Justice in workers’ compensation reforms

A South Australian colleague has pointed out some interesting elements in WorkCover SA’s review of employer incentives discussed earlier.

The following text are some of the aims of South Australia’s Workers Compensation and Rehabilitation Act.

(1) The objects of this Act are—

(a) to establish a workers rehabilitation and compensation scheme—

(i) that achieves a reasonable balance between the interests of employers and the interests of workers

(iv) that reduces the overall social and economic cost to the community of employment-related disabilities

(2) A person exercising judicial, quasi-judicial or administrative powers must interpret this Act in the light of its objects without bias towards the interests of employers on the one hand, or workers on the other.

My colleague points out that a review of employer incentives is well and good but what are the incentives for employees, given the objects of the Act concerning balance and bias?

She also criticises

“…the current incentive for employers of paying the first two weeks of the injured workers income payments if the employer supplies the claim agent with the employer section of the injury/incident report goes against the intent as outlined in Objects of the Act, as there is not any corresponding incentive offered to the injured worker.”

Whether the injury report is valid or useful is irrelevant to the incentive as it is the lodgment of the form that generates the incentive rather than any rehabilitation action for the injured worker.

There is no doubt that the workers compensation scheme needed a review.  The recent Return-To-Work (RTW) conference in Adelaide had an atmosphere of hope after the introduction of the RTW coordinator requirements for businesses.

South Australia is different from most other Australian States where a single company handles workers compensation insurance, Employers Mutual.  Not only is there a huge lack of competition in South Australia but the government and the insurer are close.

There is also a political element with Paul Caica being given the portfolio in order to fix it.  In June 2009, the Minister announced a range of projects from a fair pool of funds but many of them are focused on the workers rather than providing structural change to the system.  It is hard not to speculate how workers may benefit if the insurance industry in the State had competition.

The need for reform was clear as the South Australian workers’ compensation scheme was bleeding money but it must have been politically attractive to try to postpone an analysis of the system until the Federal Government started its national review of workers’ compensation system in a few years’ time.  It may have been that such a strategy was planned until the global financial crisis changed the public’s tolerance for government debt forcing the SA government had to act.

Kevin Jones

Fixing what is broken

WorkCover in South Australia has released a discussion paper for public comment on 9 November 2009.  The paper is called “Consultation on a new framework for employer incentives” and poses the following questions:

  • Do you think there should be any financial incentives for employers in relation to workers rehabilitation and compensation?
  • What do you think about the proposed design principles?
  • Do you have any specific ideas for employer incentives that encourage return to work?

cover Employer incentivesThis discussion paper is part of the review process by the WorkCover Corporation and should be supported.  Public comments close on 18 December 2009.

The paper itself has some points of considerable interest.  The existing incentive scheme is called a Bonus/Penalty Scheme which has existed for almost 20 years.  PricewaterhouseCoopers undertook a review and below are the findings, according to WorkCover:

“WorkCover has been working with PricewaterhouseCoopers (PWC) to gain a better understanding of the effectiveness of the Bonus/Penalty Scheme in South Australia.  Only very weak links were found between the Bonus/Penalty rate and claim outcomes.  No evidence was found to suggest that the Bonus/Penalty Scheme has delivered better health and safety outcomes for workers in South Australia.”

That last sentence seems to be a phenomenally honest statement about a scheme that has existed since 1990, been so persistent and continues to be so popular with employers.  Such forthrightness from a government authority about one of its own programs is rare.

At some point in the past there may have been some logic in the scheme as similar elements existed under the WorkCare scheme in Victoria many years ago.  But since the preventative arm, Safe Work SA, split from WorkCover around 2005, the incentive scheme has not sat comfortably with the government’s RTW focus.

The discussion paper goes on to state:

“WorkCover has not seen much evidence that the Bonus/Penalty Scheme has either reduced injury rates or made workplaces safer.  If anything it appears to have had some adverse side-effects, such as encouraging stakeholders to focus excessively on claim costs, the claim costs ‘window’ and coding, instead of return to work.”

Regardless of pointing out the difference between “no evidence” and “much evidence”, WorkCover’s comments illustrate a reality that OHS and RTW professionals have been wrestling with for years, companies have been encouraged to focus on financial cost of Return-To-Work rather than on the injured worker.

