By keeping a current workers’ compensation insurance policy and having an injury management system in place, you will ensure compliance with the Workers’ Compensation and Injury Management Act 1981 (the Act).
If a worker is injured
You should ensure a worker who has been injured receives first aid, reports and records the incident and sees a doctor as soon as possible to get a First Medical Certificate. You should also provide them with a Workers' Compensation Claim Form (Word - 1.4MB) to complete.
Receiving the claim
When a worker completes and provides to you a Workers’ Compensation Claim Form accompanied by a First Medical Certificate, you have five working days to pass the documents to your insurer (take a copy for your records, and provide a copy to the worker).
It is not your decision to accept liability for the claim. Your insurer must assess the claim and advise you and the injured worker of their decision, in writing, within 14 days of receiving the claim. The advice must indicate whether it is accepted or disputed, or if they need more time to make a decision.
Claims that involve a journey
Specific provisions in relation to claims that involve a journey are contained within the Act. Workers will normally not be treated as having suffered personal injury by accident arising out of or in the course of their employment if they suffer an injury during a journey between their place of residence and place of employment or vice versa. However, the claim must still be lodged and the insurer will determine whether the claim is accepted.
Assisting your insurer
Your insurance policy will detail what you can expect from your insurer. The most crucial way you can assist your insurer in managing your claims is by immediately providing them with any relevant information you obtain regarding an injured worker. You should involve them as soon as possible after the injury occurs.
Also, approved workers’ compensation insurers in WA have collaboratively developed the Best Practice Guidelines 2010 (PDF - 230kb). These guidelines set parameters for the insurers to follow and so provides consistency across insurers for injured workers and employers with respect to processes associated with claims management.
While the claim is being assessed
You may consider paying accrued leave to your injured worker (such as annual or sick leave). You should ask the injured worker first, make it clear this is not workers’ compensation, and that payment of accrued leave or sick leave is a voluntary option until a decision regarding liability is made. If the claim is approved, and payment from accrued sick leave entitlements has been made, these entitlements must be refunded to the employer by the insurer and recredited to the worker.
If the claim is accepted
You should begin workers’ compensation payments without delay, consulting with your insurer regarding the amount. Once payments begin, you are required to pay the worker in the usual manner and on their usual payday, unless notified by the insurer to cease payments. If you feel that you may be unable to pay an injured worker’s weekly payments in this manner, you should contact your insurer as soon as possible to discuss what options are available. If you cannot resolve the issue with your insurer, contact The Advice and Assistance Unit on 1300 794 744.
Effective Injury Management
All employers must have an Injury Management System. An Injury Management System is a written description of the steps you will take when there is an injury in your workplace.
An employer is also required to develop a formal (written) return to work program for a worker when the medical practitioner:
- advises the employer in writing that a return to work program should be established for the worker
- signs a medical certificate indicating that the worker has partial capacity to return to work
- signs a medical certificate indicating that the worker has total capacity to return to work, but for some reason is not able to return to the position held immediately prior to injury.
Employers are encouraged to read WorkCover WA’s Injury Management: A Guide for Employers (PDF - 980kb) publication which provides information to assist employers to understand their legal obligations and contains a three step approach to effective injury management.
You must keep the worker’s position available
An employer is obliged to provide an injured worker with their pre-injury job, if it is reasonably practicable, or another job comparable in status and pay. For more information, see the obligations of the key parties page under the Returning to Work section.
Getting feedback from your insurer
Ask your insurer for feedback regarding all claims, and consider arranging regular meetings with them to discuss any claims. You can expect your insurer to at least inform you of the following:
- the cost of any claims made on your policy at least once a year
- any dispute referred to the Conciliation and Arbitration Services and the outcomes of each stage of the dispute
- the renewal date for your policy.