WORKERS' COMPENSATION AND REHABILITATION REGULATION 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

• 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

• 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

• 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

• 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

• 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

• 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

• 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

• 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

• 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
• SCHEDULE 1
• SCHEDULE 2
• SCHEDULE 3
• SCHEDULE 4
• SCHEDULE 4A
• SCHEDULE 4B
• SCHEDULE 4C
• SCHEDULE 5
• SCHEDULE 6
• SCHEDULE 6A
• SCHEDULE 6B
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