New South Wales Consolidated Regulations

WORKERS COMPENSATION REGULATION 2003

- Made under the Workers Compensation Act 1987
- As at 1 September 2008
- Reg 628 of 2003

TABLE OF PROVISIONS

   PART 1 - PRELIMINARY

   1.      Name of Regulation
   2.      Commencement
   3.      Definitions
   4.      Forms

   PART 2 - WORK RELATED DISEASES

   5.      Diseases deemed work related
   6.      Brucellosis, Q fever and leptospirosis-medical tests and results to determine whether work related

   PART 3 - FUNERAL EXPENSES

   7.      Sec 27 (b): maximum amount for funeral expenses

   PART 4 - CURRENT WEEKLY WAGE RATE

   8.      Definitions
   9.      Sec 42 (1) (c), (5) (b): prescribed classes of workers by order
   10.     Sec 42 (1) (c), (5) (b): prescribed classes of workers etc-shearers
   11.     Sec 42 (1) (c), (5) (b): prescribed classes of workers etc-certain meat industry workers
   12.     Sec 42 (1) (d): prescribed rate

   PART 5 - INDEXATION OF AMOUNTS OF BENEFITS

   13.     Sec 79: definition of “latest index number”

   PART 6 - WEEKLY COMPENSATION

   14.     Notice of requirement to obtain suitable employment from other person
   14A.    Computation of average weekly earnings
   15.     Notice of intention to discontinue or reduce weekly payments

   PART 6A - RETURN-TO-WORK PROGRAMS

   15A.    Time within which program to be established
   15B.    Offence-failure to establish program
   15C.    Standard return-to-work programs for category 2 employers
   15D.    Program to comply with guidelines etc
   15E.    Guidelines for programs-directions
   15F.    Nomination in programs of accredited providers of rehabilitation services
   15G.    Offence-failure to display or notify program
   15H.    Notification etc of program by category 2 employer
   15I.    Category 1 employers must have return-to-work co-ordinator
   15J.    Functions of return-to-work co-ordinators
   15K.    Shared return-to-work programs
   15L.    Exemptions

   PART 7 - OCCUPATIONAL REHABILITATION SERVICES

   16.     Definition
   17.     Occupational rehabilitation service-additional services
   18.     Occupational rehabilitation services-maximum amount for which employer liable
   19.     Directions to employers under sec 63A (4)-insurers authorised
   20.     Applications under sec 63A-generally
   21.     Applications under sec 63A (4)-services provided by more than one provider etc
   22.     Directions by insurers-special provisions
   23.     Conditions etc-directions under sec 63A (4)
   24.     Review by Authority
   25.     Revocation by Authority of direction under sec 63A (4)
   26.     Submissions to Authority
   27.     Payment under direction by Authority not admission of liability
   28.     Claims relating to uninsured liabilities
   29.     Application of Part to self-insurers
   30.     Application of Part to proceedings pending in District Court or Commission
   31.     Authority not prevented from giving opinion on rehabilitation liability

   PART 7A - ACCREDITATION OF REHABILITATION PROVIDERS

   31A.    Application for certificate of accreditation
   31B.    Determination of application
   31C.    Form of certificate of accreditation
   31D.    Conditions of certificate
   31E.    Amendment of certificate
   31F.    Notice of refusal
   31G.    Duration of certificates
   31H.    Surrender of certificates
   31I.    Duplicate certificates
   31J.    Register of certificates
   31K.    False or misleading statements
   31L.    Cancellation or suspension of certificate
   31M.    False claim of accreditation

   PART 8 - NOTICES AND CLAIMS PROCEDURE

   32.     Notification of workplace injury
   32A.    Employer must give early notification of significant workplace injury
   33.     Notice of injury involving loss of hearing
   34.     Notice of dispute about liability
   35.     Form of notice to be posted up at workplace
   36.     Form of register of injuries to be kept at mine etc
   37.     Access to certain medical reports and other reports obtained by insurer: sections 73 and 126 of 1998 Act
   38.     Interim payment direction not presumed to be warranted: sec 297 of 1998 Act

