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Wellbeing and Support procedure - WorkCoverTitle of Parent PolicyWellbeing and Support Title of Supporting ProcedureWellbeing and Support procedure - WorkCover PreambleMonash University has a legal responsibility to provide a safe and healthy environment for its staff, students and visitors at all campuses, and promotes a preventative approach to dealing with workplace injury and illness.In the event that a staff member suffers an injury or illness, and it is established and accepted as a work-related injury, the University will compensate the staff member for any time loss, and medical expenses (up to the current employer threshold amount) incurred as a result of the injury or illness, provide occupational rehabilitation support to the staff member and provide opportunities for their return-to-work. This procedure is applicable to Academic, Professional, Trades and Services staff, including casual and fixed-term staff. WorkCover is Victoria's injured workers' compensation scheme, governed by the Accident Compensation Act 1985, and administered by the Victorian WorkCover Authority. Under the Act a worker who sustains an injury, arising out of or in the course of employment (as defined below) and if the worker's employment is determined to be a significant contributing factor, shall be entitled to compensation. WorkCover:
WorkCover places great emphasis upon early intervention and rehabilitation of injured staff. Rehabilitation is the cornerstone of the WorkCover scheme and early return-to-work is an expected outcome. DefinitionsCourse of employment: this includes a staff member's normal place of employment or an alternative place of employment where a staff member has been authorised to attend. This also includes travelling for work between two places of work. Monash University's make-up pay: this provision ensures that full salary payments are made for a period of 52 aggregate weeks in cases where it is determined by a medical practitioner that there is no capacity for work. An 'aggregate' refers to cumulative days lost resulting from a compensable claim. Days or hours that form a gradual return-to-work plan are not included in the aggregate amount. An injured staff member will be advised in writing prior to when their make-up pay ceases.. Refer to clause 43, Monash University Enterprise Agreement Monash University Enterprise Agreement (Academic and Professional Staff) 2009, clause 41 Monash University Enterprise Agreement (Trades and Services Staff - Building and Metal Trades Staff and Grounds and Gardening Staff) 2005 and clause 40 Monash University Enterprise Agreement (Trades and Services staff - Catering and Retail, Cleaning and Caretaking, and Miscellaneous services staff) 2005. Rehabilitation provider: an external provider who may be engaged to assist with rehabilitation of injured/ill staff members. The role of the rehabilitation provider is to provide rehabilitation to injured/ill staff where appropriate, and liaise with key parties to assist with development of a written rehabilitation/return-to-work plan. Rehabilitation providers are used depending on the circumstances including seriousness of the injury. Insurance excess: an insurance excess applies to WorkCover claims. If a Workers Claim for Compensation is accepted, Monash University is required to pay the first 10 days time lost and the employer threshold of reasonable medical and like services related to the claim. (Note that the threshold amount is indexed each year on 1 July). Reasonable medical and like services: includes treatment which is deemed to be appropriate given the type of injury, by treating medical practitioners as well as independent specialists. Where treatment or cost is deemed to be inappropriate or unreasonable, claimants may not be reimbursed. 1. Lodging an incident report1.1 Reporting an injury or illnessAny staff member who sustains a work-related injury/illness must notify their supervisor/manager within 30 days following injury or onset of illness. Responsibility: staff member 1.2 Taking action when receiving a report of injury or illnessOn receiving notification of a work-related injury/illness of a staff member, the supervisor/manager must notify the Safety Officer immediately, who will proceed in line with the University's Policy on Incident Reporting, Investigation and Recording. TheHazard Incident Report form [pdf] obtainable from Occupational Health and Safety (OHS) Department, Health and Safety Representatives or Safety Officers, must be completed and forwarded to OHS as soon as practicable. Note: It is important that all hazards, incidents or accidents are reported whether or not a claim for compensation is to be made. Responsibility: staff member 2. Lodging a WorkCover claim2.1 Seeking advice regarding lodgement of a WorkCover claim.If the staff member wishes to lodge a WorkCover claim, they must contact Monash HR, WorkCover on 9902 9573 or 9902 4976 to discuss whether a WorkCover claim is appropriate for them, and seek advice on other options that may also be available to them. Where pursuing a WorkCover claim is appropriate a "Workers Claim for Compensation" form, ('Claim form') must be completed and signed by the staff member as soon as practicable after the injury, and sent directly to Monash HR, WorkCover, or handed to their supervisor who must then forward immediately to Monash HR, WorkCover. Forms are available from , any Australia Post outlet. The University has a legal obligation to submit a WorkCover claim to its insurer within 10 days of receipt of the claim