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WORKERS' COMPENSATION AND REHABILITATION REGULATION 2014

WORKERS' COMPENSATION AND REHABILITATION REGULATION 2014

- Made under the Workers’ Compensation and Rehabilitation Act 2003
- As at 31 October 2022
- Reg 189 of 2014

TABLE OF PROVISIONS

   PART 1 - PRELIMINARY

   1.      Short title
   2.      Commencement
   3.      Definitions
   4.      WorkCover’s capital adequacy—Act, s 453(b)

   PART 2 - EMPLOYER INSURANCE

           Division 1 - Policies and premium assessments

   5.      Application for policy
   6.      Policies and renewals
   7.      Assessment of premium
   8.      Declaration of wages
   9.      Value of board and lodging
   10.     Payment of premium by instalments
   11.     Additional premium for late payment of premium—Act, ss 61 and 62
   12.     Premium for appeals—Act, s 569(2)(a)
   13.     Former employer may apply to cancel policy
   14.     Cancellation of policy if workers no longer employed

           Division 2 - Employer excess

   15.     Excess period—Act, s 65(2)

           Division 3 - Self-insurance

   16.     Application fees—Act, s 70(c)
   17.     Annual levy—Act, s 81(2)
   18.     Provisional annual levy—not agreed or decided
   19.     Adjusted annual levy—agreed
   20.     Adjusted annual levy—not agreed but decided
   21.     Additional amount for late payment of levy—Act, s 82(1)
   22.     Conditions of licence—Act, s 83
   23.     Premium payable after cancellation of self-insurer’s licence—Act, s 98
   24.     Deemed levy for appeals—Act, s 569(2)(a)

   PART 3 - CALCULATION OF SELF-INSURER’S LIABILITY

           Division 1 - Outstanding liability

              Subdivision 1 - Preliminary

   25.     Calculation of outstanding liability—Act, s 87(2)

              Subdivision 2 - Actuarial calculations and reports

   26.     Appointment of actuary
   27.     Regulator to give actuary information
   28.     Actuarial calculation
   29.     Actuarial report
   30.     Summary report
   31.     Agreement on amount
   32.     Reference to arbiter if no agreement on amount
   33.     Payment of amount
   34.     Transfer of claims information

           Division 2 - Total liability

              Subdivision 1 - Preliminary

   35.     Calculation of total liability after change in self-insurer’s membership—Act s 90(9)

              Subdivision 2 - Actuarial calculations and reports

   36.     Appointment of actuary
   37.     Relevant parties to give actuaries information
   38.     Actuarial calculation
   39.     Actuarial report
   40.     Summary report
   41.     Agreement on amount
   42.     Reference to arbiter if no agreement on amount
   43.     Payment of amount
   44.     Transfer of claims information

           Division 3 - Liability after cancellation of self-insurer’s licence

              Subdivision 1 - Preliminary

   45.     Calculation of liability after cancellation—Act, s 102(3)

              Subdivision 2 - Actuarial calculations and reports

   46.     Appointment of actuary
   47.     Former self-insurer to give actuaries information
   48.     Actuarial calculation
   49.     Actuarial report
   50.     Summary report
   51.     Agreement on amount
   52.     Reference to arbiter if no agreement on amount
   53.     Payment of amount

           Division 4 - Estimated claims liability

              Subdivision 1 - Preliminary

   54.     Calculation of estimated claims liability—Act, s 84(3)(b)

              Subdivision 2 - Actuarial calculations and reports

   55.     Approved actuary
   56.     Self-insurer to give Regulator and approved actuary information
   57.     Actuarial calculation
   58.     Actuarial report
   59.     Copy of actuarial report to Regulator and self-insurer
   60.     Regulator to advise self-insurer whether agreement on amount
   61.     Reference to Regulator’s actuary if no agreement on amount
   62.     Agreement on amount
   63.     Reference to arbiter

           Division 5 - Self-insurers who become non-scheme employers

              Subdivision 1 - Preliminary

   64.     Calculation of non-scheme employer’s liability—Act, s 105I(2)

              Subdivision 2 - Actuarial calculations and reports

   65.     Appointment of actuary
   66.     Non-scheme employer to give actuaries information
   67.     Actuarial calculation
   68.     Actuarial report
   69.     Summary report
   70.     Agreement on amount
   71.     Reference to arbiter if no agreement on amount
   72.     Payment of amount

              Subdivision 3 - Calculation—finalised non-scheme employer’s liability

   73.     Calculation of finalised non-scheme employer’s liability amount—Act, s 105I(2)
   74.     Appointment of actuary
   75.     WorkCover to give actuaries information
   76.     Actuarial calculation
   77.     Actuarial report
   78.     Summary report
   79.     Agreement on amount
   80.     Reference to arbiter if no agreement on amount
   81.     Payment of amount

