on land, on a water bed or floating on water a part of a premises. A contribution made to Comcare calculated on the estimated costs of an employer s workers compensation costs for a given financial year. It is based on fully funded principles and is designed to be responsible to the employer s claims experience. Premium claim Claim with a date of injury after the introduction of Comcare s premium system on 1 July Also referred to as an insured claim. Premium rate Pre-premium claim Provider Reconsideration Rehabilitation Return-to-work plan (RTWP) RTW Rate expressed as a percentage of wage/salary dollar, which when multiplied by the estimate of wage/salary, will provide the premium payable by that employer. Claim with a date of injury prior to the introduction of Comcare s premium system on 1 July These claims and the resultant expenditure may also be called uninsured. Person or organisation providing medical, rehabilitation or health services in relation to a work-related injury or disease. An employee or employer, who is dissatisfied with a decision made by Comcare, may ask for that decision to be reviewed by an officer not involved in the making of the decision in question. The result of such a review is call a reviewable decision. See occupational rehabilitation A document detailing a claimant s rehabilitation program including return-to-work objectives, timeframes, a breakdown of proposed services and costs. Return to work SRCC AUSTRALIA S SAFEST WORKPLACES Compendium of OHS & Workers Compensation Statistics 58

59 Reviewable decision Safety, Rehabilitation and Compensation Act 1988 (SRC Act) Safety, Rehabilitation and Compensation Commission (SRCC or the Commission) Scheme Serious personal injury (SPI) SRC The term used to describe a decision reconsidered by Comcare under s.38 or s.62 of the SRC Act. Only when there is a Reviewable Decision can there be an application to the Administrative Appeals Tribunal (see reconsideration and AAT). The legislation which established Comcare and defines how the workers compensation function is to be administered for the Australian Government or ACT Government and any corporation that is a holder of a licence under Part VIII of the SRC Act. Is responsible for issuing licenses for self-insurance and claims management, and for various regulatory functions under the occupational health and safety legislation. It reports to the Minister for Employment and Workplace Relations. See Comcare scheme Under the Occupational Health and Safety (Safety Arrangements) Regulations 1991, r.2(1) a serious personal injury is an injury to, or disease in a person, caused in the course of work for which the person needed: emergency treatment by a registered medical practitioner (including psychologist) treatment in a hospital as a casualty, without being admitted to the hospital admission to a hospital. Safety, Rehabilitation and Compensation SRC Act See Safety, Rehabilitation and Compensation Act 1988 SRCC SRCOLA Act TOOCS Type of Occurrence Classification System (TOOCS) Work-related Workers compensation expenditure Workplace See Safety, Rehabilitation and Compensation Commission The Safety Rehabilitation Compensation and Other Legislation Amendment Act (2007) was implemented from 13 April 2007 and removed workers compensation coverage for non-work related journeys and, where there is a lack of employer control over employee activity, from recess breaks. The SRCOLA Act also strengthened the connection between work and eligibility for workers compensation, particularly in regard to disease claims. See Type of Occurrence Classification System Provides a system for coding the circumstances surrounding an injury/disease occurrence. Current classification system in use is the third edition TOOCS 3.1. The incident arose out of the conduct of the employer s undertaking, or work performed by an employee in connection with the employer s undertaking. Expenditure under the SRC Act. Includes expenditure on incapacity, medical and associated travel, rehabilitation costs, certain legal costs and other claim related expenses. A workplace under the OHS Act, s.5 is: any Commonwealth premises (premises owned or occupied by the Commonwealth or a Commonwealth Authority) any non-commonwealth licensee premises (premises owned or occupied by the non- Commonwealth licensee) in which Commonwealth or non-commonwealth licensee employees, contractors or Commonwealth Authority employees work. It does not include any part of a premises that is primarily used as a private dwelling. SRCC AUSTRALIA S SAFEST WORKPLACES Compendium of OHS & Workers Compensation Statistics 59

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