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The scheme

The Comcare scheme

Our role is to support participation and productivity through healthy and safe workplaces. We also aim to minimise the impact of harm in workplaces covered by Comcare.

We administer the Commonwealth's statutory framework for rehabilitation and workers' compensation, and we are the national work health and safety regulator under the federal Work Health and Safety Act 2011 (WHS Act).

Comcare also:

The Comcare scheme:

  • works in partnership with employers and their employees to prevent workplace injuries
  • appropriately uses regulatory sanctions for any demonstrable failure of the employer’s duty of care
  • empowers employers to work with their employees to maintain an employee with a workplace injury at work, or to achieve an early, safe and durable return to work
  • appropriately compensates and supports employees with a workplace injury.

Explore more detailed work health and safety and workers’ compensation statistics

Compare performance information across Australia and New Zealand

Scheme coverage

Premium paying entities including ACT Government

The Comcare scheme delivers a consistent set of benefits to employees regardless of the geographic location of their usual place of work or their location at the time of injury.
Full time equivalent employees covered under the SRC Act (FYTD as at 31 Mar 2017)
Proportion of total Australian workforce by industry type (top 4)
Public administration and safety
Financial and insurance services Professional, Scientific and Technical
Transport, postal and warehousing
Information, media and telecommunications
FYTD as at 31 Mar 2017
% Australian industry (2015-16)
Public administration and safety
Financial and insurance services Professional, Scientific and Technical
Transport, postal and warehousing
Information, media and telecommunications

Prevention

Comcare works with employers, employees and other stakeholders to improve work health, prevention, safety and rehabilitation outcomes. Our aim is to make workplaces safer through prevention of injury and effective compliance.

The most recent comparative performance data shows that Comcare has the lowest injury incidence and frequency rates of any jurisdiction.

We will continue working towards becoming a zero fatality scheme—no workplace death is ever acceptable.

Comcare also improves work health and safety outcomes including programs to encourage early intervention after workplace injury and to promote the Health Benefits of Work.

Workplace incidents

Persons conducting a business or undertaking are required to notify Comcare of incidents that result in the death, serious injury or illness of a person, or that are dangerous in nature. The WHS Act defines which events are notifiable.

Has an injury, illness or dangerous incident occurred at your workplace? If so, you may be legally required to notify Comcare about what has happened.

In 2015–16, Comcare received around 2000 incident notifications. Of these, 1400 were assessed as notifiable under the WHS Act.
Dangerous
incident
Serious injury or illness
Fatalities

The most prevalent incident types (2015-16)

Contact with electricity
Being hit by falling objects
Single contact with chemical or substance
Falls from a height

Regulatory response

Comcare has a compliance and enforcement role covering both work health and safety and workplace rehabilitation regulation. This role combines proactive and reactive elements. Comcare’s regulatory activities may be undertaken in response to workplace incidents and notifications, but they may also be triggered by other means such as complaints or allegations, media articles, research and reports, or Comcare’s analysis of workplace risks and hazards.

Comcare's Compliance and Enforcement Policy details our regulatory approach.

Breakdown of regulatory activities (2015–16)
Total Notifications and Concerns Received
Compliance Enforcement Activities
Statutory Notices Issued
Prosecutions Commenced

Safety systems

Comcare conducts an annual program of work health and safety and rehabilitation management system audits to identify positive aspects of the systems in place and highlight any deficiencies that need to be addressed.

Our safety system audits use a range of audit tools and templates.

In addition, in 2015–16 Comcare made over 4500 authorisation and approval decisions to ensure high risk work activities are only undertaken after the suitability of persons, things or processes have been assessed.

Major hazard facility licences
Hazardous chemicals authorisations
High risk plant registrations
High risk work licences

Recent enforcement activity

Comcare applies a range of compliance tools prior to using enforcement options. Some compliance tools are backed by legislated enforcement options, and Comcare uses these options when necessary and appropriate.

On 25 July 2013 there was a chemical fire at Cleanaway’s (formerly Transpacific Industries) Wingfield Chemical Waste Process Plant near Port Adelaide.

Workers were conducting Cleanaway’s first production-scale trial to distil a new industrial solvent from a chemical mixture when there was a loud explosive rush of air followed by a large flame emanating from a metal still. A worker standing about five metres away from the still was knocked to the ground by the force of the fire. He was treated in hospital for minor injuries.

Cleanaway was convicted and fined $650,000 over the incident on 19 April 2017. Cleanaway Operations Pty Ltd had pleaded guilty to a single charge of failing in its duty to ensure the health and safety of workers under the Commonwealth Work Health and Safety Act 2011.