   PART 9 - MEDICAL EXAMINATIONS AND DISPUTES

           39, 40. (Repealed)
   41.     Application to refer matter to medical referee or panel etc

   PART 10 - RESTRICTIONS ON OBTAINING MEDICAL REPORTS

   42.     Definitions
   43.     Restrictions on number of medical reports that can be admitted
   43AA.   Supplementary reports admissible
   43A.    Restriction on disclosure of forensic medical reports to approved medical specialists
   44.     (Repealed)
   45.     Restrictions on recovery of cost of medical reports
   46.     Medical treatment not affected
   47.     Reports of medical panels and referees not affected
   48.     Transitional
   48A.    Further transitional provision

   PART 11 - INSURANCE POLICIES

   48B.    Administration fees and late payment fees for exempt employers
   49.     Provisions of policies of insurance
   50.     (Repealed)
   51.     Excess recoverable from employer: section 160
   52.     Information to be provided for certificate of currency
   52A.    Certificate of currency-period of insurance
   53.     Liability for subcontractor premiums-exemption for farming operations
   53A.    Employers excluded from grouping provisions: section 175D (3)

   PART 11A - MODIFICATION OF PROVISIONS APPLYING TO SELF-INSURERS

   53AA.   Interpretation
   53AB.   References to “insurer”
   53AC.   Modification of exceptions for self-insurers
   53AD.   Preparation of injury management plan
   53AE.   Self-insurer’s licence

   PART 12 - INSURERS’ CONTRIBUTION FUND

   54.     Definition of “financial year”
   55.     Definition of “premium income”
   56.     Prescribed contribution payable by insurer
   57.     Time for payment of insurer’s contribution

   PART 13 - WORKCOVER AUTHORITY FUND

   58.     Definitions
   59.     Definition of “premium income” for purposes of insurers’ contributions
   60.     Definition of “deemed premium income” for purposes of self-insurers’ contributions
   61.     Alternative contribution by self-insurers

   PART 14 - DEEMED EMPLOYMENT

   62.     Ministers of religion

   PART 15 - PREMIUMS ADJUSTMENT FUND

   63.     Definitions of “financial year” and “Fund”
   64.     Definition of “premium income”
   65.     Amount of contribution payable by insurer into Fund
   66.     Time for payment of contribution by insurer into Fund

   PART 16 - INSURERS’ GUARANTEE FUND

   67.     Definitions
   68.     Financial years for contributions to Insurers’ Guarantee Fund
   69.     Time etc for payment of insurer’s contribution
   70.     Further contributions payable by insurers
   71.     Rebates for insurers who contributed to an advance from the Premiums Adjustment Fund
   72.     Determination of contributions and further contributions

   PART 17 - PENALTY NOTICE OFFENCES

   73.     Penalty notice offences

   PART 18 - MARKETING OF WORK INJURY LEGAL SERVICES AND AGENT SERVICES

           Division 1 - Preliminary
           Note

   74.     Definitions

           Division 2 - Advertising by lawyers and agents

   75.     Restriction on advertising work injury services
   75A.    Exception for advertisements about discrimination-community legal centres
   76.     Exception for advertising specialty
   77.     Other exceptions
   78.     Responsibility for employees and others
   78A.    Responsibility for advertisements published by others
   79.     Double jeopardy
   80.     Transitional-finalised publications

           Division 3 - Advertising by persons other than lawyers and agents

   80A.    Application of Division
   80B.    Definition of “work injury advertisement”
   80C.    Restrictions on work injury advertisements
   80D.    Exception for advertisements about discrimination-community legal centres
   80E.    Exception for advertising specialty
   80F.    Other exceptions
   80G.    Protection of publishers
   80H.    Double jeopardy
   80I.    Transitional-finalised publications

   PART 19 - COSTS

           Division 1 - Preliminary

   81.     Definitions
   81A.    Sec 332 of 1998 Act: definition of “costs”
   82.     Costs not regulated by this Part

           Division 2 - Costs recoverable in compensation matters

              Subdivision 1 - Preliminary

   83.     Application of Division

              Subdivision 2 - Maximum costs recoverable by legal practitioners and agents in compensation matters

