contents brief overview of the commission legislative amendments: changes to the rules and...

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Contents •Brief Overview of the Commission •Legislative Amendments: Changes to the Rules and Regulations •Practice & Procedure update

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Page 1: Contents Brief Overview of the Commission Legislative Amendments: Changes to the Rules and Regulations Practice & Procedure update

Contents

•Brief Overview of the Commission

•Legislative Amendments: Changes to the Rules and Regulations

•Practice & Procedure update

Page 2: Contents Brief Overview of the Commission Legislative Amendments: Changes to the Rules and Regulations Practice & Procedure update

• Workers Compensation Act 1987

• Work Injury Management and Workers Compensation Act 1998

• Workers Compensation Regulation 2010

• Workers Compensation Rules 2011

• Practice Directions / Guidelines

Key Legislative Instruments

Page 3: Contents Brief Overview of the Commission Legislative Amendments: Changes to the Rules and Regulations Practice & Procedure update

The Commission consists of:

President

Deputy Presidents (including ADPs)

Registrar

Senior Arbitrators and Arbitrators

Approved Medical Specialists (Senior AMS Panel)

Mediators

Staff (including Registrar’s delegates)

Establishment

Page 4: Contents Brief Overview of the Commission Legislative Amendments: Changes to the Rules and Regulations Practice & Procedure update

RegistrarRegistrar

Deputy Registrar

Legal & Medical ServicesOrganisational

Strategy

Deputy Registrar

Operations & Business Support

Arbitrators, Mediators & AMS

Deputy Presidents

PresidentPresident

Legal & Medical Support

Arbitrator Support

Operations Business Support

WCC ORGANISATIONAL CHART

Presidential Unit

Page 5: Contents Brief Overview of the Commission Legislative Amendments: Changes to the Rules and Regulations Practice & Procedure update

Overall Workload

Application Type 2008 2009 2010

Application to Resolve a Dispute (Form 2) 8,898 8,707 8,921

Interim Payment Directions (Form 1) and Revocation of an IPD (Form 1A)

558 586 516

Workplace Injury Management dispute 154 124 139

Registration for Assessment of Costs 245 256 240

Commutations (Form 5A) and Redemptions (Form 5B) 163 267 227

Mediations (Form 11) 598 705 848

Arbitral Appeals (Form 9) 161 185 135

Medical Appeals (Form 10) 655 606 566

TOTAL 11,432 11,436 11,592

Page 6: Contents Brief Overview of the Commission Legislative Amendments: Changes to the Rules and Regulations Practice & Procedure update
Page 7: Contents Brief Overview of the Commission Legislative Amendments: Changes to the Rules and Regulations Practice & Procedure update
Page 8: Contents Brief Overview of the Commission Legislative Amendments: Changes to the Rules and Regulations Practice & Procedure update
Page 9: Contents Brief Overview of the Commission Legislative Amendments: Changes to the Rules and Regulations Practice & Procedure update

Practice Directions• Practice Direction No. 1: Determination of matters without a conciliation conference

or arbitration hearing in person ('on the papers') • Practice Direction No. 2: Adjournment of Commission proceedings • Practice Direction No. 3: Expert evidence • Practice Direction No. 4: Correction of 'obvious error' in a certificate of determination • Practice Direction No. 5: Reference of question of law on compensation claim to the

Workers Compensation Commission constituted by the President • Practice Direction No. 6: Appeal against a decision of the Commission constituted

by an Arbitrator • Practice Direction No. 7: Directions to produce documents • Practice Direction No. 8: Notices for Production • Practice Direction No. 9: Lodgment of late documents • Practice Direction No. 10: Determination of disputes concerning past weekly

payments for a period not exceeding 12 weeks. • Practice Direction No. 11: Process for Resolution of Permanent Impairment Disputes

Lodged with the Commission • Practice Direction No. 12: Joinder of Other Parties and Disputes

Page 10: Contents Brief Overview of the Commission Legislative Amendments: Changes to the Rules and Regulations Practice & Procedure update

Registrar’s Guidelines

• Registrar’s Guidelines on:Practice on Conciliation/Arbitration in the

Commission

Reconsiderations

Standards of Conduct in Proceedings

Work Injury Damages

• All available on the website: www.wcc.nsw.gov.au

Page 11: Contents Brief Overview of the Commission Legislative Amendments: Changes to the Rules and Regulations Practice & Procedure update

Recent Amendments

Workers Compensation Commission Rules 2011 –operational on 1 July 2011.

