Claiming workers’ compensation


What does an employee need to prove to claim workers’ comp?

A worker’s entitlement to weekly payments is influenced by their current work capacity assessed and certified by a medical practitioner.

What are an employer’s obligations if a compensation claim is accepted?

An employer will have to keep open the employee’s pre-injury position during the first 12 months of payments and be in a position to return the employee to that role on either an unrestricted or restricted basis. Alternatively, the employee could return to work in an equivalent position on either an unrestricted or restricted basis.

For example, if a production worker receiving weekly benefits needs to work three months on restricted duties before being fit enough to resume full pre-injury duties, an employer may be required to provide these restricted duties.

Does an employee accrue paid leave entitlements while absent from work and receiving workers’ compensation?

An employee who is receiving workers’ compensation payments under a Commonwealth, State or Territory workers’ compensation law may accrue annual leave if the relevant workers’ compensation law permits it. For example, the Commonwealth and Queensland workers’ compensation laws unequivocally allow the accrual of annual, personal and long service leave – while in other States, the ability to accrue some types of leave is unclear.

We have an employee who is continually late to work. We believe he may be suffering from an illness. How is this situation best handled?

You should meet with the employee to explain the lateness and whether they have any personal issues that might be contributing to their unsatisfactory performance. If the employee indicates that their health is a contributing factor, explain that you need to understand why so that you can determine if there are steps you could take to help them perform their role satisfactorily. You could suggest that the employee obtain a medical report from the doctor.

The employee may refuse to provide medical details. If this happens, inform the employee that they must provide information within a reasonable period. If not, you will have no option but to act in relation to their performance issue without considering the impact on their health.

When you receive the medical information you will need to determine whether the employee’s health is a contributing factor to the performance issue. If so, you need to decide what measures to take to help them turn up for work on time.

Can I require an employee to submit to a medical assessment by a doctor appointed by the employer?

Generally, no. However, if the employee fails to comply with reasonable requests for medical evidence to determine the employer’s lawful obligations, the employer is entitled to act on the information it holds. Workers’ compensation legislation provides for requirements to submit to medical assessments arranged by the insurer as a condition for receiving benefits.

Can I fill or make the employee’s position redundant while the employee is on stress leave?

In the short term, it would be best not to make any decisions that might impact on the employee’s ongoing employment until efforts are made to enable a return to work.

If a return to work is unlikely or would cause the employee unjustifiable hardship, the employee’s position may be filled or made redundant provided that this decision is taken solely on the basis of the requirements of the business rather than the employee’s impairment.

If you’re grappling with an HR issue, AHRI:ASSIST is an HR guidance and support centre, with information sheets, checklists, guidelines, templates and much more. 

This article is an edited version. The full article was first published in the May 2015 issue of HRMonthly magazine as ‘AHRI:Assist Q&A’. AHRI members receive HRMonthly 11 times per year as part of their membership. Find out more about AHRI membership here

Leave a reply

avatar
100000
  Subscribe to receive comments  
Notify me of
More on HRM

Claiming workers’ compensation


What does an employee need to prove to claim workers’ comp?

A worker’s entitlement to weekly payments is influenced by their current work capacity assessed and certified by a medical practitioner.

What are an employer’s obligations if a compensation claim is accepted?

An employer will have to keep open the employee’s pre-injury position during the first 12 months of payments and be in a position to return the employee to that role on either an unrestricted or restricted basis. Alternatively, the employee could return to work in an equivalent position on either an unrestricted or restricted basis.

For example, if a production worker receiving weekly benefits needs to work three months on restricted duties before being fit enough to resume full pre-injury duties, an employer may be required to provide these restricted duties.

Does an employee accrue paid leave entitlements while absent from work and receiving workers’ compensation?

An employee who is receiving workers’ compensation payments under a Commonwealth, State or Territory workers’ compensation law may accrue annual leave if the relevant workers’ compensation law permits it. For example, the Commonwealth and Queensland workers’ compensation laws unequivocally allow the accrual of annual, personal and long service leave – while in other States, the ability to accrue some types of leave is unclear.

We have an employee who is continually late to work. We believe he may be suffering from an illness. How is this situation best handled?

You should meet with the employee to explain the lateness and whether they have any personal issues that might be contributing to their unsatisfactory performance. If the employee indicates that their health is a contributing factor, explain that you need to understand why so that you can determine if there are steps you could take to help them perform their role satisfactorily. You could suggest that the employee obtain a medical report from the doctor.

The employee may refuse to provide medical details. If this happens, inform the employee that they must provide information within a reasonable period. If not, you will have no option but to act in relation to their performance issue without considering the impact on their health.

When you receive the medical information you will need to determine whether the employee’s health is a contributing factor to the performance issue. If so, you need to decide what measures to take to help them turn up for work on time.

Can I require an employee to submit to a medical assessment by a doctor appointed by the employer?

Generally, no. However, if the employee fails to comply with reasonable requests for medical evidence to determine the employer’s lawful obligations, the employer is entitled to act on the information it holds. Workers’ compensation legislation provides for requirements to submit to medical assessments arranged by the insurer as a condition for receiving benefits.

Can I fill or make the employee’s position redundant while the employee is on stress leave?

In the short term, it would be best not to make any decisions that might impact on the employee’s ongoing employment until efforts are made to enable a return to work.

If a return to work is unlikely or would cause the employee unjustifiable hardship, the employee’s position may be filled or made redundant provided that this decision is taken solely on the basis of the requirements of the business rather than the employee’s impairment.

If you’re grappling with an HR issue, AHRI:ASSIST is an HR guidance and support centre, with information sheets, checklists, guidelines, templates and much more. 

This article is an edited version. The full article was first published in the May 2015 issue of HRMonthly magazine as ‘AHRI:Assist Q&A’. AHRI members receive HRMonthly 11 times per year as part of their membership. Find out more about AHRI membership here

Leave a reply

avatar
100000
  Subscribe to receive comments  
Notify me of
More on HRM