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Work injury policy issues

Bill Birmingham

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Disability Benefit For whom?

• All disabled people– New Zealand – No fault accident compensation scheme for all

accidents• All social insurance contributors

– Netherlands – no work injury scheme, but comparable coverage by sickness, invalidity and survivors benefits

• Employees who have suffered a work injury or contracted an occupational disease

• Employees and self-employed who have suffered a work injury or contracted an occupational disease

• Students and trainees• Are those who suffer injury due to work accident be

treated better than those injured in any other way or who are genetically disabled or disabled during childhood

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What is a work injury?

• Injury caused by accident arising out of and in the course of employment, but does it cover– Accident during travel to and from work

• Employer’s transport• Other transport• Travel to other than normal place of employment

– Accident during meal break– Accident caused by worker’s (or other worker’s) prank– Accident caused while worker drunk– Accident playing for works sports team or recreation– Accident while engaged in rescue attempt– Accident at work while doing something for worker’s own

purpose– Accident while doing something illegal or when instructed not to– Accident while attending a meeting

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Occupational disease or process

• Occupational diseases– Statutory list– To what employments do they relate?– When is a disease or employment added?– Degree of impairment, eg occupational deafness

• Process – Where not a recognised occupational disease– Where no specific accident– A succession of continual activities which cause

impairment, eg damage caused by use of keyboard

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Basis for work injury or occupational disease benefit

• Total incapacity for work• Partial incapacity for work• Total loss of earning capacity• Partial loss of earning capacity• Loss of function, eg loss of a finger or loss of an

eye – but effect may be greater for certain employments

• Additional costs due to disability, eg attendance and mobility expenses

• Is there a distinction between short-term and long-term disability?

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Who assesses disablement or determines entitlement?

• Individual’s own doctor• Employer • Employer’s own doctor or medical adviser• Social security agency in the light of medical

evidence• Social security agency’s doctor• Independent doctor• Independent medical tribunal• Are there special requirements, eg for

psychological impairment

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Length of award

• For life• Until retirement• For a specified period

– Pending review– Pending rehabilitation

• Death benefit– For widow or widower

• For life• Until remarriage• Pending employment

– For orphans• For life• Until completion of education

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Review or appeal

• Right of appeal– Appellate body– The courts

• Circumstances of review– Whether automatic or on request– At whose request

• The claimant• The Social Insurance Agency

– How frequently

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Work injury insurance and civil liability

• New Zealand – no civil liability claims – covered by statutory accident insurance scheme – but costly

• United Kingdom – Recovery of Benefits Act– Does not deprive individual of civil liability claim– Where social insurance benefit paid after accident or

occupational disease– Where compensation paid for injury

• If paid by employer (or employer’s insurance), or• If paid by motor insurance

– Compensator must • first apply to Social Insurance agency to determine recoverable

benefit• repay recoverable benefits for 5 year period following accident or

onset of occupational disease

• Avoids duplicate provision

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Rehabilitation & Training

• Is rehabilitation a condition for entitlement to benefit?

• Is rehabilitation compulsory or voluntary?• Who meets the cost of rehabilitation?• After rehabilitation, does the disabled person

receive training for a new job and, if so, in what circumstances?

• Who pays for the training?– The work injury insurance– A separate Government budget– The current or future employer

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Disability aids

• Prostheses and wheelchairs• Occupational therapy and physiotherapy• Adaptation of home environment• Adaptation of workplace environment• Adaptation of work equipment• Adaptation of transport

• What effect on life style and work ability

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Work options for persons with work injury or occupational disease• Occupations restricted to disabled persons

– Piano tuner only for blind persons– Switchboard operator if blind or mobility problems

• Workplaces restricted to disabled people– Subsidised by Government– Eg Making toys or playground equipment

• Requirement for employers to employ at least a specified percentage of disabled workers – with criminal sanctions for non-compliance; or

• Government subsidy for employers to employ disabled workers

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Health and Safety

• Work injury insurance contribution rate– Higher for high risk enterprises– Flat rate for all

• Health and safety legislation– Government inspectorate to ensure

compliance– Health and safety committees at work place

• Representatives of management• Representatives of workers