Workers Compensation Legislation Amendment Act 2010 - amends both the 1987 and the 1998 Acts – operational 1 Feb 2011.

Workers Compensation Regulation 2010 – operational on 1 Feb 2011.

Page 12: Contents Brief Overview of the Commission Legislative Amendments: Changes to the Rules and Regulations Practice & Procedure update

Significant changes and tips for preparation

1. Some significant changes and tips for preparation:a) Claim for future medical expenses (Widdup amendment)

b) Admission of forensic medical reports

c) Section 73 reimbursement

d) Tips and traps in preparation: Properly particularising the claim

Section 74 notices

Workers’ statements of evidence

2. New amendments in appeal proceedings:a) Arbitral appeals

b) Medical appeals and reconsideration of MAC

3. Costs

Page 13: Contents Brief Overview of the Commission Legislative Amendments: Changes to the Rules and Regulations Practice & Procedure update

Authorities

NSW Sugar Milling Co-op Ltd v Manning [1998] NSWCC 33; (1998) 44 NSWLR 44

Widdup v Hamilton [2006] NSWWCCPD 258

Amendment

Section 60(5) - Commission now has jurisdiction to determine disputes regarding future medical expenses

“The jurisdiction of the Commission with respect to a dispute about compensation payable under this section extends to a dispute concerning any proposed treatment or service and the compensation that will be payable under this section in respect of any such proposed treatment or service. Any such dispute must be referred by the Registrar for assessment under Part 7 (Medical assessment) of Chapter 7 of the 1998 Act, unless the regulations otherwise provide.”

Future Medical Expenses

Page 14: Contents Brief Overview of the Commission Legislative Amendments: Changes to the Rules and Regulations Practice & Procedure update

Admission of forensic medical reports

Clause 49 (formerly cl 43)

• a mandatory provision (like former cl 43). It is not discretionary

Rinker Group Ltd v Mackell [2008] NSWWCCPD 100

• The definition of “forensic medical report” in 49(4) has been amended and now clarifies that a forensic medical report:

“(c) does not include a report from a specialist medical practitioner who has not treated the worker and has been obtained for the purpose of proving or disproving an entitlement, or the extended entitlement, in respect of another claim or dispute.”

Page 15: Contents Brief Overview of the Commission Legislative Amendments: Changes to the Rules and Regulations Practice & Procedure update

Admission of forensic medical reports

Clause 50 (formerly cl 43AA) – supplementary reports

Cl 50(1) - new sub-clauses - a supplementary report may be admitted if it has the purpose of:

• clarifying the original report, or

•updating original report by confirming, modifying or retracting an opinion expressed in original report, or

• addressing issues omitted from the original report, or

• addressing an opinion in the other party’s medical report

Page 16: Contents Brief Overview of the Commission Legislative Amendments: Changes to the Rules and Regulations Practice & Procedure update

Section 73 of the 1987 Act

Reimbursement for costs of medical examination and report

• Section 73(1) - medico-legal report deemed section 60 expense

• Section 73(3) – new section

- no payment under s73 until PI claim determined: s73(3)(a)

• Where a worker succeeds in permanent impairment claim, the cost of the examination and report can be a disbursement cost or section 60 expense (s 73(1))

• Where a worker is unsuccessful in permanent impairment claim or receives 0% assessment, cost of report can be claimed as section 60 expense (s73(1))

• Transitional provision – retrospective operation (Part 19G Sch 6 of 1987

Act).

