| 17 April 2019Tips and Tricks for Young Players

2019 BALLINA SEMINAR

TIPS AND TRICKS FOR YOUNG PLAYERS

Fiona Seaton

Principal Lawyer, ILARS

17 April 2019

| 17 April 2019Tips and Tricks for Young Players

Revised ILARS Funding Policy | Counsel

▸Pre-approval no longer required to brief Counsel when ILARS-funded matter listed for con/arb

▸Counsel must be an ALSP

▸Provide WIRO with information about the listing;

- date ARD registered

- Form 1 or Form 2

- teleconference date

- date of con/arb

- name of barrister

- usually no more than 2 matters per day

| 17 April 2019Tips and Tricks for Young Players

▸A statement with all the necessary information is vital in a workers compensation claim

▸Don’t assume any answers – ask the obvious questions

▸Ask as many questions as you can

Importance of Statements

| 17 April 2019Tips and Tricks for Young Players

▸A basic statement is the best form of information to ground a grant of funding

▸Not required to be signed

▸Information can be provided within the body of the application form

Statement for an ILARS Application

| 17 April 2019Tips and Tricks for Young Players

▸Identification information; full name, DOB, current address

▸Name of employer at time of injury

▸Date of injury

▸Mechanism of injury

▸Any information that assists in understanding the nature and purpose of funding grant requested

What Should a Basic Statement Cover?

| 17 April 2019Tips and Tricks for Young Players

▸ My name is Amelia Jones

▸ My date of birth is 19 September 1985

▸ My address is 1 Happy Drive, Padstow NSW 2211

▸ I am employed as a full time diesel mechanic.

▸ My employer is ABC Pty Ltd.

▸ On 23 January 2019 I was carrying out my usual work duties at ABC Pty Ltd’s premises at 10 Banks Street Padstow when I tripped over a truck part.

▸ The fall caused me to hurt my right leg and I have not been able to walk or stand on that leg ever since.

▸ I saw my GP, Dr Catt, the same day I injured myself and she told me that I will not be able to work for at least 6 weeks.

▸ I have not received any payments of workers compensation since the injury and I do not understand my rights.

Statement example

| 17 April 2019Tips and Tricks for Young Players

▸Keep in mind requirements of the Workers Compensation Commission when you begin taking a statement, usually no oral evidence

▸WCC Rules 2011 – Rule 10.3 Material to be lodged in proceedings – a signed written statement of the evidence to be given by the worker

▸WCC Practice Direction No 3 - Information, documents and other evidence –13. Form of statements - should include work history, circumstances of injury, medical treatment and summary of ongoing effects

Tips for New Players

| 17 April 2019Tips and Tricks for Young Players

▸Psychiatric impairment rating scale (PIRS); NSW workers compensation guidelines for the evaluation of permanent impairment 4th edition

▸6 Tables - Self-care and personal hygiene, social and recreational activities, travel, social functioning, concentration, persistence and pace, employability

▸Ballas v Department of Education (State of NSW) [2019] NSWSC 234 –categories general, generic and overlapping, discretion of AMS based on history taken and clinical examination

▸Statement with detailed chronology and history critical

Psychological Injury Statements

| 17 April 2019Tips and Tricks for Young Players

▸One claim for s66 after 19 June 2012

▸Only one assessment of permanent impairment after 19 June 2012

▸When is the best time?

Whose Claim is it Anyway?

| 17 April 2019Tips and Tricks for Young Players

▸section 39 - after 260 weeks you must have 20% WPI to continue to receive weekly payments

▸section 59A - 0 – 10% WPI medicals for 2 years post weekly payments, 10% - 20% WPI medicals for 5 years, over 20%WPI medicals for life

▸section 60AA –15% WPI to access domestic assistance long term

▸WID claims require 15% WPI

▸Each threshold occurs at different milestones in the life of a claim

▸All the above has to be accommodated in one assessment

Important Considerations Affecting the Timing of the section 66 Claim

| 17 April 2019Tips and Tricks for Young Players

▸Centrelink payback

▸Centrelink and the preclusion period affecting the worker’s entitlement to future benefits

▸The threshold for future benefits eg Centrelink qualification requirements

▸Medicare and the quantum of any payback

▸What effect will any of the terms of settlement have on private health insurance

▸Will the settlement effect benefits received under an income protection policy

▸Rights arising from TPD, superannuation and life insurance policies

Important Considerations Affecting Resolution

| 17 April 2019Tips and Tricks for Young Players

Insurers are required to give notice of the following decisions from 1 January 2019;

- Dispute of liability

- Discontinuance or reduction of weekly compensation

▸What happens in other circumstances?

▸Not all work capacity decisions are contained within a section 78 notice

▸What if your client disagrees?

WCD and section 78 of the WIM Act 1998

| 17 April 2019Tips and Tricks for Young Players

Notice of a decision involving both a liability dispute and a discontinuation or reduction of weekly compensation may be combined into a single notice

• Is it a liability dispute or a WCD or both?

• What notice provisions apply?

• What if two notices are issued?

Notice and section 78 of the WIM Act 1998

| 17 April 2019Tips and Tricks for Young Players

Insurer must not discontinue or reduce payments of weekly payments to a worker unless the required period of notice has expired

• Work Capacity Decision – 3 months

• Liability Decision - payments < 1 year – 2 weeks

- payments > 1 year – 6 weeks

• What if the notice period hasn’t expired?

Section 80 of the WIM Act 1998

| 17 April 2019Tips and Tricks for Young Players

Notice provisions apply if the worker has received payments for a continuous period of at least 12 weeks

• What meaning is given to “continuous”?

• What if the worker has had periods on and off work?

Section 80(2) of the WIM Act 1998

| 17 April 2019Tips and Tricks for Young Players

Referral to the WCC of a WCD dispute to discontinue or reduce payments operates to stay the decision

• Prevents the taking of action by an insurer

• Does not apply to an internal review under s287A

• Must be referred before expiry of notice period

• What does this mean for you?

Section 289B of the WIM Act 1998

| 17 April 2019Tips and Tricks for Young Players

Worker may request an internal review

▸ Insurer must conduct review and notify within 14 days

▸May be made at any time before the referral to the WCC

▸No stay applies to internal reviews

▸What does this mean for you?

Section 287A of the WIM Act 1998

| 17 April 2019Tips and Tricks for Young PlayersTIPS AND TRICKS FOR

YOUNG PLAYERS

17 April 20192019 BALLINA SEMINAR

Principal Lawyer, ILARS

fiona.seaton@wiro.nsw.gov.au

Fiona Seaton