Guide to understanding customer reports. Claims with a Date of Injury within the Last Four Years...

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Guide to Understanding Customer Reports - May 2012 1 GUIDE TO UNDERSTANDING CUSTOMER REPORTS May 2012

Transcript of Guide to understanding customer reports. Claims with a Date of Injury within the Last Four Years...

Guide to Understanding Customer Reports - May 2012

1

GUIDE TO UNDERSTANDING CUSTOMER REPORTS

May 2012

Guide to Understanding Customer Reports - May 2012

Disclaimer

This Guide has been developed by Comcare and

all attempts have been made to incorporate

accurate information. The information included

in the Guide has been compiled in October 2011.

This Guide is supplied on the terms and

understanding that Comcare is not responsible

for the results of any action taken on the basis of

information in this publication, nor for any error

or omission from this publication. Comcare

expressly disclaims all and any liability and

responsibility to any person, in respect of

anything, and the consequences of anything,

done or omitted to be done, by any such person

in reliance, whether wholly or partially, upon the

whole or any part of this publication.

Copyright

Published by Comcare ABN 41 640 788 304

© Commonwealth of Australia 2012-05-07

This work is copyright. Apart from any use as

permitted under the Copyright Act 1968, no part

may be reproduced by any process without prior

written permission from the Australian

Government and from the Commonwealth.

Requests and inquiries concerning reproduction

and rights should be addressed to the

Commonwealth Copyright Administration,

Attorney-General’s Department, National Circuit,

Barton ACT 2600 or posted at

http://www.agh.gov.au/cca

Contacts for further information

To obtain further information about the contents

of this Guide, contact:

CIS Helpdesk

Comcare

GPO Box 9905

Canberra ACT 2601

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Contents

Comcare’s Customer Information System 5

Making the most of CIS ............................................................................................ 5

Where can I get more information? ............................................................................ 5

Section 1 - Management Reports 6

1. Progressive Costs Report ...................................................................................... 8

2. Prevention and Rehabilitation Performance Summary ............................................. 11

3. Claims and total cost by mechanism of incident - chart .......................................... 14

4. Claims, cost and time lost by cost centre .............................................................. 16

5. Number of injuries resulting in 5, 30 and 60 or more days of incapacity ................... 17

6. Number of injuries resulting in 5 days incapacity by mechanism of incident .............. 18

7. Number of Death Claims ..................................................................................... 20

8. Frequency of lost time injuries............................................................................. 21

9. Percentage of claimants with >= 10 days incapacity determined with a Return to Work

Plan ................................................................................................................ 22

10. Quality of Return to Work Outcomes .................................................................. 24

11. T1 Numbers of workplace injury and disease ....................................................... 25

12. T3 - weeks lost time ......................................................................................... 27

13. T4 - Average weeks for Return to Work activity to commence ............................... 29

14. Occupation by mechanism of incident - Claims .................................................... 31

15. Occupation by mechanism of incident - total cost ................................................. 33

16. Age group by mechanism of incident - claims ...................................................... 35

17. Age group by mechanism of incident - total cost .................................................. 37

18. Duty status by mechanism of incident - claims .................................................... 39

19. Duty status by mechanism of incident - total cost ................................................ 41

20. Claims and total cost by age group .................................................................... 43

21. Mechanism of injury by costs, incapacity and claims ............................................. 45

22. Cost centre structure report .............................................................................. 48

23. Case Manager Details by Customer report ........................................................... 49

24. CIS user access list .......................................................................................... 50

Section 2 - Case Management Reports 51

66. Customer Data Report - Claim Detail .................................................................. 52

30. Customer Data Report - claims by cost centre and case manager........................... 54

31. Customer Data Report - Open Claims ................................................................. 54

32. Customisable Customer Data Report .................................................................. 55

33. Accepted claims by date ................................................................................... 56

34. Claims incurring payment ................................................................................. 57

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36. Open Return to Work Plan ................................................................................. 58

37. Claim activity post return to work ...................................................................... 59

38. Rehabilitation Expenditure ................................................................................ 60

39. Open/expired return to work plan ...................................................................... 61

40. RTWP average cost and duration ........................................................................ 62

41. Early Intervention ............................................................................................ 64

42. Provider Performance ....................................................................................... 66

43. Claims with multiple RTW plans ......................................................................... 67

44. Customer Data Report - Return to Work ............................................................ 68

45. Open Claims by Cost Centre by Mechanism of Incident ......................................... 70

46. Claim Details by Nature of Injury/Disease ........................................................... 71

47. Claim Details by Agency Of Injury/Disease .......................................................... 72

48. Claims with Reconsiderations ............................................................................ 73

49. Claims with AAT Case Decision .......................................................................... 74

50. Top 50 Claims by Cost to Date........................................................................... 75

51. Claims with a Date of Injury within the Last Four Years ........................................ 76

52. High Cost Claims ............................................................................................. 77

Section 3 - Financial Reports 79

70. Incapacity Determinations ................................................................................ 80

71. Payment Remittance Detail Report by Date ......................................................... 81

72. Payment Remittance Detail Report by Payment Number ....................................... 82

73. Payment Remittance Summary Report ............................................................... 83

74. Claims approaching 45 weeks incapacity ............................................................. 84

Section 4 – Using the CIS 85

Generating a report ............................................................................................... 85

Viewing a claim ..................................................................................................... 87

Cost Centre Restrictions ......................................................................................... 89

Preferences .......................................................................................................... 90

Section 5 – CIS Glossary of Terms 92

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Comcare’s Customer Information System

The Customer Information System (CIS) provides customers with access to injury

management and claims information through a secure website, and can be used to improve

the measurement and monitoring of your agency’s injury management and claims

performance.

Access to CIS is granted to authorised personnel only.

Making the most of CIS

The Guide to Understanding Customer Reports provides you with detailed information on

the various reports available through CIS, explaining the various reporting fields and terms

used. The Guide also provides you with a brief guide to using the CIS application, and

contact details for the CIS helpdesk.

We have grouped the report information according to how it appears in CIS:

Section 1 - Management Reports

Section 2 - Case Management Reports and

Section 3 - Finance Reports

Section 4 - Using CIS and

Section 5 - Glossary of terms

There are three levels of user access in CIS, and your level of access will determine which of

the reports you can run. Your Agency CIS Administrator can provide you with more

information on your level of access, and is the first point of contact should you wish to

request an amendment to your CIS user account.

Where can I get more information?

There are a range of supporting documents and systems to make using CIS an easy and

informative experience. An online help function is available both from within CIS itself and

also from the main CIS website. The CIS website also provides you with a range of “how-

to” documents and frequently asked questions around the application itself.

You can access the CIS from the Comcare website - go to www.comcare.gov.au and follow

the link on the right hand side to the Customer Information System.

We also have a dedicated team of staff in the Comcare CIS Helpdesk that can be contacted

on 1300-366-979, or by email at [email protected] .

Guide to Understanding Customer Reports - May 2012

Section 1 - Management Reports

The suite of management reports provides essential management information about claims

experience, associated costs and the claim profile of claims with a date of injury within a

specified date range. The reports are represented in list and graphical formats.

An agency can monitor performance trends and assist in the development of effective injury

prevention and case management strategies for their agencies. The reports can be selected

to compare performance across an agency, dependant on the Agency’s cost centre structure

within Comcare’s management database.

Report Content

Data within these reports is at the Management level of access only (no claim level detail).

All reports provide a number of content and presentation options. For example, reports can

usually provide data by:

All (whole of agency)

Cost Centre

Cost Centre View (grouping of cost centres created by Comcare on request)

Reporting Periods

There is a number of reporting period options available for selection:

Financial year

Calender year

Other, as required

Note: the earliest reporting period available is 1.1.1998.

The number of periods available for selection varies between each report - some reports will

allow a comparison of 4 periods on the one report, others 1 or 2.

Data currency

The claims information within the Management Reports is updated on a daily basis, with

data as at close of business. This means that on any day, CIS will be reporting with data as

at close of business on the day immediately prior. Information about total costs, including

future cost estimates are updated on the following schedule:

Month case

estimate based on

Available on CIS

July First week October

August First week November

September First week December

October First week January

November First week February

December First week March

January First week April

February First week June - The extra wait for the estimates is to increase the

quality of the estimates of claim costs used in premium calculations.

CIS continues to show these estimates until mid July.

March Second last week of July

April Last week of July

May First week August

June First week September

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All reports are available through the Comcare Customer Information System via the

Comcare Website, or can be produced on request as required.

Important notes:

Any claims with actual or potential Third Part Recovery action will reduce the future

cost estimate (case estimate) for that claim, which will in turn reduce the total cost of

that claim. The Third Party Recovery part of the likely future cost calculations takes

into consideration such things as the likelihood of successfully gaining a recovery and

the likely future size of that recovery. Please bear this in mind when reading reports

which include future cost estimate data.

It is important to note when looking at data for any given Date of Injury period there

may be a percentage of injuries incurred by employees that have not yet been

reported to Comcare, and will therefore not be included in reports. This is especially

true of reports run for recent Date of Injury periods. CIS only reports on accepted

claims, there it is useful to refer to your agency’s OH&S incident reporting records

when trying to gauge an overall picture of your agencies injury history and

performance.

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1. Progressive Costs Report

Description: This report illustrates how claim costs accumulate over the life of a claim.

Access Level Required: Management level access

Export options: .pdf, .rtf

Benefits: This report is in contrast to the other reports available in CIS because it reports

on costs of claims that occur in each year, as opposed to just costs indiscriminate of the

claims injury year. In that sense it is beneficial to see the costs progress for all accepted

claims of a given year.

Parameters: The report is calculated based on Accepted claims with a date of injury within

the last 5 years inclusive of the current year.

Fields:

Field Description

Inj Year The year that the accepted claims injury occurred.

Mature Months The number of months since the beginning of the calendar year

being measured.

Month/Year The period other fields within report relate to.

No of Claims The number of claims that have occurred in the period.

<1 Day Incap The number of claims with a date of injury in the reported calendar

year that have less than 1 day incapacity.

>=1 Day Incap The number of claims with a date of injury in the reported calendar

year that have equal to or more than 1 day incapacity.

>45 Wk Incap The number of claims with a date of injury in the reported calendar

year that have more than 45 weeks incap.

Avg Wks Incap The average incapacity of all claims with a date of injury within the

reported calendar year.

Incapacity Costs The accumulation of incapacity costs for claims with a date of

injury within the reported year.

Medical Costs The accumulation of medical costs for claims with a date of injury

within the reported year.

Travel Costs The accumulation of travel costs for claims with a date of injury

within the reported year.

Other Costs The accumulation of other costs for claims with a date of injury

within the reported year.

Total Costs to Date

($)

The accumulation of all claim costs for claims with a date of injury

within the reported year.

Notes: This report allows an agency to compare the progressive costs, number of claims,

and total claim costs over a number of years.

Example Report: Following page

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1. Progressive costs report

A Sample Agency

Period(s): [01/01/2011 - 31/12/2011]

lists progressive claim costs and incap durns

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Inj Year

Mature Months

Month/Year No of Claims

<1 Day

Incap

>=1 Day

Incap

>45 Wk

Incap

Avg Wks

Incap

Incapacity Costs($)

Medical Costs($)

Travel Costs($)

Other Costs($)

Total Costs to Date($)

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2. Prevention and Rehabilitation Performance Summary

Description: This report provides a snapshot view of claim numbers, delays and costs.

Access Level Required: Management level access

Export options: .pdf, .rtf

Benefits: A quick overview of claim statistics in regard to claim numbers, time lost, costs,

Return to Work and claim lodgement delays for the last completed quarter, previous year

and previous four years. This report also directs the user to more specific reports on each

topic.

Fields and Parameters:

Field Description

Period 4 year data reflects the performance of claims accepted in the

four years to 30 June of the previous financial year

1 year data reflects the performance of claims accepted in the

previous financial year.

Last quarter data reflects the performance of claims accepted

for the latest completed quarter. Due to the immaturity of

claims determined in this period, this data should be viewed

with caution and should not be used in isolation to inform any

assessment of a change in an agency's performance.

Claims accepted includes all claims for which Comcare issued

a determination accepting liability. This includes claims that

were accepted following reconsideration or review by the

Administrative Appeals Tribunal.

Number of claims Number of claims counts all claims accepted by Comcare in

the specified period/s.

This number can be used to calculate your agency's claim

frequency. Divide the number of accepted claims by $ million

payroll for your agency.

Number of lost time

injury claims

Number of lost time injury claims is a subset of the

number of claims and counts those claims that have recorded

one shift or more time away from the workplace due to a

compensated injury.

This number can be used to calculate your agency's lost time

frequency rate. Divide the number of lost time injury claims

by the total number of hours worked by all agency employees

in the period and multiply by 1,000,000. The total number of

hours worked can be derived from the actual hours worked or

from the number of hours of paid work, less a notional

estimate for leave hours.

Average cost of claims Average cost of claims is calculated by dividing the total cost

of claims accepted in the specified period/s by the number of

claims accepted in the period/s. Claim costs in this report

represent claims accepted in the period with any date of injury

and are not limited to claims with a date of injury in the last

quarter, year or 4 yearly period.

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Field Description

Time taken to lodge

claims

Time taken to lodge a claim measures the average number

of calendar days taken for claims to be forwarded to Comcare

from a date of injury. This measure only includes claims

determined by Comcare in the specified period/s and excludes

any claim received by Comcare 1000 calendar days or more

after the date of injury.

Number of claims

reaching the 5th day of

lost time / Number of

claims reaching the 30th

day of lost time /

Number of claims

reaching the 60th day of

lost time

Number of claims reaching the 5th, 30th and 60th days

of lost time count claims that recorded the 5th, 30th or 60th

cumulative calendar day of incapacity entitlement in the

specified period/s.

This measure counts all claims with an incapacity entitlement

recorded in the period/s, irrespective of the date of injury, the

date the claim was received or determined or the date or

length of the period of incapacity entitlement.

Percentage of claims

with a new Return to

work plan

Percentage of claims with a new Return to work plan

counts the number of claims, having had 10 or more days

incapacity determined, who commenced a RTW plan

determined either in the period or prior to the 10th day of

incapacity being determined.

The percentage is calculated by dividing this count by the total

number of claims that recorded the 10th cumulative calendar

day of incapacity entitlement in the specified period/s.

Quality of return to work Quality of return to work counts the number of claimants

who actually returned to work at the end of a return to work

plan. This measure only includes return to work plans with an

end date in the specified period/s. It exclude claims where the

return to work plan has been amended to extend the initial end

date.

Example Report: following page

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2. Prevention and rehabilitation performance summary

*A Sample Agency

An explanation of these indicators and precisely what they measure is provided in the help system

Indicator Last Quarter

1 Year 4 Year Refer reports(s)

Number of claims 7 86 26

Number of lost time injuries 2 18 6 Report 8

Avg. cost of claims($) 18,316.10 130,276.66 89,737.02

Avg. time taken to lodge claims 32.00 25.00 53.50

Number of claims reaching the 5th day of lost time 1 4 3 Report 5

Number of claims reaching the 30th day of lost time 0 1 3 Report 5

Number of claims reaching the 60th day of lost time 0 1 2 Report 5

Percentage of claims with a new Return to work plan 0% 50% 50% Report 9

Quality of return to work 0% 0% 40% Report 10

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3. Claims and total cost by mechanism of incident - chart

Description: This report shows the claim cost and number of claims for a given period,

grouped by the major Mechanism of Incident groups.

Access Level Required: Management level access

Export options: .pdf, .rtf

Benefits: This report allows the user to break down costs and numbers of claims for each

Mechanism of Injury category, to help the user better understand how injuries are occurring

and how much they are costing. There are 3 charts available for the user to view the data.

