How do I ask my insurer/scheme agent to review a decision about liability?
Top If an insurer/scheme agent decides to deny liability for all or part of your claim or reduce weekly payments they must send you a letter that advises of their decision. The letter is required to set out, amongst other things:
- the decision (e.g. decline liability or reduce benefits)
- identify all matters in the decision
- state the reasons for the decision and issues relevant to the decision
- attach all documents relevant to the decision
- the procedure for requesting a review of the decision, with a standard review form attached.
If you want the insurer to review the decision you will need to complete that form and send it back to the Insurer.
The insurer is required to respond back to you in writing within 14 days of receiving the request for a review. The insurer will either decide to accept the claim or maintain their decision and issue a reviewed notice, with any additional information relevant to this decision.
Make sure that in completing the form you raise with the insurer all of the relevant issues you would like them to reconsider including any additional information that you think the insurer should consider.
If you lodge an Application for Dispute Resolution at the Workers Compensation Commission you will only be permitted to include information that has been considered by the insurer and listed in the insurer’s notice.
If the Insurer has sent you a review notice after requesting the optional review, and you are still wishing to dispute that decision you should use the review notice and the original notice to lodge your application with the Workers Compensation Commission.
Download a copy of the standard review form or contact the Claims Assistance Service on 13 10 50 for further assistance.
How do I claim workers compensation for injuries suffered whilst travelling to/from work?
Top Workers compensation benefits are available for injuries suffered in the course of most journeys to and from the place of employment or any other place you are required to attend for work-related reasons.
You can lodge a claim with your employer's insurer in the usual way and they will decide if compensation is payable.
Further information is available under journey and work break claims.
How do I find a trainer or assessor?
Top See the training and assessment area of our website for information on finding a trainer or assessor.
How do I find out what to do if my employer can't provide suitable duties?
Top As the worker, you should contact the insurer and tell them your employer cannot offer suitable work. A weekly benefit will be paid to you while you are actively seeking work or undergoing approved rehabilitation training.
The insurer should tell you what you are expected to do.
You must:
- take reasonable steps to find suitable work with some other employer and if you find suitable work you must accept it or your workers compensation benefits will be stopped
- be willing to accept work that is within your abilities and circumstances, or
- undertake rehabilitation and/or retraining needed to improve your chances of getting suitable work.
How do I know if personal protective equipment (PPE) is adequate?
Top Designers, manufacturers or suppliers of PPE can give advice on the specifications and appropriate use of their products.
This is important because, for example, no one type of glove provides adequate protection against all chemicals. A respirator designed to be effective against medium air levels of a chemical may not be effective against high levels of the same chemical (or low levels of another chemical).
It may also be helpful to consult relevant Australian Standards.
How do I know if we need an OHS committee or OHS representative?
Top Under the OHS Act 2000 all employers have a duty to consult with their workers. Chapter 3 of the OHS Regulation 2001 outlines specific provisions with regard to OHS consultation.
Briefly, the three forms of OHS consultation are:
- establishment of an OHS committee
- election of an OHS representative or representatives
- establishment of other agreed consultation arrangements.
If an employer has twenty or more workers and a majority of the workers request an OHS committee, or WorkCover so directs, an OHS committee must be established.
An OHS representative must also be elected if at least one of the workers so requests, or WorkCover directs.
Other consultative arrangements require agreement between the employer and the worker. (Section 17, OHS Act 2000).
For more information, see consultation and committees and the Code of Practice: OHS Consultation.
How do I know my duty of care obligations if employees are working very long hours or shift work?
Top The issue of long hours or shift work for duty of care is whether or not employees or other people in the workplace are at risk of injuring themselves or others at the workplace.
An employer may be in breach of his or her Section 8 of the Occupational Health and Safety Act 2000 obligation to ensure the health, safety and welfare of all employees if this is the case. An employer, under this general duty, must ensure that the systems of work and the working environment of the employees are safe and without risks to health.
For example, if employees operate machinery through long hours, this may lead to fatigue which could increase the probability of an accident occurring. To meet their duty of care, employers should identify the risks which long hours or shift work may raise and implement control strategies to remove or minimise the risks.
This may involve such options as:
- restricting overtime;
- rotating staff; or
- introducing rest periods.
(Although not directly related to duty of care, it is recommended that the Office of Industrial Relations be consulted to ensure the hours worked are within the provisions of the employee’s Award).
How do I know the responsibilities of the subcontractor?
Top Under clause 229 of the OHS Regulation 2001, subcontractors must not commence work unless they:
- have been provided with a copy of the relevant parts of the OHS management plan
- have undertaken risk assessment of the work to be carried out and provided a written safe work method statement to the principal contractor, including the risk assessment
- have ensured that they and their employees have undertaken OHS induction training as required
- maintain and keep up-to-date the safe work method statement
- provide the principal contractor with updated safe work method statements and other information in relation to hazardous substances.
Where high risk construction work is carried out, a subcontractor must not commence work unless they have:
- undertaken risk assessment of the work to be carried out and provided the principal contractor with a written safe work method statement including any changes made to that statement
- ensured that they and theirworkers have undertaken OHS training as required.
How do I know which forklifts which do not require a licence ?
Top Although a Certificate of Competency is not required for pedestrian operated forklifts, employers have a general duty of care to their employees under Section 8 of the Occupational Health and Safety Act 2000.
An employer must provide such information, instruction, training and supervision as may be necessary to ensure the employees’ health and safety at work. Under this general duty an employer must also ensure that there are safe systems of work in place.
How do I know who can make an incident notification?
Top A notification to the workers compensation insurer can be made by the employer or their representative, a worker or their representative.
A notification to WorkCover can be made by the employer, employer nominee, or person in control of the workplace where the incident happened.
For more information, see reporting an incident or injury or call 13 10 50.
How do I know who pays for the personal protective equipment (PPE) I need?
Top The employer must pay for all safety equipment required at the workplace.
Section 22 of the Occupational Health and Safety Act 2000 makes it an offence for an employer to charge an employee or permit a charge to be imposed for any safety equipment.
How do I make a workplace complaint?
Top Before WorkCover becomes involved in the issue, you might like to try resolving it "in house", if you haven't already done so. This might include:
- complaint to the workplace OHS Committee
- direct negotiation with management
- negotiation with management through union representatives.
If none of these courses of action are appropriate or successful contact the WorkCover Information Centre on 13 10 50.
For further information see
Raising a safety issue.
How do I use my plant operators licence (eg forklift) in other states?
Top If your licence is a nationally uniform certificate of competency issued by WorkCover NSW, it is automatically recognised throughout Australia.
Also, nationally uniform certificates issued by another state allow the holder to work in NSW.
Although some states and territories do not issue certicates for the operation of all classes of loadshifting equipment, certificates issued in NSW on a national card are recognised as evidence of a person's competency in the area.
A person from a state or territory that does not issue certificates for loadshifting equipment must obtain a certificate of competency in NSW by undertaking an assessment with an accredited assessor.