In sentencing, the court found that workers had very limited information about the new product and Cleanaway did not provide all the technical information to the workers on the ground. The sentence took into account the gravity of the offence and the court considered there to be a high degree of culpability.

On 15 June 2012 at Urban Superway Project, Angle Park South Australia workers were installing a four-metre concrete drain pipe when a two metre, 40 kilogram section broke off and fell 15 metres. The pipe hit two cars stopped at traffic lights smashing the windscreen of one vehicle. No one was injured in the incident. The pipe broke as it was not properly supported when being manoeuvred into position.

In sentencing, the court found that John Holland did not carry out a risk assessment for the job or ensure the work was done safely. John Holland was convicted and fined $130 000 over the incident on 8 June 2016. This is first sentence to be imposed under the WHS Act.

On 7 August 2011, in Darwin, an airport firefighting truck with emergency lights and siren on, went through a red light and hit a motor vehicle killing the three occupants. The three firefighters in the truck were not injured.

Airservices Australia admitted it failed to train, inform and instruct its employees appropriately regarding risks associated with driving under emergency conditions on public roads, and failed to conduct an appropriate risk assessment to identify and control hazards relating to the task of driving the fire truck on public road under emergency conditions. Airservices breached the OHS Act by failing to take reasonably practicable steps to protect the health and safety of its workers and members of the public, and on 22 April 2016, was fined $160,000.

On 29 September 2011, at Brisbane Airport Link Project, a worker suffered fatal injuries. The worker had been disassembling the smoke duct formwork when a section he was cutting collapsed causing severe crush injuries.

John Holland admitted it failed to provide the worker with training on risk or control measures for the work, or a safe system of work for the cutting of the formwork. On 11 May 2016, John Holland was fined $170 000 for failing to take reasonably practicable steps to protect the health and safety of its workers. This was the final penalty handed down under the Commonwealth Occupational Health and Safety Act 1991 (OHS Act).

Claims

Our collaborative efforts in prevention and early intervention are getting results. Through stronger partnerships with employers and our focus on improving recovery and return to work outcomes we are making workplaces safer.

Comparative data shows that the Comcare scheme has fewer workplace injuries and better return to work outcomes for injured employees than any other Australian scheme.

Accepted claims rate (per 1000 FTE)

The number of new claims received in the Comcare scheme has reduced by 25 per cent over the past five years. This is driven by a 30 per cent fall in claims for injury and physical disease. The number of psychological injury claims has also started to fall over the past two years.

Did you know you can now lodge claim forms online?

See how your organisation compares.

Get more detailed claims data.

By type, cause and body part (FYTD as at 31 Mar 2017)

Psychological injuries are shown to lead to employees having more time off work and higher claim costs. Comcare is committed to reducing psychological harm in the workplace through our Health Benefits of Work program.

Type of claim
Injury
Disease
Psychological
Cause of claim (top 5)
Cause of claim (top 4)
Body stressing
Falls, trips and slips of a person
Being hit by moving objects
Vehicle incidents and other
Mental stress

Body part injured (top 4)

Psychological
Shoulder
Elbow
Lower back
Wrist
Fingers
Knee

Time off work (compensated)

Evidence shows that after spending 20 days off work, an employee has a 70 per cent chance of ever returning to work. After 70 days, the likelihood of returning to work drops to just 35 per cent. Read about Comcare's return to work rehabilitation framework.

Number of weeks off work (FYTD as at 31 Mar 2017)
Median
Average
Time off work durations (FYTD as at 31 Mar 2017)

Improving return to work outcomes remains the key challenge in the scheme. Comcare works in collaboration with employers to ensure employees receive early and appropriate treatment services and an effective rehabilitation program. Comcare also works with employers to identify flexible arrangements to maximise an employee's capacity for work.

<4 weeks
4<13 weeks
13<26 weeks
26<52 weeks
>52 weeks

Costs

In recent years in the Comcare scheme, the length of time that ill and injured employees are away from their work has increased and psychological injury costs have risen. Comcare has continued to work with scheme participants to achieve a sustainable and better practice scheme resulting in decreasing claims costs paid over the past three years.

Ask your Comcare account manager about how you can impact on your organisation’s claims costs, or use our Customer Information System.

Total claims costs

Claims costs by type (FYTD as at 31 Mar 2017)

Time off work (compensated)
Medical
Associated legal
Other costs
Rehabilitation services

Average cost paid per claim (FYTD as at 31 Mar 2017)

Reports the average paid cost per active claim (claim that received a payment in the reporting period).

