WA is the government agency responsible for administering the Workers’ Compensation and Injury Management Act 1981 (the Act). All employers in Western Australia are required to have workers’ compensation insurance coverage for anyone defined as a ‘worker’ under the Act.
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What is workers’ compensation?
Workers’ compensation is financial compensation provided to workers who become injured during the course of their employment.
Workers’ compensation can include:
• weekly payments to cover loss of earnings
• medical and related expenses
• lump sum payments in case of permanent impairment and/or permanent incapacity for work
• workplace rehabilitation assistance.
Any worker who suffers a work-related injury requiring medical treatment or time off work is entitled to claim workers’ compensation.
Why do I need workers’ compensation insurance?
Workers’ compensation insurance is mandatory and protects your business from the financial cost of a workers’ compensation and common law claim.
If you don’t have workers’ compensation insurance, you can be fined $5,000 per worker you employ while uninsured, plus you will need to pay any avoided premium.
Additionally, if an injured worker makes a claim while you are uninsured, you will be responsible for all costs associated with the claim.
Workers’ compensation and common law claims can cost in excess of $1,000,000 so it’s simply not worth the risk.
Who do I need to cover?
You must have workers’ compensation insurance for anyone you employ who is defined as a ‘worker’ under the Act. This includes:
• full-time workers on a wage or salary
• part-time, casual and seasonal workers
• workers on commission
• piece workers
• working directors (optional).
A contractor or sub-contractor may also be defined as a ‘worker’ if they are engaged to do work for the purpose of your trade or business and they are paid in substance for their personal manual labour or services. For more information refer to the publication A technical note on contractors and workers’ compensation available from the WA website.
How do I get an insurance policy?
You can contact an insurer to obtain a premium quote for your business. A list of approved insurers is available on the WA website at www.workcover.wa.gov.au/service-providers/ insurers/.
Alternatively, you can use the services of an insurance broker who will negotiate with an insurer on your behalf.
Your insurance premium will vary depending on:
• the number of workers you employ
• the amount of wages paid to your workers
• the industry in which you operate
• your claims history and risk factors.
The claims process
The following steps must be taken following a workplace injury:
1. Apply first aid to the injured worker and report the injury in your incident reporting system.
2. Get the worker to see a doctor of their choice as soon as possible.
3. Ask the worker to obtain a
First Certificate of Capacity from their treating doctor.
4. Provide the worker with a Workers’ Compensation Claim Form and ask them to complete the worker’s section.
5. Obtain the completed Claim Form and First Certificate of Capacity from the injured worker.
Note: All received claim forms must be forwarded on to your insurer.
You can be fined $1,000 if you fail to submit a claim to your insurer within five days.
6. Complete the employer’s section of the Claim Form.
7. Take copies of both documents for your own and your worker’s records.
8. Submit the First Certificate of Capacity and Claim Form to your insurer within five days.
You can be fined $1,000 if you fail to submit the documents to your insurer in time.
9. Your insurer is required to advise you and the injured worker within 14 days if the claim has been accepted, disputed or pended.
Waiting for a decision
An injured worker is responsible for covering the costs of medical treatment for their injury until
a decision on liability is made by the insurer. It’s important the worker keeps receipts during this time. If the claim is accepted, the costs will be reimbursed by the insurer.
While awaiting a decision on a claim, you may consider paying accrued leave, such as annual or sick leave, to an injured worker. It’s important you seek the worker’s agreement before taking this action.
If a claim is accepted, any sick leave must be credited back to the worker. Enquiries about annual leave can be referred to the Fair Work Ombudsman on 13 13 94.
Your insurer is required to advise you and the injured worker within 14 days if a claim has been accepted, disputed or pended.
If a claim is accepted by the insurer, the worker’s compensation entitlements will commence.
If a claim is disputed, no compensation will be paid and the insurer will advise you and the worker of the reason.
If the worker disagrees with the insurer’s decision, they can lodge an application with WA’s Conciliation and Arbitration Services.
If a claim is pended, this usually means the insurer needs more information to make a decision.
The insurer has a further 10 days to decide whether to accept or dispute liability.
If no decision is made after this time, the claim is said to be ‘in dispute’ and the worker can apply to WA’s Conciliation and Arbitration Services for resolution of the dispute.