The report also allows the user to compare 2 reporting periods to assess the differences in

cost attributed to specific injury types.

Parameters: The report represents Accepted claims with a date of injury within the period

defined by the user.

Fields:

Field Description

Period This field displays the date range the report was generated for.

Mechanism of Injury

Major Group

Refers to the classification groups within the Type of

occurrence classification system.

Cost to date ($) The total of costs incurred on the claim as of yesterday.

Future cost estimate ($) The estimate of future costs on the claim as of the case

estimate date. The future cost estimate is determined by a

complex calculation that takes into account a wide array of

factors.

Avg. cost to date ($) The cost to date of all claims within the given period divided by

the number of claims meeting the given caveat within the same

period.

No. Claims The number of claims that meet the criteria of the column.

Total Cost The total of Costs to date ($) plus Future Cost Estimate ($), as

at the case estimate date.

Notes: By grouping the major Mechanism of Incident categories, this report aids with

identifying the action, exposure or event which was the direct cause of the most serious

injury or disease, providing an excellent indicator of injury patterns in your agency.

Example report: following page

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3. Claims and total cost by mechanism of incident

*A Sample Agency

Period(s): [01/07/2009 - 30/06/2010]

representing accepted claims with a date of injury in period chosen Total Cost: as at date of case estimates, sum of costs til then and likely future cost.

Costs to date and Future Cost Estimate

NOTE: When comparing recent periods with previous years data it should be noted that the data on the current period is the least mature and may not give a definitive view of related performanc

Period Mechanism Injury Major

Group

Cost To

Date($)

Future Cost

Estimate($)

Avg. Cost

To Date($)

No.

Claims

Tot. Cost

($)

07/2009-06/2010 Falls, Trips and Slips 568386.94 1162089.00 18335.06 31 1661037.59

07/2009-06/2010 Hitting Objects with Body 11934.22 33499.00 2983.56 4 43323.38

07/2009-06/2010 Being Hit by Moving Objects 150788.53 454491.00 30157.71 5 586134.04

07/2009-06/2010 Sound and Pressure 53516.18 69909.00 10703.24 5 118059.12

07/2009-06/2010 Body Stressing 2385338.81 7419351.00 18208.69 131 9514779.49

07/2009-06/2010 Heat, Elec + Other Enviro Fact 0.00 0.00 0.00 0 0.00

07/2009-06/2010 Chemicals and Other Substances 46553.47 122584.00 23276.74 2 148671.07

07/2009-06/2010 Biological Factors 7086.05 5256.00 7086.05 1 12318.05

07/2009-06/2010 Mental Stress 921345.72 3000249.00 32905.20 28 3804535.42

07/2009-06/2010 Other and Unspecified 218011.82 926865.00 31144.55 7 1118820.72

07/2009-06/2010 Total 4362961.74 13194293.00 20387.67 214 17007678.88

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4. Claims, cost and time lost by cost centre

Description: This report shows the claim frequency, total and average cost, total

incapacity weeks and average incapacity weeks for a given period, grouped by the cost

centre structure of your agency.

Access Level Required: Management level access

Export options: .pdf, .rtf

Benefits: This report can useful both, when utilising formal or notional devolution, or to

highlight injury and claim hotspots within your agency.

Parameters: This report represents accepted claims with a date of injury within the period

chosen.

Fields:

Field Description

Liable cost centre No. The unique number that identifies the liable cost centre within

each agency.

Liable cost centre The reporting group that has been allocated to the claim. Usually

this is the business area or region the employee worked in when

they were injured. Liable cost centres are supplied by the

customer and the level of detail is dependant on the customers

reporting needs.

No. Claims The number of claims that meet the criteria of the column.

Cost to date ($) The total of costs incurred on the claim as of yesterday.

Future cost estimate ($) The estimate of future costs on the claim as of the case estimate

date. The future cost estimate is determined by a complex

calculation that takes into account a wide array of factors.

Total Cost($) The sum of costs to date and the future cost estimate at the date

the estimate was calculated.

Average cost($) Total Cost divided by the number of claims.

Incapacity Weeks The total number of incapacity weeks accrued as of yesterday.

Avg. Incapacity weeks The total incapacity weeks accrued divided by the No. of claims.

Example Report:

4. Claims, cost and time lost by cost centre

A sample agency

Period(s): [01/01/2010 - 31/12/2010]

representing accepted claims with a date of injury in period chosen Total Cost: as at date of case estimates, sum of costs til then and likely

future cost.

Liable Cost Centre No.

Liable Cost Centre

No. Claims

Cost To Date($)

Future Cost Estimate($)

Total Cost($)

Average Cost($)

Incapacity Weeks

Avg. Incapacity Weeks

10 Cost Centre A 1 360.30 1332.00 1692.30 1692.30 0.00 0.00

12 Cost Centre B 1 663.30 0.00 0.00 0.00 0.00 0.00

18 Cost Centre E 1 0.00 0.00 0.00 0.00 0.00 0.00

Total 3 1023.60 1332.00 1692.30 1692.30 0.00 0.00

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5. Number of injuries resulting in 5, 30 and 60 or more days of incapacity

Description: This report displays data on the number of claims to have their 5th, 30th and

60th day of incapacity determined in the chosen reporting period.

Access Level Required: Management level access

Export options: .pdf, .rtf

Benefits: This report allows users to see the volume of claims reaching their 5th, 30th, and

60th day of incapacity in any given month.

Parameters: This report counts claims which have had the 5th day of incapacity, the 30th

day of incapacity and the 60th day of incapacity determined within the reporting period,

irrespective of the date of injury, the date of receipt of the claim, initial determination date

or dates of incapacity.

Fields:

Field Description

Month/Year Separates the months within the financial year.

5th day of incap

determ

The number of claims that had their 5th day of incapacity

determined with in the reporting period.

30th day of incap

determ

The number of claims that had their 30th day of incapacity

determined with in the reporting period.

60th day of incap

determ

The number of claims that had their 60th day of incapacity

determined with in the reporting period.

Example Report:

5. Numbers of injuries resulting in 5, 30 and 60 or more days incapacity

*A sample agency

Period(s): [01/07/2010 - 30/06/2011]

Month/Year 5th day of incap determ 30th day of incap determ 60th day of incap determ

Jul-10 136 77 54

Aug-10 129 69 55

Sep-10 123 76 51

Oct-10 105 66 35

Nov-10 150 94 74

Dec-10 117 70 67

Jan-11 90 69 54

Feb-11 94 74 51

Mar-11 0 0 0

FIN YEAR 2010/2011 944 595 441

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6. Number of injuries resulting in 5 days incapacity by mechanism of incident

Description: This report displays data on the number of claims to have their 5th day of

incapacity determined in the chosen reporting period, and is then broken down by

Mechanism of Incident.

This report is presented as a table, with data grouped by month.

Access Level Required: Management level access

Export options: .pdf and .rtf

Benefits: These measures provide a proxy of the numbers of work related injuries occurring

in the period and accumulating the 5th day's incapacity. This forms the base data for the P2

SRCC indicators and needs to be supplemented and calculated using the additional average

number of FTE employee data element available in house as:

Indicators displayed are:

Incidence of injuries resulting in 5 days incapacity (for each MOI) = (Number of

claims in which the 5th of incapacity was determined (for each MOI) divided by the average number of FTE employees who worked in the period) * 1000

Parameters: Number of claims in which the 5th of incapacity was determined in the period

resulting from the major Mechanism of Incident groups.

Fields:

Field Description

Month/Year The period other fields within report relate to.

Falls, Trips and slips The major group used in the Type of Occurrence Classification

System to differentiate how claimants have been injured.

Hitting objects with

body

The major group used in the Type of Occurrence Classification

System to differentiate how claimants have been injured.

Being hit by moving

objects

The major group used in the Type of Occurrence Classification

System to differentiate how claimants have been injured.

Sound and pressure The major group used in the Type of Occurrence Classification

System to differentiate how claimants have been injured.

Body Stressing The major group used in the Type of Occurrence Classification

System to differentiate how claimants have been injured.

Heat, Elec + other

enviro fact

The major group used in the Type of Occurrence Classification

System to differentiate how claimants have been injured.

Chemicals and other

substances

The major group used in the Type of Occurrence Classification

System to differentiate how claimants have been injured.

Biological factors The major group used in the Type of Occurrence Classification

System to differentiate how claimants have been injured.

Mental stress The major group used in the Type of Occurrence Classification

System to differentiate how claimants have been injured.

Other and unspecified The major group used in the Type of Occurrence Classification

System to differentiate how claimants have been injured.

Total The sum of previous fields on the report.

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Example Report:

6. Numbers of injuries resulting in 5 days incapacity by mechanism of incident

*A Sample Agency

Period(s): [01/07/2010 - 30/06/2011]

Month/Year Falls, Trips and Slips

Hitting Objects with Body

Being Hit by Moving Objects

Sound and Pressure

Body Stressing

Heat, Elec + Other Enviro Fact

Chemicals and Other Substances

Biological Factors

Mental Stress

Other and Unspecified

Total

Jul-10 22 1 8 2 72 0 1 2 23 5 136

Aug-10 21 2 5 1 59 1 1 1 33 5 129

Sep-10 24 4 6 1 49 0 2 0 31 6 123

Oct-10 17 2 8 1 50 0 0 1 24 2 105

Nov-10 25 4 4 1 83 1 0 1 27 4 150

Dec-10 18 4 4 0 56 0 2 1 29 3 117

Jan-11 12 2 3 1 46 1 0 2 21 2 90

Feb-11 18 0 5 1 48 1 1 0 19 1 94

Mar-11 0 0 0 0 0 0 0 0 0 0 0

Total 157 19 43 8 463 4 7 8 207 28 944

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7. Number of Death Claims

Description: This report provides the number of claims for death (death benefit or funeral

costs) accepted within the reporting period.

Access Level Required: Management level access

Export options: .pdf, .rtf

Benefits: This forms the base data for the SRCC P3 indicators and needs to be

supplemented and calculated using the additional data element available in house as:

Average number of FTE employees who worked in the period.

Parameters: Number of claims for death (death benefit or funeral costs) accepted within

the period.

Fields:

Field Description

Month/Year The period other fields within report relate to.

No of claims for death The total number of death claims accepted in the reporting

period.

Example Report:

7. Numbers of death claims

*A Sample Agency

Period(s): [01/07/2010 - 30/06/2011]

Month/Year No of claims for death

Jul-10 6

Aug-10 2

Sep-10 3

Oct-10 3

Nov-10 0

Dec-10 0

Jan-11 0

Feb-11 0

Mar-11 2

Apr-11 0

May-11 0

Jun-11 0

FIN YEAR 2010/2011 16

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8. Frequency of lost time injuries

Description: This report displays the number of claims that had their first incapacity

determination in the chosen reporting period of at least one lost day or shift.

Access Level Required: Management level access

Export options: .pdf and .rtf

Benefits: This forms the base data for the SRCC P4 indicators and needs to be

supplemented and calculated using the additional data element available in house as:

Total number of hours worked in the period by all employees (derived from actual

hours worked or from hours paid less a notional estimate for leave hours as per AS.1885 and the ABS leave estimate)

Parameters: This report represents the number of lost time injuries which is measured by

the number of claims with the determination in the reporting period of at least one lost day

or shift.

Fields:

Field Description

Month/Year The period other fields within report relate to.

No. of lost time injuries Number of claims that have had the first determination of

incapacity of at least one day or shift.

Example Report:

8. Frequency of lost time claims

A Sample Agency

Period(s): [01/07/2010 - 30/06/2011] [01/07/2011 - 30/06/2012]

Month/Year No of lost time injuries

Jul-10 0

Aug-10 1

Sep-10 2

Oct-10 0

Nov-10 4

Dec-10 4

Jan-11 1

Feb-11 1

Mar-11 0

FIN YEAR 2010/2011 13

Guide to Understanding Customer Reports - May 2012

22

9. Percentage of claimants with >= 10 days incapacity determined with a Return to Work Plan

Description: This report highlights the number of claims with 10 or more incapacity days

and the percentage of those claims with a registered return to work plan (RTW) with

Comcare.

Access Level Required: Management level access

Export options: .pdf, .rtf

Benefits: The indicator below measures the number of claimants, having had 10 or more

days incapacity determined, who commenced a RTW plan determined in the period (or,

having had at any time prior to the end of the period a RTW plan determined, have the 10th

day of incapacity determined in the period) as a percentage of the number of claimants who had the 10th day of incapacity determined in the period.

percentage of claimants with >=10 days incap with a RTW Plan = (Number of

claimants who, having had 10 or more days incapacity determined prior to the

period, commenced a RTW plan that was determined in the period + Number of

claimants who, having the 10th day of incapacity determined in the period, also had

at any time prior to or within the period commenced a RTW plan divided by Number

of claimants who, in the period, reached the 10th day of incapacity * 100

Parameters: The number of claimants who, in the period, reached the 10th day of

incapacity. The number of claimants who, having had 10 or more days incapacity

determined prior to the period commenced a RTW plan that was determined in the period.

The number of claimants who, having the 10th day of incapacity determined in the period

also had at any time prior to or within the period commenced a RTW plan.

Fields:

Field Description

Month/Year The period other fields within report relate to.

Reaching 10

days incap

Number of claimants who, in the period, reached the 10th day of

incapacity

Start RTWP prior

10 days

Number of claimants who, having had 10 or more days incapacity

determined prior to the period, commenced a RTW plan that was

determined in the period

Reach 10 days

with a RTWP

Number of claimants who, having the 10th day of incapacity

determined in the period, also had at any time prior to or within the

period commenced a RTW plan

% starting a

RTWP

percentage of claimants with >=10 days incap with a RTW Plan =

(Number of claimants who, having had 10 or more days incapacity

determined prior to the period, commenced a RTW plan that was

determined in the period + Number of claimants who, having the 10th

day of incapacity determined in the period, also had at any time prior

to or within the period commenced a RTW plan divided by Number of

claimants who, in the period, reached the 10th day of incapacity * 100

Example Report: following page

Guide to Understanding Customer Reports - May 2012

23

9. Percentage of claimants with >= 10 days incapacity determined with a RTW plan

A Sample Agency

Period(s): [01/07/2010 - 30/06/2011]

Month/Year Reaching 10 days incap Start RTWP prior 10days

Reach 10 days with RTWP

% starting a RTWP

Jul-10 1 0 1 100%

Aug-10 1 0 1 100%

Sep-10 2 0 2 100%

Oct-10 0 0 0 0%

Nov-10 2 1 0 50%

Dec-10 2 0 0 0%

Jan-11 0 1 0 0%

Feb-11 1 0 0 0%

Mar-11 0 1 0 0%

FIN YEAR 2010/2011 9 3 4 78%

Guide to Understanding Customer Reports - May 2012

24

10. Quality of Return to Work Outcomes

Description: This report displays a summary of the outcomes of Return to Work Plans,

measuring the nature of the outcome of the return to work plan, at the closure of the case.

Access Level Required: Management level access

Export options: .csv, .pdf and .rtf

Benefits: This report allows the user to monitor the outcomes of return to work plans over

a three financial years.

Parameters: This report represents a tabulation of the number of return to work plans that

have ended in the month specified and their outcomes.

Fields:

Field Description

Month/Year The period other fields within report relate to.

Same Emp Same Job Number & percentage of claimants who returned to pre injury

employment with the same employer in the period

Same emp mod job Number & percentage of claimants who returned to a modified job

with the same employer in the period

New emp same job Number & percentage of claimants who changed employer but

kept same job in the period

New emp any job Number & percentage of claimants who changed employer and job

in the period

Total RTW achieved Number & percentage of claimants who returned to work in the

period

RTW not achieved Number & percentage of claimants who did not achieve RTW

outcomes in the period.