Cost per claim
Time off work (compensated) claims
Medical only claims

Reviews

The Comcare scheme has both informal and formal avenues to review a decision about workers’ compensation. The scheme works to resolve these reviews as quickly as possible and monitors their outcomes to inform continuous improvement and effective claims management.
Decision disputed and upheld (FYTD as at 31 Mar 2017)
All Paid Claims
Reconsideration rate
Reconsideration
affirmation rate
Appealed
to AAT
AAT decisions
affirmation rate

Recent cases

Comcare and the SRCC monitor Court and Administrative Appeals Tribunal proceedings concerning the Safety, Rehabilitation and Compensation Act 1988. The SRCC has a policy on reporting potentially scheme significant matters.
What does ‘as a result of’ mean for the purposes of the reasonable administrative action exclusion?

Full Federal Court - [2017] FCAFC 64 (24 April 2017)

Federal Court – [2016] FCA 709 (15 June 2016)

Tribunal – [2015] AATA 189 (27 March 2015)

Dr Lim was employed by the Australian Communications and Media Authority (ACMA). She was responsible for responding to complaints and inquiries made by members of the public. In March 2011, Dr Lim made a claim for workers’ compensation for ‘adjustment reaction with depressant anxiety’. She alleged this was caused by workplace bullying and harassment related to a disagreement with her supervisor about the use of template letters to respond to inquiries that could not be properly dealt with under the Telecommunications Act 1997.

Comcare found that Dr Lim’s psychiatric condition was contributed to, to a significant degree, by employment but denied liability on the basis that the disease was suffered ‘as a result of’ reasonable administrative action, taken in a reasonable manner (RAA). The Tribunal affirmed this decision, finding that:

  • Dr Lim suffered her psychiatric condition on 18 March 2011, rather than September or October 2010 as alleged by Dr Lim; and
  • this condition was caused by
    • dealings with her supervisor over the use of template letters, and ACMA’s response to enquiries under the Telecommunications Act; and
    • a performance appraisal on 31 January 2011, which the Tribunal found was RAA.

As the Tribunal found that the RAA contributed to Dr Lim’s psychiatric condition, it concluded that the RAA exclusion applied and her condition was not compensable. The Federal Court affirmed this decision. Dr Lim appealed to the Full Federal Court which unanimously allowed her appeal. Both the Tribunal and Federal Court decisions were made before the High Court’s decision in Comcare v Martin [2016] HCA 43 but the Full Federal Court appeal was heard after that decision was handed down.

In Comcare v Martin the High Court held that the ‘as a result of’ causation test in the RAA exclusion requires the decision-maker to consider whether the employee would have suffered the disease without the RAA. In Lim, the Full Federal Court followed the High Court and clarified the application of this test where the only causes of the claimed condition are employment-related. In such cases, the decision-maker need only consider whether the employee would have suffered the ailment (or aggravation) if the RAA had not been taken. If the ailment would not have been suffered without the RAA, the ‘as a result of’ RAA test is satisfied. Consequently, the Full Federal Court found that the Tribunal did not properly consider the ‘as a result of’ causation test as expressed by the High Court in Comcare v Martin when finding that the RAA exclusion applied in Dr Lim’s case.

The Court also commented that where a disease is caused by both employment and non-employment factors, the decision-maker also needs to consider whether employment would still have contributed to the ailment, to a significant degree, without the RAA.

What does ‘as a result of’ mean for the purposes of the reasonable administrative action exclusion?

High Court of Australia—[2016] HCA 43 (9 November 2016)

Full Federal Court—[2015] FCAFC 169 (30 November 2015)

Federal Court—[2015] FCA 4 (8 January 2015)

Tribunal—[2014] AATA 553 (11 August 2014)

Ms Martin was employed by the Australian Broadcasting Corporation as a producer of a local radio program. The employee did not have a good working relationship with her supervisor and attempted to remove herself from his supervision by applying for a number of positions. She was appointed to an acting position as a cross media reporter under a different supervisor and then applied for this position permanently. Ms Martin was advised by her supervisor at the time in a telephone conversation that she had not been successful in her application for permanency. When the conversation turned to the employee returning to her previous position she ‘broke down immediately’ and went home. Ms Martin sought medical treatment the next day. She was diagnosed as suffering from ‘adjustment disorder.’

Comcare rejected the claim on the basis that the ailment arose as a result of ‘reasonable administrative action taken in a reasonable manner’ (RAA).

