Employer > Contacts/Other useful information > Incentive for early reporting of injuries (Waiver of employer excess)

Incentive for early reporting of injuries (Waiver of employer excess)

Responding quickly to treat injuries and commence rehabilitation is paramount to injury and claims management and critical to rapid return to work. Quick action in this regard may prevent an injured worker from being away from work for a prolonged period of time.

The prerequisite for early action is early notification of a claim. Under the new legislation that commenced on 1 January 2009, employers are financially rewarded for notifying Employers Mutual that an injury has occurred within two business days by not being required to pay the first two weeks of weekly payments (currently in South Australia, employers are required to cover the first two weeks).

What constitutes a notification of injury?

A notification of injury is when the worker notifies their employer (if the worker is in employment) and Employers Mutual/WorkCover of their workplace injury. A worker or their representative (for instance, the employer or a medical practitioner) can also make a notification.

All incidents involving an injury or illness, where workers compensation is payable or may be payable, should be notified to Employers Mutual or WorkCover as soon as possible. The notification should be in writing (including by electronic means) or orally (including over the phone). If the notification has been given by someone other than the employer, the case manager will always make contact with the employer to confirm that they are aware of the occurrence.

In order to qualify for the waiver, the employer must meet their obligations under section 52 of the Act and send the WorkCover Claim form, the Employer Report Form and any WorkCover medical certificates to WorkCover or Employers Mutual within two business days of receipt.

In the event that the worker or another party has notified Employers Mutual first, and the employer then also notifies Employers Mutual within two business days of the worker notifying the employer, the employer will be entitled to the waiver of the first two weeks of weekly payments.

Who will make the decision if a waiver applies and how will this be done?

When Employers Mutual makes the decision to commence weekly payments (either as an accepted claim for compensation or payments under provisional liability), the case manager will establish whether the claim was reported within two business days by the employer.

If this has occurred, the case manager will then confirm with the employer that the worker is to receive weekly payments (and ascertain who is to pay the worker). They will also advise the employer that they do not have to pay or, if they have already paid, that they are entitled to seek reimbursement of the costs for the first two weeks of incapacity.

The case manager will include confirmation of this advice in the initial claim determination letter sent to the employer.

Can the waiver be applied if the worker is receiving provisional liability payments?

Yes, employers will be eligible for the waiver in instances where provisional payments have commenced if the injury has been reported within two business days.

How do I claim back the waiver?

If you have already paid the worker, then all you will need to complete is a Weekly Payment Reimbursement Request (WPRR) and include the cost of the first two weeks of incapacity.

When will the waiver of the employer’s excess not occur?

A waiver of the employer's excess will not occur when a notification of injury is not reported to Employers Mutual within two business days of notification to the employer

or

when a WorkCover Medical Certificate or a WorkCover Claim form has not been submitted

or

an employer has failed to provide the necessary information requested by Employers Mutual to determine an injured worker's average weekly earnings, which is needed to commence the payment of weekly compensation and determine the claim for compensation.

How will this affect my bonus penalty?

Your bonus/penalty will not be affected if you meet the requirements. A system flag in the claims management database will be activated to assist in the identification of the cost of the first two weeks to ensure that the payments are excluded from the employer’s claims costs for bonus/penalty purposes. This will also pick up situations where the agent has paid the worker directly, but the cost of the first two weeks is to be excluded from the employer’s bonus penalty calculation, as they have met the reporting requirement for waiver of the excess.

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