by the injured staff member. Note: Where a claim form is not forwarded immediately to Monash HR, WorkCover, causing a delay in processing, Monash University can be penalised and fined. Fines will be passed on to the area responsible for the delay. Responsibility: supervisor The claim form must be accompanied by a valid WorkCover Certificate of Capacity and an 'Application for Leave' form. Monash University policy requests that a certificate of capacity be provided for claims relating only to medical expenses as well. Responsibility: staff member 2.2 Forwarding a claim to the Monash HRA supervisor/manager must immediately forward the claim form, the WorkCover Certificate of Capacity together with an authorised leave form, and any accounts/receipts relating to the injury and a copy of the incident report to: Manager, Employee Assistance 2.3 Acknowledgment and Discussion of the claimOn receipt of the claim form and associated documentation as listed in 2.1, the Manager, Employee Assistance, on behalf of the University, will send a letter to the injured staff member acknowledging their injury, while also promptly contacting the injured/ill staff member and their supervisor/manager to discuss the matter as set out below: Discussion with claimant -
Discussion with Supervisor/Manager -
Please note that witnesses to an incident may also be contacted at this stage. Responsibility: Manager, Employee Assistance 3. Rehabilitation/return-to-workIf rehabilitation is required, the Manager, Employee Assistance will facilitate a rehabilitation/return-to-work program [pdf] in conjunction with key parties. In some cases an external rehabilitation provider (refer definitions) may be engaged to assist with rehabilitation of the injured/ill staff member. The primary emphasis is for the line manager to find suitable alternate duties for the injured/ill staff member. Discussions can be held with the Manager, Employee Assistance for further information. Responsibility: staff member, supervisor and Manager, Employee Assistance 4. Taking leave resulting from injuryThe staff member must ensure that the dates on their leave form correspond with the dates on the WorkCover Certificate of Capacity. The application for WorkCover leave is processed by Monash HR, WorkCover initially as personal (formerly sick) leave. If liability for the claim is accepted the period of personal (formerly sick) leave is credited and processed as WorkCover leave. Responsibility: Manager, Employee Assistance 5. Documentation required for claim validity5.1 Time lost claimsIf a staff member loses time from work due to their work-related injury/illness, they are required to lodge the following documentation:
If a claim and/or certificate is not valid according to WorkCover guidelines, then further information will be requested before the claim can be processed and liability determined. Responsibility: staff member 5.2 No time lost claims (claim for medical and like services only)Under the legislation the only requirement for this type of claim is a fully completed 'Workers Claim for Compensation' form. However, Monash University policy requires that a WorkCover Certificate of Capacity must be provided for 'No Time Lost Claims', to ensure appropriate support is provided where needed. If a claim and/or certificate is not valid according to WorkCover guidelines, then further information will be requested before the claim can be processed and liability determined. Responsibility: staff member5.3 WorkCover Certificate of CapacityA staff member who is injured, must obtain a WorkCover Certificate of Capacity signed by a medical practitioner. A staff member is not entitled to receive weekly compensation benefits without supplying a valid WorkCover Certificate of Capacity. A WorkCover Certificate of Capacity that does not meet the specific guidelines will be returned to the claimant so that a correct certificate can be issued by the medical practitioner. Responsibility: staff member6. Time limits on acceptance of claims6.1 Time loss claimsThe University's insurer has 28 days, from the date of receipt of a valid claim, to advise the claimant in writing whether their claim is accepted. Responsibility: Manager, Employee Assistance and the University's Insurer 6.2 Other claimsIf the WorkCover claim is for medical and like services only, the University's insurer has 60 days, from the date of receipt to advise the claimant in writing whether their claim is accepted. Responsibility: Manager, Employee Assistance and the University's Insurer 7. Reimbursement of reasonable expensesThe University will reimburse reasonable medical and like services costs paid by the staff member with a valid and open WorkCover claim. If the University's threshold amount is reached, Monash HR, WorkCover will forward any receipts or unpaid accounts to its insurer for payment. Reasonable costs include the maximum amount paid by WorkCover for various medical services. Some treating health practitioners charge above the maximum rate approved by WorkSafe. For accepted claims, the claimant should instruct their health practitioner(s) to send his/her service accounts directly to the University ( Monash HR, WorkCover) for payment and/or forwarding to the insurer. Where a claim involving absence from work is accepted or determined in favour of the claimant, all workplace agreement and allied entitlements in accordance with their pre-injury classification and hours of work will be accrued during a make-up pay period. Related ProceduresRelated Enterprise Agreement Clauses
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