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WORKERS' COMPENSATION AND REHABILITATION REGULATION 2014 NO. 189
TABLE OF PROVISIONS
Contents
Part 1--Preliminary
1. Short title
2. Commencement
3. Definitions
4. WorkCover's capital adequacy—Act, s 453(b)
Part 2--Employer insurance
Division 1--Policies and premium assessments
5. Application for policy
6. Policies and renewals
7. Assessment of premium
8. Declaration of wages
9. Value of board and lodging
10. Payment of premium by instalments
11. Additional premium for late payment of premium—Act, ss 61 and 62
12. Premium for appeals—Act, s 569(2)(a)
13. Former employer may apply to cancel policy
14. Cancellation of policy if workers no longer employed
Division 2--Employer excess
15. Excess period—Act, s 65(2)
Division 3--Self-insurance
16. Application fees—Act, s 70(c)
17. Annual levy—Act, s 81(2)
18. Provisional annual levy—not agreed or decided
19. Adjusted annual levy—agreed
20. Adjusted annual levy—not agreed but decided
21. Additional amount for late payment of levy—Act, s 82(1)
22. Conditions of licence—Act, s 83
23. Premium payable after cancellation of self-insurer's licence—Act, s 98
24. Deemed levy for appeals—Act, s 569(2)(a)
Part 3--Calculation of self-insurer's liability
Division 1--Outstanding liability
Subdivision 1--Preliminary
25. Calculation of outstanding liability—Act, s 87(2)
Subdivision 2--Actuarial calculations and reports
26. Appointment of actuary
27. Regulator to give actuary information
28. Actuarial calculation
29. Actuarial report
30. Summary report
31. Agreement on amount
32. Reference to arbiter if no agreement on amount
33. Payment of amount
34. Transfer of claims information
Division 2--Total liability
Subdivision 1--Preliminary
35. Calculation of total liability after change in self-insurer's membership—Act s 90(9)
Subdivision 2--Actuarial calculations and reports
36. Appointment of actuary
37. Relevant parties to give actuaries information
38. Actuarial calculation
39. Actuarial report
40. Summary report
41. Agreement on amount
42. Reference to arbiter if no agreement on amount
43. Payment of amount
44. Transfer of claims information
Division 3--Liability after cancellation of self-insurer's licence
Subdivision 1--Preliminary
45. Calculation of liability after cancellation—Act, s 102(3)
Subdivision 2--Actuarial calculations and reports
46. Appointment of actuary
47. Former self-insurer to give actuaries information
48. Actuarial calculation
49. Actuarial report
50. Summary report
51. Agreement on amount
52. Reference to arbiter if no agreement on amount
53. Payment of amount
Division 4--Estimated claims liability
Subdivision 1--Preliminary
54. Calculation of estimated claims liability—Act, s 84(3)(b)
Subdivision 2--Actuarial calculations and reports
55. Approved actuary
56. Self-insurer to give Regulator and approved actuary information
57. Actuarial calculation
58. Actuarial report
59. Copy of actuarial report to Regulator and self-insurer
60. Regulator to advise self-insurer whether agreement on amount
61. Reference to Regulator's actuary if no agreement on amount
62. Agreement on amount
63. Reference to arbiter
Division 5--Self-insurers who become non-scheme employers
Subdivision 1--Preliminary
64. Calculation of non-scheme employer's liability—Act, s 105I(2)
Subdivision 2--Actuarial calculations and reports
65. Appointment of actuary
66. Non-scheme employer to give actuaries information
67. Actuarial calculation
68. Actuarial report
69. Summary report
70. Agreement on amount
71. Reference to arbiter if no agreement on amount
72. Payment of amount
Subdivision 3--Calculation—finalised non-scheme employer's liability
73. Calculation of finalised non-scheme employer's liability amount—Act, s 105I(2)
74. Appointment of actuary
75. WorkCover to give actuaries information
76. Actuarial calculation