Total RTW Number of claimants who had a RTW ending in the period

Example Report:

10. Quality of RTW Outcome

A Sample Agency

Month/Year Same emp same job

% Same emp mod job

% New emp same job

% New emp any job

% Total RTW achieved

% RTW not achieved

% Total RTW

Guide to Understanding Customer Reports - May 2012

25

11. T1 Numbers of workplace injury and disease

Description: This report is based on the Comcare 2012 targets. It displays the number of

total claims with the 5th day of incapacity determined in each financial year against the

target of reducing the number of claims that reach the 5th day of incapacity by 40 percent

by 2012.

Access Level Required: Management level access. (Drill down functionality requires Case

Manager Detail Level Access).

Export options: .pdf, .rtf

Benefits: The purpose of this report is to measure the injury prevention performance of an

agency against the target indicator.

To calculate the incident rate use the formula:

Incidence rate = the number of claims in which the 5th day of incapacity was determined (in

a year) X 100 divided by the number of FTE employees (in that year).

Please note that the results provided for the current year are cumulative, and will increase

toward the final outcome over the course of the year.

Parameters: This report represents claims that have had their 5th day of incapacity

determined in each financial year. The target is calculated by averaging the agencies

performance in the first three years and then from that point setting the target at a 40%

reduction.

Fields:

Field Description

Month/Year The period other fields within report relate to.

No. Claims The number of claims that meet the criteria of the column.

Target Claims The goal number of claims to meet the Comcare 2012 targets. Report

31.T1 the target is a 40% reduction in claims over 10 years based on

the average number of claims in the 2001/2002, 2002/2003 financial

years.

Example Report: following page

Guide to Understanding Customer Reports - May 2012

26

11. T1 - numbers of workplace injury and disease

A Sample Agency

representing claims with a 5th day of incapacity determined in each financial year

T1 - numbers of workplace injury and disease

WARNING: The results provided for the current year are cumulative, and will increase toward the final outcome over the course of the year.

Month/Year No. Claims Target Claims

2001/02 143 130

2002/03 132 125

2003/04 141 120

2004/05 168 114

2005/06 182 109

2006/07 163 104

2007/08 108 99

2008/09 173 94

2009/10 148 88

2010/11 122 83

2011/12 0 78

Guide to Understanding Customer Reports - May 2012

27

12. T3 - weeks lost time

Description: It displays the total number of weeks of incapacity determined in each

financial year period, commencing 2001-2002 against the target of reducing the number of

weeks lost by 40 percent by 2012.

Access Level Required: Management level access (Drill down functionality requires Case

Manager Detail Level Access).

Export options: .pdf, .rtf

Benefits: When viewed online, this report allows the user to drill down into the details of a

claim affecting a column on the chart. The report itself allows agencies to track time lost

and assess performance against the target indicator.

Parameters: This report represents claims (commuting claims excluded) that have had

incapacity determined in each financial year. The target is calculated by averaging the first

3 years worth of performance and from that point setting the target at a 40% reduction.

Fields:

Field Description

Month/Year The period other fields within report relate to.

Total wks

incap

The total number of incapacity weeks determined in the period.

Target wks The goal number of incapacity weeks to meet the Comcare 2012 targets.

Report 32.T3 the target is a 40% reduction over 10 years. In report 33.T4

the target is to reach 2 weeks by 2012, some claims are excluded from this

calculation such as claims with over 1000 days difference between their S36

service date and date of injury.

Example Report: following page

Guide to Understanding Customer Reports - May 2012

28

12. T3 - weeks lost time

A Sample Agency

representing claims with incapacity determined in each financial year

T3 - weeks lost time

WARNING: The results provided for the current year are cumulative, and will increase toward the final outcome over the course of the year.

Month/Year Total Wks Incap Target Wks

2001/02 4.30 26.80

2002/03 30.78 25.72

2003/04 22.21 24.65

2004/05 31.05 23.58

2005/06 31.86 22.51

2006/07 24.84 21.44

2007/08 74.33 20.36

2008/09 29.55 19.29

2009/10 93.92 18.22

2010/11 122.36 17.15

2011/12 0.00 16.08

Guide to Understanding Customer Reports - May 2012

29

13. T4 - Average weeks for Return to Work activity to commence

Description: This report displays the average time taken (in calendar weeks) from date of

injury to the date the first rehabilitation assessment service is provided. It also shows how

performance needs to improve in order to reach the target of two weeks or less by 30 June

2012.

Access Level Required: Management level access (Drill down functionality requires Case

Manager Detail Level Access).

Export options: .pdf, .rtf

Benefits: This report measures early intervention performance for each financial year.

When viewed online, this report allows the user to drill down into the details of a claim

affecting a column on the chart. The report itself allows agencies to track time lost and

assess performance against the target indicator.

Parameters: This report displays the average amount of time between claims injury date

and its first rehabilitation service date in each financial year. The rehabilitation service date

is defined by the first s36 service date in our claims management database. The target is

set at 2 weeks for all agencies.

Fields:

Field Description

Month/Year The period other fields within report relate to.

Avg wks to RTW

activity

Claims that have had and we have recorded the first S36 service date

minus Date of Injury divided by total number of claims that have had

the first S36 service date in the financial year.

Target wks The goal number of incapacity weeks to meet the Comcare 2012

targets. Report 32.T3 the target is a 40% reduction over 10 years. In

report 33.T4 the target is to reach 2 weeks by 2012, some claims are

excluded from this calculation such as claims with over 1000 days

difference between their S36 service date and date of injury.

Example Report: following page

Guide to Understanding Customer Reports - May 2012

30

13. T4 - average weeks for RTW activity to commence

A Sample Agency

representing claims with the first rehabilitation service date in each financial year

T4 - average weeks for RTW activity to commence

Month/Year Avg Wks to RTW Activity Target Wks

2004/05 10.57 2.00

2001/02 0.00 2.00

2005/06 88.43 2.00

2007/08 27.21 2.00

2003/04 5.10 2.00

2008/09 6.00 2.00

2009/10 0.00 2.00

2006/07 3.00 2.00

2002/03 9.14 2.00

2010/11 46.00 2.00

2011/12 0.00 2.00

Guide to Understanding Customer Reports - May 2012

31

14. Occupation by mechanism of incident - Claims

Description: This report lists the number of claims with a date of injury in the specified

period, sorted by both occupation and mechanism of injury.

Access Level Required: Management level access

Export options: .pdf, .rtf

Benefits: This report enables senior mangers, middle managers, and health and safety

managers to monitor occupational trends in injury incidence. This assists in identifying

particular risk areas within the agency which require improved injury prevention and case

management strategies.

Parameters: This report represents accepted claims with a date of injury within the period

chosen.

Fields:

Field Description

Occupation The category of occupation the claimant works as.

Falls, Trips and slips The major group used in the Type of Occurrence

Classification System to differentiate how claimants have

been injured.

Hitting objects with body The major group used in the Type of Occurrence

Classification System to differentiate how claimants have

been injured.

Being hit by moving objects The major group used in the Type of Occurrence

Classification System to differentiate how claimants have

been injured.

Sound and pressure The major group used in the Type of Occurrence

Classification System to differentiate how claimants have

been injured.

Body Stressing The major group used in the Type of Occurrence

Classification System to differentiate how claimants have

been injured.

Heat, Elec + other enviro fact The major group used in the Type of Occurrence

Classification System to differentiate how claimants have

been injured.

Chemicals and other

substances

The major group used in the Type of Occurrence

Classification System to differentiate how claimants have

been injured.

Biological factors The major group used in the Type of Occurrence

Classification System to differentiate how claimants have

been injured.

Mental stress The major group used in the Type of Occurrence

Classification System to differentiate how claimants have

been injured.

Other and unspecified The major group used in the Type of Occurrence

Classification System to differentiate how claimants have

been injured.

Total The sum of previous fields on the report.

Example Report: following page

Guide to Understanding Customer Reports - May 2012

32

14. Occupation by mechanism of incident - claims

A Sample Agency

Period(s): [01/01/2010 - 31/12/2010]

representing accepted claims with a date of injury in period chosen

Total Claim Numbers by Occupation

Occupation Falls, Trips and

Slips

Hitting Objects

with Body

Being Hit by

Moving Objects

Sound and

Pressure

Body Stressing

Heat, Elec + Other Envir

o Fact

Chemicals and Other

Substances

Biological Factors

Mental Stress

Other and Unspecified

Total

Managers & Administrators

35 6 10 0 67 1 3 0 17 5 144

Professionals 37 8 10 2 122 4 7 2 31 10 233

Adv Clerical & Service

241 52 74 22 761 10 9 6 155 32 1362

Int Clerical, Sales & Service

0 2 0 0 7 0 0 0 2 1 12

Elem Clerical, Sales & Service

7 5 6 1 25 1 1 0 2 0 48

Total 320 73 100 25 982 16 20 8 207 48 1799

Guide to Understanding Customer Reports - May 2012

33

15. Occupation by mechanism of incident - total cost

Description: This report lists the total cost (cost to date plus outstanding liability) of

claims with a date of injury in the specified period sorted by both occupation and

mechanism of injury.

Access Level Required: Management level access

Export options: .pdf, .rtf

Benefits: This report enables managers to obtain a breakdown of total cost by occupation

and Mechanism of Incident group. It can provide early identification of occupational groups

which may require preventative education programs.

Parameters: This report represents accepted claims with a date of injury within the period

chosen.

Fields:

Field Description

Occupation The category of occupation the claimant works as.

Falls, Trips and slips The major group used in the Type of Occurrence Classification

System to differentiate how claimants have been injured.

Hitting objects with

body

The major group used in the Type of Occurrence Classification

System to differentiate how claimants have been injured.

Being hit by moving

objects

The major group used in the Type of Occurrence Classification

System to differentiate how claimants have been injured.

Sound and pressure The major group used in the Type of Occurrence Classification

System to differentiate how claimants have been injured.

Body Stressing The major group used in the Type of Occurrence Classification

System to differentiate how claimants have been injured.

Heat, Elec + other

enviro fact

The major group used in the Type of Occurrence Classification

System to differentiate how claimants have been injured.

Chemicals and other

substances

The major group used in the Type of Occurrence Classification

System to differentiate how claimants have been injured.

Biological factors The major group used in the Type of Occurrence Classification

System to differentiate how claimants have been injured.

Mental stress The major group used in the Type of Occurrence Classification

System to differentiate how claimants have been injured.

Other and unspecified The major group used in the Type of Occurrence Classification

System to differentiate how claimants have been injured.

Total The sum of previous fields on the report.

Example Report: following page

Guide to Understanding Customer Reports - May 2012

34

15. Occupation by mechanism of incident - total cost

A Sample Agency

Period(s): [01/01/2010 - 31/12/2010]

representing accepted claims with a date of injury in period chosen Total Cost: as at date of case estimates, sum of costs til then and likely

future cost.

Total Cost by Occupation

Occupation Falls, Trips and

Slips

Hitting Objects

with Body

Being Hit by Moving

Objects

Sound and

Pressure

Body Stressing

Heat, Elec + Other Enviro Fact

Chemicals and Other

Substances

Biological Factors

Mental Stress

Other and Unspecified

Total

Managers & Administrators

62965 642 61 0 472437 0 0 0 79630 22437 638172

Professionals 3172286 34702 1062935 28258 5314986 0 648715 0 1949851 265080 12476814

Adv Clerical & Service

1065340 191137 315353 0 2583834 66348 6884 23413 1534295 51519 5838123

Int Clerical, Sales & Service

0 0 0 0 0 0 0 0 0 0 0

Elem Clerical, Sales & Service

160344 8145 30028 0 512372 0 0 0 0 4422 715311

Total 4460935 234626 1408377 28258 8883629 66348 655599 23413 3563776 343458 19668420

Guide to Understanding Customer Reports - May 2012

35

16. Age group by mechanism of incident - claims

Description: This report lists the number of claims with a date of injury in the specified

period sorted by both age profile and mechanism of injury.

Access Level Required: Management level access

Export options: .pdf, .rtf

Benefits: This report enables managers to identify any age related trends in injury

incidence for particular Mechanism of Incident groups. This can assist in development of

effective injury prevention and case management strategies.

Parameters: This report represents accepted claims with a date of injury within the period

chosen.

Fields:

Field Description

Age Group The age group of the claimant at time of injury

Falls, Trips and slips The major group used in the Type of Occurrence

Classification System to differentiate how claimants have

been injured.

Hitting objects with body The major group used in the Type of Occurrence

Classification System to differentiate how claimants have

been injured.

Being hit by moving objects The major group used in the Type of Occurrence

Classification System to differentiate how claimants have

been injured.

Sound and pressure The major group used in the Type of Occurrence

Classification System to differentiate how claimants have

been injured.

Body Stressing The major group used in the Type of Occurrence

Classification System to differentiate how claimants have

been injured.

Heat, Elec + other enviro fact The major group used in the Type of Occurrence

Classification System to differentiate how claimants have

been injured.

Chemicals and other

substances

The major group used in the Type of Occurrence

Classification System to differentiate how claimants have

been injured.

Biological factors The major group used in the Type of Occurrence

Classification System to differentiate how claimants have

been injured.

Mental stress The major group used in the Type of Occurrence

Classification System to differentiate how claimants have

been injured.

Other and unspecified The major group used in the Type of Occurrence

Classification System to differentiate how claimants have

been injured.

Total The sum of previous fields on the report.

Example Report: following page

Guide to Understanding Customer Reports - May 2012

36

16. Age group by mechanism of incident - claims

A Sample Agency

Period(s): [01/07/2010 - 30/06/2011]

representing accepted claims with a date of injury in period chosen

Total Claim Numbers by Age Group

Age Group

Falls, Trips and

Slips

Hitting Objects

with Body

Being Hit by

Moving Objects

Sound and

Pressure

Body Stressing

Heat, Elec + Other Enviro Fact

Chemicals and Other

Substances

Biological Factors

Mental Stress

Other and Unspecified

Total

< 25 2 1 5 0 1 0 0 0 0 0 9

25 - 35

11 4 4 0 15 1 1 0 0 1 37

35 - 45

16 7 11 0 36 1 2 1 7 3 84

45 - 55

23 7 16 0 41 0 1 0 11 3 102

55 - 65

16 4 6 0 19 2 0 1 6 1 55

> 65 3 1 0 0 0 0 0 0 0 1 5

Total 71 24 42 0 112 4 4 2 24 9 292

Guide to Understanding Customer Reports - May 2012

37

17. Age group by mechanism of incident - total cost

Description: This report lists the total cost (cost to date plus outstanding liability) of

claims with a date of injury in the specified period sorted by both age profile and

mechanism of injury group.

Access Level Required: Management level access

Export options: .pdf and .rtf

Benefits: This report enables managers to obtain a breakdown of total cost by age and

mechanism of incident group. It can be used to identify employee4s who may be at risk of

injury and assist in developing specific injury prevention programs and case management

strategies.

Parameters: This report represents accepted claims with a date of injury within the period

chosen.

Fields:

Field Description

Age Group The age group of the claimant at time of injury

Falls, Trips and slips The major group used in the Type of Occurrence

Classification System to differentiate how claimants have

been injured.

Hitting objects with body The major group used in the Type of Occurrence

Classification System to differentiate how claimants have

been injured.

Being hit by moving objects The major group used in the Type of Occurrence

Classification System to differentiate how claimants have

been injured.

Sound and pressure The major group used in the Type of Occurrence

Classification System to differentiate how claimants have

been injured.

