Workers' Compensation in NSW: Claims, Dispute Resolution, and Reforms

This report analyzes the worker's compensation system in New South Wales (NSW), focusing on claims and dispute resolution procedures. It details the processes for handling various disputes, including those related to work capacity, liability, injury management, and premiums. The report examines the role of key entities like insurers, WIRO, SIRA, and the Workers Compensation Commission (WCC) in resolving these disputes. It assesses the extent to which the current procedures align with best practice models, highlighting reforms aimed at improving dispute resolution efficiency. The report also provides recommendations for further reforms, emphasizing the need for quicker, fairer processes and clearer communication with workers. It references relevant legislation, including the Workers Compensation Legislation Amendment Act 2018, and provides a comprehensive overview of the claims process, including weekly payments and compensation for medical expenses and return-to-work costs. The report concludes with a call for experienced gatekeepers and internal reconsideration processes to maximize dispute resolution effectiveness. The report contains references to various books, journals, and online resources to support the claims and arguments.

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Table of Contents
INTRODUCTION ..........................................................................................................................1
QUESTION 1...................................................................................................................................1
1. The Claims and Dispute resolution procedures in the worker's compensation statute of
NSW............................................................................................................................................1
2. Extent to which this procedure comply with suggestions as per the best practise model.......3
3. Recommendation to reform the procedure to comply with best practise model.....................3
REFERENCES................................................................................................................................5
Books and Journals ....................................................................................................................5
Online..........................................................................................................................................5