As part of WorkCover’s analysis of the existing incentive scheme, it undertook a literature review on experience ratings systems and found the following

“There were some noteworthy findings about experience rating systems, for example:

  • there is no clear consensus that they have reduced injury rates or made workplaces safer;
  • they have created perverse motivations, for example to suppress claims, dispute the coding of claims, or only focus on reducing claims within the ‘experience window’;
  • they may reduce claim numbers but not average claim costs, and average claim severity tends to increase – this is further evidence that the reporting of small claims is sometimes ‘suppressed’; and
  • there is no obvious link between experience rating bonuses/penalties and an employer’s commitment to safety and return to work.”

The Productivity Commission in 2004 (as discussed in Alan Clayton’s workers compensation review for the Tasmanian Government) recommended experience ratings for large employers as a contributor to the full funding of workers compensation schemes. ( p.44)  It is strongly suggested that those wanting to comment on this South Australian WorkCover paper should closely look at the recent changes to workers’ compensation made by the Tasmanian Government.

But it is not all gloom and doom as WorkCover SA has set the parameters for the next scheme.  In the discussion paper, they list 11 proposed design principles for consideration:

  • Focus on return to work
  • Be affordable and sustainable
  • Have a direct and substantial effect
  • Target the right employers
  • Tailor to specific employer groups
  • Loss matters
  • Be simple to explain and run
  • Use a mix of solutions
  • Capitalise on the tools and resources we already have
  • Be transparent
  • Use an evidence-based approach

In anticipation of the Federal Government’s plans to harmonise workers compensation once OHS is out of the way, such discussion papers, reviews and, more importantly, the public submissions, may provide some clues to how Australia workers compensation and RTW programs may look in ten years time.

Kevin Jones

Combining safety and RTW awards

Finally, a State-based safety awards night that has both OHS and Return-to-Work awards.  On 27 October 2009, Workplace Health & Safety Queensland held its annual safety awards night as part of Safe Work Australia Week.  In a media release, the Minister for Industrial Relations, Cameron Dick, said

“The inaugural Return to Work Awards are run by Q-COMP – the statutory authority that oversees workers’ compensation in Queensland – to showcase the state’s top employers who understand the importance of helping injured workers make a successful return to work.”

It is curious that other States do not also have combined awards.  The logic of the combination would, perhaps, be easiest for Victoria as the Victorian Workcover Authority handles rehabilitation through VWA as well prevention through WorkSafe Victoria.  The combination may be simpler for those States that have a single insurer for workers compensation.

It is noted that one workers compensation insurer in Victoria, xchanging (formerly Cambridge), has conducted its own awards for several years.  (The author was a judge of these awards several years ago)  The judging process was tripartite with applicants from a pool of the insurer’s clients.  Whether an insurer would relinquish such a role is unknown but the opportunity for State recognition of RTW performance should be attractive.

It should also be noted that winners of State OHS awards are also nominated for national OHS awards conducted by Safe Work Australia.

SafetyAtWorkBlog has questioned the plethora of OHS awards nights in the past as Australia has a fairly small industry and as OHS and workers compensation laws are becoming harmonised, it seems sensible for Safe Work Australia, or the Australian Government more generally, to start harmonising the award processes.  Just imagine how many corporations would be champing at the bit to receive an award for safety that covers all aspects of their safety management.  It would be an award for leadership that may just be warranted.

Kevin Jones

Safe Work Australia Week 2009 begins

The last week of October 2009 is Safe Work Australia Week.  The federal OHS authority sets an overall framework for the States’ OHS promotional activities.

A media statement in support of the week, reiterated the statistics –

“More than 260 Australians die as a result of work related injuries and over 135,000 are seriously injured every year.”

Below is a list of the links for each Australian State’s acitivities.

SWAW_generic_WEB

Who is advising John Holland?

The person, Sir John Holland, died in May 2009.  The company, John Holland Group (JHG), is in danger of a shortened life if it continues to make bizarre decisions.

John Holland Group has been widely criticized by the union movement, principally for its decision to jump out of State OHS jurisdictions to the Commonwealth (Comcare) structure.  This was seen as a purely financial response to a politically sensitive  opportunity that was presented by the Liberal government of then-Prime Minister John Howard.  Comcare was seen as the insurer of the defence forces and public servants and, unions claimed, enforcement of OHS to an acceptable level was beyond the skills and resources of the administrative agency.