   84.     Maximum costs recoverable
   84A.    Maximum costs involving medical or related treatment or certain fees for health service providers
   85.     Special provisions for costs where claim transferred to Commission
   85A.    Costs not recoverable in certain circumstances (workers compensation matters)

           Division 3 - Costs recoverable in work injury damages matters

              Subdivision 1 - Maximum costs recoverable by legal practitioners in work injury damages matters

   86.     Application of Division
   87.     Fixing of maximum costs recoverable by legal practitioners
   88.     Contracting out-practitioner/client costs

              Subdivision 2 - Restriction on awarding of costs
              Note

   89.     Costs where claimant no less successful than claimant’s final offer
   90.     Costs where claimant less successful than insurer’s final offer or insurer found not liable
   91.     Costs in other cases
   92.     Deemed offer where insurer denies liability and no mediation
   93.     Subdivision does not apply to ancillary proceedings
   94.     Multiple parties

           Division 4 - Assessment of costs

              Subdivision 1 - Preliminary

   95.     Definitions
   96.     Application by client for assessment of practitioner/client or agent/client costs
   97.     Application by instructing practitioner or agent for assessment of practitioner/client or agent/client costs
   98.     Application by billing practitioner or agent for assessment of practitioner/client or agent/client costs
   98A.    Application for assessment of party/party costs-compensation matters
   99.     Application for assessment of party/party costs-work injury damages matters
   100.    How is an application to be made?
   101.    Persons to be notified of application
   102.    Registrar may require documents or further particulars
   103.    Consideration of applications
   104.    Assessment to give effect to maximum costs, 1998 Act and orders and rules of the Commission or court

              Subdivision 2 - Assessment of bills of costs between practitioner or agent and client

   105.    Assessment of bills generally
   106.    Additional matters to be considered in assessing bills of costs
   107.    Costs agreements not subject to assessment
   108.    Unjust costs agreements
   109.    Interest on amount outstanding

              Subdivision 3 - Assessment of party/party costs

   110.    Assessment of costs-costs ordered by court or Commission or subject of agreement
   111.    Additional matters to be considered by Registrar in assessing costs ordered by court or Commission
   112.    Effect of costs agreements in assessments of party/party costs
   113.    Court or Commission may specify amount etc

              Subdivision 4 - Enforcement of assessment

   114.    Certificate as to determination
   115.    Reasons for determination
   116.    Recovery of costs of costs assessment
   117.    Correction of error in determination
   118.    Determination to be final

              Subdivision 5 - Appeals

   119.    Appeal against decision of Registrar as to matter of law
   120.    Effect of appeal on application

              Subdivision 6 - Miscellaneous

   121.    Liability of legal practitioner or agent for costs in certain cases
   122.    Referral of misconduct to Legal Services Commissioner

           Division 5 - Goods and services tax

   123.    GST may be added to costs

           Division 6 - Miscellaneous

   124.    Modifications to Legal Profession Act 1987 relating to assessment of costs
   125.    Transitional provisions
   125A.   Transitional provisions-amendments made by Workers Compensation Amendment (Costs) Regulation 2006
   126.    Special provision for matters involving coal miners
   126A.   Bill of costs to be in approved form
   126B.   Costs orders in respect of certain matters

   PART 20 - INSURANCE PREMIUMS

           Division 1 - Preliminary

   127.    Definitions
   128.    Meaning of “injury year”
   129.    Non wages-based calculation of premium

           Division 2 - Declaration of wages

   130.    Employer to supply insurer with return relating to wages
   131.    (Repealed)
   132.    Experience premium return
   133.    Offence by employer

           Division 3 - Input tax credit entitlements

   134.    Employer to give insurer notice of input tax credit entitlement

           Division 4 - Certification of cost of claims

   135.    Definition
   136.    Prevention of double allowance for provisional compensation payments
   137.    Cost of an individual claim
   138.    Cost of provisional payments of compensation
   139.    Certificates relating to cost of claims
   140.    Effect of certificate
   141.    Employers who were previously self-insurers