Page 17: Contents Brief Overview of the Commission Legislative Amendments: Changes to the Rules and Regulations Practice & Procedure update

Tips and traps in preparing matters in the WCC

1. Particularising the claim – “nature and conditions”

2. Section 74 notice

3. Worker’s statement of evidence

Page 18: Contents Brief Overview of the Commission Legislative Amendments: Changes to the Rules and Regulations Practice & Procedure update

Tips and traps

Properly particularising the claim – “nature and conditions”

Particulars should precisely identify nature of alleged injury:

• personal injury (s 4(a)), or

• disease contracted in the course of (s 4(b)(i)), or

• aggravation of a disease (s 4(b)(ii))

Toplis v Coles Group t/as Coles Logistics [2009] NSWWCCPD 70 at [65]

Smith v Parkes Shire Council [2010] NSWWCCPD 130 at [105]-[106]

Page 19: Contents Brief Overview of the Commission Legislative Amendments: Changes to the Rules and Regulations Practice & Procedure update

Tips and traps

Section 74 notices

• The s 74 notice must contain:

a statement of the reasons the insurer disputes liability

the issues relevant to the decision

the issues genuinely in dispute and

the reasons for the dispute

• And the notice must be:

expressed in clear, plain and unambiguous language

evidence-based

Page 20: Contents Brief Overview of the Commission Legislative Amendments: Changes to the Rules and Regulations Practice & Procedure update

Tips and traps

Section 74 notice

Section 9A – only plead when it is genuinely in issue

• Under s 9A, for compensation to be payable, employment must be a substantial contributing factor to the injury.

• Employment does not have to be a substantial contributing factor to the incapacity.

• Employment does not have to be a substantial contributing factor to the need for medical treatment.

Page 21: Contents Brief Overview of the Commission Legislative Amendments: Changes to the Rules and Regulations Practice & Procedure update

Tips and traps

Workers’ statements

• Part 14 r 14.2 of the 2010 Rules

Gardiner v Spotless Services Australia Pty Ltd [2008] NSWWCCPD 129 at [71]

• Check list

Page 22: Contents Brief Overview of the Commission Legislative Amendments: Changes to the Rules and Regulations Practice & Procedure update

Arbitral appeals

Interlocutory changes

• An order of an interlocutory nature is one that does not finally determine parties’ rights (P & O Ports Ltd v Hawkins [2007] NSWWCCPD 87 and Licul v Corney [1976] HCA 6; 50 ALJR 439).

• From 1 Feb 2011, appeals from interlocutory decisions allowed with leave of Presidential member.

Page 23: Contents Brief Overview of the Commission Legislative Amendments: Changes to the Rules and Regulations Practice & Procedure update

Arbitral appeals

Appeal – error of fact, law or discretion

Appeals are restricted under s 352 to determination of whether decision appealed against was/was not affected by error of fact, law or discretion + correction of such error.

Page 24: Contents Brief Overview of the Commission Legislative Amendments: Changes to the Rules and Regulations Practice & Procedure update

Arbitral appeals

Fresh evidence

Commission is not to grant leave to admit fresh evidence unless:

• the evidence concerned was not available to the party and could not reasonably have been obtained by the party before proceeding concerned; or

• failure to grant leave would cause substantial injustice in the case.

Practice Direction No 6 dated 1 February 2011

Page 25: Contents Brief Overview of the Commission Legislative Amendments: Changes to the Rules and Regulations Practice & Procedure update

Arbitral appeals

Fresh evidence

Parties’ submissions should address whether:

• the evidence is credible

• there is high degree of probability that there would have been different decision if evidence had been admitted at arbitration; and/or

• it will cause a substantial injustice if the evidence is not admitted

Page 26: Contents Brief Overview of the Commission Legislative Amendments: Changes to the Rules and Regulations Practice & Procedure update

Arbitral appeals

Chronology

A significant amendment in the 2011 Rules

• Application to appeal must now include:

“[a] chronology of events, comprising a list of principal events leading up to the lodging of the appeal, numbered consecutively with a date, a short description of each event, and references to arguments in favour of review.” (Pt 16 r 16.2(4)(e)).

• The respondent can provide alternative or supplementary chronology (Pt 16 r 16.2(9)).

Page 27: Contents Brief Overview of the Commission Legislative Amendments: Changes to the Rules and Regulations Practice & Procedure update

Arbitral appeals

Chronology

The chronology should include:

• relevant procedural events

• principal factual events such as:

• date of alleged injury

• date of notice of injury

• date of notice of claim, date worker first sought medical treatment

• date the worker first ceased employment

• dates of employment in suitable duties

• date on which entitlement to compensation commenced, etc

Page 28: Contents Brief Overview of the Commission Legislative Amendments: Changes to the Rules and Regulations Practice & Procedure update

Arbitral appeals

Stay

• appeal under s 352 does not stay or otherwise affect the operation of a decision as to weekly compensation payments. These remain payable despite any appeal

• section 352(5A) operates retrospectively to all pending appeals

Page 29: Contents Brief Overview of the Commission Legislative Amendments: Changes to the Rules and Regulations Practice & Procedure update

Appeals - Medical appeals

• Section 327(3) - grounds for appeal against an AMS assessment:

(a) deterioration

(b) additional relevant information (but only if the additional information was not available and could not reasonably have been obtained before medical assessment)

(c ) incorrect criteria,

(d) demonstrable error.