Due to union pressure, John Holland Rail was dropped from the finalists for a national safety award in early 2009.  JHG probably came in for more criticism than other companies who also jumped because it is in the highly-unionised construction sector and their construction work is so public.

One of the advantages of moving to the Federal OHS scheme was that any prosecutions would occur in that jurisdiction and JHG has been prosecuted there.  JHG had several OHS breaches in 2005 and 2006.  It came under the Federal OHS law in March 2007.  In September 2008, Worksafe Victoria charged the company over one of the 2006 breaches.

According to a report in The Age on 14 October 2009, JHG

“issued a High Court challenge, claiming the charges were ”incompetent” because it was not liable for conviction under Victorian workplace law for offences committed before it came under the Commonwealth jurisdiction.”

John Holland v Vic Workcover Authority  John Holland v Ins_High Court challenges are not cheap and the wisdom of the decision to contest the State actions was always questionable, doubly so now the High Court unanimously decided against JHG’s arguments.

The High Court challenge confirmed for many the impression that John Holland Group will try to avoid safety obligations, if possible, and that the move to a “softer” regulatory scheme was one of the reasons behind the move to the Comcare scheme.  The legal action undermines all of the positive safety culture messages that the corporation has issued.

JHG is involved with many new infrastructure and construction projects.  Harmonised OHS laws are set for 2011 which include the federal OHS laws under which Comcare operates.  Within a decade of taking up an opportunity for a “softer” regulatory regime, the advantage may be gone and the John Holland Group Board should ask themselves “was it worth it?”

Kevin Jones

HWCA could be influential in Australia’s workers’ compensation reforms

Australia and New Zealand have a small strategic organisation called the Heads of Workers’ Compensation Authorities (HWCA, pronounced “howca” by those in the know).  It is a regular meeting (some say “love-in”, others say “coven”) of the CEOs of the various workers’ compensation bodies in Australia and New Zealand.  Over the next five years, as the Australian Government begins to harmonise/reform the workers’ compensation system, HWCA will be important to watch.

In early October 2009, HWCA met and endorsed a coordination strategy, that has yet to be publicly released.  The main objectives of the strategy were noted in a media release (also not yet publicly available) to mark the latest meeting.

  • “To deliver best practice services to injured workers and employers to assist recovery: and
  • to build sustainable workers’ compensation schemes.”

The terminology of the first objective may provide a good indication of the type of organisation HWCA seems to be.  “Best practice services”???  “Best practice” is one of the worst corporate jargons being used at the moment.  This article at Wikipedia outlines the context of the phrase well.

“As the term has become more popular, some organizations have begun using the term “best practices” to refer to what are in fact merely ‘rules’….”

In other words, HWCA has a strategy to do what its member organisations should have been doing all along – enforcing the rules of good customer service and providing the best level of service to injured workers.

Perhaps it is the second strategic objective that best illustrates the aims of HWCA – to make sure that the workers’ compensation schemes do not lose money.

According to the communique that is released after every meeting (top points for open communication)

“HWCA agreed the Bio-psychosocial Rehabilitation Working Group would develop a national action plan regarding prevention of long-term disability and work loss, which will support the strategy.”

Prevention is the role of the OHS authorities in Australia and the Department of Labour in New Zealand.  Clearly HWCA will be discussing these strategic aims with those in charge of preventing injuries and illnesses.  But can the various WorkCovers and WorkSafes cope with biopsychosocial hazards?  Surely HWCA will also be talking with all the NGOs who lobby on depression, anxiety, fatigue, stress, wellness, happiness ………….. (Get ready for even more influence for BeyondBlue)

Consultation will also be needed with the various government departments involved with health promotion, public and occupational.  Not to mention the unions, employer associations and health professional bodies.

A strategy of such magnitude would require considerable resources and horse-trading through government ranks in all jurisdictions.  It is hard to see this being achieved through a meeting of Chief Executive Officers, and should such a strategy be pushed through individual workers’ compensation bodies anyway?