77. Actuarial report
78. Summary report
79. Agreement on amount
80. Reference to arbiter if no agreement on amount
81. Payment of amount
Division 6--Total liability—member of a group who becomes non-scheme employer
Subdivision 1--Preliminary
82. Calculation of non-scheme members' total liability—Act, s 105O(3)(a)
Subdivision 2--Actuarial calculations and reports
83. Appointment of actuary
84. Parties to give actuaries information
85. Actuarial calculation
86. Actuarial report
87. Summary report
88. Agreement on amount
89. Reference to arbiter if no agreement on amount
90. Payment of amount
91. Transfer of claims information
Division 7--Actuarial arbiter
92. Function of actuarial arbiter
93. Selection and appointment of actuarial arbiter
94. Arbiter must decide amount
95. Arbiter's decision is final
96. Arbiter's costs
Part 4--Compensation
Division 1--Calculation of NWE
97. Calculation of NWE—Act, s 106(3)
98. What amounts may be taken into account
99. NWE if impracticable to calculate rate of worker's remuneration
100. NWE if worker worked for 2 or more employers
101. NWE if insurer considers calculation unfair
Division 2--Compensation application and other procedures
102. Application for compensation to include evidence or particulars—Act, s 132(3)(b)
103. If dentist, doctor or nurse practitioner not available
104. Certificate given by dentist, doctor or nurse practitioner
105. Application for compensation for assessment of DPI—Act, s 132A(3)(c)(ii)
106. Request for examination of claimant or worker—Act, ss 135 and 510
Division 3--Entitlement to compensation for permanent impairment
107. Additional lump sum compensation—workers with latent onset injuries that are terminal—Act, s 128B(2)(c)
108. Calculating lump sum compensation—Act, s 180(1)
109. Additional lump sum compensation for certain workers—Act, s 192(2)
110. Additional lump sum compensation for gratuitous care (occupational therapist's assessment)—Act, ss 193(4) and 224(3)
111. Additional lump sum compensation for gratuitous care (occupational therapist's report)—Act, ss 193(5)(b) and 224(4)(b)
112. Additional lump sum compensation for gratuitous care—Act, s 193(6)
Division 4--Liability for Caring allowance
113. Payment of caring allowance—Act, s 225(a)
Part 5--Rehabilitation
Division 1--Rehabilitation and return to work coordinators
114. Functions of rehabilitation and return to work coordinator—Act, s 41(b)
115. Criteria for employer to appoint rehabilitation and return to work coordinator—Act, s 226(1)
Division 2--Guidelines for standard for rehabilitation
116. Standard for rehabilitation—Act, s 228(2)
117. Availability of guidelines
Part 6--Damages
Division 1--Particulars in notice of claim
118. Notice of claim for damages—Act, s 275
119. Particulars of claimant and worker
120. Particulars of event
121. Injury particulars
122. Particulars of hospital, treatment and rehabilitation
123. Particulars if claim for diminished income earning capacity
124. Particulars if injury causes death
125. Particulars of mitigation
Division 2--General provisions
126. Time for adding another person as contributor—Act, s 278A(1)
127. Contribution notice to contain particular information—Act, s 278B(1)(a)
Part 7--Assessment of damages
128. Prescribed amount of damages for loss of consortium or loss of servitium—Act, s 306M
129. Rules for assessing injury scale value—Act, s 306O(1)(c)(i)
130. General damages calculation provisions—Act, s 306P(2)
131. Prescribed amount of award for future loss—Act, s 306R(2)
Part 8--Costs
Division 1--Proceeding before industrial magistrate or industrial commission
132. Costs—proceeding before industrial magistrate or industrial commission
133. Payment of additional amount for costs
Division 2--Claim for damages
134. Who this division applies to
135. Costs before proceeding started
136. Costs after proceeding started
