2.4 Employer pays compensation

2.4.1 Employer's liability | 2.4.2 Employer excess table | 2.4.3 Employer liability under administrator and receiver situations | 2.4.4 Exceptions to employer's liability | 2.4.5 Assumption of liability by WorkSafe | 2.4.6 Exceptions for injuries before 4pm 30/6/1993

Employers have a number of obligations about paying compensation to a worker.

2.4.1 Employer's liability

The Agent determines liability on a claim. When an Agent makes a decision to accept a claim they will advise both the worker and employer in writing. In the case of claims for compensation in the form of weekly payments, the Agent will advise the amount of weekly payments to be paid to the worker.

The employer must comply with the decision of the Agent and make weekly payments subject to the provision of valid Certificates of Capacity.

Employer's payment threshold

When liability has been accepted on a claim an employer is liable for the first 10 days of incapacity and the first $824 (indexed annually) of medical and like expenses unless they take out the buy-out option on their WorkCover insurance. If the worker is entitled to provisional payments for a mental injury, the employer is not liable for the first $824 of medical and like expenses.

Note: An Agent's decision to accept or reject liability will not be influenced by an employer making payments to a worker before a claim is accepted. If the claim is accepted, such payments may form part of the employer’s excess.

For information on an additional liability which an employer may have to pay in some circumstances see: Penalties for late lodgement.

First 10 days of incapacity

The first 10 days of incapacity are the first 10 working days that the worker would have worked if they had not been injured.

For example if a worker is employed for only one day a week, the employer's liability would extend for 10 weeks.

If a worker is only partially incapacitated and is still working but working reduced hours, any day that they are working reduced hours will count towards the 10 days of incapacity.

Any day the worker would not have worked had the injury not occurred is not included.

For example rostered days off are not included as part of the first 10 days. Weekends and public holidays are not included unless they are work days.

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Calculation of Employer Liabilities

Note: ACCtion pays Saturday to Friday

Part-time employee

A part-time employee works on Tuesday, Wednesday and Thursday. When packing up at the end of the day on Wednesday 6 November 2013 they hurt their back. They do not come in to work on the Thursday because of the back injury.

Night Shift Worker

A worker is employed as a night shift worker and works 10pm to 6am Wednesday, Thursday, Friday, Saturday & Sunday night and sustained an injury around 4am Thursday morning.

Casual worker

A worker has a casual job at the local supermarket and works to a roster on a week by week basis. Some weeks the worker may work one day, others 3 days.

Public Holidays

A worker works Monday to Friday when walking through the office tripped over an extension cord and broke a leg on the morning of Thursday 21 March 2013 and was taken to hospital by ambulance.

Notification of payment of employer liability

The employer must provide details to the Agent of payments made as part of their liability as follows:

• the days/dates for which payments have been made for time off work (maximum 10 days)
• medical and like expenses ($824 - indexed annually).

If medical and like expenses payments exceed the initial liability, the employer must forward to the Agent copies of accounts clearly showing amounts paid or unpaid.

The employer advises the Agent of payments made to or on behalf of a worker under the employer’s liability using the Employer Liability - Advice on Payments form.

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Payment of medical excess to Agent

The Agent may offer the employer the option of paying the medical excess directly to them.

Agents can send the employer a medical and like excess invoice to make a single payment in lieu of paying individual accounts as part of their employer excess obligation where:

• medical and like expenses incurred on the claim have already exceeded the medical excess threshold, or
• it is established that due to the nature of the claim that medical and like expenses are likely to exceed the threshold.

Agents can request a Medical and Like Excess Invoice be generated using ACCtion. The medical and like excess invoice may include an adjustment amount to recognise any medical and like amounts the employer has already paid. Invoice data files will be transmitted to an external printer in nightly batches. The external printer will print and send the invoice and cover letter to employers via their preferred method.

Once a medical and like invoice has been sent to an employer, the Agent then takes over the management and processing of medical and like expenses on behalf of the employer, even if the employer’s excess payment has not yet been received.

Employers can choose to pay by EFT, BPAY, deposit slip, credit card online or by phone. Employer excess payments made using the details on the excess invoice will be automatically processed from daily bank files and recorded against their respective claim in ACCtion. In the event that payments are not automatically applied to the claim, the Agent will need to manually apply the funds to the correct claim.

Once the employer’s full excess payment is received, the Agent can override employer liability with reason code 4 (employer pays Agent excess).

Shared liability: employer & WorkSafe

The employer’s liability under the excess for the initial expenses of a claim is separate from WorkSafe’s liability to pay compensation. The following examples show different scenarios of payment of an employer’s liability:

• worker injured 1 July 2018
• employer has not paid for any liability
• during that year the employer’s liability was limited to $707.

Claim	Accounts received by Agent	Employer liability	WorkSafe's liability
Claim A	1 August 2018 received account for $240	$240	Nil
Claim B	1 August 2018 received accounts for $707 and $466	$707	$466
Claim C	1 August 2018 received account for $1000	$707	$293

Exceptions to employer liability

The employer is liable to pay the excess in the majority of cases with a few exceptions.

See: Exceptions to employer's liability

Payment of gratuitous services

The employer may claim services provided to the worker as part of their liability for initial medical and like expenses, provided they submit an itemised account. This could include the treatment of the worker by an in-house company doctor that is not charged to the worker.

If the value of these services is greater than the excess, the employer may be reimbursed for the amount above the excess.

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