Body Stressing The major group used in the Type of Occurrence

Classification System to differentiate how claimants have

been injured.

Heat, Elec + other enviro fact The major group used in the Type of Occurrence

Classification System to differentiate how claimants have

been injured.

Chemicals and other

substances

The major group used in the Type of Occurrence

Classification System to differentiate how claimants have

been injured.

Biological factors The major group used in the Type of Occurrence

Classification System to differentiate how claimants have

been injured.

Mental stress The major group used in the Type of Occurrence

Classification System to differentiate how claimants have

been injured.

Other and unspecified The major group used in the Type of Occurrence

Classification System to differentiate how claimants have

been injured.

Total The sum of previous fields on the report.

Example report: following page

Guide to Understanding Customer Reports - May 2012

38

17. Age group by mechanism of incident - total cost

A Sample Agency

Period(s): [01/10/2010 - 31/03/2011]

representing accepted claims with a date of injury in period chosen Total Cost: as at date of case estimates, sum of costs til then and likely

future cost.

Total Cost by Age Group

Age Group

Falls, Trips and

Slips

Hitting Objects

with Body

Being Hit by

Moving Objects

Sound and

Pressure

Body Stressing

Heat, Elec + Other Enviro Fact

Chemicals and Other

Substances

Biological Factors

Mental Stress

Other and Unspecified

Total

< 25 48111 107110 2396 0 6470 0 0 0 0 0 164087

25 - 35

248207 3942 0 0 160132 13969 0 0 0 11953 438203

35 - 45

427473 53456 27232 0 406430 0 0 23413 0 0 938003

45 - 55

193286 0 416010 0 521793 0 0 0 19605 8701 1159395

55 - 65

297273 0 18410 0 165638 8517 0 0 0 0 489839

> 65 0 642 0 0 0 0 0 0 0 470 1112

Total 1214350 165150 464048 0 1260464 22486 0 23413 19605 21124 3190640

Guide to Understanding Customer Reports - May 2012

39

18. Duty status by mechanism of incident - claims

Description: This report lists the number of claims with a date of injury in the specified

period, sorted by both duty status and mechanism of injury group.

Access Level Required: Management level access

Export options: .pdf and .rtf

Benefits: Enables managers to identify the injury profile of their agency. it can alert

management to the most high-risk activities and identify the need for organisational policy

and guidelines to assist in effective injury prevention.

Parameters: This report represents accepted claims with a date of injury within the period

chosen.

Fields:

Field Description

Duty status The task the claimant was performing when injured.

Falls, Trips and slips The major group used in the Type of Occurrence

Classification System to differentiate how claimants have

been injured.

Hitting objects with body The major group used in the Type of Occurrence

Classification System to differentiate how claimants have

been injured.

Being hit by moving objects The major group used in the Type of Occurrence

Classification System to differentiate how claimants have

been injured.

Sound and pressure The major group used in the Type of Occurrence

Classification System to differentiate how claimants have

been injured.

Body Stressing The major group used in the Type of Occurrence

Classification System to differentiate how claimants have

been injured.

Heat, Elec + other enviro fact The major group used in the Type of Occurrence

Classification System to differentiate how claimants have

been injured.

Chemicals and other

substances

The major group used in the Type of Occurrence

Classification System to differentiate how claimants have

been injured.

Biological factors The major group used in the Type of Occurrence

Classification System to differentiate how claimants have

been injured.

Mental stress The major group used in the Type of Occurrence

Classification System to differentiate how claimants have

been injured.

Other and unspecified The major group used in the Type of Occurrence

Classification System to differentiate how claimants have

been injured.

Total The sum of previous fields on the report.

Example report: following page

Guide to Understanding Customer Reports - May 2012

40

18. Duty status by mechanism of incident - claims

A Sample Agency

Period(s): [01/01/2010 - 31/12/2010]

representing accepted claims with a date of injury in period chosen

Total Claim Numbers by Duty Status

Duty Status

Falls, Trips and

Slips

Hitting Objects

with Body

Being Hit by Moving

Objects

Sound and

Pressure

Body Stressing

Heat, Elec + Other Enviro Fact

Chemicals and Other

Substances

Biological Factors

Mental Stress

Other and Unspecified

Total

While working 95 27 67 3 178 3 10 2 52 11 448

MTA while working

1 0 0 0 0 0 0 0 0 12 13

Working elsewhere

16 1 3 1 10 1 1 0 0 2 35

While on break 0 0 0 0 0 1 0 0 0 0 1

Travelling to/from work

0 0 0 0 0 0 0 0 0 1 1

Approved study 0 1 0 0 0 0 0 0 0 0 1

Authorised sport

0 0 0 0 1 0 0 0 0 0 1

Other 4 1 4 0 7 0 1 0 1 0 18

Home based work

0 0 0 0 1 0 0 0 0 0 1

All diseases 0 0 0 0 0 0 0 0 0 0 0

Total 116 30 74 4 197 5 12 2 53 26 519

Guide to Understanding Customer Reports - May 2012

41

19. Duty status by mechanism of incident - total cost

Description: This report lists the total cost (cost to date plus outstanding liability) of

claims with a date of injury in the specified period sorted by both duty status and

mechanism of injury group.

Access Level Required: Management level access

Export options: .pdf and .rtf

Benefits: This report can be used in conjunction with report 18 to identify the total cost

estimates by duty status for a Mechanism of Incident group. By comparison with the actual

incidences in these categories in Report 18, it is possible to identify the cost drivers and

therefore focus prevention and case management strategies more effectively.

Parameters: This report represents accepted claims with a date of injury in period chosen.

The total cost is as at date of Case Estimates, sum of costs until then and likely future costs.

Fields:

Field Description

Duty status The task the claimant was performing when injured.

Falls, Trips and slips The major group used in the Type of Occurrence

Classification System to differentiate how claimants have

been injured.

Hitting objects with body The major group used in the Type of Occurrence

Classification System to differentiate how claimants have

been injured.

Being hit by moving objects The major group used in the Type of Occurrence

Classification System to differentiate how claimants have

been injured.

Sound and pressure The major group used in the Type of Occurrence

Classification System to differentiate how claimants have

been injured.

Body Stressing The major group used in the Type of Occurrence

Classification System to differentiate how claimants have

been injured.

Heat, Elec + other enviro fact The major group used in the Type of Occurrence

Classification System to differentiate how claimants have

been injured.

Chemicals and other

substances

The major group used in the Type of Occurrence

Classification System to differentiate how claimants have

been injured.

Biological factors The major group used in the Type of Occurrence

Classification System to differentiate how claimants have

been injured.

Mental stress The major group used in the Type of Occurrence

Classification System to differentiate how claimants have

been injured.

Other and unspecified The major group used in the Type of Occurrence

Classification System to differentiate how claimants have

been injured.

Total The sum of previous fields on the report.

Example Report: following page

Guide to Understanding Customer Reports - May 2012

42

19. Duty status by mechanism of incident - total cost

A Sample Agency

Period(s): [01/01/2010 - 31/12/2010]

representing accepted claims with a date of injury in period chosen Total Cost: as at date of case estimates, sum of costs til then and likely

future cost.

Total Cost by Duty Status

Duty Status Falls, Trips and Slips

Hitting Objects

with Body

Being Hit by

Moving Objects

Sound and

Pressure

Body Stressing

Heat, Elec + Other Enviro Fact

Chemicals and Other Substanc

es

Biological

Factors

Mental Stress

Other and Unspecifie

d

Total

While working

15772859 2157479 3758534 547896 46262996 278360 294697 250419 27100365 2867891 99291497

MTA while working

2206 0 6321 0 143845 0 0 0 18624 380971 551966

Working elsewhere

3257932 776973 292603 11286 3344615 6832 40945 153928 140970 26307 8052390

While on break

202288 12999 402433 0 1220 0 0 11149 0 13983 644072

Travelling to/from work

305822 0 0 0 187802 0 0 0 0 32270 525894

Approved study

226687 1668 207758 0 305712 0 0 0 722994 9661 1474479

Total 21548044 2983594 4821964 564971 53610913 289460 335641 415496 28991027 4548770 118109880

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20. Claims and total cost by age group

Description: This report displays a graph showing the number of claims and the

associated total costs by age groupings.

Access Level Required: Management level access

Export options: .pdf and .rtf

Benefits: This report can be of benefit when assessing the highest risk age group in your

agency, bearing in mind the age spread of agency population.

Parameters: This report represents accepted claims with a date of injury in the period

chosen.

Fields:

Field Description

Period This field displays the date range the report was generated for.

Age Group The age group of the claimant at time of injury

Cost to Date ($) The total of costs incurred on the claim as of yesterday.

Future Cost Estimate

($)

The estimate of future costs on the claim as of the case

estimate date. The future cost estimate is determined by a

complex calculation that takes into account a wide array of

factors.

Avg. Cost to Date ($) The cost to date of all claims within the given period divided by

the number of claims meeting the given caveat within the same

period.

No. Claims The number of claims that meet the criteria of the column.

Example Report: following page

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44

20. Claims and total cost by age group

A Sample Agency

Period(s): [01/01/2010 - 31/12/2010] [01/01/2011 - 31/12/2011]

representing accepted claims with a date of injury in period chosen

Claims and total cost by age group

NOTE: When comparing recent periods with previous years data it should be noted that the data on the current period is the least mature and may not give a definitive view of related performance

Period Age Group Cost To Date($) Future Cost Estimate($) Avg. Cost To Date($) No. Claims

01/2010-12/2010 < 25 168202.35 759848.00 3364.05 50

01/2010-12/2010 25 - 35 3024071.13 18520987.00 8217.58 368

01/2010-12/2010 35 - 45 5094606.70 26566723.00 8937.91 570

01/2010-12/2010 45 - 55 8482613.79 41907361.00 10062.41 843

01/2010-12/2010 55 - 65 3968355.74 14331069.00 8721.66 455

01/2010-12/2010 > 65 1052054.85 488499.00 30942.79 34

01/2010-12/2010 Total 21789904.56 102574487.00 9392.20 2320

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21. Mechanism of injury by costs, incapacity and claims

Description: This report provides Mechanism of Injury information on accepted claims with

a date of injury in the chose period, by Costs, Incapacity and number of claims. Graphs and

charts are provided for each.

Access Level Required: Management level access

Export options: .pdf and .rtf

Benefits: This can be used as a quick summary of the average cost, number of claims, and

incapacity data of each major category or Mechanism of Incident. This information can be

useful to identify priority areas for injury prevention and case management strategies. It

can also be utilised to monitor performance trends over time.

Parameters: This report represents accepted claims with a date of injury in period chosen.

Total Cost: as at date of case estimates, sum of costs til then and likely future cost. This

report can be run for up to 4 periods.

Available charts: When run for a single period, this report provides eight (8) different

graphs and charts, however when run for more than a single period, the pie charts are not

available due to the complexity of the data.

Fields:

Field Description

Period This field displays the date range the report was generated for.

Mechanism Injury Major

Group

Refers to the classification groups within the Type of

occurrence classification system.

Tot. Cost ($) The sum of the cost to date and future cost estimate on the

most recent estimate date

Avg. Tot. Cost ($) The sum of the cost to date and future cost estimate on the

most recent estimate date divided by the number of accepted

claims in the period.

Cost to Date ($) The total of costs incurred on the claim as of yesterday.

Weeks Lost Total number of weeks lost for accepted claims in the period

Avg. Weeks Lost Total number of weeks lost divided by the total number of

accepted claims in the period

No. Accepted Claims The total number of accepted claims in the period.

Example Report: following page

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46

21. Mechanism of Injury by Costs, Incapacity and Claims

A Sample Agency

Period(s): [01/01/2010 - 31/12/2010]

representing accepted claims with a date of injury in period chosen Total Cost: as at date of case estimates, sum of costs til then and likely

future cost.

Guide to Understanding Customer Reports - May 2012

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Period Mechanism Injury Major

Group Tot. Cost($) Avg. Tot. Cost($)

Cost to Date($)

Weeks Lost

Avg. Weeks Lost

No. Accepted

Claims

01/2010-12/2010

Falls, Trips and Slips 21548043.89 51304.87 4105488.59 1801.08 4.29 420

01/2010-12/2010

Hitting Objects with Body 2983593.74 27625.87 519216.38 264.53 2.45 108

01/2010-12/2010

Being Hit by Moving Objects

4821964.12 29950.09 866967.40 335.72 2.09 161

01/2010-12/2010

Sound and Pressure 564970.71 16142.02 188187.45 22.65 0.65 35

01/2010-12/2010

Body Stressing 53610913.34 44124.21 9602286.01 3903.33 3.21 1215

01/2010-12/2010

Heat, Elec + Other Enviro Fact

289459.81 12585.21 35677.81 20.51 0.89 23

01/2010-12/2010

Chemicals and Other Substances

335641.37 10488.79 696799.97 18.81 0.59 32

01/2010-12/2010

Biological Factors 415495.61 27699.71 62930.36 66.83 4.46 15

01/2010-12/2010

Mental Stress 28991027.47 126598.37 4571291.12 2580.11 11.27 229

01/2010-12/2010

Other and Unspecified 4548770.28 55472.81 1141059.47 391.67 4.78 82

01/2010-12/2010

Total 118109880.34 50909.43 21789904.56 9405.24 4.05 2320

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22. Cost centre structure report

Description: This report provides details on the Agency’s cost centre structure and

associated contacts reflected on Comcare’s database system.

Access Level Required: Management level access

Export options: .pdf and .rtf

Benefits: This report will assist customers in identifying cost centres for allocation to

claims and subsequent targeted reporting. It will also assist in maintaining current contact

details.

Parameters: Represents all active cost centres and their relationships.

Fields:

Field Description

Level No. This number denotes which level in the hierarchy the cost centre sits. If you think of the hierarchy like an organisational chart, the cost centres

that have a level number of 1 would be the top level of the structure and then subsequently the cost centres with number 2 would be below.

Parent CC No. This denotes the relationships between the cost centres. The parent cost centre number listed identifies which cost centre is above this one in the structure.

CC No. This is the unique identifier of the cost centre.

CC name 1 The name of the cost centre. Only cost centres that are level 1 cost

centres have their name in this field.

CC name 2 The name of the cost centre. Only cost centres that are level 2 cost

centres have their name in this field.

CC name 3 The name of the cost centre. Only cost centres that are level 3 cost centres have their name in this field.

CC name 4 The name of the cost centre. Only cost centres that are level 4 cost centres have their name in this field.

CC name 5+ The name of the cost centre. Only cost centres that are level 5 cost centres have their name in this field.

CC Short Name The abbreviated name for the cost centre

Cust. Ref The reference supplied by the customer for the individual cost centre

Liable Ind. Can only be 2 values ‘Y’ = the cost centre can be registered as the liable

cost centre on a claim. ‘N’ = The cost centre cannot be used as a liable cost centre.

Payroll Ind. Can only be 2 values ‘Y’ = the cost centre can be registered as the payroll

cost centre on a claim. ‘N’ = The cost centre cannot be used as a payroll cost centre. The payroll cost centre receives various reports on incapacity determinations.

Chq Rec. Ind Can only be 2 values ‘Y’ = the cost centre can be registered as the cheque receiving cost centre on a claim. ‘N’ = The cost centre cannot be used as a cheque receiving cost centre. The cheque receiving cost centre receives

cheques and remittance advice.

Title The title of the contact on the cost centre.

Given Name The given name of the contact on the cost centre.

Surname The surname of the contact on the cost centre.

Phone The phone number of the contact on the cost centre.

Mail address The mail address of the contact on the cost centre.