           Division 6 - Total liability—member of a group who becomes non-scheme employer

              Subdivision 1 - Preliminary

   82.     Calculation of non-scheme members’ total liability—Act, s 105O(3)(a)

              Subdivision 2 - Actuarial calculations and reports

   83.     Appointment of actuary
   84.     Parties to give actuaries information
   85.     Actuarial calculation
   86.     Actuarial report
   87.     Summary report
   88.     Agreement on amount
   89.     Reference to arbiter if no agreement on amount
   90.     Payment of amount
   91.     Transfer of claims information

           Division 7 - Actuarial arbiter

   92.     Function of actuarial arbiter
   93.     Selection and appointment of actuarial arbiter
   94.     Arbiter must decide amount
   95.     Arbiter’s decision is final
   96.     Arbiter’s costs

   PART 4 - COMPENSATION

           Division 1 - Calculation of NWE

   97.     Calculation of NWE—Act, s 106(3)
   98.     What amounts may be taken into account
   99.     NWE if impracticable to calculate rate of worker’s remuneration
   100.    NWE if worker worked for 2 or more employers
   101.    NWE if insurer considers calculation unfair

           Division 2 - Compensation application and other procedures

   102.    Application for compensation to include evidence or particulars—Act, s 132(3)(b)
   103.    If dentist, doctor or nurse practitioner not available
   104.    Certificate given by dentist, doctor or nurse practitioner
   105.    Application for compensation for assessment of DPI—Act, s 132A(3)(c)(ii)
   105A.   Application for certificate of dependency—Act, s 132B(3)(c)(ii)
   106.    Request for examination of claimant or worker—Act, ss 135 and 510

           Division 3 - Entitlement to compensation for permanent impairment—generally

   107.    Additional lump sum compensation—workers with latent onset injuries that are terminal—Act, s 128B(2)(c)
   108.    Calculating lump sum compensation—Act, s 180(1)
   109.    Additional lump sum compensation for workers with DPI of 30% or more—Act, s 192(2)
   110.    Additional lump sum compensation for gratuitous care (occupational therapist’s assessment)—Act, ss 193(4) and 224(3)
   111.    Additional lump sum compensation for gratuitous care (occupational therapist’s report)—Act, ss 193(5)(b) and 224(4)(b)
   112.    Additional lump sum compensation for gratuitous care—Act, s 193(6)

           Division 3A - Entitlement to additional compensation for permanent impairment—Act, s 193A

              Subdivision 1 - Preliminary

   112A.   Definitions for div 3A
   112B.   Operation of div 3A

              Subdivision 2 - Amount and condition of entitlement

   112C.   Amount of compensation—Act, s 193A(2)(a)
   112D.   Qualifying condition—Act, s 193A(2)(b)

              Subdivision 3 - Process for deciding qualifying condition

   112E.   Application of sdiv 3
   112F.   Insurer to consider qualifying condition
   112G.   Notification
   112H.   Worker may request reasons
   112I.   Giving information
   112J.   Decision based on worker’s information
   112K.   Meeting before decision made

              Subdivision 4 - Review of insurer’s decision

   112L.   Definition for sdiv 4
   112M.   Application of sdiv 4
   112N.   Application for review
   112O.   Insurer to give information to panel
   112P.   Review by panel
   112Q.   Insurer must notify amount of entitlement

              Subdivision 5 - Establishment of panel

   112R.   Panel—Act, s 193A(3)
   112S.   Appointment to panel
   112T.   Administrative matters

              Subdivision 6 - Miscellaneous

   112U.   Liability not affected

           Division 3AA - Entitlement to compensation for pneumoconiosis

   112V.   Working out pneumoconiosis score—Act, s 36F
   112W.   Lump sum compensation for workers with pneumoconiosis—Act, s 128G

           Division 4 - Liability for caring allowance

   113.    Payment of caring allowance—Act, s 225(a)

   PART 5 - REHABILITATION

           Division 1 - Rehabilitation and return to work coordinators

   114.    Functions of rehabilitation and return to work coordinator—Act, s 41(b)
   115.    Criteria for employer to appoint rehabilitation and return to work coordinator—Act, s 226(1)

           Division 2 - Guidelines for standard for rehabilitation

   116.    Standard for rehabilitation—Act, s 228(2)
   117.    Availability of guidelines

   PART 5A - TREATMENT, CARE AND SUPPORT PAYMENTS

           Division 1 - Assessing entitlement

              Subdivision 1 - Preliminary

   117A.   Definitions for division

              Subdivision 2 - Eligibility criteria

   117B.   Purpose of subdivision
   117C.   Eligibility criteria for permanent spinal cord injury
   117D.   Eligibility criteria for traumatic brain injury
   117E.   Eligibility criterion for the amputation of a leg through or above the femur
   117F.   Eligibility criteria for the amputation of more than 1 limb or parts of different limbs
   117G.   Eligibility criteria for a full thickness burn to all or part of the body
   117H.   Eligibility criterion for an inhalation burn resulting in a permanent respiratory impairment
   117I.   Eligibility criterion for permanent blindness caused by trauma