INTRODUCTION
Laws are made for the betterment of the society and are applicable for every person. The
workers at the workplace must be treated fairly and equally without discrimination as per the
laws and to provide the workers with fair wages there are laws made to protect the interest of
workers. This essay is related to the worker's compensation in which it will include the claims
and dispute resolution procedures. Moreover, It will include the compliance of the procedure as
per the best practise model. In addition to this, It will provide the aims and legislative intent
behind Anti- discrimination legislation. Furthermore, It will include statutory provisions as per
the anti- discrimination legislation. Also, it will provide understanding of common law for anti-
discrimination legislation.
QUESTION 1
1. The Claims and Dispute resolution procedures in the worker's compensation statute of NSW
The NSW government to protect the workers and provide the fair compensation and
claims for the various dispute at the workplace has made various reforms. There are various
disputes in relation to the worker's compensation which includes work capacity decision ,
permanent impairment and medical, liability, Injury management and premium disputes. The
NSW government has passed a new worker's compensation legislation Amendment Act, 2018 to
improve the process of dispute resolution (Elbers And et.al., 201). The disputes regarding the
work capacity decision in which the worker disagree with the insurer decision about ability to
work. The work capacity decision is the decision taken by the insurer for the worker and their
current work capacity, current weekly earnings, pre- injury average weekly earnings, suitable
employment, and matters that impact on weekly payment of compensation.
This dispute arises due to inability of the workers to return to work after some injury.
When a worker contact the insurer for liability disputes that person provide its decision notice on
the matter. The disputes regarding this may occur when the insurer does not consider the person
that making the claim is the worker under the legislation. The disputes also occur if the insurer
consider that the injury was not due to the employment (Minter, 2017). The workers for the
disputes has to provide information to the insurer regarding the claim and the insurer have to
respond to the worker within 14 days to review the decision. To resolve the dispute the worker
can contact WIRO ( worker compensation independent review office) if the worker is
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dissatisfied by the decision made by the insurer. WIRO in order to resolve the dispute provide
advise from the lawyer under the independent legal assistance and review service ( ILARS). If
the dispute is not resolved at this stage then the worker can apply to the worker's compensation
commission to resolve the dispute.
The worker in the dispute regarding Injury management can take assistance from the
insurer and if the worker is not satisfied by the decision taken by that person then the worker can
apply to SIRA. It is the regulator of worker compensation system in NSW. If the workers is not
satisfied by the decision of SIRA then it can apply to Worker compensation commission to
resolve the dispute. It is the independent tribunal which helps to resolve workers compensation
disputes between workers, employers and / or insurer (Grant and Gnanaseelan, 2017). NSW
government has planned to reform the worker's compensation dispute resolution system. The
reforms include Enquiries and complaints from the injured workers that are not resolved with the
insurer in the first process then it will be directed to Workers compensation independent review
office for assistance. Moreover, All enquiries and complaints from the employers and other
system participant will be referred to State insurance regulatory Authority. Also, The worker's
compensation commission will undertake all the dispute resolution after the internal review is
finished by the insurer (Lane, 2017). The workers can claim for weekly payments if it is injured
at the workplace. The claim procedure for weekly payments includes notifying the employer and
insurer regarding the injury. After that, the insurer will contact the worker to provide them
information regarding the support available. If the worker related injury has affected the earning
of the worker then it is entitled for the compensation.
The worker can claim the cost of some or all medical treatment and services is it meets
the definition described in Section 59 of 1987 Act. Also, If it is approved by the insurer. The
other Claims for which the workers is eligible includes cost that is associated with returning to
work. The worker can claim total upto $1000 for expenses involved in returning to work. The
procedure for worker compensation claims include that every employer is required to have
workers compensation insurance to protect the workers. The injured workers must be provided
with medical treatment first. The next step is notifying the employer regarding the injury. Then
fill out the claim form (which must be provided by the employer) and the detailed information
must be kept with the workers regarding the treatment.
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2. Extent to which this procedure comply with suggestions as per the best practise model
The suggestion as per the best practise model provide that the NSW government has
provided the system for dispute resolution which includes that they are following the suggestion
of best practise initiative and met the procedure for pragmatic intervention to respond quickly
towards the disputes. The NSW government has made the reforms to resolve the disputes
quickly. For dispute resolution the workers can appeal to Insurer, WIRO, SIRA, WCC. Also,
the procedure comply with the suggestions as per the best practise model as the worker can
appeal for the decision review from the insurer.
The disputes should be subject to a process of internal reconsideration before being
refereed as dispute resolution service is not met under the NSW reforms. The state is having the
alternative dispute resolution process such as negotiation for disputed matters. The NSW has
appointed the various authorities for the dispute resolution (Whincop, Keyes and Posner, 2018).
Moreover, It is also using the medial panel such as MAS medical assessor for determining the
injury for disputes resolution process. Moreover, for the dispute resolution process there are
tribunal such as SIRA to which the worker can apply for resolving the dispute. The worker have
to provide information to the insurer regarding the injury for claiming the compensation for
returning to work.
Moreover, insurer is appointed to resolve the disputes regarding the worker compensation
and make decision regarding the amount of compensation for which the worker is eligible. If the
worker is not satisfied by the insurer decision the person can apply to the other higher authorities
for the dispute resolution process (Aldrich, 2017). There is less participation of all the parties in
the dispute resolution process. The alternative dispute resolution provide assistance in resolving
the disputes by using merit reviews, mediation etc.
3. Recommendation to reform the procedure to comply with best practise model.
The NSW government in order to comply with the best practice model must ensure that
they are following the easy dispute resolution process which is responding quickly to the
disputes of the workers. Moreover, it should make provide the parties to reach to the agreement
and resolve issues before it becomes the formal dispute. Moreover, It is recommended that to
comply with best practise model the procedure should be reformed in which for dispute
resolution there are procedure which are quickly and fair for the workers (Williamson, 2016).
Moreover, The workers should be provided with clear understanding of the decision made by the
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insurer and if the worker is not satisfied with the decision make appeal to WIRO for further
dispute resolution process. The procedure reformed assist in complying with the best practice
model which will helps in resolving the disputes quickly.
The decision must be made by the insurer by understanding all the facts relating to the
disputes. The procedure must provide the worker to provide their information relating to the
dispute. For dispute resolution process there are various authorities to which the worker can
make an appeal that consist of insurer, WIRO, SIRA WCC etc. By reforming the current
procedure the one can comply with the best practise model which is the most effective way for
resolving the worker's compensation disputes and claims (Groves, 2016). Moreover, It is
recommended that the dispute resolution service should appoint an experienced gatekeeper to
screen and stream disputes to maximise the prospects of resolution.
Also, before the dispute resolution service dispute should be subject to internal
reconsideration. The worker's compensation legislation Amendment Act was passed By the
NSW parliament to improve the worker's compensation system. Moreover, as per the section 192
(A)of workers compensation Act 1987 provide the information regarding the claims for the
workers under dispute resolution procedure. As per the section 43 of Workers compensation
Amendment Act 2018 which is related to the work capacity decision by insurer for the dispute
resolution procedure (Workers Compensation Legislation Amendment Act 2018 No 62, 2018).
Section 27 provide with the functions of individual review officer which provide that the
authorities of the dispute resolution process should functions as per the section provided by the
Act.
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REFERENCES
Books and Journals
Aldrich, H., 2017. The stolen generations group action: An alternative model to redress a
traumatic past. Precedent (Sydney, NSW). (141). pp.22.
Elbers, N. A. And et.al., 2016. Differences in perceived fairness and health outcomes in two
injury compensation systems: a comparative study. BMC public health. 16(1). pp.658.
Grant, G. and Gnanaseelan, R., 2017. Show us the data! Shining a light on settled
injury. Precedent (Sydney, NSW). (141). pp.4.
Groves, P., 2016. Workplace Bullying and the New South Wales Workers Compensation
Commission: A Foucauldian qualitative content analysis of the medico-legal response
to a complex social problem (Doctoral dissertation, Charles Sturt University Wagga
Wagga).
Lane, P., 2017. The Land Acquisition (Just Terms Compensation) Amendment Act 2016
(NSW)-How will the Amendments Work?.
Minter, K., 2017. Negotiating labour standards in the gig economy: Airtasker and Unions New
South Wales. The Economic and Labour Relations Review. 28(3). pp.438-454.
Whincop, M. J., Keyes, M. and Posner, R. A., 2018. Policy and Pragmatism in the Conflict of
Laws. Routledge.
Williamson, B. C., 2016. Liability for Workplace Injuries to Transnational Employees in
Australia: Issues and Case Studies. US-China L. Rev. 13. p.147.
Online
Workers Compensation Legislation Amendment Act 2018 No 62. 2018. [Online]. Available
through : <https://legislation.nsw.gov.au/~/view/act/2018/62/historical2018-12-02/
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