The scheme is characterised by:
- limited access to common law except for payments for:
- an employee electing to sue for damages for non-economic loss rather than taking statutory benefits
- actions for damages claimed by dependants of deceased employees
- a comprehensive benefit structure including:
- payment of reasonable cost of medical treatment
- 100% payment of normal weekly earnings (NWE) for the first 45 weeks of incapacity
after 45 weeks, payment of between 75-100% NWE
- employer responsibility for the occupational rehabilitation of injured employees. Employers can :
- appoint a case manager to assist the employee to return to work
- arrange with an approved provider for the provision of a suitable program to assist with return to work.
Legislative provisions
The SRC Act provides the legislative basis for the Commonwealth workers’ compensation scheme. The SRC Act establishes Comcare and the Safety, Rehabilitation and Compensation Commission (the Commission). It also sets out the role and functions of both bodies including administrative, regulatory, and service responsibilities. The SRC Act involves a comprehensive benefit structure that includes:
- the payment of the reasonable cost of medical treatment
- income replacement for periods of incapacity for work
- payment of a lump sum for permanent impairment
- payment for rehabilitation programs.
Comcare supports the Commission in exercising its functions and powers. These relate broadly to the regulation of workplace safety, rehabilitation and compensation responsibilities in the Commonwealth under the Occupational Health and Safety Act 1991 and the SRC Act.
Jurisdiction and funding
Comcare is the workers’ compensation insurer for all Commonwealth departments, most Commonwealth authorities and the ACT government, providing safety, rehabilitation and compensation services to their employees under the auspices of the Commission.
The SRC Act establishes a fully funded premium based system and a licensed self-insurance based system of compensation and rehabilitation for employees who are injured in the course of their employment. It covers:
- all Commonwealth employees (including members of the Australian Defence Force)
- employees of certain private sector corporations
- ACT public service employees.
The SRC Act allows certain Commonwealth authorities and eligible corporations, for example Australia Post and Telstra, to self-insure and manage their workers’ compensation claims. This is done under licence from the Commission.
Benefits of the Commonwealth workers’ compensation scheme
The Commonwealth workers’ compensation scheme is characterised by:
- a fully funded approach where employers are financially accountable for the cost of work related injury and disease through the payment of an annual premium to Comcare (where Comcare is the insurer)
- a ‘no fault’ scheme, with limited access to common law
- an integrated and cost effective approach to injury prevention, workers’ compensation and occupational rehabilitation (see fact sheet: Rehabilitation and return to work policies and strategies).
- employer responsibility for the rehabilitation of injured employees
- coverage of allowable medical, rehabilitation and related costs associated with the treatment of work related injury and disease
- entitlement to fortnightly incapacity payments until age 65 and in certain circumstances for up to two years after the age of 65
- lump sum payments for permanent impairment
- additional benefits available
- compensation may be payable to the dependants of an employee who has died as a result of a work-related injury or disease.
Limited access to common law
The SRC Act provides for limited access to common law action for employees who are injured at work. Common law actions against the Commonwealth, ACT Government, a Commonwealth authority, or another Commonwealth employee, may only be taken where:
- the employee has been assessed by Comcare following an appropriate medical assessment, as having a permanent impairment of greater than 10% of the whole person and
- the employee has elected to sue for damages for non-economic loss as an alternative to statutory benefits or
- where actions for damages are instituted by dependants of a Commonwealth employee who has died as a result of a work-related injury or disease.
A comprehensive benefit structure
Incapacity payments may be paid for periods of time off work, or of reduced earnings, that are the result of a compensable condition and are supported by medical evidence linking the absence with the compensable condition.
During the first 45 weeks of incapacity, payment may be made for:
- 100% of NWE if the employee is unable to return to work because of the compensable injury or
- a ‘top-up’ payment equal to the difference between what the employee is able to earn and their NWE.
After 45 weeks of incapacity the employee may be paid between 75% and 100% of their NWE depending on the number of hours they are able to work.
Employer responsibility for the occupational rehabilitation of injured employees
The SRC Act gives an employer the power to determine that an employee should undertake a rehabilitation program and the power to arrange with an approved rehabilitation provider for the provision of a suitable program. The employer’s responsibilities include:
- taking account of the advice of the treating doctor
- making all reasonable changes to the workplace to minimise the chance of further injuries or accidents and to assist in the employee’s rehabilitation
- nominating a case manager as soon as possible to assist the employee to return to work, where required
- providing the employee with information about the SRC Act, including assistance with forms and procedures
- maintaining confidentiality in relation to the employee’s claim. Reasonable medical treatment
The SRC Act provides for payment for reasonable medical treatment. Medical treatment includes services which are provided by, or under the supervision of, a legally qualified medical practitioner. It may also include treatment by a health professional such as a qualified physiotherapist, osteopath or dentist, as well as prescribed medications, and so on.
Lump sum payments for permanent impairment
If, as a result of the compensable injury, the employee is assessed as suffering from a permanent impairment (it is likely to continue indefinitely), the employee may be entitled to claim a permanent impairment lump sum payment. In determining the degree of permanent impairment:
- an assessment will be made using Comcare’s Guide to the assessment of the degree of permanent impairment
- in most cases the employee must have a permanent impairment of at least 10% of the whole person.
In addition payment may also be made for non-economic loss.
Entitlement to incapacity payments until age 65
The SRC Act provides that incapacity payments can be made to an injured employee until the age of 65. Injured employees may receive incapacity payments beyond the age of 65 for a maximum period of 104 weeks if they are injured after the age of 63.
Additional benefits available
As part of a rehabilitation program an employee may also be assessed as needing additional assistance such as:
- household services
- attendant care
- modifications to their home or vehicle
- provision of aids or appliances.
Compensation payable to dependants
Compensation may be payable to the dependants of someone who has died as a result of a work-related injury or disease. This may include:
- a lump sum payment to dependants
- weekly payments for each dependent child who was a dependant of the employee at the date of death and is under the age of 16, or aged between 16 and 25 and undertaking full-time education and not working
- funeral expenses.