              Subdivision 3 - Assessing eligibility criteria

   117J.   Requirements for using functional independence measure instrument or childrens functional independence measure instrument to assess injuries

           Division 2 - Assessing worker’s needs

              Subdivision 1 - Assessment process

   117K.   Assessment generally
   117L.   Intervals for carrying out assessments

              Subdivision 2 - Matters for deciding necessary and reasonable treatment, care and support needs

   117M.   Purpose of subdivision
   117N.   Benefit to worker
   117O.   Appropriateness of service
   117P.   Appropriateness of provider
   117Q.   Cost-effectiveness

              Subdivision 3 - Other matters relating to assessing needs

   117R.   Additional requirement about assessing particular treatment, care or support
   117S.   Treatment, care or support that must be provided by a registered provider

              Subdivision 4 - Support plans and service requests

   117T.   Support plans
   117U.   Amending support plans
   117V.   Deciding service request

           Division 3 - Payment options

   117W.   Circumstances in which payment request may be made
   117X.   Deciding payment request
   117Y.   Limit on amount payable under payment request

           Division 4 - Review of entitlement

   117Z.   Review of worker’s entitlement

   PART 6 - DAMAGES

           Division 1 - Particulars in notice of claim

   118.    Notice of claim for damages—Act, s 275
   119.    Particulars of claimant and worker
   120.    Particulars of event
   121.    Injury particulars
   122.    Particulars of hospital, treatment and rehabilitation
   123.    Particulars if claim for diminished income earning capacity
   124.    Particulars if injury causes death
   125.    Particulars of mitigation

           Division 2 - General provisions

   126.    Time for adding another person as contributor—Act, s 278A(1)
   127.    Contribution notice to contain particular information—Act, s 278B(1)(a)

   PART 7 - ASSESSMENT OF DAMAGES

   128.    Prescribed amount of damages for loss of consortium or loss of servitium—Act, s 306M(1)(b)
   129.    Rules for assessing injury scale value—Act, s 306O(1)(c)(i)
   130.    General damages calculation provisions—Act, s 306P(2), definition general damages calculation provisions
   131.    Prescribed amount of award for future loss—Act, s 306R(2)

   PART 8 - COSTS

           Division 1 - Proceeding before industrial magistrate or industrial commission

   132.    Costs—proceeding before industrial magistrate or industrial commission
   133.    Payment of additional amount for costs

           Division 2 - Claim for damages

   134.    Who this division applies to
   135.    Costs before proceeding started
   136.    Costs after proceeding started
   137.    Outlays

   PART 9 - MEDICAL ASSESSMENT TRIBUNALS

   138.    Medical assessment tribunals—Act, s 492
   139.    Constitution of General Medical Assessment Tribunal
   140.    Chairperson and deputy chairperson of General Medical Assessment Tribunal
   141.    Constitution of a specialty medical tribunal
   142.    Chairperson and deputy chairperson of a specialty medical tribunal
   143.    Constitution of Composite Medical Tribunal
   144.    Chairperson and deputy chairperson of Composite Medical Tribunal

   PART 10 - MISCELLANEOUS

   144A.   First responders—Act, s 36EB
   144B.   Eligible employees—Act, s 36EC
   144C.   Presumption of injury—Act, s 36ED
   145.    Declaration of designated courts—Act, s 114(4), definition designated court
   146.    Declaration of provisions—Act, s 322(2), definition a State’s legislation about damages for a work related injury
   146A.   WorkCover funding and provision of programs and incentives—Act, s 385A, definition prescribed entity
   147.    Documents and particulars to be kept—Act, s 532D(1) and (2)
   147A.   Allowances and expenses for person required to attend for examination—Act, s 532S
   148.    Reasons for decisions must address certain matters—Act, ss 540(4) and 546(3AA)

   PART 11 - SAVINGS AND TRANSITIONAL PROVISION FOR WORKERS’ COMPENSATION AND REHABILITATION AMENDMENT REGULATION (NO. 1) 2015

   149.    Decision about qualifying condition if DPI decided before commencement
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           SCHEDULE 3
           SCHEDULE 4
           SCHEDULE 4A
           SCHEDULE 4B
           SCHEDULE 4C
           SCHEDULE 5
           SCHEDULE 6
           SCHEDULE 6A
           SCHEDULE 6B
           SCHEDULE 7
           SCHEDULE 8
           SCHEDULE 9
           SCHEDULE 10
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