To achieve true reform of workers’ compensation and to resist the substantial pressure that is likely to come from the Australian and international insurance companies, the Australian government is going to need considerable negotiating skills.  Because of the involvement with the financially influential insurance companies, it is doubtful the intended reforms will be achieved. (HWCA already has discussions with the “Heads of Compulsory Third Party Insurers” according to the communique)

Almost as a post-script, it is noted that Greg Tweedly, CEO of WorkSafe Victoria, takes over the chairmanship of HWCA from the CEO of WorkCover NSW, Jon Blackwell.  Tweedly is a very busy CEO and will become more so, if the rumour proves true that he will be joining the National Board of the Safety Institute of Australia.

As the chairmanship moves from New South Wales, so will HWCA’s administrative support.  The next HWCA meeting is scheduled for 5 February 2010 and will be coordinated through the Victorian Workcover Authority or Comcare.

Kevin Jones

Civil liability and work-related diseases

On 4 October 2009, Queensland’s Attorney-General Cameron Dick released details of his intentions to increase the compensation available for individuals and their relatives through his  Civil Liability and Other Legislation Amendment Bill.  Below is a table which shows the level of the  increase.

It needs to be pointed out that this is not workers’ compensation but OHS legislation is blurring the demarcation between workers compensation and civil liability in the context of safety management.  New Australian legislation is placing OHS obligations on workers and employers for the off-site effects of workplace activities.

The Attorney-General, who is also the Minister for Workplace Relations had this to say about the importance and breadth of the draft Bill:

“This legislation will increase the maximum caps, for the first time in six years, on general damages available under the Civil Liability Act 2003 for personal injuries,” Mr Dick said…. “These amendments will afford injured persons the monetary compensation they need to help them get on with their lives.  The amendments also ensure a de facto partner of an injured person is now able to claim for loss of earnings.”

Dick goes on to discuss the good news concerning dust-related diseases as the amendments will also abolish the statutory limitation period for dust-related disease claims including asbestosis, mesothelioma and silicosis.  It is unclear whether workers’ compensation insurance has similar limitations.

“The removal of the statutory limitation period for dust-relates (sic) diseases will deliver significant benefits to sufferers, by improving their access to justice and reducing the costs and stress associated with pursuing a claim,” Mr Dick said.  “This amendment will have retrospective effect to ensure it captures current cases of dust-related disease originating from exposure during the 1950s, 1960s and 1970s.”

Dick said the amendments also ensure that the caps will be annually indexed to average weekly earnings.

These changes raise the possibility that a workplace may have an event that directly injures workers and also affects people outside the worksite. This could generate two processes for compensation – the workers and members of the public.  The business operator would be involved in both processes, of course.

But Australian OHS legislation is moving towards one OHS “Act” that would involve the management of a hazard and its potential off-site effects.  Why then split the compensation  mechanisms?  Would it not be easier for the business owner to manage the environmental, public and worker impacts of the one event in an integrated fashion?

The model OHS legislation deals with multiple parties affected by work processes surely the government should be looking at a single compensation process that also addresses multiple parties?

The workers’ compensation harmonisation review is still a couple of years away but potential changes should be anticipated.  The table below perhaps should be compared to the Table of Maims used in workers’ compensation in the spirit of harmonisation to determine a broader social justice.

Perhaps in this period of public comment on draft OHS model legislation, the government and stakeholders should anticipate the social consequences of the OHS management obligations it is currently considering.  If environmental legislation and management imposes a “cradle-to-grave” context, why should safety management legislation not?

Kevin Jones

Injury Injury Scale Value Currently worth Maximum from 1 July 2010 will be worth
Serious Facial Injury 14 to 25 $16,600 to $35,000 $19,550 to $41,220
Loss of one eye 26 to 30 $37,000 to $45,000 $43,560 to $53,000
Loss of one testicle 2 to 10 $2000 to $11,000 $2360 to $12,950
Loss of both kidneys 56 to 75 $110,360 to $166,400 $130,000 to $196,000
Loss of one arm from the shoulder 50 to 65 $93,800 to $136,100 $110,500 to $160,300
Loss of one hand 35-60 $56,000 to $121,400 $65,950 to $143,000
Loss of a finger 5 to 20 $5000 to $26,000 $5900 to $30,600
Loss of one leg above the knee 35 to 50 $56,000 to $93,800 $65,950 to $110,500
Loss of one foot 20 to 35 $26,000 to $56,000 $30,600 to $65,950
Total loss of hair on head 11 to 15 $12,400 to $18,000 $14,600 to $21,200
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