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2.3 Employer forwards claim


2.3.1 Receive claim from worker | 2.3.2 Forward claim to Agent | 2.3.3 Timeframes to forward claims | 2.3.4 Penalties for late lodgement and additional liability


General employer obligations

Employers must meet the obligations outlined in this section to meet the requirements of the legislation.

Employers have a number of obligations when a worker is injured. These obligations apply when they receive a notice of injury or a claim for compensation.

Safe working environment

Employers have obligations to provide a safe and healthy workplace for workers and contractors. The Occupational Health and Safety Act 2004, related regulations and Codes of Practice set out further information about these obligations.

The employer has a legal responsibility to 'so far as is reasonably practicable, provide and maintain for employees of the employer a working environment that is safe and without risks to health'.


Notice of injury

When an employer receives notice of injury or condition they must:

  • ensure the required particulars of the injury or condition are recorded in the register of injuries

  • give the worker written acknowledgement of receiving notification of an injury or condition.

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2.3.1 Receive claim from worker

An employer may receive a claim by hand or mail.

Fax

An employer may outline in a general policy that a worker may give or serve claims to them via fax. Alternatively, consent may be given verbally to fax a claim form to the employer when a worker informs their employer that they have an injury and intend to make a claim.

In both cases the employer will provide the worker with the appropriate fax number to receive the claim.

Email

An employer must first give consent to receive claim by email from a worker.

Consent is provided where an employer’s operational policy specifically states that the employer will accept the service of claim forms via an identified email address or verbally where an employer instructs a worker to email a copy of the claim forms to an identified email address.

In both cases, the employer will provide the worker with the appropriate email address to forward the claim.

If consent is not given, a worker may not serve a claim by email.

Note: If an employer has not given consent to receive claims via email as outlined above and a worker emails a claim to the employer’s email address, the claim form will not be considered to have been given to or served on the employer.

See: Timeframes to forward claims | Penalties for late lodgement | Death claims


Employer's Injury Claim Report

The Employer Injury Claim Report is an official document employers should complete and send to their Agent. It is a record of the employer’s details, the worker’s details, particulars of the incident, and an opportunity for employers to provide additional information, such as where disputing liability. WorkSafe encourages employers to complete this report.

If an employer does not agree with the claim and there is not enough room on the Employer Injury Claim Report to provide their reasons, a covering letter can be attached to the report.

Unregistered employers to forward claims within five days

Employers who are not registered for WorkCover insurance or are exempt must forward claims they receive to the Authority within five days.

Employer early notification requirements for claims including a mental injury also apply to unregistered employers.

See: 6.5.1 Employer obligations for mental injury claims

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2.3.2 Forward claim to Agent

Employers have obligations about what to do when they receive a claim for compensation. Employers must not refuse a claim for compensation or dismiss worker for making a claim.

Offence to discriminate

It is an offence for an employer to treat a worker differently because the worker:

  • has given the employer or any other employer notice of an injury
  • has taken steps to pursue a claim for compensation against the employer or any other employer
  • has given or attempted to give, a claim for compensation to the employer or any other employer, WorkSafe or its Agents
  • has complied with a request made by WorkSafe about obtaining information and evidence or using their inspection powers.

It is an offence for an employer to take any of the following actions because a worker makes a claim:

  • dismiss or threaten to dismiss a worker from employment
  • alter or threaten to alter the position of a worker to the worker’s detriment
  • treat a worker less favourably than another worker about a promotion or re-employment.

See: Employer obligations - penalty units


Employer action when receiving a claim for compensation

When an employer receives a claim form they must:

  • complete and sign Part A (question 7) and Part B of the claim form
  • acknowledge receipt of the claim in writing. This can be done by giving the worker a copy - for example the worker’s copy of the signed claim form
  • indicate on the Worker’s Injury Claim Form the date they are forwarding the claim form to their Agent (there is a separate date field in Part A and in Part B)
  • keep the employer copy of the claim form for their own records
  • employers should also complete an Employer Injury Claim Report indicating if they are accepting or rejecting liability for the claim
  • employers must forward the claim form, medical certificate (where there is a claim for weekly payments), Employer Injury Claim Report (where one has been completed) and other related documentation to the Agent within the required timeframes.
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2.3.3 Timeframes to forward claims

Employers can be penalised for not forwarding a claim to their Agent within the legislated timeframes.

An employer must forward to WorkSafe medical certificates about a claim for compensation for weekly payments.

See: Penalties for late lodgement

Summary of employer requirements

Early notification to be provided in 3 business days – mental injury claims

If the claim includes a mental injury (with or without a physical injury), to avoid financial penalties, employers must:

  • forward Part A of the Worker’s Injury Claim Form (early notification) to their Agent, including question 7 completed and signed by the employer, no later than three business days after receiving the claim from the worker, and
  • forward the completed and signed Part B of the Worker’s Injury Claim Form, and any WorkSafe Certificates of Capacity, to their Agent no later than 10 calendar days after receiving the claim from the worker

If the claimant is not a worker of the employer on whom the claim was lodged, the employer must still provide early notification of a mental injury to their Agent, attaching evidence of the claimant not being their worker to Part A of the claim form.

