3.7.2 Worker moves overseas
3.7.2 Worker moves overseas | 3.7.2 Worker moves overseas | 3.7.2.3 Temporary absence from Australia | 3.7.2.4 IMEs for overseas workers - claims management
Workers with existing entitlements to compensation
If a worker receiving weekly payments ceases to reside in Australia, their entitlement to weekly payment ceases unless before leaving Australia, they satisfy the Agent that they have:
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no current work capacity Under the legislation, unless inconsistent with the context or subject-matter — current work capacity, in relation to a worker, means a present inability arising from an injury such that the worker is not able to return to his or her pre-injury employment but is able to return to work in suitable employment, declared training program (NCWC No Current Work Capacity, in relation to a worker, means a present inability arising from an injury such that the worker is not able to return to work, either in the worker's pre-injury employment or in suitable employment), and are likely to have NCWC indefinitely
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for claims reaching 130 weeks on or after 31 March 2024, a whole person impairment (WPI Whole person impairment) of 21% or more.
Agents and self-insurers are encouraged to complete any impairment assessments prior to the worker permanently ceasing to reside in Australia. The Agent or self-insurer may determine that it is not necessary or practicable to refer the worker for an impairment assessment if the worker resides overseas, in which case an administrative determination of the WPI can be made.
See: Impairment assessment for SEP (130 week) review
Workers claiming entitlements to compensation after leaving Australia
If a worker ceased to reside in Australia and subsequently claims to be entitled to compensation they must:
For weekly payments:
- establish their entitlement, and
- satisfy the Agent or self-insurer that they have NCWC and are likely to have NCWC indefinitely and, for claims reaching 130 weeks on or after 31 March 2024, a whole person impairment (WPI) of 21% or more. Where WPI has not already been determined, an administrative determination will be required.
For medical expenses:
- receive approval for the reasonable cost of services to be provided overseas.
The Agent or self-insurer must provide the worker with written confirmation of the overseas medical services and costs that have been approved. Any medical services outside of the initial authorisation will require further approval by the Agent or self-insurer.
Define "ceases to reside in Australia"
The legislation does not define "ceases to reside in Australia". Each case must be assessed individually.
A worker does not have to leave Australia permanently to cease to reside in Australia; however, precedent has established that there must be some degree of permanency in the departure, which can be ascertained from the worker’s intention.
The worker’s intention to return, or otherwise, can be expressed or implied from the worker’s actions, circumstances of the worker’s departure and stay outside Australia.
Factors indicating that a worker ceases to reside in Australia
These can include:
- the worker is not an Australian citizen, and their work permit, temporary entry permit or processing entry permit has expired including deportation.
- the worker disposes of or intends to dispose of their home and other belongings (e.g. their motor vehicle) in Australia.
- the worker purchases or rents a home overseas, as opposed to staying in short term accommodation or with family or friends.
- the worker severs financial ties with Australia (e.g. pays out loans and closes accounts).
- the worker undertakes activities overseas which are consistent with living in a particular place (e.g. joining a local club or becoming employed).
- the worker’s immediate family leaves Australia to live with the worker overseas and they enrol in schools or take up employment there.
Temporary absence from Australia
A worker does not cease to reside in Australia if they are temporarily absent. For example, a person who has a three month holiday or a work assignment overseas is not normally considered to have ceased to live in Australia.
See: Temporary absence from Australia.
Assessing if the worker is likely to have no current work capacity indefinitely
If the worker considers they should remain on weekly payments, the Agent should inform the worker of the legislation – that payments will cease unless it is determined their incapacity is indefinite.
The worker should also be advised they need to provide evidence of their incapacity being indefinite prior to them leaving the country. This should occur at a minimum of six weeks prior to departing Australia.
The Agent should then undertake an immediate review of the file, and any evidence provided. They may need to seek further information as required to complete the review (e.g. arrange an IME Independent Medical Examiner / Independent Medical Examination, or seek further information from treating professionals).
The effect of a worker "ceasing to reside in Australia"
If the worker has not satisfied the criteria::
- their weekly payments are terminated from the day after their departure.
- no period of notice is needed to terminate weekly payments if a person has ceased to live in Australia. However, the Agent must advise the worker and employer, where applicable of the termination.
