The WorkCover Authority of NSW administers legislation concerned with compensation to workers and the main legislation which deals with the obligations, responsibilities and rights of employers, workers, insurance and WorkCover.

The provisions are set out in the Workers Compensation Act 1987 and the Workplace Injury Management & Workers Compensation Act, 1998 and regulations under those Acts. These two Acts cover different parts of the workers compensation system and therefore need to be read together to obtain the full picture.

Roles and Responsibilities

Injured worker

As an injured worker, you have an obligation to:

• report the injury to your employer or supervisor as soon as possible after injury, and before you voluntarily leave the employment where the injury occurred;
• attend a doctor to obtain a WorkCover medical certificate if you wish to claim loss of wages, medical expenses or damage to personal property. If the injury has been notified by telephone, the insurance company will contact you to confirm details;
• co-operate in any injury management plan developed for you by the insurance company, and return to work plan developed by your employer.

Note:  Unreasonable failure on your part to comply with a requirement after being requested to do so by the insurance company may result in stopping of weekly payments. The insurance company must advise you in writing that weekly payments will cease, together with the reasons for ceasing and the action you must take for the payments to resume.

Employers

As an employer, your first obligation is to:

• have a current workers compensation policy with a licensed insurer in NSW, unless you are a self-insurer.

Further obligations:

• develop a Return to Work Program which is consistent with your insurance company’s Injury Management Program;
• notify your insurance company as soon as you become aware (or at a maximum of 48 hours afterwards) that a worker will be absent from work for seven days or more (that is, they have sustained a significant injury). Insurance companies will accept telephone notification in the first instance;
• report all other injuries to your insurance company within seven days;
• forward claims for compensation or any other related documentation to your insurance company within seven days of receipt;
• forward any workers compensation money to the injured worker as soon as practicable;
• participate in the development of an Injury Management Plan for the individual worker which will include enabling a return to work on suitable duties, where possible.

The suitable employment provided to the worker must meet the definition described in S43A of the Workers Compensation Act 1987, and be employment that is suited to the worker, having regard to the nature of the worker's incapacity and the employment in which the worker was in at the time of the injury.

You must notify the insurance company if you are unable to provide suitable duties.

Note:  Failure to provide suitable employment at the request of an injured worker could affect your workers compensation premium payable, either through a weighting in the claims experience factor or through a surcharge on the premium payable.

Insurers

As workers compensation insurer, you have the responsibility to:

• when an injury occurs, to contact the worker, treating doctor and employer within three days of the notification, if the worker is likely to be unfit for his/her usual duties for seven or more days;
• develop an Injury Management Program and lodge it with WorkCover;
• advise your insured employers of the need for a Return to Work Program and ensure that those employers are aware of the contents of your Injury Management Program;
• ensure that an injury management plan is developed for the worker that will assist the person to return to work in a timely, safe and durable way. This plan will contain details of the Nominated Treating Doctor and the obligations of each party in relation to the return to work of the injured worker.
• commence weekly compensation payments within seven days of receiving notification of a significant injury.

Note: Prior to acceptance of liability, you can pay for services provided by the nominated treating doctor if the doctor is prepared to participate in the Injury Management Plan, and for the reasonable cost of other specified treatment.

Doctors

Doctors play a pivotal role in the administration of the scheme. The focus is on early intervention and communication with the workplace. In order to achieve this, medical practitioners will be requested to agree to be the Treating Doctor following nomination by the injured worker.

As a nominated treating doctor, you will:

• become the initial focal point of all plans in relation to injury management for individual workers;
• co-ordinate all aspects of the worker's treatment and return to work management;
• provide appropriate medical certification of incapacity, participate in the Injury Management Plan, provide medical reports relating to the worker's fitness for work, provide and arrange appropriate treatment and recommend suitable duties that the worker is capable of performing;
• be available to discuss the worker's injury management with the employer, insurer and other service providers.