137. Outlays
Part 9--Medical assessment tribunals
138. Medical assessment tribunals—Act, s 492
139. Constitution of General Medical Assessment Tribunal
140. Chairperson and deputy chairperson of General Medical Assessment Tribunal
141. Constitution of a specialty medical tribunal
142. Chairperson and deputy chairperson of a specialty medical tribunal
143. Constitution of Composite Medical Tribunal
144. Chairperson and deputy chairperson of Composite Medical Tribunal
Part 10--Miscellaneous
145. Declaration of designated courts—Act, s 114(4), definition designated court
146. Declaration of provisions—Act, s 322(2), definition a State's legislation about damages for a work related injury
147. Documents and particulars to be kept—Act, s 532D(1) and (2)
148. Reasons for decisions must address certain matters—Act, ss 540(4) and 546(3AA)
SCHEDULE 1 -- ADDITIONAL PREMIUM
SCHEDULE 2 -- GRADUATED SCALE FOR ADDITIONAL COMPENSATION FOR WORKERS WITH TERMINAL LATENT ONSET INJURIES
1. Graduated scale
2. How to use the graduated scale
SCHEDULE 3 -- GRADUATED SCALE OF ADDITIONAL COMPENSATION FOR CERTAIN WORKERS
1. Graduated scale
2. How to use the graduated scale
SCHEDULE 4 -- GRADUATED SCALE FOR ADDITIONAL COMPENSATION FOR GRATUITOUS CARE
1. Graduated scale
2. How to use the graduated scale
SCHEDULE 5 -- GRADUATED SCALE OF CARE REQUIRED FOR PAYMENT OF CARING ALLOWANCE
1. Graduated scale
2. How to use the graduated scale
SCHEDULE 6 -- LEGAL PROFESSIONAL COSTS
SCHEDULE 7 -- DESIGNATED COURTS AND PROVISIONS THAT ARE A STATE'S LEGISLATION ABOUT DAMAGES FOR WORK RELATED INJURY
SCHEDULE 8 -- MATTERS TO WHICH COURT IS TO HAVE REGARD IN THE APPLICATION OF SCH 9
Part 1--Objectives of sch 9 (Ranges of injury scale values)
1. Objectives of sch 9
Part 2--How to use sch 9
Division 1--Injury
2. Injury mentioned in sch 9
3. Multiple injuries
4. Multiple injuries and maximum dominant ISV inadequate
5. Adverse psychological reaction
6. Mental disorder
7. Aggravation of pre-existing condition
Division 2--Other matters
8. Court must have regard to particular provisions of sch 9
9. Court may have regard to other matters
10. DPI
11. Medical report stating DPI
12. Greater weight to assessments based on AMA 5
13. Greater weight to assessments of PIRS rating
14. ISV must be a whole number
SCHEDULE 9 -- RANGES OF INJURY SCALE VALUES
Part 1--Central nervous system and head injuries
1. Quadriplegia
2. Paraplegia
3. Hemiplegia or severe paralysis of more than 1 limb
4. Monoplegia
5. Extreme brain injury
6. Serious brain injury
7. Moderate brain injury
8. Minor brain injury
9. Minor head injury, other than an injury mentioned in pt 3
Part 2--Mental disorders
10. Extreme mental disorder
11. Serious mental disorder
12. Moderate mental disorder
13. Minor mental disorder
Part 3--Facial injuries
Division 1--Skeletal injuries of the facial area
14. Extreme facial injury
15. Serious facial injury
16. Moderate facial injury
17. Minor facial injury
18. Injury to teeth or gums
Division 2--Scarring to the face
19. Extreme facial scarring
20. Serious facial scarring
21. Moderate facial scarring
22. Minor facial scarring
Part 4--Injuries affecting the senses
Division 1--General comment
Division 2--Injuries affecting the eyes
23. Total sight and hearing impairment
24. Total sight impairment
25. Complete sight impairment in 1 eye with reduced vision in the other eye
26. Complete sight impairment in 1 eye or total loss of 1 eye
27. Serious eye injury
28. Moderate eye injury
29. Minor eye injury
Division 3--Injuries affecting the ears
30. Extreme ear injury
31. Serious ear injury
32. Moderate ear injury
33. Minor ear injury
Division 4--Impairment of taste or smell
34. Total loss of taste or smell, or both
35. Partial loss of taste or smell, or both
Part 5--Injuries to internal organs
Division 1--Chest injuries
36. Extreme chest injury