- A worker may remain entitled to the reasonable costs of medical and like services subject to the workers’ compensation legislation and all WorkSafe policy and guidelines relevant to the approval of overseas services and providers.
See: Weekly payments and medical expenses for a worker who lives overseas
If the worker has satisfied the criteria:
- See: Weekly Payments for worker who lives overseas.
- Update ACCtion CM01
- code 'resides overseas' flag to Y
- add effective date the worker moved overseas from
If the worker returns to Australia to live on a permanent basis:
- the 'resides overseas' flag will need to be removed (ie. left blank)
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3.7.2.3 Temporary absence from Australia
Weekly payments
A worker who is temporarily absent from Australia is entitled to a maximum aggregate period of 28 days of weekly payments, based on certificates issued by overseas practitioners.
The worker may submit:
- a certificate issued by an Australian practitioner covering a period of up to 28 days, issued before the worker leaves Australia, and
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additional certificates issued by an overseas practitioner for up to a total of 28 days, issued after the worker leaves Australia (Note: Telehealth consultations do not extend to workers who are outside of Australia).
The 28 day time limit may be extended by an Agent if they believe there are special circumstances.
Upon receipt of a certificate from a worker, Agents should follow the process detailed above from step 3 onwards, remembering the 28 day limit.
A worker:
- has a certificate in Australia for the period 1-28 January
- travels overseas for five months from mid-January to mid-June
- provides certificates from overseas doctors for the whole period
- the Agent is not satisfied that an extension is justified.
In this case, weekly payments are payable as follows:
- 1 - 28 January on the Australian certificate
- 29 January - 25 February (28 days) on the overseas certificates.
There is no further entitlement to weekly payments until further certificates are issued by a doctor in Australia.
Accounts from overseas providers
The Agent must have accepted liability for services provided whilst the worker is outside Australia. When accounts are received the normal checks or vetting that is required before any account can be paid must also be carried out on accounts for services rendered overseas.
Special attention must be paid to the information provided on the account. If the name, address, qualifications and type of service provided are not clearly legible the account should be returned to the worker or the service provider. Workers are required to provide a copy of the invoice for medical and like service(s) in English.
Copies of accounts, translated into English if required, should be forwarded to the Registrations Branch of WorkSafe. A service provider registration/amendment form must be included.
Agents are unable to fund written translation services to translate letters/correspondence this includes medical and like invoices/receipts.
3.7.2.4 IMEs for overseas workers - claims management
Worker not yet overseas
Where possible, Agents should have the worker medically examined before they leave Australia, as part of determining ongoing eligibility for weekly payments.
Worker already overseas
If the worker is already overseas, Agents should limit IMEs to where absolutely necessary for effective claims management.
A person with seniority at the Agent should:
- undertake a thorough review of the information already on file
- consider whether any extra information required to assess the worker’s ongoing entitlements could be obtained by other means, e.g. through the worker’s current treaters
- the Agent must refer the matter to a Medical Advisor to determine whether an IME is necessary and to assist in determining the appropriate speciality of any examiner/s required.
If it is determined that an examination is required, the Agent must seek WorkSafe’s endorsement prior to arranging the examination. Referrals for endorsement should be emailed to the WorkSafe Entitlements Team’s mailbox at entitlements@worksafe.vic.gov.au.
Returning to Australia for an IME
Agents can pay reasonable travel expenses incurred by a worker returning to Australia to attend an IME, e.g. return flights, accommodation, meals and transportation needed for the duration of their stay.
See: Travel expenses for an independent medical examination
If multiple examinations or other appointments such as worker interviews, OR Occupational Rehabilitation services and vocational assessment are needed, the Agent should ensure they are all completed in one trip.
Organising an IME overseas
Where the worker is unable to travel to Australia an IME can be arranged in their country of residence or a country within a reasonable distance to the worker.
Private investigations
For information on how to arrange private investigations for workers residing overseas please see Process for investigations.
Ongoing entitlement reviews
Regular reviews of a worker’s ongoing entitlement to weekly payments should occur as is reasonably necessary, and for claims post second entitlement period, at least every two years.