• Section 327(3)(b) - now stricter test

Reverses decision in Summerfield v Registrar of the Workers Compensation Commission of NSW [2006] NSWSC 515

Page 30: Contents Brief Overview of the Commission Legislative Amendments: Changes to the Rules and Regulations Practice & Procedure update

Medical appeals

• Fresh evidence – s 328(3)

• Appeal limited to the grounds made – s 328(2)

Siddick v WorkCover Authority of New South Wales [2008] NSWCA 116

• Further assessment or reconsideration

• Section 378

• Section 327(6)

• Section 329

Page 31: Contents Brief Overview of the Commission Legislative Amendments: Changes to the Rules and Regulations Practice & Procedure update

Costs

Workers Compensation Regulation 2010

• Costs provisions - change only to numbering of Part and clauses

– Now under Part 17 (previously Part 19) - now clauses 97 to 143– Schedule 6 - renaming of Parts A, B and C to Parts 1, 2 and 3

• In-principle agreement by WorkCover User Group for a general increase to legal fees across the board

– Agreement yet to be ratified by the Minister

Page 32: Contents Brief Overview of the Commission Legislative Amendments: Changes to the Rules and Regulations Practice & Procedure update

Dispute resolution pathways

Common issues in lodgment

Electronic service delivery

Regional service delivery

Practice and Procedure Update

Page 33: Contents Brief Overview of the Commission Legislative Amendments: Changes to the Rules and Regulations Practice & Procedure update

Expedited Pathway

- Application through Form 1

General Pathway

– Application through Form 2, Form 2D or Form 20

Lump Sum Quantum Only Pathway

– Application through Form 2

Future Medical Expenses Pathway

– Application through Form 2

Pathways for Disputes

Page 34: Contents Brief Overview of the Commission Legislative Amendments: Changes to the Rules and Regulations Practice & Procedure update

Includes: Interim Payment Directions (IPDs)

weekly compensation up to 12 weeks medical expenses up to $7,500

Small claims

• Referred to delegate of Registrar• Teleconference within 14 days• Workcover Guide for Interim Payment Directions• Practice Direction 10 – Small Claims

Expedited Pathway

Page 35: Contents Brief Overview of the Commission Legislative Amendments: Changes to the Rules and Regulations Practice & Procedure update

Form 2 Applications for: Weekly payments > 12 weeks Medical expenses > $7,500 Liability for permanent impairment Pain and sufferingForm 2D Applications for: Compensation for death of a workerForm 20 Applications for (eg): Weekly compensation whilst overseas Order for interest Review of award Order for refund

Referred to Arbitrator

General Disputes Pathway

Page 36: Contents Brief Overview of the Commission Legislative Amendments: Changes to the Rules and Regulations Practice & Procedure update

• Disputes regarding level of permanent impairment only

• Referred by delegate of Registrar• AMS to be agreed by parties or Registrar to

choose• Medical certificate binding on parties• Pain and suffering threshold• Practice Direction No 11

Lump Sum Quantum Only Pathway

Page 37: Contents Brief Overview of the Commission Legislative Amendments: Changes to the Rules and Regulations Practice & Procedure update

Disputes regarding proposed medical treatment or services

• Referred by delegate of Registrar to AMS for opinion

• Medical Certificate issued• Referred to Arbitrator to settle or determine

Future Medical Expenses Pathway

Page 38: Contents Brief Overview of the Commission Legislative Amendments: Changes to the Rules and Regulations Practice & Procedure update

Form 2 s66 Matters

• On lodgment of Reply matter may be retracked where issues in dispute differ from the Application

– Liability in dispute – to General pathway

– Liability not in dispute – to Lump Sum Quantum only pathway

• Issues relating to DOI, body parts/systems, documents to be referred dealt with by delegate of Registrar or referred to Arbitrator to determine