37. Serious chest injury
38. Moderate chest injury
39. Minor chest injury
Division 2--Lung injuries other than asthma
40. Extreme lung injury
41. Serious lung injury
42. Moderate lung injury
43. Minor lung injury
Division 3--Asthma
44. Extreme asthma
45. Severe asthma
46. Moderate asthma
47. Minor asthma
Division 4--Injuries to male reproductive system
48. Impotence and sterility
49. Loss of part or all of penis
50. Loss of both testicles
51. Loss of 1 testicle
Division 5--Injuries to female reproductive system
52. Infertility
53. Any other injury to the female reproductive system
Division 6--Injuries to digestive system
Subdivision 1--Injuries caused by trauma
54. Extreme injury to the digestive system caused by trauma
55. Serious injury to the digestive system caused by trauma
56. Moderate injury to the digestive system caused by trauma
57. Minor injury to the digestive system caused by trauma
Subdivision 2--Injuries not caused by trauma
58. Extreme injury to the digestive system not caused by trauma
59. Serious injury to the digestive system not caused by trauma
60. Moderate injury to the digestive system not caused by trauma
61. Minor injury to the digestive system not caused by trauma
Division 7--Kidney or ureter injuries
62. Extreme injury to kidneys or ureters
63. Serious injury to kidneys or ureters
64. Moderate injury to kidneys or ureters
65. Minor injury to kidneys or ureters
Division 8--Liver, gall bladder or biliary tract injuries
66. Extreme injury to liver, gall bladder or biliary tract
67. Serious injury to liver, gall bladder or biliary tract
68. Moderate injury to liver, gall bladder or biliary tract
69. Minor injury to liver, gall bladder or biliary tract
Division 9--Bowel injuries
70. Extreme bowel injury
71. Serious bowel injury
72. Moderate bowel injury
73. Minor bowel injury
Division 10--Bladder, prostate or urethra injuries
74. Extreme bladder, prostate or urethra injury
75. Serious bladder, prostate or urethra injury
76. Moderate bladder, prostate or urethra injury
77. Minor bladder, prostate or urethra injury
Division 11--Pancreas and spleen injuries
78. Injury to the pancreas
79. Loss of spleen (complicated)
80. Injury to the spleen or uncomplicated loss of spleen
Division 12--Hernia injuries
81. Severe hernia
82. Moderate hernia
83. Minor hernia
Part 6--Orthopaedic injuries
Division 1--Cervical spine injuries
84. Extreme cervical spine injury
85. Serious cervical spine injury
86. Moderate cervical spine injury— fracture, disc prolapse or nerve root compression or damage
87. Moderate cervical spine injury—soft tissue injury
88. Minor cervical spine injury
Division 2--Thoracic or lumbar spine injuries
89. Extreme thoracic or lumbar spine injury
90. Serious thoracic or lumbar spine injury
91. Moderate thoracic or lumbar spine injury— fracture, disc prolapse or nerve root compression or damage
92. Moderate thoracic or lumbar spine injury—soft tissue injury
93. Minor thoracic or lumbar spine injury
Division 3--Shoulder injuries
94. Extreme shoulder injury
95. Serious shoulder injury
96. Moderate shoulder injury
97. Minor shoulder injury
Division 4--Amputation of upper limbs
98. Loss of both upper limbs, or loss of 1 arm and extreme injury to the other arm
99. Loss of 1 upper limb
Division 5--Elbow injuries
100. Extreme elbow injury
101. Serious elbow injury
102. Moderate elbow injury
103. Minor elbow injury
Division 6--Wrist injuries
104. Extreme wrist injury
105. Serious wrist injury
106. Moderate wrist injury
107. Minor wrist injury
Division 7--Hand injuries
108. Total or effective loss of both hands
109. Serious injury to both hands
110. Total or effective loss of 1 hand
111. Amputation of the thumb or part of the thumb
112. Amputation of index, middle and ring fingers, or any 2 of them
113. Amputation of individual fingers
114. Amputation of thumb and all fingers