Example Report: following page

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49

22. Cost Centre Structure

A Sample Agency

This report may best be printed in landscape orientation

Level no

Parent CC no

CC no

CC name 1

CC name 2

CC name 3

CC name 4

CC name 5+

CC short name

Cust ref.

Liable ind

Payroll ind

Chq rec. ind

Title Given name

Surname Phone Mail address

23. Case Manager Details by Customer report

Description: Provides details of all case managers Comcare has listed against a particular

agency.

Access Level Required: Management level access

Export options: .pdf and .rtf

Benefits: This report assists the agency in managing their Comcare Case Managers, and

maintaining currency of their contact details. This is also utilised for Case Manager Audits.

Parameters: This report represents all active case managers for the agency.

Fields:

Field Description

Customer The agency that the case manager represents.

Case Manager No. The unique identifier of the case manager’s profile within

Comcare’s database.

Title The title of the contact on the case manager.

Given Name The given name of the contact on the case manager.

Surname The surname of the contact on the case manager.

Tel. No. The phone number of the contact on the case manager.

Fax. No. The fax number of the contact on the case manager.

Address The mail address of the contact on the case manager.

Example Report:

23. Case manager details by customer

A Sample Agency

Customer Case Mgr No

Title Given name Surname Tel No Fax No Address

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24. CIS user access list

Description: Provides details of all CIS users within an agency.

Access Level Required: CIS administrator level access

Export options: .pdf and .rtf

Benefits: This report assists the agency in managing who has access to the data in CIS.

Parameters: This report represents all active CIS users for the agency.

Fields:

Field Description

Userid The username the user uses to log into CIS. Will always be an email

address.

Surname The surname of the user.

Given Name The given name of the user.

Management Denotes whether the user has access to the reports under the

'management' category in CIS

Case

Management

Denotes whether the user has access to the reports under the 'case

management' category in CIS

Admin Denotes whether the user is authorised to grant other users access and

whether the user can amend other users cost centre restrictions.

Finance Denotes whether the user has access to the reports under the 'finance'

category in CIS

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Section 2 - Case Management Reports

Designed to support an Agency’s Case Management team, this suite of reports provides

more detailed claims information to assist an agency with the ongoing management of their

workers compensation claims. This also allows for enhanced management of claims with

extended periods of incapacity, and those with Return to Work activity (as recorded in

Comcare’s central database).

A number of the reports in this section are larger customer data reports, which can be

generated in .csv (spreadsheet) format, to allow an agency to perform detailed claims

analysis.

Report Content

All reports provide a number of content and presentation options. For example, reports can

usually provide data by:

All (whole of agency)

Cost Centre

Cost Centre View (grouping of cost centres created by Comcare on request)

Reporting Periods

There are a number of reporting period options available for selection:

Financial year

Calender year

Other, as required

The number of periods available for selection varies between each report - some reports will

allow a comparison of 4 periods on the one report, others 1 or 2.

Data currency

The claims information within the Management Reports is updated on a daily basis, with

data as at close of business. This means that on any day, CIS will be reporting with data as

at close of business on the day immediately prior. Information about total costs, including

likely future costs, is updated on a monthly basis.

All reports are available through the Comcare Customer Information System via the

Comcare Website, or can be produced on request as required.

Important notes:

Reports 50, 51, and 52 are of particular relevance for an Agency when monitoring

claims which may have an impact on the Agency’s premium.

Reporting on Reconsideration and Appeal cases is now available

The number of Customer Data Reports has been increased, including the addition of

report 32 - Customisable Data Report. Based on report 66, this will provide an

Agency with greater flexibility in reporting.

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66. Customer Data Report - Claim Detail

Description: This report provides a complete record of all claims for your agency.

Access Level Required: Case Management Detail level access

Export options: .csv

Benefits: Enables you to run your own analysis and reporting to produce tailored reports

to meet your own requirements.

Parameters: This report displays claims related data for all claims that the agency is liable

for.

Fields:

Field Name Description

Surname Employee's surname.

Given Names Employee's first name/s.

Empl No A unique eight digit claim identification number allocated by

Comcare. for each claimant.

Suffix A two digit number identifying the claim sequence number i.e. if the claimant has had two previous claims then these last two digits of the claim number for their third claim would be 03.

Date Resignation/ Termination

Date of effect if employee is no longer a Commonwealth employee

Date of Birth Employee's date of birth.

Gender Employee's gender.

Post code The post code relevant to the claimant’s address.

Date of Injury The date of injury i.e. the specific day on which the claimed injury occurred or a disease was first medically diagnosed.

Comcare Receipt Date The date the claim was received by Comcare.

Liability Status

The current liability status for the injury or disease. This can change throughout the life of the claim - only the current value is

listed

Note Premium calculation includes claims with a Liability Status of

'A' at the time of the data extraction for Likely Future Costs.

The valid values for this field are:

(A)ccepted Liability has been accepted for this claim, e.g. medical claims etc. can be paid.

(D)eleted Claim has been deleted.

(N)on-Compliance Does not meet the requirements of the legislation, e.g. medical certificate missing,

inadequate etc. Claims are received by Comcare (Date of Receipt), then when all legislative requirements for the claim are met the Date of Compliance is set. For most claims, Date of Compliance equals Date of Receipt.

(R)ejected The claim is not accepted as a liability for

Comcare, i.e. injury is not covered by the workers compensation Act.

(U)ndetermined Liability for a claim is yet to be determined by Comcare.

(W)ithdrawn The claimant has withdrawn the claim.

Decision Date Date of most recent liability decision made by Comcare

Claim Status The Open/Closed/Reopened status of the claim.

Status Date The date when the Claim Status field was last changed.

Liable Cust & Liable Cost Ctr Customer and cost centre liable for the injury. Usually the current

employer as at the 'Date of Injury'

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Field Name Description

Payroll Cust & Payroll Cost Ctr This is the Comcare code for the current employer. This may or

may not be the same as the code for the liable employer.

Case Manager Agency contact responsible for rehab on claim

Claim Manager Comcare contact responsible for the management of the claim

First Rehab assessment Date of first Rehab assessment

Month 5th day incap detd Month in which the 5th day of incapacity was determined

Claim Lodged with Employer Date the claim was lodged with the liable employer

Employee sign date Date the employee signed the claim form

Agree with claim Does the employer agree with the claim

Body Location (code & description)

The Body Location Of Injury/Disease classification is intended to identify the part of the body affected by the most serious injury or disease. These codes are based on the Type of Occurrence Classification System (TOOCS).

Nature of Injury (code & description)

The Nature of Injury classification is intended to identify the most serious injury or disease sustained or suffered by the worker.

These codes are based on the TOOCS

Occupation (code & description)

The Occupation classification is intended to identify the occupation of the claimant at the time of the injury. These codes are based on the TOOCS. The codes reported in the CDS are the first two digits

of the six digit TOOCS code recorded by Comcare.

Agency of Accident The Agency of Accident classification is intended to identify the object, substance, or

(code & description) Circumstance that was principally involved in, or most closely

associated with, the point at which things started to go wrong and which ultimately led to the most serious injury or disease. These codes are based on the TOOCS

Mechanism of Incident (code & description)

The Mechanism of Incident classification is intended to identify the action, exposure, or event, which was the direct cause of the most serious injury or disease. These codes are based on the TOOCS

Duty Status The location of the employee in relation to their employment at the

time of injury. Length: 1 character. The valid values for this field are:

A - working at usual workplace;

B - traffic accident whilst working;

C - while working elsewhere;

D - while having a break;

E - while travelling to or from work;

F - while attending approved course of study;

G - during an authorised sporting activity;

H - other;

X - all diseases.

Claim Cust Reference The employer's reference number for this claim.

Payroll code The employer’s internal payroll code for this claim

Total Weeks Incap Paid This is the total incapacity recorded against the claim. This field is

the sum of all periods of incapacity to date. The calculation is

based on standard hours worked and is expressed in decimal weeks.

NWE Normal Weekly Earnings of employee

Total Incap Total Incapacity Cost. This is the total cost of Incapacity payments

received from Comcare from 1/12/88 to date.

Total Medical Total Medical Cost. This is the total cost of Medical payments from 1/12/88 to date.

Total Other This is the total of all payments not specified elsewhere from

1/12/88 to date. This amount includes AAT & legal costs.

Guide to Understanding Customer Reports - May 2012

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Field Name Description

Total Travel Total Travel Cost. This is the total cost of Travel payments from

1/12/88 to date.

Total Rehab Total Rehab Cost. This is the total cost of Rehabilitation payments from 1/12/88 to date excluding any GST amount claimable by Comcare as an Input Tax Credit.

Costs to Date Total Cost. of claim to date. This is the sum of Total Incap, Total Medical, Total Subseq, Total Travel and Total Rehab excluding any GST amount claimable by Comcare as an Input Tax Credit.

Likely Future Costs Actuarial assessment of the possible future costs of the claim for the life of that claim.

AGS No Employee’s AGS number

30. Customer Data Report - claims by cost centre and case manager

Description: This report lists claim detail for all claims attached to a specified case

manager, cost centre or customer structure (Cost Centre grouping).

Access Level Required: Case Management Detail level access

Export options: .csv

Benefits: Containing the same data fields as report 66, this report is a valuable tool for

Case Mangers to review claims assigned to them, without having to export the entire

Customer Data Report. This is of particular benefit for larger agencies for whom the size of

report 66 can be prohibitive.

Parameters: This report displays claims related data for claims that the agency is liable for

and groups these claims by cost centre and case manager.

Fields: See above – Report 66. Customer Data Report – Claim Detail.

31. Customer Data Report - Open Claims

Description: This report lists claim detail for all Open claims (with a status of O - Open

and R - Reopened) for the selected agency.

Access Level Required: Case Management Detail level access

Export options: .csv

Benefits: Containing the same data fields as report 66, this report displays only those

claims with an Open or Reopened status, without having to export the entire Customer Data

Report. This is of particular benefit for larger agencies for which the size of report 66 can

be prohibitive.

Parameters: This report displays claims related data for open claims that the agency is

liable for.

Fields: See above – Report 66. Customer Data Report – Claim Detail.

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32. Customisable Customer Data Report

Description: This report is a customisable version of Report 66, allowing you to select the

fields that you wish to display for all claims for your agency.

Access Level Required: Case Management Detail level access

Export options: .csv

Benefits: Report 66 is one of the most used reports within CIS, although its size can be

prohibitive for larger agencies.

This customisable version of the report allows you to select the columns that you want to

display in the final report, with Employee Number, Given Names, Suffix and Surname being

the only mandatory columns.

You can then filter the report further by Claim Status, Date of Injury, Liability Status, Liable

Cost Centre, and Payroll Cost Centre. For example, you may want to run a report for a

certain number of columns, where the Date of Injury is between 1 June 2010 and 30

September 2011, where the Claim Status is Reopened (R), and the Liability Status is

Accepted (A).

Parameters: The report allows to choose which data is pulled from the claim listing of all of

the claims the agency is liable for.

Fields: User selects fields from the list available in report 66. Customer Data Report –

Claim Detail.

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33. Accepted claims by date

Description: This report provides a listing of all claims accepted within the chosen period.

Access Level Required: Case Management Detail level access

Export options: .csv

Benefits: This report allows the user generate a list of claim that have been accepted in

the specified period.

Parameters: This report represents claims that have been accepted in the specified period.

Fields: This report is based on Report 66 - for a listing of the fields included in this report,

please refer to page 52 of this Guide.

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34. Claims incurring payment

Description: This report provides a list of claims that Comcare has recently processed

payments for.

Access Level Required: Case Management Detail level access

Export options: .csv, .rtf, .pdf

Benefits: This summary listing of invoices paid within a given period allows the user to see

which claims have been active within the time period. It can provide insight for a case

manager on which claims to take particular notice of. Additional information can then be

sought on individual claims through the View Claim function.

Parameters: Claims that have any Comcare determination date on an invoice within the

selected period. A summary of the invoices for each claim appears.

Fields:

Field Description

Claim

Number

The unique number that identifies a claim.

Claimant

Name

The name of the injured employee.

Liable

cost

centre

The reporting group that has been allocated to the claim. Usually this is

the business area or region the employee worked in when they were

injured. Liable cost centres are supplied by the customer and the level of

detail is dependant on the customers reporting needs.

Case Mgr The name of the case manager

Claim Status

The Open/Closed/Reopened status of the claim.

Invoice

Category

The category of the invoice. INC - Incapacity. RHB - Rehabilitation. MED -

Medical. TRA - Travel. SUB - All others.

No. of

Invoices

The number of invoices Comcare has determined.

Invoice

Amt Paid

The sum amount of the invoice category

Invoice

Amt

Recovered

The sum amount recovered by invoice category.

Total The sum of the total of invoice amount paid and invoice amount

recovered.

Example Report:

34. Claims incurring payment

A Sample Agency

Quarter = Oct-2010 to Dec-2010

lists claims incurring payments in period

Claim No Claimant Name

Liable Cost Ctr

Case Mgr Claim Stat

Invoice Category

No of Invoices

Invoice Amt Paid

Invoice Amt Recovered

Total

Guide to Understanding Customer Reports - May 2012

58

36. Open Return to Work Plan

Description: This report allows a customer to identify all of their open return to work plans

by case manager.

Access Level Required: Case Management Detail level access

Export options: .csv, .rtf, .pdf

Benefits: Enables the agency to closely monitor open Return to Work Plans.

Parameters: This report represents all return to work plans that are open.

Fields:

Field Description

Employee

Name

The name of the injured employee.

Claim Number The unique number that identifies a claim.

Case Manager The person within the agency responsible for management of the claim.

RTWP Start

Date

The date that the return to work plan commenced.

RTWP End Date The date that the return to work plan is due to be finalised.

Est. Final Goal The outcome that the return to work plan hopes to achieve.

s37 Cost to

Date

The sum of all Section 37 costs to date.

Cost to date

($)

The total of costs incurred on the claim as of yesterday.

Provider The contracted provider responsible for implementing the return to work

plan.

Example Report:

36. Open return to work plan

A Sample Agency

Employee Name

Claim No

Case manager

RTWP start date

RTWP end date

Est. final goal

S37 cost to date

Cost to Date

Provider

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59

37. Claim activity post return to work

Description: This report looks at all closed Return to Work plans, and provides information

about incapacity and medicals since the closure of the Return to Work plan. Records are

listed in date order.

Access Level Required: Case Management Detail level access

Export options: .csv, .rtf, .pdf

Benefits: A successful Return to Work plan will result in a reduction in incapacity

payments, and eventually a reduction in the need for medical treatments. This report helps

an agency to measure that outcome.

Parameters: This report represents return to work plans that have a closure date within

the period chosen by the user.

Fields:

Field Description

Employee Name The name of the injured employee.

Claim Number The unique number that identifies a claim.

Incap Wks Post RTW

Close

The number of weeks of incapacity that have occurred after the

closure of the return to work plan.

Total Incap Cost The sum of all incapacity costs on the claim.

No. Med payments since

RTW Closure

The number of medical payments determined by Comcare after

the closure of the return to work plan.

Total Medical Cost($) The sum of all medical costs associated with the claim.

Future cost estimate ($) The estimate of future costs on the claim as of the case

estimate date. The future cost estimate is determined by a

complex calculation that takes into account a wide array of

factors.

RTW Closure Date The date that the return to work plan was finalised.

Claim Status The Open/Closed/Reopened status of the claim.

Example Report:

37. Claim activity post RTW

A sample agency

Period(s): [01/01/2010 - 31/12/2010]

representing RTW plans with a closure date in the period chosen

Employee Name

Claim Number

Incap wks

post RTW close

Total incap cost

No. Meds since

RTW closure

Total medical cost

Likely future cost estimate

RTW closure date

Claim status

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60

38. Rehabilitation Expenditure

Description: This report provides the customer with a representation of the amount of

money being expended on rehabilitation in comparison with total costs to date.