Page 39: Contents Brief Overview of the Commission Legislative Amendments: Changes to the Rules and Regulations Practice & Procedure update

Issues in Lodgment – Form 2s

• Parties restricted to matters previously notified, except by leave of Commission – s289A

• Requirement to attach compliance documentation

• Liability s74/s54/s287A notice

• PI degree – correspondence re exchange of offers

• Failure to determine – CAS notification

• Parties required to certify compliance

• Registrar power to reject application not complying – s288(2)

Page 40: Contents Brief Overview of the Commission Legislative Amendments: Changes to the Rules and Regulations Practice & Procedure update

Issues in Lodgment – Form 2s

Form 2 Application

• Part 5.6 Permanent Impairment Claims

– Information consistent with claim

– Correct use of terminology depending on DOI

Form 2A Reply

• Part 3 Matters in Dispute

– List issues in dispute where leave sought to include

Page 41: Contents Brief Overview of the Commission Legislative Amendments: Changes to the Rules and Regulations Practice & Procedure update

Issues in Lodgment – Form 2s

Form 2 Application and Form 2A Reply

• Part 6 Supporting Documentation

– Paginated

– Chronological order for part 6.1 - PI degree claims

– Chronological order within suggested document groupings for Part 6.2 – other disputes

Page 42: Contents Brief Overview of the Commission Legislative Amendments: Changes to the Rules and Regulations Practice & Procedure update

Issues in Lodgment – Form 11s

Form 11C Application for Mediation• 28 days since service of Prefiling Statement

• Must not be lodged if defective prefiling dispute on foot

• Certificate of Service required if no Response lodged

Form 11D Response to Application for Mediation• Due within 21 days of registration of application – Rule

17.10(1)

• Must indicate whether declining to participate in mediation as defendant wholly disputes liability – s318(A)(3)

Page 43: Contents Brief Overview of the Commission Legislative Amendments: Changes to the Rules and Regulations Practice & Procedure update

Electronic Service DeliveryOnline Lodgment

eScreens

What is it?

• An online lodgment facility for forms

Where can I access it?

• Link from the Commissions website or at URL https://escreens.wcc.nsw.gov.au

Page 44: Contents Brief Overview of the Commission Legislative Amendments: Changes to the Rules and Regulations Practice & Procedure update

Electronic Service DeliveryOnline Lodgment

What are the benefits of eScreens?• 24/7 access to lodge applications, replies and other forms;

• online help text for completing forms and help line support;

• faster turn around time for submitting applications;

• data validation to help minimise unnecessary errors when submitting forms;

• electronic filing - upon filing, an electronic copy of your form will be available for you to view, save and print;

• electronic service - a sealed copy of your form will be returned electronically enabling you to serve electronically; and

• reduction in printing and photocopying costs.

.

Page 45: Contents Brief Overview of the Commission Legislative Amendments: Changes to the Rules and Regulations Practice & Procedure update

Electronic Service DeliveryOnline Lodgment

What is the catch with eScreens?• Limited to certain forms• Lodgment to be wholly electronic• Operating platform limited• Broadband v dial-up• File size limitation to 10MB per document• Each document separately uploaded

What changes are in progress?• Saving of partially completed forms• All documents uploaded together

.

Page 46: Contents Brief Overview of the Commission Legislative Amendments: Changes to the Rules and Regulations Practice & Procedure update

Regional Service Delivery

Arbitral Services• Venue policy – approved locations• Two full-time equivalent Arbitrators based in Newcastle• Local sessional Arbitrators for regional matters where

possible• Sydney based Arbitrators assigned as regional co-ordinators

Medical Services• Regionally based Approved Medical Specialists in most

frequently utilised specialties• Option for travel to Sydney where parties agree

Page 47: Contents Brief Overview of the Commission Legislative Amendments: Changes to the Rules and Regulations Practice & Procedure update

Further Information

The Commission’s website:

www.wcc.nsw.gov.au

The Commission’s email:

[email protected]

The Commission’s toll free number:

1300 368 040

Page 48: Contents Brief Overview of the Commission Legislative Amendments: Changes to the Rules and Regulations Practice & Procedure update

Thank you for your attention