115. Any other injury to 1 or more of the fingers or the thumb
116. Extreme hand injury
117. Serious hand injury
118. Moderate hand injury
119. Minor hand injury
Division 8--Upper limb injuries, other than injuries mentioned in divisions 3 to 7
120. Extreme upper limb injury, other than an injury mentioned in divisions 3 to 7
121. Serious upper limb injury, other than an injury mentioned in divisions 3 to 7
122. Moderate upper limb injury, other than an injury mentioned in divisions 3 to 7
123. Minor upper limb injury, other than an injury mentioned in divisions 3 to 7
Division 9--Pelvis or hip injuries
124. Extreme pelvis or hip injury
125. Serious pelvis or hip injury
126. Moderate pelvis or hip injury
127. Minor pelvis or hip injury
Division 10--Amputation of lower limbs
Subdivision 1--Amputation of both lower limbs
128. Loss of both lower limbs above or through the knee
129. Below the knee amputation of both lower limbs
Subdivision 2--Amputation of 1 lower limb
130. Above or through the knee amputation of 1 lower limb
131. Below the knee amputation of 1 lower limb
Division 11--Lower limb injuries, other than injuries mentioned in division 9 or 10 or divisions 12 to 15
132. Extreme lower limb injury, other than an injury mentioned in division 9 or 10 or divisions 12 to 15
133. Serious lower limb injury, other than an injury mentioned in division 9 or 10 or divisions 12 to 15
134. Moderate lower limb injury, other than an injury mentioned in division 9 or 10 or divisions 12 to 15
135. Minor lower limb injury, other than an injury mentioned in division 9 or 10 or divisions 12 to 15
Division 12--Knee injuries
136. Extreme knee injury
137. Serious knee injury
138. Moderate knee injury
139. Minor knee injury
Division 13--Ankle injuries
140. Extreme ankle injury
141. Serious ankle injury
142. Moderate ankle injury
143. Minor ankle injury
Division 14--Foot injuries
Subdivision 1--Amputations
144. Amputation of both feet
145. Amputation of 1 foot
Subdivision 2--Other foot injuries
146. Extreme foot injury that is not an amputation
147. Serious foot injury
148. Moderate foot injury
149. Minor foot injury
Division 15--Toe injuries
150. Extreme toe injury
151. Serious toe injury
152. Moderate toe injury
153. Minor toe injury
Division 16--Limb disorders
Part 7--Scarring to parts of the body other than the face
154. Scarring to a part of the body other than the face
Part 8--Burn injuries
Part 9--Injuries affecting hair
155. Extreme injury affecting head hair
156. Serious injury affecting head hair
157. Moderate injury affecting head hair or loss of body hair
Part 10--Dermatitis
158. Extreme dermatitis
159. Serious dermatitis
160. Moderate dermatitis
161. Minor dermatitis
SCHEDULE 10 -- MATTERS RELEVANT TO PIRS ASSESSMENT BY MEDICAL EXPERT
Part 1--Explanation of the PIRS
1. PIRS rates permanent impairment caused by mental disorder
2. Areas of functional impairment
Part 2--Assessment of PIRS rating
3. Medical expert must comply with requirements
4. How to assess a PIRS rating
5. Assessment if pre-existing mental disorder
6. How to work out a median class score
7. Conversion table
8. Example worksheet
Part 3--Particular cases
9. Refusal of treatment
10. Cognitive impairment
11. Pre-existing mental disorder
Part 4--Report of PIRS rating
12. Court to be given PIRS report
SCHEDULE 11 -- PSYCHIATRIC IMPAIRMENT RATING SCALE
SCHEDULE 12 -- GENERAL DAMAGES CALCULATION PROVISIONS
1. General damages calculation provision—1 July 2010 to 30 June 2011
2. General damages calculation provision—1 July 2011 to 30 June 2012
3. General damages calculation provision—1 July 2012 to 30 June 2013
4. General damages calculation provision—1 July 2013 to 30 June 2014
5. General damages calculation provision—1 July 2014
SCHEDULE 13 -- DICTIONARY
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