Access Level Required: Case Management Detail level access

Export options: .csv, .rtf, .pdf

Benefits: A simple comparison between the total cost of a claim and the amount spent on

rehabilitation.

Parameters: This report represents accepted claims with a date of injury within the period

chosen by the user.

Fields:

Field Description

Section 36 Cost The sum of all costs associated with section 36 on the claim.

Section 37 Cost The sum of all costs associated with section 37 on the claim.

Total Rehab.

Expenditure

The sum of all rehabilitation costs on the claim.

Other Costs to

Date

The sum of all other costs not associated with rehabilitation on the

claim.

Cost to date ($) The total of costs incurred on the claim as of yesterday.

Rehab as % of

Cost to Date

The total percentage that rehabilitation costs make up on the claims

overall expenditure.

Example Report:

38. Rehabilitation expenditure

A Sample Agency

Period(s): [01/01/2010 - 31/12/2010]

representing accepted claims with a date of injury in period chosen

Section 36 cost

Section 37 cost

Total rehab. expenditure

Other costs to date

Cost To Date($)

Rehab as % of cost to date

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61

39. Open/expired return to work plan

Description: This report provides the customer with a listing of all their Return to Work

(RTW)) plans where the plan end date has expired with no recorded lodgement of a RTW

plan amendment or closure form.

Access Level Required: Case Management Detail level access

Export options: .csv, .rtf, .pdf

Benefits: This enables agencies to identify RTW plans that may require extension or

closure.

Parameters: This report represents all return to work plans that have passed their

scheduled end date, but have not had a recorded lodgement to amend the plan or a

lodgement to advise the plan has closed.

Fields:

Field Description

Case Manager The person within the agency responsible for management of the claim.

Provider The contracted provider responsible for implementing the return to work

plan.

Claim Number The unique number that identifies a claim.

RTWP Start

Date

The date that the return to work plan commenced.

RTWP End Date The date that the return to work plan is due to be finalised.

Liable cost

centre

The reporting group that has been allocated to the claim. Usually this is

the business area or region the employee worked in when they were

injured. Liable cost centres are supplied by the customer and the level

of detail is dependant on the customers reporting needs.

Example Report:

39. Open/Expired return to work plan

A Sample Agency

Case

Manager

Provider Claim no Claimant

name

RTWP start

date

RTWP end

date

Liable

Cost

centre

Case,

Manager

Rehab

Profile

888888/01 Surname, F 21/09/2009 28/02/2010 Example

Cost

Centre

Guide to Understanding Customer Reports - May 2012

62

40. RTWP average cost and duration

Description: This report provides the customer with a representation of the average cost

and duration of their closed Return to Work (RTW) programs.

Access Level Required: Case Management Detail level access

Export options: .csv, .rtf, .pdf

Benefits: This report enables agencies to view the average cost and duration of RTW

programs by injury group.

Parameters: This report represents return to work plans that have a registered start date

within the period chosen by the user.

Fields:

Field Description

Period This field displays the date range the report was generated for.

Mechanism Injury

Major Group

The major group used in the Type of Occurrence Classification

System to differentiate how claimants have been injured.

Avg. RTWP cost The average cost of Return To Work Plans with a start date in the

specified period.

Avg. RTWP duration

(days)

The average length of Return To Work Plans with a start date in

the specified period.

Example Report: following page

Guide to Understanding Customer Reports - May 2012

63

40. RTWP average cost and duration

A Sample Agency

Period(s): [01/01/2009 - 31/12/2009]

representing RTW plans with a start date in the period chosen

RTWP average cost and duration

Period Mechanism Injury Major Group Avg. RTWP cost Avg. RTWP duration (days)

Guide to Understanding Customer Reports - May 2012

64

41. Early Intervention

Description: This report details open claims with 5 or more days of incapacity with no

section 37 costs incurred.

Access level required: Case Management Detail level access.

Export options: .csv, .rtf, .pdf

Benefits: The purpose of this report is to highlight claims that have had incapacity but no

record of rehabilitation intervention. This report allows case managers to target claims early

in an effort to reduce overall costs.

Parameters: This report represents open claims that have had 5 or more days of incapacity

but have not yet recorded any s37 costs.

Fields:

Field Description

Date of Injury The date that claimants injury occurred.

Employee Name The name of the injured employee.

Claim Number The unique number that identifies a claim.

Incapacity Weeks The total number of incapacity weeks accrued as of yesterday.

Total Cost The sum of the future cost estimate and costs to date on the day

the estimate is made.

Liable cost centre The reporting group that has been allocated to the claim. Usually

this is the business area or region the employee worked in when

they were injured. Liable cost centres are supplied by the customer

and the level of detail is dependant on the customers reporting

needs.

Case Manager The person within the agency responsible for management of the

claim.

Last Incap Date The last date that the employee was off work due to incapacity.

Cost to date ($) The total of costs incurred on the claim as of yesterday.

Future cost estimate

($)

The estimate of future costs on the claim as of the case estimate

date. The future cost estimate is determined by a complex

calculation that takes into account a wide array of factors.

MOI Major Group The major group used in the Type of Occurance Clasification

System to deferentiate how claimants have been injured.

Claim Status The Open/Closed/Reopened status of the claim.

Example Report: following page

Guide to Understanding Customer Reports - May 2012

65

41. Early intervention

A Sample Agency

representing open claims with >= 5 days incap and no S37 cost incurred Total Cost: as at date of case estimates, sum of costs til then and likely

future cost. This report may be best printed in landscape orientation

Injury date Employee

name

Claim number Incapacity

weeks

Total cost($) Cost centre

22/03/1988 Surname,

Firstname

888888/02 993.20 268751.38 273

13/06/2008 Surname,

Firstname

777777/02 2.00 35936.14 463

08/01/1988 Surname,

Firstname

666666/01 1094.34 563179.53 273

Continued from above…

Case

manager

Last incap date Cost to

date($)

Future cost

estimate($)

MOI Major Group Claim

status

Manager, Case 29/11/2006 231954.22 39285.00 Other and Unspecified O

Manager, Case 18/07/2008 15567.86 22318.00 Body Stressing R

Manager, Case 11/01/2009 481431.39 82727.00 Other and Unspecified O

Guide to Understanding Customer Reports - May 2012

66

42. Provider Performance

Description: This report details Return to Work plan goals and outcomes by Provider.

Access level required: Case Management Detail level access.

Export options: .csv, .rtf, .pdf

Benefits: The purpose of this report is to highlight the performance of rehabilitation

providers being utilised by an agency.

Parameters: This report represents return to work plans that have been closed but have a

start date within the period chosen by the user.

Fields:

Field Description

Provider The contracted provider responsible for implementing the return to work

plan.

Employee Name The name of the injured employee.

Claim Number The unique number that identifies a claim.

RTWP Start Date The date that the return to work plan commenced.

RTWP End Date The date that the return to work plan is due to be finalised.

RTWP Duration The length of the return to work plan. From the start date to end date.

Section 37 Cost The sum of all costs associated with section 37 on the claim.

RTW Goal The outcome that the return to work plan hopes to achieve.

Example Report:

42. Provider performance

A Sample Agency

Period(s): [01/01/2010 - 31/12/2010]

representing closed RTW plans with a start date in the period chosen

Provider Employee name

Claim no RTWP start date

RTWP end date

RTWP duration

Section 37 cost

RTW goal

Guide to Understanding Customer Reports - May 2012

67

43. Claims with multiple RTW plans

Description: A listing of all open claims with more than 1 Return to Work plan.

Access level required: Case Management Detail level access.

Export options: .csv, .rtf, .pdf

Benefits: The report assists agencies in evaluating the effectiveness of their Return to

Work plan activity and policies.

Parameters: This report represents claims that have more than one return to work plan

registered against it.

Fields:

Field Description

Employee Name The name of the injured employee.

Claim Number The unique number that identifies a claim.

Liable cost centre The reporting group that has been allocated to the claim. Usually

this is the business area or region the employee worked in when

they were injured. Liable cost centres are supplied by the customer

and the level of detail is dependant on the customers reporting

needs.

Date of Injury The date that claimants injury occurred.

Provider The contracted provider responsible for implementing the return to

work plan.

RTW Start Date The date that the return to work plan commenced.

RTW End Date The date that the return to work plan is due to be finalised.

Cost to date ($) The total of costs incurred on the claim as of yesterday.

Future cost estimate

($)

The estimate of future costs on the claim as of the case estimate

date. The future cost estimate is determined by a complex

calculation that takes into account a wide array of factors.

Case Manager The person within the agency responsible for management of the

claim.

Example Report:

43. Claims with multiple RTW plans

A Sample Agency

representing open claims with more than one RTW plan This report may be best printed in landscape orientation

Employee name

Claim number

Cost centre

Injury date

Provider name

Provider status

RTW start date

RTW end date

Cost to date

Case estimate

Case manager

Guide to Understanding Customer Reports - May 2012

68

44. Customer Data Report - Return to Work

Description: A complete record of all claims with a Return to Work plan for your agency.

Access level required: Case Management Detail level access.

Export options: .csv, .rtf, .pdf

Benefits: This report enables you to run your own analysis and reporting to produce

tailored reports to suit your requirements.

Parameters: This report is a data dump of all return to work records for the selected

agency.

Fields:

Field Name Description

Surname Employee's surname.

Given Names Employee's first name.

Empl No A unique eight digit claim identification number allocated by Comcare Australia. for each claimant.

Suffix A two digit number identifying the claim sequence number i.e. if the

claimant has had two previous claims then these last two digits of the claim number for their third claim would be 03.

Date of Birth Employee's date of birth.

Gender Employee's gender.

Date of Injury The date of injury i.e. the specific day on which the claimed injury occurred or a disease was first medically diagnosed.

Liable Customer Employer at date of injury.

Plan Id This code is assigned by Comcare to uniquely identify a RTWP. The first plan for a claim is always “A” and subsequent plans are assigned alphabetically.

Rehab Assessment Date

The date the plan was assessed by the Service Provider.

Plan Start Work Status The working status of the employee at the time of RTWP creation. The

valid values for this field are: W - Wage and Salary earner C - Ceased M - Modified duties R - Reduced hours B - Both Modified duties and reduced hours N - No Change

X - Off work E - Employers and self-employed O - Other

Plan Start Date RTWP start date as specified on the RTWP Form

Date Plan Signed The day the plan was signed by the case manager and employee.

Comcare Receipt Date The date the RTWP form is received in Comcare.

Plan End Date RTWP end date as specified on the RTWP Form

Plan Current Status Indicates current status of Comcare's agreement to the RTWP. The valid values for this field are: A - Acknowledge D - Deleted I - Ignore N- Non-compliant

R - Review W - Waiting

Guide to Understanding Customer Reports - May 2012

69

Field Name Description

X - Closed at migration

Z - Rehab not required

Plan Closure Date The date the Closure Report is signed by the Case Manager.

Plan Closure Reason Code identifying the reason for closure of the RTWP. The valid values for this field are: A - Deceased B - Back at Work C - Rehab Authority (usually employer) cessation of program

D - Deferred E - Employee withdrew from program or declined work I - “R” and “N” status has not been changed to “A” so ignore P - Provider Cessation of Involvement R - Redundancy T - Totally and permanently incapacitated for work U - Partial incapacity - unable to place in suitable employment

V - Voluntary retirement X - Closed at migration 19 May 1993

Z - Rehab not required

Expected RTW Date The date the injured employee is expected to return to work in any capacity ie. full time or reduced hours.

Actual RTW Date The date on which the employee commenced employment, as reported on the Closure Report, following a Rehabilitation Program. This date is also for those employees who, while on a rehabilitation program, commence on a Graduated Return To Work.

Plan Estimated Cost The total estimated cost of the return to work plan as detailed at Part 2 of the RTWP form.

Plan Actual Cost RTWP costs to date

Receipt Claim form in

Comcare

Receipt date of original claim form in Comcare

Guide to Understanding Customer Reports - May 2012

70

45. Open Claims by Cost Centre by Mechanism of Incident

Description: This report provides details for claims with a date of injury in the specified

period, sorted by liable cost centre and then mechanism of injury.

Access Level Required: Case Management Detail Level Access

Export Options: .csv, .rtf, .pdf

Benefits: As this report only lists OPEN or REOPENED claims it allows managers to focus on

the currently active claims which have the potential to impact most significantly on agency

premium programs. The weeks lost field is a useful indicator of the likely long term cost of a

claim and can alert managers of the need to develop return to work strategies for the

injured employee.

Parameters: This report represents accepted claims with a date of injury within the period

chosen by the user.

Fields:

Field Description

Liable cost

centre

The reporting group that has been allocated to the claim. Usually this is

the business area or region the employee worked in when they were

injured. Liable cost centres are supplied by the customer and the level

of detail is dependant on the customers reporting needs.

MOI Major

Group

Refers to the classification groups within the Type of occurrence

classification system.

Employee

Name

The name of the injured employee.

Claim Number The unique number that identifies a claim.

Injury Date The date that claimants injury occurred.

Cost to date

($)

The total of costs incurred on the claim as of yesterday.

Future cost

estimate ($)

The estimate of future costs on the claim as of the case estimate date.

The future cost estimate is determined by a complex calculation that

takes into account a wide array of factors.

Incapacity

Weeks

The total number of incapacity weeks accrued as of yesterday.

Example Report:

45. Open Claims by Cost Centre by Mechanism of Incident

*A Sample Agency

Period(s): [01/07/2010 - 30/06/2011]

representing accepted claims with a date of injury in period chosen This report may be best printed in landscape orientation

Liable Cost Centre

MOI Major Group Employee Name Claim Number

Injury Date Cost to Date

Likely Future Cost

Weeks Lost

Claim Status

2 Body Stressing Surname, F 99999/1 09/11/2010 704.00 2675.00 0.00 Open

3 Being Hit by Moving Objects

Surname, F 88888/1 25/12/2010 1637.56 5434.00 0.00 Open

Total 2341.56 8109.00 0.00

Guide to Understanding Customer Reports - May 2012

71

46. Claim Details by Nature of Injury/Disease

Description: This report lists claims details by the eleven major TOOCS categories of

Nature of Injury, which is intended to identify the most serious injury or disease

sustained/suffered.

Access Level Required: Case Management Detail Level Access

Export Options: .csv, .rtf, .pdf

Benefits: This report can be used to view detailed claim information, including cost and

incapacity information, but most importantly identifies the type of injury/disease for each

claim occurring within the period specified by the user.

Parameters: This report represents accepted claims within the period chosen by the user.

Fields:

Field Description

Nature of Injury The type of injury sustained by the claimant

Claim Number The unique number that identifies a claim.

Employee Name The name of the injured employee.

Sex The gender of the claimant.

Liable cost centre

No.

The number identifying the cost centre

Liable cost centre The reporting group that has been allocated to the claim. Usually

this is the business area or region the employee worked in when

they were injured. Liable cost centres are supplied by the customer

and the level of detail is dependant on the customers reporting

needs.

Injury Date The date that claimants injury occurred.

Incapacity Weeks The total number of incapacity weeks accrued as of yesterday.

Cost to date ($) The total of costs incurred on the claim as of yesterday.

Future cost

estimate ($)

The estimate of future costs on the claim as of the case estimate

date. The future cost estimate is determined by a complex

calculation that takes into account a wide array of factors.

