Working with you for successful
claims outcomes
Lynn Milne
Customer Advisor
WorkCover Queensland
About WorkCover Queensland
• Statutory authority operating as an
independent commercial enterprise
• Expert provider of tailored workers’
compensation insurance solutions
• We deliver Australia’s lowest
average premium rate
$1.20 (per $100 in wages)
About WorkCover Queensland
• One of Australia’s best return to work rates
• Balance the needs of employers and injured
• Customer satisfaction drives continuous service
improvement and online innovation
• Expert management of the entire claims
management life cycle keeps claims costs down
Benefits to employers
Strong industry alignment
Simplified premium model for
employers with ≤ $1.5 million
in wages
Prudent financial management
delivers premium certainty
Online customer service
innovations deliver real value
for money and cut red tape
Benefits to injured workers
Australian first Worker Assist app
delivers real-time data on
claim expenses, upcoming
medical appointments and
payment timeframes
In 2013–2014, 96% of injured
workers returned to work
within 12 months. This means
improved workplace productivity
and reduced family and
community impacts
Employer obligations:
As an employer you have obligations for workers’ compensation and return
to work. You must:
• have a current workers’ compensation insurance policy that covers all
your workers
• submit your wages information and pay your premium by the due dates
• notify WorkCover Queensland of any workplace injuries within eight
business days
• make suitable duties available to your injured workers where possible
• work with WorkCover Queensland, the injured worker, their doctor and
other health-care providers to develop an effective return to work program
• not dismiss an injured worker solely or mainly because of their injury
within 12 months of the injury or illness occurring.
Legislative amendments
• The Workers’ Compensation and Rehabilitation and Other Legislation
Amendment Bill 2013 was passed in parliament in October 2013
• The main changes applying from 15 October 2013
• New method in determining permanent impairment
• A > 5% common law threshold has been introduced
• Requirement & training for a RRTWC has changed
• The main changes applying from 29 October 2013
• The way psychological/psychiatric claims are determined
• The insurer is responsible for rehabilitation (including common law)
• Employers can now ask workers for disclosure of pre-existing injuries
• We have a video of a webinar, and detailed presentations
• Detailed information at
Who is a worker
- Changes to legislation from 1 July 2013 may affect who is a worker
according to the Workers’ Compensation and Rehabilitation Act 2003
- To reduce red tape, WorkCover has aligned the definition of who is a
worker to the Australian Taxation office (ATO) definition.
- You can utilise the ATO online decision tool for determining ‘who is a
worker’ and keep a copy of the determination for your records.
Section 11 of the Act:
A worker is ‘a person who works under a contract and, in relation to the
work, is an employee for the purpose of assessment for PAYG withholding
under the Taxation Administration Act 1953 (Cwlth), schedule 1, part 2-5’.
Only an individual can be a worker (even if they have an Australian
Business Number (ABN) or are responsible for their own tax)
Companies, partnerships and trusts are excluded.
Industry statistics – total claims costs (stat &
common law)*
Horticulture statutory
claims cost
Horticulture common
law cost
Industry statistics – Stay at work percentage
Industry statistics – average days to first
return to work (RTW)
Industry statistics – Injury location (2013/14)
Industry statistics – Injury location (2013/14)
Industry statistics – Final RTW percentage
Mushroom & vege
Fruit & Tree Nut Growing
Other Crop Growing
2010/11 2011/12 2012/13 2013/14 2014/15
Health benefits of work
• Early return to work reduces the risk of long-term
• Injured workers who are offered suitable duties are
twice as likely to return to work
• Strong evidence suggests that work absence tends to
perpetuate itself: that is, the longer someone is off work,
the less likely they become ever to return
• We encourage a stay at, or prompt return to work
strategy. This is possible through a suitable duties
program or host employment.
The longer someone remains off work the less likely it
is they will ever return. If someone is off work for:
• 20 days, the chance of ever getting back to work is
• 45 days, the chance of ever getting back to work is
reduced to 50% and
• 70 days, the chance is then again reduced to 35%.
Realising the Health Benefits of Work
Best practice injury management
When a workplace injury occurs:
• notify WorkCover Queensland within eight business days
• encourage early medical attention and treatment
• make suitable duties available to your injured workers where possible
• work with WorkCover Queensland, the injured worker, their doctor and
other health-care providers to develop an effective return to work program
• do not dismiss an injured worker solely or mainly because of their injury
within 12 months of the injury or illness occurring.
Suitable Duties
• Where possible, a ‘stay at work’ approach is best for
• Duties and hours at work are just as important as other
• Suitable duties allow people to develop confidence by:
-gradually increasing tasks back to their usual job
-maintaining social contact and support
-feeling valued for what they contribute
-creating a positive workplace culture
-contributing to productivity
Think about :
• What tasks are required
• Are there tasks within the persons role or not
• Consider tasks with different positions
Scenario – Crush injury to right foot sustained
when hydraulic gate in seed spreader closed
General assumptions:
No actual claim details have been
used for privacy and confidentiality
• A fictitious employer policy has
been used
• Minimal current claims (statutory
or common law)
Premium prior to injury $182,600
WIC is Vegetable Growing (outdoors)
Current premium rate 2.551
Current industry rate 2.636
Wages remain the same at
The worker was travelling in a
seed spreader when the
hydraulic gate closed on his
foot. He sustained a crush
injury to his right foot. The
worker works a 38 hour
Diagnosis: Crush injury
including multiple fractures to
Conservative and surgical
treatment was undertaken.
No return to work.
Statutory claims costs and impact on premium
Includes physiotherapy,
return to work assessment
For treatment
Weekly benefit
$10,000 (13 weeks totally
Specialist consults,
radiography, surgical
procedure, medical reports
Not accepted
A maximum of $175,000
per statutory claims
impacts premium
Statutory claims costs and impact on premium
Crush type injury to foot $19,500 claim with $6,900
(under the max. Statutory wages (employer has
cost $175,000)
offered suitable duties at the
6 week mark saving $3,100
(4 weeks x $770)
$182,600 Premium
Increased premium to
$189,700 ($7,100)
Increased premium to
$187,600 ($5000). This will
have an accumulative saving
over 3 years
Premium rate 2.551 2.65 (no capping applies to
premium as under 1.5xR)
Industry rate 2.636
Wages $6,200,000
What you can do
• prevention is better than cure—keep your
workplace safe and prevent injuries
• be return to work focused and provide
suitable duties—focus on what your worker
can do, not what they can’t
• work with us to help your worker stay at, or
return to work as soon as possible
• consider Recover At Work (RAW)
• communicate regularly and openly with all
parties—stay in contact with your worker
and check their progress
• utilise consultancy services.
Online services
Our online services are free, quick and easy to
use. You can access your policy information at
a time that suits you. You can also lodge
information online and opt to receive your
policy information and updates electronically –
convenient and good for the environment.
Employer online
declare wages and pay your premium
view premium notices
produce a Certificate of Currency
find key dates for workers’ compensation
performance scorecards
useful links.
Free services
Some ways we can help you:
• forecast your premium
• develop return to work strategies including suitable duties plans
• provide individual and industry performance analysis
• access online services
• access industry pages, films and case studies
• network opportunities with peers via industry forums
• work with Workplace Health and Safety Queensland to develop
workplace health and safety initiatives
• download the worker assist app.
Contact us
If you would like more information, please
call or email me:
• 3006 6770
• lynn.milne
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