WorkSafe also encourages employers to provide early notification (Part A of the worker claim form) for physical injury claims.

Claims to be forwarded within 10 calendar days of receipt

In addition to the early notification requirements for mental injuries, employers must forward the following types of claims to their Agent within 10 calendar days of receiving them:

  • claims for compensation for weekly payments
    These claims should be accompanied by a medical certificate. If the claim is not accompanied by a medical certificate, the employer must also forward the medical certificate within 10 days of receiving this.

  • claims for compensation for medical and like expenses which are over the employer excess
  • claims for compensation for medical and like expenses which are under the employer excess but for which the employer has an issue about their liability
  • claims for compensation where the worker has noted a cease work date on their claim form (even if it is still under the employer liability period)
  • claims for impairment benefits
  • claims for death benefits.

Claims deemed accepted if not received by Agent within 38 days

If the valid claim for weekly payments is received from the employer by the Agent or WorkSafe more than 38 days from the date the worker gave to or served the claim on the employer, the claim is deemed to be accepted upon receipt and compensation for weekly payments are made.


Reports to be forwarded quarterly

Employers can report physical injury only claims for medical and like expenses which are under the employer excess and where they have no issue over liability to their Agent within 14 days calendar days of the end of the quarter (March, June, September and December) in which they received notification.

These claims are also referred to as minor claims.


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2.3.4 Penalties for late lodgement and additional liability

Penalties

WorkSafe may prosecute the employer for:

  • failing to forward a claim for weekly payments, or any medical certificate relating to that claim, within 10 calendar days without reasonable cause (WIRC s73), and/or
  • failing to provide early notification of a claim which includes a mental injury within 3 business days (WIRC s73a)

In relation to each of these offences, an employer can be fined up to 60 penalty units for a natural person and 300 penalty units for a body corporate.

Note:

  • These provisions do not apply to a self-insurer except in relation to the employment of a student worker

  • Penalty provisions for failing to provide early notification for a claim including a mental injury commence on 1 January 2022

Additional liability

In addition to prosecution and penalties, the employer may incur an additional liability calculated as follows:

Employer action Additional liability
An employer fails without ‘reasonable cause’ to forward a claim for weekly payments, or any medical certificate relating to that claim, to the Agent with within 10 calendar days of receiving these

The employer’s additional liability is the weekly payments made by the Agent to the worker:

starting on the later of:

  • after the employer’s excess is reached (or after the employer’s excess has been met by the Agent if the employer has elected the buy-out option)
  • the day the employer received the claim for weekly payments accompanied by a medical certificate or
  • the day the employer received the medical certificate if the claim was not accompanied by a medical certificate.

and ending on the later of:

  • the day the Agent received the claim for weekly payments or
  • the day the Agent received the medical certificate.
An employer delays forwarding a claim for weekly payments to the Agent by more than 38 days after receiving the claim resulting in the claim being deemed to be accepted

The employer’s additional liability is the weekly payments made by the Agent to the worker:

starting on the later of:

  • the day after the claim was given to the employer or
  • the day after the certificate was given to the employer if the claim was not accompanied by a medical certificate.

and ending on the day the Agent received the claim and medical certificate from the employer.

Responsibility of Agents

Late claim lodgement and additional liability

Agents are responsible for the application and administration of additional employer liability, and for taking appropriate actions where an employer has been in breach of their lodgement obligations.

Agents need to oversee their employers and monitor employer compliance, particularly focusing on those employers which may be non-compliant in multiple areas.

Agents need to:

  • identify claims for weekly payments which have been received late
  • issue warning letters to employers for their first late claim
  • issue reasonable cause letters to employers for subsequent late claims
  • assess the grounds for reasonable cause provided by employers for late claims
  • refer assessments to WorkSafe's Enforcement Group if they are unable to determine if the grounds given by the employer are reasonable
  • notify employers of the outcome of assessments and apply any additional liability
  • collect additional liability from employers
Early notification of mental injuries

Agents need to:

  • identify claims where early notification for a mental injury was received late
  • issue the ‘Warning – late notification of mental injury claim’ Novus letter to employers on each claim where the employer is in breach of the early notification requirement
  • Agents can also call employers to remind them of their obligations
  • refer assessments to WorkSafe’s Enforcement Group if an employer has consistently demonstrated non-compliance
Responsibility of WorkSafe

WorkSafe's Enforcement Group investigates referrals, provides recommendations on matters that have been referred by the Agent and prosecutes employers for serious late claim offences.

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