workers compensation commission self-insurers forum
TRANSCRIPT
Workers Compensation Workers Compensation CommissionCommission
Self-Insurers ForumSelf-Insurers Forum
Workers Compensation Workers Compensation CommissionCommission
Self-Insurers ForumSelf-Insurers Forum
2
Recent developments in the Commission
New President and Registrar appointed in late 2007
Major client survey and organisational review conducted in 2008
Number of significant changes introduced or being implemented
3
Some recent changes
Professional Development Framework for Arbitrators and Approved Medical Specialists
Consolidated Medical Appeal Panels
Key Performance Indicators Framework
Regional Venues Review
Forms Review
New Recording Software
4
Future changes
Internal restructure
Transition from contractors to in-
house Arbitrators
Coordination of regional
hearings
Electronic lodgment
5
Professional Development Frameworks
AIM – to improve the quality of decision-making
Key Components
Competency Framework
Performance indicators / measures linked to framework
Self Development Plans
Peer Review
Performance Appraisal
6
Uses of the competency framework
The foundation for: self assessment peer review Appraisal design and development of professional
developments opportunities including conferences
7
Arbitrator Framework of Competency
A. Knowledge and values
B. Communication
C. Conduct of cases
D. Evidence
E. Decision-making
F. Facilitation, case management and administrative skills
8
AMS Framework of Competency
A. Knowledge and values
B. Communication
C. Conduct of Medical Assessment
D. Report of Medical Assessment
E. Case management and administrative skills
9
Consolidated Medical Appeal Panels
Aim – to improve consistency and timeframes of Medical Appeal Panels
Significantly reduced number of Arbitrators and Approved Medical Specialists who sit on panels.
2007 Approx. 50 Arbitrators, 120 AMS
2008 15 Arbitrators, 20 AMS (Primary)
Preliminary results:
decrease in average time taken from 106 days to 95 days
decrease in medical appeal rate from 21 per cent (Feb 08 to 11 per cent (Jan 09)
decrease in revocation rate from 21 per cent (Feb 08) to 5 per cent (Jan 09)
10
Key Performance Indicators
Aim – to provide information targeted at various levels
1.Corporate Key Performance Indicators
2. Management Performance Indicators
3. Operational Performance Indicators
4. Support Performance Indicators
5. Service Standards
The framework provides for both outcome and output based performance indicators
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Key Performance Indicators
Measures performance of Commission against legislative objectives
Basis for formal reporting to Minister
Public release in the Annual Review
External publication includes statistics on workloads and throughputs e.g. counts of new and finalised applications by type, outcomes for applications and work in progress
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Time taken to resolve matters
Disputes finalised within 3 months(including matters with appeals)
42.0% 42.1% 41.7%39.9%
44.3%
40.9%
34.6%
30.6%
42.2% 41.6%
39.7%41.4%
0.0%
5.0%
10.0%
15.0%
20.0%
25.0%
30.0%
35.0%
40.0%
45.0%
50.0%
Jan-08 Feb-08 Mar-08 Apr-08 May-08 Jun-08 Jul-08 Aug-08 Sep-08 Oct-08 Nov-08 Dec-08
Cu
mu
lati
ve %
3 months
Performance Target
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Time taken to resolve mattersDisputes finalised within 6 months
(including matters with appeals)
82.8%
86.5%
82.3%
84.7%
77.8%
84.0%
82.4%82.9%
85.6%
87.5%
86.5%
83.2%
75.0%
76.0%
77.0%
78.0%
79.0%
80.0%
81.0%
82.0%
83.0%
84.0%
85.0%
86.0%
87.0%
88.0%
Jan-08 Feb-08 Mar-08 Apr-08 May-08 Jun-08 Jul-08 Aug-08 Sep-08 Oct-08 Nov-08 Dec-08
Cu
mu
lati
ve %
6 months
Performance Target
14
Time taken to resolve mattersDisputes finalised within 9 months
(including matters with appeals)
95.2%
94.0%
93.4%
96.3%
94.9% 95.0%94.4%
93.0%
97.5%
95.5%
90.5%
94.8%
86.0%
88.0%
90.0%
92.0%
94.0%
96.0%
98.0%
100.0%
Jan-08 Feb-08 Mar-08 Apr-08 May-08 Jun-08 Jul-08 Aug-08 Sep-08 Oct-08 Nov-08 Dec-08
Cu
mu
lati
ve %
9 months
Performance Target
15
Regional VenuesAim: Regional service provision to be better
coordinated and more efficiently delivered
Reduce number of approved locations from 48 to 16 locations across New South Wales
Review quality and adequacy of existing venues at each location
Better coordination of regional hearings
16
New Recording Software
2008 - piloted the use of two voice recording hearing rooms on level 21 of the Commission’s Oxford St premises.
2009 – progressive roll out of the new technology to the remaining hearing and conference rooms on level 21.
17
Some observations for Respondents
Some insurers are briefing too late (leads to problems at t/c with respondent lawyers being unavailable or not properly prepared)
Focus on early exchange – don’t wait unit you’re in the Commission before seeking GP / hospital notes
Lack of clarity around lead agent provisions
Scatter gun approach – don’t say it’s in dispute if it isn’t!
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Some observations for Respondents
Parties can agree on an Approved Medical Specialist
Check the AMS referral document – don’t wait until after a Medical Assessment Certificate has been issued to make objections
Reconsideration power
Uplift in costs for complexity
19
General Points to remember At no stage do any of the parties contact the
AMS
The insurer does not arrange the examination or instruct the AMS
The WCC makes all arrangements with the AMS instructs the AMS and informs the parties of the outcome
20
WPI Thresholds
1% - 9% WPI entitled to s66 only 6% binaural hearing loss to be entitled to a lump
sum – s69A 10% WPI and over to receive s67 15% WPI to receive Ss66 or 67 for psychiatric
injury 15% WPI to get domestic assistance – s60AA 15% WPI to make a Work Injury Damages claim 15% WPI to commute HIV/AIDS automatically pays 100% WPI and
maximum amount for Pain & Suffering
21
Deduction for Pre-existing condition or injury For injuries before 1 Jan 2002 and
For injuries on and after 1 Jan 2002
deductions are now governed by S323 of the WIM Act & the WorkCover Guides
under s323 if it is too difficult or expensive to assess pre-existing impairment the AMS will deduct 10 per cent
22
Section 8 – Work Injury Damages
Before a worker can bring a claim for damages the worker must have 15% WPI
This applies no matter when the injury occurred
If the injury occurred before 1 Jan 2002 worker must be re-assessed on WPI basis
– i.e. % loss converted to WPI