Total Cost ($) The sum of the cost to date and future cost estimate on the most

recent estimate date

Example Report:

46. Claim Details by Nature of Injury/Disease

*A Sample Agency

Period(s): [01/01/2010 - 31/12/2010]

representing accepted claims with a date of injury in period chosen Total Cost: as at date of case estimates, sum of costs til then and likely future cost. This report may be best printed in landscape orientation

Nature Of Injury

Claim No.

Employee Name

Sex Liable Cost Centre No.

Liable Cost Centre

Injury Date Incapacity Weeks

Cost to Date

Future Cost Estimate

Total Cost

Trauma To Muscles

9999/02 Surname, Firstname

F 1 Central Office

29/04/2010 0.00 866.25 1432.00 2298.25

Total 0.00 866.25 1432.00 2298.25

Guide to Understanding Customer Reports - May 2012

72

47. Claim Details by Agency Of Injury/Disease

Description: Lists the claim details by the nine major TOOCS categories of Agency of

Injury, which is intended to identify the object, substance or circumstance that was

principally involved in or mostly closely associated with inflicting the injury or disease.

Access Level Required: Case Management Detail Level Access

Export Options: .csv, .rtf, .pdf

Benefits: The principal benefit of this report is that allows the user to determine what has

caused injuries to claimants with accepted claims within the specified date range.

Parameters: This report represents accepted claims within the period chosen by the user.

Fields:

Field Description

Agency of Injury The type of injury sustained by the claimant

Claim Number The unique number that identifies a claim.

Employee Name The name of the injured employee.

Sex The gender of the claimant.

Liable cost centre No. The number identifying the cost centre

Liable cost centre The reporting group that has been allocated to the claim.

Usually this is the business area or region the employee

worked in when they were injured. Liable cost centres are

supplied by the customer and the level of detail is dependant

on the customers reporting needs.

Injury Date The date that claimants injury occurred.

Incapacity Weeks The total number of incapacity weeks accrued as of yesterday.

Cost to date ($) The total of costs incurred on the claim as of yesterday.

Future cost estimate ($) The estimate of future costs on the claim as of the case

estimate date. The future cost estimate is determined by a

complex calculation that takes into account a wide array of

factors.

Total Cost ($) The sum of the cost to date and future cost estimate on the

most recent estimate date

Example Report:

47. Claim Details by Agency of Injury/Disease

Aboriginal Hostels Ltd

Period(s): [01/07/2010 - 30/06/2011]

representing accepted claims with a date of injury in period chosen Total Cost: as at date of case estimates, sum of costs til then and likely

future cost. This report may be best printed in landscape orientation

Agency of Injury

Claim No. Employee Name

Sex Liable Cost Centre No.

Liable Cost Centre

Injury Date Incapacity Weeks

Cost to Date

Likely Future Cost

Total Cost

Kitchen Food Preparation Appliances

111111/01 Surname, Firstname

M 3 Victoria 25/12/2010 0.00 1637.56 5434.00 5434.00

Total 0.00 1637.56 5434.00 5434.00

Guide to Understanding Customer Reports - May 2012

73

48. Claims with Reconsiderations

Description: This report provides details of claims that have a reconsideration requested

within the chosen period.

Access Level Required: Case Management Detail Level Access

Export Options: .csv, .rtf, .pdf

Benefits: This is a new report added to the suite of reports to allow agency users to

monitor pending reconsiderations.

Parameters: This report represents claims that have a reconsideration requested within

the specified period.

Fields:

Field Description

Employee Name The name of the injured employee.

Claim Number The unique number that identifies a claim.

Claim Status The Open/Closed/Reopened status of the claim.

Date of Injury The date that claimants injury occurred.

Recon Received

Date

The date Comcare received the request to reconsider the claim.

Recon Decision

Date

The date Comcare determined the outcome of the reconsideration

request.

Issue The end result of the reconsideration process.

Outcome Displays whether the original decision has been affirmed or not.

Recon Officer Name of the assigned Comcare Reconsideration Officer.

Example Report:

48. Claims with Reconsiderations

*A Sample Agency

Period(s): [01/01/2010 - 31/12/2010]

representing claims that have had a reconsideration decision within the specified period.

Employee Name

Claim No Claim Status

Date of Injury

Recon Received Date

Status Recon Decision Date

Issue Outcome Recon Officer

Surname, Firstname

1111111/01 O 02/07/2007 31/03/2010 Completed 18/05/2010 Denied Benefits - other

medical

Affirm Firstname Lastname

Surname, Firstname

2222222/10 O 30/04/2009 24/06/2010 Completed 09/09/2010 Accept benefits - pharmacy

Vary favourably

Guide to Understanding Customer Reports - May 2012

74

49. Claims with AAT Case Decision

Description: This report provides the details of claims that have had AAT referrals within

the chosen period.

Access Level Required: Case Management Detail Level Access

Export Options: .csv, .rtf, .pdf

Benefits: This is a new report that allows agencies to track pending AAT claim disputes.

Parameters: This report represents claims that have filed an AAT appeal within the

specified period.

Fields:

Field Description

Employee Name The name of the injured employee.

Claim Number The unique number that identifies a claim.

AAT Notice Date The date the AAT was notified of the dispute.

S29 Received Date The date the initiator filed the dispute.

Status Current status of the appeal

Recon Decision

Date

The date Comcare determined the outcome of the reconsideration

request.

Initiator The party who filed the dispute.

Decision The end result of the AAT process.

Decision Date The date of the decision.

Instructing Officer Name of the assigned Comcare Instructing Officer

Example Report:

49. Claims with AAT case decisions

*A Sample Agency

Period(s): [01/01/2010 - 31/12/2010]

representing claims that have filed an AAT appeal within the specified period

Employee Name

Claim No AAT Notice Date

S29 Received Date

Status Recon Decision Date

Initiator Decision Decision Date

Instructing Officer

Surname, Firstname

1111111/01 29/07/2010 05/07/2010 Completed 08/09/2010 Claimant Conceded 08/09/2010 Firstname Lastname

Surname, Firstname

2222222/02 23/04/2010 24/03/2010 Completed 01/10/2010 Claimant Set Aside 01/10/2010 Firstname Lastname

Guide to Understanding Customer Reports - May 2012

75

50. Top 50 Claims by Cost to Date

Description: This report provides a listing of claim details for the top 50 high cost claims to

date with a date of injury in the specified period.

Access Level Required: Case Management Detail Level Access

Export Options: .csv, .rtf, .pdf

Benefits: This report can be used as a way of identifying priority claims for review. This

allows agencies and case managers in particular, to focus on the key claims and maximise

their case management strategies.

Parameters: This report represents the top 50 (by cost to date) accepted claims with a

date of injury within the specified period.

Fields:

Field Description

Mechanism of Injury

Major Group

Refers to the classification groups within the Type of occurrence

classification system.

Cost to date ($) The total of costs incurred on the claim as of yesterday.

Claim Number The unique number that identifies a claim.

Date of Injury The date that claimants injury occurred.

Employee Name The name of the injured employee.

Liable cost centre The number of the liable cost centre where the employee was

injured. This can be cross referenced with report 22. Liable cost

centres are supplied by the customer and the level of detail is

dependant on the customers reporting needs.

Incapacity Weeks The total number of incapacity weeks accrued as of yesterday.

Claim Status The Open/Closed/Reopened status of the claim.

Example Report:

50. Top 50 claims by cost to date

*A Sample Agency

Period(s): [01/01/2010 - 31/12/2010]

representing accepted claims with a date of injury in period chosen

Mechanism Injury Major Group

Cost To Date($)

Claim Number

Date of Injury Employee Name

Liable Cost Centre No.

Incapacity Weeks

Claim Status

Falls, Trips and Slips

78183.56 111111/1 05/05/2010 Surname, Firstname

66 27.67 Open

Falls, Trips and Slips

61465.09 666666/6 14/05/2010 Surname, Firstname

142 39.36 Open

Falls, Trips and Slips

42501.07 888888/4 09/06/2010 Surname, Firstname

12 24.40 Reopened

Guide to Understanding Customer Reports - May 2012

76

51. Claims with a Date of Injury within the Last Four Years

Description: This report is a statement of accepted claims with a date of injury in the last

four experience years.

Access Level Required: Case Management Detail Level Access

Export Options: .rtf, .pdf

Benefits: This report helps inform agencies of the costs of their employees' claims so that

they can initiate appropriate action to contain those costs. As it is sorted by liable cost

centre it can also be used by managers to identify injury levels and trends in particular

workplaces.

Parameters: The report represents accepted claims with a date of injury within the last

four calendar years.

Fields:

Field Description

Liable cost centre

No.

The number of the liable cost centre where the employee was

injured. This can be cross referenced with report 22. Liable cost

centres are supplied by the customer and the level of detail is

dependant on the customers reporting needs.

Employee Name The name of the injured employee.

Claim Number The unique number that identifies a claim.

Date of Injury The date that claimants injury occurred.

NWE Stands for 'Normal Weekly Earnings'. This is the amount the

claimant would normally earn in a week.

Incap Cost Refers to the total amount of incapacity

Cost to date ($) The total of costs incurred on the claim as of yesterday.

Incap Status The current incapacity status of the claim: A-At work(claim open), I-

Incapacitated, G-Graduated return to work or partial incapacity, D-

Deceased, C-At work claim closed, E-Error code treated as

incapacity, F-Error code treated as at work.

Incap Transpired The number of calendar days lapsed, including week-ends, since the

date the claimant's incapacity status last changed.

Incapacity Weeks The total number of incapacity weeks accrued as of yesterday.

Incap Duration The number of calendar days on benefit due to incapacity excluding

the current spell.

Example Report:

51. Claims influencing future premiums

*A Sample Agency

Period(s): [01/07/2010 - 30/06/2011]

This report may be best printed in landscape orientation

Liable Cost Ctr

Employee Name

Claim No Claim Stat

Date of Injury NWE Incap Cost

Cost to date

Incap Status

Incap Transpired

Incap Duration

2 Surname, Firstname

22222/02 O 21/08/2009 1427.46 26819.15 43586.04 I 51 300

Guide to Understanding Customer Reports - May 2012

77

52. High Cost Claims

Description: This report provides a listing of open/active claims which have an estimated

total liability of over $10K. The claims are identified in broad total liability categories and

are listed in descending order of total liability.

Access Level Required: Case Management Detail Level Access

Export Options: .csv, rtf, pdf

Benefits: Focuses on high cost claims which impact significantly on premiums, so that

appropriate action to contain these costs can be initiated.

Parameters: This report represents open claims that have an estimated liability over

$10,000.

Fields:

Field Description

Case Mgr Name The name of the employee within the claimants agency looking after

the claim.

CTD + FCE ($) Stands for Cost to Date + Future Cost Estimate. Distinct from 'Total

Costs' because it includes incurred up to yesterday in addition to the

estimate formulated on the case estimate date.

Employee Name The name of the injured employee.

Claim Number The unique number that identifies a claim.

Date of Injury The date that claimants injury occurred.

Mechanism of

Injury Major Group

Refers to the classification groups within the Type Of Occurrence

Classification System.

Liable cost centre

No.

The number of the liable cost centre where the employee was

injured. This can be cross referenced with report 22. Liable cost

centres are supplied by the customer and the level of detail is

dependant on the customers reporting needs.

RTWP Status This indicates the current Return to Work Plan Status of the claim.

The valid values for this field are: O = There is currently an open

RTWP for this claim. C = There is a closed RTWP for this claim. N =

There is no RTWP registered for this claim

Medical CTD($) This is the total cost to date of Medical payments made on this

claim.

Incap CTD($) This is the total cost to date of Incapacity payments made on this

claim.

Rehab CTD($) This is the total cost to date of Rehabilitation payments made on this

claim.

Travel CTD($) This is the total cost to date of Travel payments made on this claim.

Other CTD($) This is the total cost to date of all other payments not already

defined on this claim.

Total CTD($) The total costs of all payments made on this claim.

Guide to Understanding Customer Reports - May 2012

78

Notes: These high cost claims are those most likely to have a significant impact on

premiums. The report re-directs attention to the Return to Work Plan (RTWP) status for

each claim. Where the status is C (closed) or N (no RTWP registered for claim) agencies

may consider developing a RTWP in an endeavour to reduce further incapacity and resultant

costs.

The report includes claims data relating to an agencies current employees. In some cases

liability for specific claims may rest with a former or other employer. It also includes pre-

premium claims.

Example Report:

52. High Cost Claims

*A Sample Agency

Estimated future costs valid as at date of case estimates update This report may be best printed in landscape orientation

Case Mgr Name CTD + FCE($)

Employee Name

Claim No Date of Injury

Mechanism Injury Major Group

Liable Cost Centre No.

CaseManager, A 1321748 Surname, F 111111/01 28/06/2005 Other and Unspecified

1

CaseManager, A 1585415 Surname, F 222222/01 08/10/1995 Being Hit by Moving Objects

85

Continued from above…

RTWP Status

Medical CTD($) Incap CTD($) Rehab CTD($) Travel CTD($)

Other CTD($) Total CTD($)

C 34113.10 409825.63 7799.00 2529.25 0.00 454266.98

C 316919.11 423270.21 45888.49 1821.50 63813.64 851712.95

Guide to Understanding Customer Reports - May 2012

79

Section 3 - Financial Reports

Designed to support an Agency’s payroll and financial management team, this suite of

reports provides detailed remittance advice and a listing of incapacity determinations to

assist an agency with the ongoing management of their workers compensation claims.

Some of the reports in this section are larger data reports, which can be generated in .csv

(spreadsheet) format, to allow an agency to perform detailed claims analysis.

Report Content

All reports provide a number of content and presentation options. For example, reports can

usually provide data by:

All (whole of agency)

Cost Centre

Reporting Periods

There are a number of reporting period options available for selection:

Financial year

Calender year

Other, as required

The number of periods available for selection varies between each report - some reports will

allow a comparison of 4 periods on the one report, others 1 or 2.

Data currency

The claims information within the Management Reports is updated on a daily basis, with

data as at close of business. This means that on any day, CIS will be reporting with data as

at close of business on the day immediately prior.

All reports are available through the Comcare Customer Information System via the

Comcare Website, or can be produced on request as required.

Important notes:

Report 70 has been amended to include withdrawn incapacities to give the agency the

entire view of determinations.

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70. Incapacity Determinations

Description: This report is a statement of incapacity determinations made within a chosen

period, allowing both individual daily reports as well as cumulative fortnightly reports. The

report can be run for individual cost centres as well as for all cost centres within the agency.

Access Level Required: Finance Level Access

Export Options: .csv

Benefits: This report allows agencies to view new incapacity determinations, and changes

to existing determinations. The report is especially useful for viewing incapacity

determinations applicable to the current pay period, and aligns with the paper incapacity

report. Finance areas can utilise this report to reconcile employees pay and expected

reimbursements from Comcare.

Parameters: This report represents incapacity determinations made by Comcare within the

specified period, and can be run for a maximum of twelve months.

Fields:

Field Description

Cost Ctr No Payroll Cost Centre for the Employee

Name Name of the Payroll Cost Centre

Claim No Employee number and claim suffix against which the incapacity

was paid

Employee Name Name of the Employee with incapacity

Cust Ref The payroll cost centre customer reference

Payroll Code The employee's payroll code for the given claim, if entered on

the claim

Incap Det No Comcare's unique number assigned for the incapacity

determination

Lost Wks-HH:MM The number of incapacity weeks, hours and minutes, lost as a

consequence of the incapacity

Incap Status The status of the incapacity determination:

A An incapacity accepted for payment

D An unpaid incapacity that was deleted

R An unpaid incapacity that was rejected

U An incapacity was entered but not accepted

(undetermined). For instance, the claim may still be

undetermined.

