2.1.8 Responding to serious incidents
2.1.8.1 Incident notification | 2.1.8.2 Initial engagement | 2.1.8.3 Commence entitlements | 2.1.8.4 Ongoing support
A serious incident that results in a worker sustaining an injury or severe injury (requiring immediate hospital admission) must be managed sensitively and without delay.
To achieve this, Agents should:
- provide proactive tailored support to injured workers, their families, employers and other persons affected by serious incidents
- facilitate early lodgement of claims and supporting documentation
- validate and process claims efficiently
- nominate one specialist support role, in addition to those managing the claim (such as liability decisions and entitlement processing), to provide wellbeing support to impacted workers and their families and to coordinate recovery and claims management activities.
Definition of serious incident
For the purposes of this section, ‘serious incident’ means a workplace incident that results in an injury requiring immediate treatment as an in-patient (admitted) in a hospital, in particular where the admission will be longer than five consecutive nights.
Typically, injuries are severe.
Agents may choose to apply the principles in this section more broadly for:
- serious incidents that require shorter hospital admissions (less than five days)
- claims for a terminal illness* such as cancer or silicosis
- emergency psychiatric inpatient admissions.*
*These conditions are not defined as ‘severe injury’ therefore family members Family member means a partner, parent, grandparent, sibling or child of the worker or of the worker's partner do not have an entitlement to compensation.
See: Entitlements
Note: Employers must immediately notify WorkSafe following any death or specified serious injury in the workplace; employers can call 13 23 60 or visit WorkSafe’s website.
Notification of a serious incident
Agents may become aware of a serious incident from:
- WorkSafe by way of formal notification from the injury employer as required under sections 37 and 38 of the Occupational Health and Safety Act 2004
- WorkSafe by way of email within 24 hours of notification
- a general enquiry for information to claim for serious injury / hospital admission
- identification of claims payments that indicate a serious incident (i.e. payment of hospital invoices).
Response framework
| Receipt of notification of a serious incident | |
|---|---|
| Timeframe | Action |
| Within 24 hours |
Agent contacts employer and worker or their next of kin. Contact with the hospital may be required. |
| Within one week |
Agent facilitates visit or phone call to assist worker or their family with completion of a claim form, explain their potential entitlements and next steps and discuss any needs. Where the worker’s prognosis is grave, the Imminent Risk of Death Impairment Claim Guidelines must be considered. |
| Within two weeks |
Within 1 week of receiving the claim, Agent will:
|
| Within six months |
Agent provides tailored support to the worker and their family, assisting with hospital discharge preparation (such as ADL), recovery, return to work, and community and social engagement. |
| 6 months + |
Ongoing claims management and support provided on an agreed frequency or as needed basis until hospital discharge. |
Person-centred support
The Agent support role must provide tailored support to meet the emotional, financial and community needs of the worker and their family while an inpatient and preparing for hospital discharge; this support can last months.
The Agent support role must respect the wishes of the worker/family member Family member means a partner, parent, grandparent, sibling or child of the worker or of the worker's partner not to participate or not to be contacted.
Hospital or home visits
Face to face contact with the worker and family enables a better connection, to understand their needs, as well as an opportunity to exchange information about next steps and claiming compensation.
Appointments for a hospital or home visit with the worker or their family must be made with the consent of the family. It may be that the worker or family are not ready for a visit and may ask for it to take place later. The Agent must respect their wishes.
Multiple visits can be undertaken.
Entitlements
If a worker’s injury is work-related An injury/disease is work related if it arose out of or in the course of employment and the scope of employment. they may be entitled to compensation such as weekly payments and medical and like services.
They may also have an entitlement for Impairment Benefits and Common Law damages.
Immediate family members may also have an entitlement to specific medical and like services.
| Family member entitlements | Criteria |
|---|---|
|
Capped amount, indexed annually |
Must be a family member as defined. Injury must meet ‘severe’ definition and worker required immediate inpatient treatment in a hospital. Provider of service must be approved by WorkSafe. |
|
Capped amount, indexed annually |
Must be a family member as defined. Injury must meet ‘severe’ definition and worker required immediate inpatient treatment in a hospital. The hospital is greater than 100 kilometres from the family member’s normal place of residence. |
Specific services and programs
In additional to ‘standard’ medical and like services such as hospital and rehabilitation costs, specific medical and like services and programs should be proactively considered, particularly at hospital discharge or as part of a longer term recovery plan.
See: A-Z of medical and like services