Workers compensation

See What do do in the event of an accident / injury / incident for further information.

You must see a doctor if you have sustained a work-related injury or illness and you are considering making a claim for workers compensation.

You should talk to your doctor about work tasks that you can still perform and obtain a Work Capacity Certificate.

You must then complete the Return to WorkSA Claim Form, also available from the WHS Unit. Forward/bring the completed form, with the Work Capacity Certificate issued by your doctor, to the University Return to Work Coordinator in the WHS Unit.

Your claim cannot be determined if your Claim Form is not accompanied by the Work Capacity Certificate.

Note: the staff member is legally responsible for all medical and associated costs until the claim has been accepted. Accounts should therefore be addressed to the staff member, NOT the University.

Flinders University is a registered employer in all other States and Territories. Staff in these jurisdictions  will have their claims managed by the relevant Claims Manager in accordance with the jurisdictions workers compensation legislation. There is a wide variation between States and Territories in managing Workers Compensation.

To lodge a claim, you must consult a registered medical practitioner (doctor), advise the treating doctor that the injury is work related and obtain the required workers compensation medical certificate, from the doctor.

You must then complete the relevant Workers Compensation Form. Forward the completed form with the appropriate medical certificate to the University Return to Work (RTW) Coordinator in the WHS Unit. If the Claim Form is not accompanied by the appropriate Medical Certificate the Claim cannot be determined.

NT WorkSafe  (for staff located in the Northern Territory)

WorkSafe Victoria  (for staff located in Victoria)

WorkCover Queensland  (for staff located in Queensland)

WorkCover Authority NSW (for staff located in NSW)

WorkCover WA (for staff located in Western Australia)

WorkCover Tasmania (for staff located in Tasmania)

You are legally responsible for all medical and associated costs until your claim has been accepted. Accounts should therefore be addressed to you, NOT the University.

If you have accounts and receipts at the time of lodging your Claim documentation, you should include them.

If your claim is accepted, all accounts for the following must be forwarded to the Return to Work Coordinator for processing and payment:

• medical expenses relating to that injury; 
• approved treating practitioners (physiotherapist etc); 
• related travel expenses; and
• pharmaceutical expenses related to the treatment programme.
  

A staff member injured whilst working is entitled to lodge a workers' compensation claim.

The South Australian Return to Work Act, 2014 and the Victorian Workers Compensation Act 1958 exclude compensation for injuries arising from everyday travel to and from a staff member's home and work.

The Northern Territory Return to Work Act does provide for compensation for injuries arising from everyday travel to and from a staff member's home and work except if the accident involved a motor vehicle.

South Australia

The Return to Work Coordinator will forward the completed Claim documentation to the University Claims Manager within two business days of receipt. The Return to Work Coordinator will notify you, your supervisor and the Dean and/or Director of your College/Portfolio that the claim has been lodged.

The Return to Work Coordinator

• will contact you and your supervisor
• may request additional information to assist in determining the rate of weekly payments
• will arrange services to help you to recover and return to work this may include visiting you if you are likely to be away from work for more than two weeks.
  

The University Claims Manager will make a determination on the claim and will advise you, and the Return to Work Coordinator will advise your supervisor and the Dean and/or Director of your College/Portfolio, whether or not the claim has been accepted.

Other Australian states and territories

The RTW Coordinator will forward the claim documentation to the Insurance Company Claims Manager in your State or Territory for determination of the Claim. The submission of the form will meet the requirements of the legislation according to the State or Territory requirements.

The RTW Coordinator will explain to you the payment of weekly wages and medical expenses as stipulated by the legal requirements relevant to your State or Territory. You will need to use your sick leave and/or annual leave until the claim is determined. If the claim is accepted, your sick leave and annual leave entitlements will be restored.

The University will work within the legislative requirements of each State/ Territory in the provision of rehabilitation. The RTW Coordinator in South Australia will liaise with the person injured, their supervisor and the Claims Manager to plan a safe and efficient return to work when this is medically possible. The return to work may include alternative duties and/or modified duties and varied hours worked.

How long will it take to make a decision about your application?

A decision will be made as soon as possible. Most claims are determined within 10 days of the completed Claim documentation being received by the Claims Manager. You can reduce the decision making time by providing clear and accurate details on the Claim Form. If you need help completing the form with your consent, a representative such as your treating doctor, a friend or family member or the Return to Work Coordinator can help you to complete the information on the Form.

If your application is not complete, there may be a delay in the decision making process. For example, if the Work Capacity Certificate given by your doctor is unclear about your injury or illness or your work capacity, you may need to return to the doctor for more details.

Complex claims may take longer to decide. You will be kept informed of the progress with your application and notified as soon as a decision is made

If your claim cannot be determined within 10 business days of its receipt by the Claims Manager, you will be offered interim payments. You may choose instead to use any entitlements to sick leave or annual leave, pending determination of the claim. If the claim is ultimately accepted, such leave will be reinstated.

If the claim is rejected, the University is entitled to recover the amount of interim payments as a debt from you.

You will be given reasons in writing if your workers compensation claim application is not accepted. You will also be advised of your rights of review.

In the first instance you should discuss the matter with the University Claims Manager or the Return to Work Coordinator. If the Claims Manager/ Return to Work Coordinator are unable to resolve the matter they will refer the matter to the Associate Director or the Director, People and Culture.

If the matter is not resolved satisfactorily in this manner, you may choose to lodge an appeal of the decision with the South Australian Employment Tribunal. You must do so within one month of receipt of the decision.

Income maintenance

Where, as a result of the compensable injury or disease, you are unable to be at work (lost time) and your claim has been accepted you will be paid Income Maintenance based on your Average Weekly Earnings (AWE):

• 100% of AWE for the first 52 weeks, then 80% of AWE to 104 weeks 

Income Maintenance payments cease at 104 weeks from the date on which the incapacity for work first occurs (except for seriously injured). The method of calculating income maintenance is stipulated in the legislation. AWE is based on your income over the last 12 months or a fraction thereof, less certain allowances. Additional income support may be provided for pre-approved surgery for a period of up to 13 weeks post-surgery.

Medical expenses

You are entitled to have all reasonable medical and similar expenses related to the injury paid. Except for some specific circumstances, entitlement to medical services ends 12 months after the end of Income Maintenance, or if no entitlement to Income Maintenance after 12 months (except seriously injured).

You can apply for pre-approval of expenses in “prescribed classes“(e.g. major surgery) rather than being required to claim compensation once costs have been incurred.

You can choose your own treating medical practitioner.

In the case of field trips:

• If a staff member undertakes a field trip starting from/returning to University premises then injuries arising during travel to and from the field trip will be covered under return to work legislation, as it is clear that the travel relates to the staff member's work.
• If a staff member undertakes a field trip starting from/returning to the staff member's private residence, then injuries arising during travel to and from the field trip may be covered under the legislation.

Whether or not particular circumstances relating to travel undertaken during a field trip are covered by the legislation can only be determined when all the circumstances relating to a particular claim are evaluated.

Ms Karen Hayden
University Return to Work Coordinator

Ms Helen Webb
Associate Director, Work Health and Safety