           Division 5 - Demand for premium

   142.    Notice of premium calculation

           Division 6 - Procedure before Authority relating to insurance premiums

   143.    Applications
   144.    Answer
   145.    Decision of Authority
   146.    Procedure generally

           Division 7 - Policies exempt from insurance premiums orders

   147.    Further policies exempt from order-unregulated premiums

           Division 8 - Payment of premiums by instalments

              Subdivision 1 - Payment in three instalments

   148.    Policies under which premiums may be paid by three instalments
   149.    Number, size and times for payment of instalments

              Subdivision 2 - Payment in four instalments

   149A.   Policies under which premiums may be paid in four instalments
   149B.   Number, size and times for payment of instalments

              Subdivision 3 - Payment in twelve instalments

   149C.   Policies under which premiums may be paid in twelve instalments
   149D.   Number, size and times for payment of instalments

           Division 9 - Miscellaneous

   150.    Transitional-operation of amendments
   150A.   Rebate of premium where fraud or mistake involved in claims

   PART 21 - PREMIUM DISCOUNT SCHEME

           Division 1 - Preliminary

   151.    Commencement
   151A.   Staged closure of Premium Discount Scheme
   152.    Interpretation
   153.    Premium Discount Scheme
   154.    Employers eligible to participate in PDS (General)
   155.    Employers entitled to participate in Small Business Strategy

           Division 2 - Premium Discount Scheme (General)

              Subdivision 1 - Premium Discount Advisers

   156.    Approval of Premium Discount Advisers
   157.    Conditions of approval
   158.    Functions of a PDA
   159.    Relationship with employer
   160.    Principals of a PDA
   161.    Functions of Principals
   162.    Review of PDAs by Authority

              Subdivision 2 - PDA Ratings

   163.    Initial PDA Ratings
   164.    Subsequent determination of PDA Rating by Authority
   165.    PDA Rating not transferable

           Division 3 - Small Business Strategy

   166.    Approval of sponsors
   167.    Conditions of approval
   168.    Authority may invite proposals for small business discount programs
   169.    Assessment of proposals
   170.    Funding agreements
   171.    Relationship with employer
   172.    Functions of a sponsor
   173.    Review of sponsors by Authority

           Division 4 - Premium discounts

   174.    Definitions
   175.    First year of participation
   176.    Change in PDA Rating-first year of participation
   177.    Second year of participation
   178.    Change in PDA Rating-second year of participation
   179.    Third year of participation
   180.    Change in PDA Rating-third year of participation
   181.    Verifications
   182.    Provisional entitlement not confirmed
   183.    Year of participation may be repeated
   184.    Time limits on participation in Scheme

           Division 5 - Reviews and appeals

   185.    Internal review
   186.    Appeal to Administrative Decisions Tribunal

           Division 6 - Offences
           Note

   187.    Failure to comply with Code of Conduct
   188.    Purporting to be a PDA
   189.    Failure to notify Authority of changes concerning PDA

           Division 7 - General

   190.    Premium Discount Guidelines
   191.    Directions by Authority to PDAs or sponsors
   192.    Codes of Conduct
   193.    Calculation of premium discount
   194.    Powers of Authority if PDA or sponsor ceases to operate
   195.    Statistics

   PART 22 - MISCELLANEOUS

   195A.   Disclosure of information for complaint about health practitioners (s 243 (2) (d) of the 1998 Act)
   196.    Additional records to be kept by employers
   197.    Uninsured Liability and Indemnity Scheme-modification of provisions of the Act
   198.    Costs of medical assessment: sec 330 of 1998 Act
   199.    Arrangement of business before Commission: sec 349 of 1998 Act
   200.    Proceedings to enter up award on agreement for compensation: sec 66B of 1987 Act
   200A.   Mine Safety Fund amounts payable under Insurance Premiums Order (July-December) 2005 and Insurance Premiums Order (January-June) 2006
   200B.   New claims procedures-appeal against decision of Commission constituted by Arbitrator