Ms Martin appealed this decision and the matter was heard before the Tribunal and Federal Court before being appealed to the Full Federal Court. The majority of the Full Federal Court considered that the phrase ‘as a result of’ in the RAA exclusion requires a ‘common sense’ approach to causation. The majority considered the ‘common sense’ cause of Ms Martin’s condition was her realisation that she would be returning to her previous supervisor, not her failure to obtain the promotion. The majority found that the Tribunal had confused consequence with causation, and treated an event as being causative just because it preceded the ailment.

The High Court unanimously allowed Comcare’s appeal on the basis that the Full Federal Court had incorrectly applied the causation test in the RAA exclusion.

The High Court held that the phrase ‘as a result of’ in the RAA exclusion in s 5A(1) should be construed in its statutory context and purpose. It “…is naturally read, not as imposing its own separate and free-standing test of causation, but rather as referring relevantly to the test of causation spelt out in s 5B(1)”. For disease claims, this requires that employment contributed, to a significant degree, to the ailment (or aggravation). The RAA exclusion will only apply if “…the taking of the administrative action is an event without which the employee’s ailment or aggravation would not have been a disease: it would not have been contributed to, to a significant degree, by the employee’s employment”.

The High Court also clarified that:
  • the employee’s subjective reasons for their reaction to any RAA, including any reaction to perceived consequence of an RAA, are not relevant to the causation test in s 5A(1); and
  • the RAA does not need to be the sole cause of the disease for the exclusion to apply.
What is the proper statutory construction and application of the voluntary and unreasonable assumption of an abnormal risk of injury exclusion in s 6(3) of the SRC Act?

Tribunal—[2016] AATA 606 (15 August 2016)

Federal Court—[2015] FCA 1000 (10 September 2015)

Tribunal—[2014] AATA 577 (20 August 2014)

Mr O’Loughlin was employed by Linfox Australia as a tanker operator. While he was discharging fuel at a petrol station, a woman drove a car into the petrol station and started honking its horn. A man emerged from the service station workshop and threw two objects at the car. He struck the windscreen and the driver’s window with his fist. Mr O’Loughlin yelled at him to ‘calm down.’ A verbal exchange then escalated into a physical altercation, and Mr O’Loughlin suffered injuries to his face and knee. Following the High Court’s decision in Comcare v PVYW (2013) 250 CLR 246, Linfox revoked its acceptance of liability for the injury on the basis that the PVYW test for ‘in the course of employment’ was not met as he was not induced or encouraged to engage in the altercation. The Tribunal affirmed this decision. The Federal Court overturned that decision on the basis that the principles in PVYW should only be applied where the injury occurs during an interval in an overall period of work. On remittal from the Federal Court, the Tribunal found that while the assault interrupted Mr O’Loughlin’s normal duties, that interruption did not result in the injury being sustained in an interval or interlude. Accordingly, the principles in PVYW did not apply.

The Tribunal found that:

  • Mr O’Loughlin’s injury did not arise out of his employment as the altercation which led to the injury had no causal connection with his employment; but
  • the injury arose in the course of his employment under s 5A(1) as the altercation and injury occurred while he was performing the tasks he was required to perform in his employment; and
  • as the circumstances of the injury fell within s 6(1), the ‘voluntary and unreasonable submission to an abnormal risk of injury’ exclusion in s 6(3) applied such that the injury could not be treated as having arisen out of, or in the course of, employment under s 5A(1).

In considering s 6(3), the Tribunal noted that Mr O’Loughlin was aware of his duty not to engage in altercations with members of the public. Rather than attempting to prevent the altercation from escalating, he had two further verbal exchanges with the assailant. The Tribunal found this indicated that Mr O’Loughlin was prepared to engage in a fistfight, submitting himself to an abnormal risk of an injury.

Mr O’Loughlin appealed the Tribunal’s decision to the Federal Court on the grounds that the Tribunal:

  • failed to interpret s 6(1) of the SRC Act as extending the definition of injury to certain injuries which had not satisfied s 5A(1); and
  • wrongly applied the s 6(3) exclusion his injury after finding he suffered an injury under s 5A(1)(b).

The Federal Court appeal has not yet been listed for hearing.

Surveillance shows employee no longer entitled to compensation

Tribunal—[2016] AATA 804 (13 October 2016)

Mr Atkinson had an accepted claim for compensation in relation to synovitis and tenosynovitis (bilateral), sustained on 2 February 2011. At the time of the injury, Mr Atkinson was employed as a records officer and claimed that he suffered a repetitive strain injury.

