Workers Compensation Commission Self-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  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

11 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

12 Time taken to resolve matters

13 Time taken to resolve matters

14 Time taken to resolve matters

15 Regional Venues Aim: 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 piloted the use of two voice recording hearing rooms on level 21 of the Commission’s Oxford St premises – 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!

18 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

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