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Outcomes and Workers’ Compensation Michelle Reynolds CEO, WorkCover WA Refresher Course Day FPM, ANZCA. 11 May, 2012
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22 Claims and Policy Administration Outsourced Workers’ compensation in Western Australia
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33 Variability of workers’ compensation in Australia Jurisdiction New South Wales Queensland Victoria Western Australia South Australia Tasmania Northern Territory Australian Capital Territory * Number of serious claims with one week or more incapacity Source: Safe Work Australia, Comparative Performance Monitoring Report 13 edition 2009/10 Funding model Government funded Privately underwritten Government funded Privately underwritten No of employees 3.0 million 1.9 million 2.5 million 1.0 million 0.7 million 0.2 million 0.1 million % of claims nationally 35% 24% 19% 10% 7% 3% 1%
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44 WorkCover WA’s role in the WA workers’ compensation scheme WorkCover WA Education & Information Advisory Services Conciliation Service Statistics/ research Compliance Services Regulation Scheme design Dispute services Performance monitoring Legislation/ policy Arbitration Service
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55 Key objectives of the WA workers’ compensation scheme Equitable and accessible workers’ compensation system for all stakeholders Reduce social and economic burden of having a work related injury or disease Return injured workers to suitable and sustainable employment as soon as is practicable
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66 Overview of claims in the WA workers’ compensation scheme 38,910 18,097 (47%) 1,706 (4%) Number of workers' compensation claims with lost time Number of disputes lodged for workers' compensation claims Total number of workers' compensation claims lodged in 2010/11
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77 Nature of claims (injury/disease) – 2010/11
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88 Statutory entitlements for injured workers in WA – 2011/12
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99 Proportion of claim costs by entitlements – 2010/11
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10 Key objectives of the WA workers’ compensation scheme Equitable and accessible workers’ compensation system for all stakeholders Reduce social and economic burden of having a work related injury or disease Return injured workers to suitable and sustainable employment as soon as is practicable
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11 None/temporary incapacity Partial permanent incapacity Total permanent incapacity Statutory entitlements SettlementCommon law * * * certain criteria needs to be met (i) Outcomes to assess equitable and accessible workers’ compensation system
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12 (i) Outcomes to assess equitable and accessible workers’ compensation system Utilisation of common law Utilisation of settlements as a proportion of finalised claims
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13 (i) Outcomes to assess equitable and accessible workers’ compensation system Claim frequency by age groups
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14 (i) Outcomes to assess equitable and accessible workers’ compensation system – legislative change
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15 Key objectives of the WA workers’ compensation scheme Equitable and accessible workers’ compensation system for all stakeholders Reduce social and economic burden of having a work related injury or disease Return injured workers to suitable and sustainable employment as soon as is practicable
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16 (ii) Reduce social and economic burden of a work- related injury or disease The majority of injured workers found workers compensation payments helpful in meeting day-to-day living expenses.
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17 (ii) Reduce social and economic burden of a work- related injury or disease - workers
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18 0-1 Strongly disagree 2-3 4567-89-10 Strongly agree Don’t know (ii) Reduce social and economic burden of a work- related injury or disease - employers There was sufficient information available to manage the workers’ compensation claim The claims process was open and honest There was good communication between the various people and organisations dealt with
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19 Key objectives of the WA workers’ compensation scheme Equitable and accessible workers’ compensation system for all stakeholders Reduce social and economic burden of having a work related injury or disease Return injured workers to suitable and sustainable employment as soon as is practicable
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20 (iii) Return injured workers to suitable and sustainable employment Durable return to work rate
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21 RTW rate Approved insurers:76% Self-insurers:86% RTW rate 1-59 days time lost88% 60+ days time lost:53% (iii) Return injured workers to suitable and sustainable employment Return to work outcomes
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22 Source: Heads of Workers Compensation Authorities http://www.hwca.org.au/reports_rtw.php National durable RTW rate (iii) Return injured workers to suitable and Sustainable employment
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23 Reasons for not returning to work Not recovered from work related injury Psychological reasons Left employment voluntarily (e.g. study) Retrenched/ dismissed Source: Australian Institute for Social Research “The role of the workplace in return to work” (WorkCover SA) March 2010
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24 Helping people return to work – using evidence for better outcomes Key recommendations: Use of evidence based medicine and evidence based policy making to form the basis of return to work approaches Health outcomes of workers to be routinely collected/reported Training for medical practitioners Develop systems support for improved practitioner-workplace communication Source: http://www.racp.edu.au – AFOEM publications
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25 Outcomes for compensated injuries vs non- compensated injuries
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26 Collaborative research
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27 Future challenges
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28 Thank you michelle.reynolds@workcover.wa.gov.au
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