V A paid incapacity was voided

Weekly Rate The weekly rate utilised for the incapacity liability calculation,

specific to a determination

Start Date Date on which the incapacity determination commenced

Start Time Time at which the incapacity determination commenced,

relevant to the Start Date

End Date Date on which the incapacity determination ended.

End Time Time at which the incapacity determination ended, relevant to

the End Date.

Liability The liable amount determined for the period of incapacity

Actual Earnings Total amount earned in the period, not including incapacity

Actual Worked HH:MM Actual total hours worked in the period

Section Section of the SRC Act incapacity determined under

Std Wkly HH:MM Normal working hours

Current Total Incap

Durn

Total amount of incapacity determined so far on the claim,

expressed in weeks.

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71. Payment Remittance Detail Report by Date

Description: This report gives details of reimbursements made in a specified date range.

Access Level Required: Finance Level Access

Export Options: .csv

Benefits: This report allows the user to define a date period and then view all of the

remittance advices relating to that period, which in turn allows for reconciliation of

incapacity reimbursements.

Parameters: This report represents all payments made to the agency within the specified

date range.

Fields:

Field Description

Payee Name Name of the payee (agency)

Payee No Comcare’s payee number (agency/cheque receiving cost centre

numbers)

Account paid For EFT payments this is BSB/Account number.

Chq/EFT no Payment reference. A leading C indicates a cheque; E indicates an EFT

payment.

Payment date Date the payment was issued

Payment total Total (nett) payment amount

Payroll Cost

Centre

Employee’s payroll cost centre

Cust Reference Customer reference for payroll cost centre (if any)

Name Name of payroll cost centre

Employee

Name

Name of employee reimbursed for incapacity

Claim no Employee’s claim number

State Employee’s state

Injury Date Date of injury for Employee’s claim

AGS/Payroll

No.

Employee’s AGS or payroll number

Comcare

Invoice no

Comcare’s invoice reference

Start date Incapacity determination starting date

End date Incapacity determination end date

Item Amount Amount paid or recovered (negative if recovery.)

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72. Payment Remittance Detail Report by Payment Number

Description: This report gives details of incapacity payments made within a specified date

range, by payment number.

Access Level Required: Finance Level Access

Export Options: .csv

Benefits: This report allows the user to enter a specific Payment Number and then view the

remittance advice relating to that number.

Parameters: This report represents payments to the agency that correspond with the

entered Payment Number.

Fields:

Field Description

Payee Name Name of the payee (agency)

Payee No Comcare’s payee number (agency/cheque receiving cost centre

numbers)

Account paid For EFT payments this is BSB/Account number.

Chq/EFT no Payment reference. A leading C indicates a cheque; E indicates an EFT

payment.

Payment date Date the payment was issued

Payment total Total (nett) payment amount

Payroll Cost

Centre

Employee’s payroll cost centre

Cust Reference Customer reference for payroll cost centre (if any)

Name Name of payroll cost centre

Employee

Name

Name of employee reimbursed for incapacity

Claim no Employee’s claim number

State Employee’s state

Injury Date Date of injury for Employee’s claim

AGS/Payroll

No.

Employee’s AGS or payroll number

Comcare

Invoice no

Comcare’s invoice reference

Start date Incapacity determination starting date

End date Incapacity determination end date

Item Amount Amount paid or recovered (negative if recovery.)

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73. Payment Remittance Summary Report

Description: This report provides a summary of payments made within a specified date

range.

Access Level Required: Finance Level Access

Export Options: .csv, .rtf, .pdf

Benefits: This report allows a summary view of the payments Comcare has made to an

agency.

Parameters: This report represents total amounts for cheque and EFT payments made by

Comcare to the agency within the specified period.

Fields:

Field Description

Payee Name Name of the Payee (agency)

Payee No Comcare’s payee number (agency number & cheque receiving cost

centre)

Account paid For EFT payments, this is the BSB and Account number.

Chq/EFT no Payment reference. A leading C indicates a cheque; E indicates an EFT

payment.

Payment date Date the payment was issued

Payment total (Nett) payment amount

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74. Claims approaching 45 weeks incapacity

Description: This report provides a list of claims for an agency that are approaching 45

weeks of incapacity.

Access Level Required: Case Management Detail level access

Export options: .csv, .rtf, .pdf

Benefits: The claims listed within this report will have between 35 and 55 weeks of

incapacity determined. This will assist case managers with the identification and

management of claims approaching and just passing 45 weeks of incapacity.

Parameters: This report represents claims that have had between 35 and 55 weeks of

incapacity determined.

Fields:

Field Description

Payroll Cost Centre No. The unique number that identifies the payroll cost centre where

the claim is currently registered.

Payroll cost centre name Name of the reporting group that has been allocated to the

claim. This is the business area or region the employee is

currently aligned with. Payroll cost centres are supplied by the

customer and the level of detail is dependant on the customers

reporting needs.

Claim Number The unique number that identifies a claim.

Employee Name The name of the injured employee.

Incapacity Weeks The total number of incapacity weeks accrued as of yesterday.

Example Report:

74. Claims approaching 45 weeks incapacity

A Sample Agency

lists claims approaching 45 wks incap

Payroll Cost

Centre No

Payroll Cost Centre Name Claim No Employee Name Incapacity

Wks

7 Sample Cost Centre C 09999999/04 Sample Employee A 54.95

1 Sample Cost Centre A 07777777/01 Sample Employee E 49.55

13 Sample Cost Centre B 08888888/01 Sample Employee B 44.69

13 Sample Cost Centre B 08889999/01 Sample Employee C 36.36

1 Sample Cost Centre A 09999988/01 Sample Employee D 36.14

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Section 4 – Using the CIS

The CIS is a widely used tool throughout Comcare’s jurisdiction. This section of the guide is

to provide basic first line assistance to new or inexperienced users in the fundamentals of

the system. The CIS provides 4 functions to approved users.

The ability to generate a report.

The ability to view individual claim details.

The ability for CIS agency administrators to manage cost centre restrictions.

And; the ability for users to manage their preferences such as, secret question

and answers, passwords, and favourite reports.

Generating a report

Generating a report in CIS is a streamlined process.

Step 1

Select ‘Generate Report’ from the initial CIS home screen and then click on ‘Execute’.

Step 2

Follow the prompts on the screen to generate a report:

1. Choose the group that you would like to report on (it will turn a shade of blue once

selected).

2. Choose the report category and then the report you would like to run (each selection is

confirmed by the text turning a shade of blue).

3. Once a report is selected the report generation toolbar at the top will provide you with

all the options you need to run a report. Including:

i. Filter: After clicking on this button a pop up screen will appear with a number of

caveats that you can restrict the report by.

ii. Previous Filters: Clicking on this button will apply the filters that you last used to

run a report. It will apply the filters as best as possible as some reports display

wildly different information, this option may not be applicable across all reports.

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iii. Generate: Clicking on this button will create the report and make it visible in the

web browser. For some reports this option may not be available because some

reports cannot be created within the browser and must be immediately exported

to .CSV (excel format). In that instance only the ‘Export’ button will be available.

iv. Export: The export button allows you to create the report in a number of formats,

including PDF, CSV, and RTF. (The formats that are available for each report are

dependant on their content – not all reports can be generated in CSV for

example).

v. Add to Favourites: Clicking this button will add the report to the favourite’s

category in ‘Step 2 – Choose Report’. This is beneficial if the user runs the same

reports on a regular basis.

4. Your report will appear in the main window or be exported into your chosen format.

1. Select your

group.

2. Select the report you want to run.

3. Choose the filters you would like to apply to the

report or simply hit generate/export to run the report. See above for a description of each button.

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Viewing a claim

Viewing a claim is an easy way case managers can get detailed information pertaining to

specific claims, including Comcare contact information, claim costs and estimates and a

complete listing of incapacity determinations for the claim.

Step 1

Select ‘View Claim’ from the initial CIS home screen and then click on ‘Execute’.

Step 2

Search for the claim you would like to view.

1. You can search by claim number or by the claimant’s name.

2. Once the name or claim number is entered select ‘Search’ at the bottom.

3. The search results will appear in blank middle section of the screen. Select the claim

you require - it will turn a shade of blue when selected.

4. Click ‘Next’ to access the detail of the claim.

1. Search by claim number or name.

2. Click

‘Search’ to find the claim

3. A listing of claims will

appear here after searching. Select the claim you

require.

4. After selecting the claim click next.

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Step 3

The view claim screen provides details on claim registration and condition, the employee,

the agency that is liable for the employee’s injuries, financial information and incapacity

determinations. For privacy reasons there is no detail that can be shown in this guide.

Note: printing a list of incapacity determinations

The View Claim function has been updated to allow for the export of the list of incapacity

determinations for the claim being viewed. To export and print the list of incapacity

determinations:

- Select the Incapacity tab on the View Claim Screen

- Use the Export button on the right hand side of the screen (it appears next to the

date field “reached 45 weeks”)

- On the Export window that pops up, choose the format that you would like to

export the list into (.csv, .pdf, and .rtf are all available).

- Use the Export button on the pop-up window - just like generating a report, this

will produce the data in a stand-alone document.

The information available in view claim can be viewed through these 5 tabs.

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Cost Centre Restrictions

The ‘manage cost centre access’ section of CIS allows CIS administrators who administer

agencies that have chosen to restrict user access by cost centre the ability to control the

access of users within their agency.

Step 1

Select ‘Manage Cost Centre Access’ from the initial CIS home screen and then click on

‘Execute’.

Step 2

Select your agency from the list - it is likely there will only be one selection available. Once

selected the agency name will turn a shade of blue.

The CIS agency administrator can then choose to administer access by 2 ways. Through

Manage User – Which allows the administrator to select a user and assign cost centres to

them. OR Manage Cost Centre – Which allows the administrator to select a cost centre and

assign particular users to it.

1 - Select the agency. 2 - Then select either ‘Manage

User’ OR ‘Manage Cost Centre’.

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Preferences

The preferences screen is where the user can reset their password, create their own secret

question and answers for automatic password resets, and manage their favourite reports.

Step 1

The preferences screen can be accessed from any screen within the CIS application. It is

always a link in the top left hand corner near help.

Step 2

There are 3 tabs that are accessible through preferences - ‘Password’, ‘Security Questions’

and ‘Favourite Reports’. The password screen allows the user to reset their current

password.

Password Tab – To change your password type the password you used to log into CIS into

the ‘Current Password’ field. Then enter a new password that is at least 8 characters long

and containing at least 4 alpha characters and 2 numerical characters into the ‘new

password’ and ‘confirm password’ fields. Click ‘Save’ to save the password OR click ‘Clear’ to

start again. The ‘OK’ button will take you back to CIS.

Preferences can always be accessed through this

link.

Preferences has 3 tabs. 1 – Password. 2 - Security Questions. 3 – Favourite Reports.

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Security Questions Tab – The ‘Security Question’ tab allows the user to create 3 secret

questions that can be asked if the user forgets their password. By answering a secret

question the user can automate the password reset which will send the user a new

password via without having to contact the CIS helpdesk.

Favourite Reports Tab – The ‘Favourite Reports’ tab allows the user to manage which

reports appear in the report category ‘Favourites’. This is particularly useful if a user logs on

periodically to run the same reports, for example for a monthly report to management. To

create a listing of your favourite reports:

Step 1 – Select the report you wish to ‘Favourite’ from the ‘Available’ list of reports.

Step 2 – Click on the ‘Add’ button. The report should now appear in the ‘Current’

window.

Step 3 – Click ‘Save’ to save your reports or clear to start again.

Step 1 – Select the report you would to make a favourite from the available field.

Step 2 – Click ‘Add’ and the report will move to the ‘Current’ side

Step 3 – Click ‘Save’ and the changes will be saved.

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Section 5 – CIS Glossary of Terms

A detailed listing of each field within reports can be found under the help material for each

individual report. Below is listing of common terminology used within Comcare and as such

within CIS.

Term Definition

Agency of Injury Classification intended to identify the object, substance, or

circumstance that was principally involved in, or most closely

associated with, the point at which things started to go wrong and

which ultimately led to the most serious injury or disease.

Body Location Classification intended to identify the part of the body affected by

the most serious injury or disease.

Calendar Year January to December.

Case Manager Workplace-based manager appointed and trained by the employer

to undertake Case Management activities. Responsible for

initiating, co-ordinating and monitoring the rehabilitation process.

Cheque Receiving Cost

Centre

The cost centre to which Comcare sends the incapacity

reimbursement cheques.

CIS Customer Information System

Claims Manager Comcare employee responsible for management of the claim.

Closed Claims Claims can either be closed manually, or automatically by Pracsys

when they meet specific criteria (i.e. no activity for a specified

period of time).

Common Law Payments Amounts paid to an injured worker as a result of Third Party or

Common Law action.

Cost to Date Payments made to date (payments as at the date of extraction

minus recoveries) on claims excluding any GST amount claimable

by Comcare as an Input Tax Credit. Unpaid liabilities against a

claim (eg outstanding incapacity payments) will not be included in

cost to date.

Determination A decision accepting or rejecting a claim made by Comcare

Australia in accordance with specific sections of the SRC Act.

Financial Year July to June.

Incapacity Incapacity is:

An inability to engage in any work.

An inability to work at the same level as undertaken immediately

before the injury.

Incapacity benefit Incapacity benefit is a payment made by Comcare Australia,

directly or indirectly, by way of income maintenance.

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Term Definition

Incapacity Status The current incapacity status of the claim as recorded on

PRACSYS:

A At work (claim open)

I Incapacitated

G GRTW (graduated return to work) or partial incapacity

D Deceased

C At Work (claim closed)

D Error code, treated as incapacity

F Error code, treated as at work

Incapacity Duration The number of calendar days on benefit due to incapacity

excluding the current spell.

Incapacity Spells The number of separate periods on benefit due to incapacity.

Periods which occur one day or less are not counted.

Liable Cost Centre This is the Cost Centre which has accepted liability for a claim ie.

the claimant was attached to this cost centre at the date of injury.

Mechanism of Incident

(MOI)

Classification to identify the action, exposure, or event which was

the direct cause of the most serious injury or disease.

Nature of Injury Classification to identify the most serious injury or disease

sustained or suffered by the injured worker.

Non-Incapacity Includes medical, rehabilitation, lump sum and travel costs.

Open Claims Currently active claims

Payroll Cost Centre The daily incapacity advices are generally sent to the Personnel

sections in agencies. These are called Payroll Cost Centers and

each claim needs to have one of these recorded against it.

PRACSYS Comcare’s workers' compensation data warehouse for registering

and processing claims, records benefit payment and OHS

notification/reporting statistics, and provides management

information reports.

Premium The premium charged by Comcare is the contribution of an

agency in respect of the estimated costs of that agency's workers'

compensation costs for a given financial year. It is based on fully

funded principles and is designed to be responsive to the agency's

claims experience.

Pre-Premium Claims Claims with dates of injury prior to the introduction of Comcare’s

premium system on 1 July 1989. These claims and the resulting

expenditure may also be called 'uninsured'.

Rehabilitation A program offered to injured employees to assist them to return

to their pre-injury employment status, or as close as possible to

that status. Rehabilitation is only one aspect of Comcare’s return

to work program for injured employees.

Re-Opened Claims Claims that have been closed and re-activated.

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Term Definition

Return to Work Plan A document detailing an injured employee’s rehabilitation

program including return to work objectives, time frames and a

breakdown of proposed services and costs.

TOOCS Codes Type of Occurrence Classification System v 3 (NOHSC, NDS

Codes)

Total Cost Claim Cost to date plus the likely future cost as at the date of the

latest case estimate update.

View (Pracsys) Cost Centre grouping specified by your agency and set up by

Comcare (i.e regional or state structure).

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