   PART 23 - SAVINGS, TRANSITIONAL AND OTHER PROVISIONS

           Division 1 - General

   201.    Repeal
   202.    Saving
   203.    Exemptions for coal miners-1996 amendments
   204.    Application of Chapter 4 of 1998 Act
   205.    Restrictions on commencing court proceedings
   206.    Time for making claim
   207.    Contributions to WorkCover Authority Fund
   208.    Reduction of maximum section 38 benefits period
   208A.   Effect of repeal of section 152
   209.    Application of amendment to section 52 of the 1987 Act
   210.    Application of amendments to definition of “wages”
   211.    Amendment relating to 18 month limit for common law claims-transitional provision
   211A.   Declarations by employers under clause 131
   211B.   Amendment relating to records kept about apprentices

           Division 2 - 1996 amending Act

   212.    Definition
   213.    Coal miners
   214.    Medical certificate accompanying weekly compensation claims
   215.    Discontinuation of weekly payments after 104 weeks-injuries before commencement of section 52A

           Division 3 - 2001 amending Acts

              Subdivision 1 - Preliminary

   216.    Definitions

              Subdivision 2 - Cessation of conciliation

   217.    Cessation of conciliation
   218.    Modification of section 101 of 1998 Act (Restrictions on commencing court proceedings about weekly payments)
   219.    Modification of section 102 of 1998 Act (Restrictions on commencing court proceedings for lump sum compensation)
   220.    Modification of section 103 of 1998 Act (Restrictions on commencing court proceedings about medical, hospital and other expenses)
   221.    Modification of sec 74 of 1998 Act (Insurers to give notice and reasons when liability disputed)
   222.    Modification of sec 121 of 1998 Act (Assessment of medical disputes by approved medical specialists)

              Subdivision 3 - Medical assessment of new claims in respect of pre-commencement injuries

   223.    Assessment of impairment dispute

              Subdivision 4 - Transfer of existing claims

   224.    Transfer of existing claims
   225.    Transfer of existing claims by election of worker
   226.    Transfer of existing claims pending in Compensation Court on abolition of that Court
   227.    Transitional provision-certificates
   228.    Modification of sec 281 of 1998 Act
   229.    Modification of sec 282 of 1998 Act

              Subdivision 4A - Amendments relating to work injury damages-transitional provisions

   229A.   Application of 2001 amendments relating to work injury damages to discontinued transitional proceedings

              Subdivision 5 - Miscellaneous

   230.    Uninsured Liability and Indemnity Scheme
   231.    Appointment of mediators

           Division 4 - Coal miners-2001 amending Acts

   232.    Definitions
           233, 234. (Repealed)
   235.    Modification of section 101 of 1998 Act (Restrictions on commencing court proceedings about weekly payments)
   236.    Modification of section 102 of 1998 Act (Restrictions on commencing court proceedings for lump sum compensation)
   237.    Modification of section 103 of 1998 Act (Restrictions on commencing court proceedings about medical, hospital and other expenses)
   238.    Application of amendments made by Workers Compensation (General) Amendment (Savings, Transitional and Other Matters) Regulation 2001

           Division 5 - Insurance Reforms-2003 amending Act

              Subdivision 1 - Insurance reforms

   239.    Interpretation
   240.    Authority to act as temporary agent
   241.    Directors under trustee duty
   242.    Construction of references
   243.    Contracts-references to Nominal Insurer
   244.    Transitional funding arrangements
   245.    Termination of temporary agency arrangements
   246.    Application of 2003 amendments to managed fund insurers
   247.    GIO General Limited authorised to act as temporary agent of Nominal Insurer

              Subdivision 2 - Uninsured Liability and Indemnity Scheme

   247A.   Interpretation
   247B.   Uninsured Liability and Indemnity Scheme
   247C.   Appeals against decisions of Authority
   247D.   Court proceedings for work injury damages

           Division 6 - 2006 amending Act

   248.    Definition
   249.    Saving
   250.    Transitional-prescriptions for purposes of excess recoverable from employer

           Division 7 - 2002 Regulation

   251.    Definition
   252.    Savings and transitional provisions-workplace injury management
           SCHEDULE 1
           SCHEDULE 2
           SCHEDULE 3
           SCHEDULE 4
           SCHEDULE 5
           SCHEDULE 6
           SCHEDULE 7