Making sense of workers' compensation - small business webinar

There are a lot of different scenarios in terms of travelling – a journey is something that starts from the boundary of home and ends at place of employment. For travel from worksite to worksite, generally speaking, the journey would begin when they leave home, and end if they go to depot to collect tools. Working between different sites would be considered during the course of their normal employment, there are lots of examples of jobs where workers are required to be on the road during the day. This is a bit different to a journey claim – for those roles it’s not necessarily a journey. If you have specific scenarios, please give us a call (1300 362 128) and chat through whether it’s a journey claim or an in the course of employment situation.

As well as journeys, employees are covered while temporarily absent during a normal recess – eg morning tea or lunchtime. If they get lunch, trip and fall on footpath, in those situations, their employment doesn’t need to be a significant contributing factor there – they are covered. There’s an exception, such as workers who subject themselves to an abnormal risk of injury, but we’d need to look at the specific reasons on how that injury was sustained.

There are some exclusions in terms of journeys and injuries sustained in a journey – it does depend on the exact circumstances of the journey, but broadly speaking the Workers’ Compensation and Rehabilitation Act talks about exclusions during or after substantial deviations on the journey home. If a substantial deviation has occurred, we would look at whether the deviation was connected to the worker’s employment. For example if they left work and you asked them to pick up tools related to their job from a hardware store, the deviation provision in the Act would not apply. The other thing we would consider is if a deviation is out of the worker’s control, for example a road is flooded or there’s a detour. The deviation provision in the Act would not apply in this situation. It’s another case by case decision, but that’s a very broad overview.

In this day and age that’s becoming more common. Potentially a worker working from home will be covered – it is each case on facts such as the approved time, duties, how the injury occurred. It’s definitely a possibility, we’d ask some questions about the arrangements, what was the task they were doing at the time, and how did the injury happen? In that circumstance, would it be appropriate for an employer to visit the home before they approve working from home? It does start touching on Workplace Health and Safety side which is separate. It is ideal to want to make sure any employees are all working in a safe environment and a safe manner. As far as the impact on the claim, it’s a no fault system, so if the worker has done something that has caused the injury, for example they left a box in a walkway and then tripped over box, potentially that would be accepted, in the no fault system.

It does start touching on Workplace Health and Safety side which is separate. It is ideal to want to make sure any employees are all working in a safe environment and a safe manner. As far as the impact on the claim, it’s a no fault system, so if the worker has done something that has caused the injury, for example they left a box in a walkway and then tripped over box, potentially that would be accepted, in the no fault system.

Go to the ATO employer/contractor tool, and fill that out and it will give you an answer whether that worker is a worker or a contractor. Just because someone has an ABN, it doesn’t rule them out of being a ‘worker’ under the Workers’ Compensation and Rehabilitation Act.

Over last 12 months we’ve changed how we look at premium with a targeted and tailored premium solution for small business. The rating system is designed to protect small businesses from large fluctuations. It’s based on claims costs, and a quick return to work after injury is shown to reduce impact. It’s partly claims cost and we look at your industry, as some industries riskier than others, but it also depends on the claims you’ve had in your financial year. There are protective mechanisms, so you don’t experience large fluctuations. Each year the increase in premium is capped at 10% so it’s a more stable process, so you can budget for it and understand what that maximum could be. We’ve done this to try and prevent those fluctuations that small business sometimes struggle with. A small business is one that pays less than $1.5 million in wages. If you pay more than $1.5m, you fall into the larger business group. The larger business premium model is based on Experienced Based Rating (EBR), a bit more detailed formula, but it’s based mostly on experience. The more control you have over creating a safe workplace, encouraging an early return to work, and control on expenses on claims, the more impact you can have on reducing your premium.

If a worker sustains an injury while working overseas or interstate, they are entitled to the same coverage as if the injury was sustained in Queensland, provided the worker’s principal place of employment was in Queensland.

The claim representative will be in contact with you and ask for your side of things such as whether you’re aware of injury. If you’re unsure or have your doubts, they’ll ask what is the basis for those concerns? Ultimately the claims representative will weigh up all the evidence and they need to make a decision on the balance of probabilities. If you have concerns, we encourage you to raise those concerns from the outset so our Claims Representatives can conduct the relevant investigations and they’ll be able to consider them as part of the decision making process. As the claim progresses and if it’s accepted, and you believe there was other evidence that has since come to light, there are review rights for employers through the Workers’ Compensation Regulator. If they have information that it shouldn’t have been an approved claim, they can take that decision to the Regulator as an independent body to make that decision, and we’re bound by that decision.

Even though an employer has done all the right things, if an injury does happen there’s still a potential it will get accepted at a statutory level, as it’s a ‘no fault’ system. If accepted, we’d cover medical and rehabilitation expenses and wages. That’s that no fault example. However, an employees actions come into play where claim becomes damages or common law – for example the employee sues for negligence. That’s where the employee has to prove the employer was somehow at fault for causing the injury. If it’s well documented that PPE was provided, and that it was enforced, the employer is in a much better situation in common law.