On 16 February 2015 Comcare determined Mr Atkinson has no present entitlement to compensation for the accepted conditions. The reviewable decision dated 15 May 2015 affirmed the determination and the employee appealed to the Tribunal.

Mr Atkinson’s credibility was in issue and covert surveillance was undertaken. Most medical practitioners/specialists, including Mr Atkinson’s general practitioner, were of the opinion that the surveillance footage demonstrated functional capacity and movements that were inconsistent with the restrictions he reported.

The Tribunal relied on the surveillance footage and made a finding that Mr Atkinson does not suffer from the effects of his accepted condition.

Comcare submitted to the Tribunal that Mr Atkinson never suffered a condition that was significantly contributed to by his employment (pursuant to the principles from Telstra Corporation v Hannaford [2006] FCAFC 87). The Tribunal agreed that whilst it was open to make a finding about whether Mr Atkinson’s employment significantly contributed to his condition (and therefore revisit the acceptance of liability under s 14 of the SRC Act) it found there was no need to do so because the determination that Mr Atkinson had no present entitlement was affirmed.

AAT endorses the Clinical Framework

Tribunal—[2016] AATA 827 (20 October 2016)

Ms Evans has an accepted claim for a ‘soft tissue strain to the cervical spine’ with a date of injury of 15 June 1990. Following a Comcare Clinical Panel review, a determination was made on 3 June 2015 to deny physiotherapy treatment beyond 2 June 2015 under section 16 of the SRC Act. The determination was affirmed by reviewable decision dated 8 July 2015, on the basis that Ms Evans’ ongoing physiotherapy was not in line with the Clinical Framework or the requirements of the SRC Act.

This matter proceeded to Tribunal hearing on 26 August 2016. The Tribunal found the evidence of the Clinical Panel Physiotherapist to be highly persuasive, and this evidence was therefore preferred over the evidence of Ms Evans’ treating doctors and physiotherapist. The Tribunal endorsed the Clinical Framework as being ‘an appropriate benchmark by which the objective reasonableness of medical treatment can be measured’. The Tribunal also found that Ms Evans’ treatment did not fall within the ambit of ‘therapeutic treatment’ as defined in s 4(1) of the SRC Act and explained that ‘the trend of the authorities is one of treatment whose purpose is to cure or alleviate an injury’. The Tribunal discussed the Federal Court case of Holt v Comcare (2007) 94 ALD 576 which adopted a cost-benefit analysis approach to reviewing medical treatment, and found that ‘the cost of the claimed physiotherapy treatment outweighs the therapeutic benefit derived from the physiotherapy by the Applicant’.

Financial performance

The Comcare scheme has seen significant improvement in financial performance and has shown strong performance in comparison to other schemes. Claim frequency is reducing, claim duration after injury is beginning to improve and premium rates are falling. These trends are having a very positive impact on the financial position of the premium scheme.

Cost
Claim frequency
Claim duration

Premium rate

Scheme notional rate

The scheme notional premium rate proportions the premium rate for government sector and licensees by FTE.

The scheme notional premium rate proportions the premium rate for government sector and licensees by FTE.

Comcare continues to focus on strategic projects targeting return to work outcomes, efficient and effective claims management processes, and risk based file reviews. These have contributed to a significant reduction in premium claims costs and outstanding claims liabilities.

Use our premium calculation tool to gain a better understanding of how investment today may impact future premiums.

See how you compare.

Our target is to achieve a 1.1% average premium rate in the scheme. In 2017–18, 71 per cent of employers are already at or below 1.1 per cent. Contact Comcare so we can work with you to share best practice and help you bring your premium rate down.

Funding ratio (government sector only)

The percentage of premium related total assets to premium related total liabilities.

Comcare is moving to a fully funded scheme faster than expected. Our aim is for the insured scheme to be fully funded by 2020, measured by regular valuations of liabilities and assets, to ensure the scheme remains financially sustainable.

Administration cost ratio (government sector only)

Claims administration costs as a proportion of total scheme expenditure.

Comcare aims to reduce the administration cost ratio to 20 per cent by 2018–19, measured by Safe Work Australia’s comparative monitoring methodology, to ensure cost effective management of the fund.

Two factors have contributed to the increase in Comcare’s administration cost ratio in 2015-16:

  • there was higher investment in business improvement initiatives in 2015–16, including investment in the Health Benefits of Work program and claims management projects.
  • the total scheme expenditure decreased in 2015–16 due to lower payments to insured workers.

Summary

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Page last updated: 22 May 2017