Workers’ Compensation and Rehabilitation Regulation 2025 (Qld)
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Workers’ Compensation and Rehabilitation Regulation 2025
Part 1 Preliminary
1 Short title
This regulation may be cited as the Workers’ Compensation and Rehabilitation Regulation 2025.
2 Commencement
This regulation commences on 1 September 2025.
3 Definitions
Schedule 18 defines particular words used in this regulation.
4 WorkCover’s capital adequacy—Act, s 453
For section 453(b) of the Act, WorkCover maintains capital adequacy if WorkCover’s total assets are at least equal to its total liabilities.
Part 2 Employer insurance
Division 1 Policies and premium assessments
5 Application for policy
An application for a WorkCover policy must be made to WorkCover in the approved form.
6 Policies and renewals
(1)On payment of the premium shown as payable in a premium notice issued by WorkCover to an employer, WorkCover must issue to the employer a policy, in the approved form, for the period of insurance stated in the notice.(2)A policy has no effect until—(a)WorkCover receives the premium payable to WorkCover for the policy or the policy’s renewal; or(b)WorkCover approves an instalment plan under section 10.
7 Assessment of premium
(1)WorkCover must assess the premium payable under a policy for each period of insurance shown in a premium notice.(2)This section does not apply to a policy for household workers.
8 Declaration of wages
(1)Each employer, other than a self-insurer, must, on or before 31 August in each year, give WorkCover a declaration of wages so WorkCover can assess the employer’s premium.(2)The declaration must be in—(a)the approved form; or(b)with WorkCover’s approval—another form acceptable to WorkCover.(3)If the employer gives WorkCover a declaration of wages after 31 August in a year, the employer must pay the additional premium stated in schedule 1 opposite the day when the employer gives WorkCover the declaration.(4)This section does not apply if the employer employs only household workers.
9 Value of board and lodging
(1)This section applies if a worker’s entitlements during a period of insurance include board provided by the employer.(2)The board is taken to be wages paid, or provided, by the employer to the worker.(3)For each week of board provided by the employer, the amount of wages under subsection (2) is the higher of the following—(a)the value of the board;(b)either—(i)if an industrial instrument that provides for a weekly allowance for board applies to the employment of the worker—the amount of the weekly allowance stated in the industrial instrument; or(ii)if subparagraph (i) does not apply—6% of QOTE.(4)In this section—board means accommodation, meals, laundry services or any other entitlement having a monetary value provided when lodging.
10 Payment of premium by instalments
(1)WorkCover may accept payment of a premium by instalments under an instalment plan approved by WorkCover if WorkCover is satisfied that payment of the premium by the due date would impose financial hardship on the employer.(2)The instalment plan is subject to the following conditions—(a)interest at an annual rate specified by WorkCover’s board by gazette notice must be added to the amount of each instalment;(b)interest must be calculated from the due date;(c)the interest rate that applies at the start of the instalment plan remains constant until the plan ends;(d)on approval of the instalment plan, the employer must, if required by WorkCover, enter into a payment arrangement acceptable to WorkCover;(e)if an instalment of premium is not paid on or before the due date for payment of the instalment—(i)the total amount of unpaid instalments and interest on unpaid instalments to that day immediately becomes payable to WorkCover; and(ii)an additional premium under section 11 applies to the unpaid instalments and interest mentioned in subparagraph (i); and(iii)the policy for which the premium is payable stops having effect.Note—
See also section 48 of the Actfor breach of the employer’s obligation to insure.
11 Additional premium for late payment of premium—Act, ss 61 and 62
(1)This section applies if an employer does not pay WorkCover, on or before the due date—(a)the amount stated in a premium notice; or(b)the amount by which a final assessment of an amount of premium by an industrial magistrate or the industrial court is more than the amount of premium paid under section 551(4) of the Act.(2)For sections 61 and 62 of the Act, the additional premium payable is—(a)if the amount mentioned in subsection (1) is paid to WorkCover within 30 days after the due date—5% of the amount; or(b)if the amount mentioned in subsection (1) is paid to WorkCover after 30 days but within 60 days after the due date—10% of the amount; or(c)if the amount mentioned in subsection (1) is paid to WorkCover after 60 days after the due date or if the amount is not paid—10% of the amount plus interest at the annual rate mentioned in section 10(2)(a) for the period that—(i)starts on the due date, or a later date decided by WorkCover; and(ii)ends on the day the amount mentioned in subsection (1) and the additional premium under paragraph (a) or (b) is paid to WorkCover.(3)This section does not apply if—(a)the employer employs only household workers; or(b)WorkCover has approved an instalment plan under section 10 and the employer complies with the plan.(4)In this section—due date means—(a)for an amount mentioned in subsection (1)(a)—the due date stated in the premium notice; or(b)for an amount mentioned in subsection (1)(b)—the last day of the period mentioned in section 62(1)(b) of the Act.
12 Premium for ascertaining appeal court—Act, s 569
For section 569(2)(a) of the Act, the employer’s premium, for a financial year, is the amount calculated using the formula—where—
rate means the rate for the employer’s industry or business specified by WorkCover by gazette notice under section 54(2) of the Act, or decided by WorkCover under section 54(3) of the Act, that applies to the financial year.wages means—(a)the wages paid, or provided, by the employer for the preceding financial year; or(b)if the employer has been insured for only part of a financial year—a reasonable estimate of the wages that would have been paid, or provided, by the employer for the financial year.
13 Former employer may apply to cancel policy
(1)This section applies if a person (the former employer) wants to cancel a policy because the former employer has stopped employing workers.(2)The former employer must give WorkCover a written notice stating—(a)that the former employer wants to cancel the policy because the former employer has stopped employing workers; and(b)the day the former employer stopped employing workers (the end day); and(c)the wages paid, or provided, by the former employer during the period that—(i)starts on 1 July last preceding the end day; and(ii)ends on the end day; and(d)the address to which any document addressed to the former employer may be sent.(3)This section does not apply if the person employed only household workers.
14 Cancellation of policy if workers no longer employed
(1)This section applies if—(a)a person (the former employer) has given WorkCover a written notice under section 13(2); or(b)WorkCover is satisfied, after making reasonable enquiries, that a person (also the former employer) has stopped employing workers.(2)WorkCover may cancel the former employer’s policy.(3)WorkCover must assess the amount of premium payable by the former employer for the period during which the Act required the former employer to hold a policy.(4)If the premium paid by the former employer for the last employment period was more than the amount of premium assessed under subsection (3), WorkCover must refund the amount overpaid to the former employer.(5)If the premium paid by the former employer for the last employment period was less than the amount of premium assessed under subsection (3), the former employer must pay WorkCover the amount of the deficit on or before the due date under a premium notice issued for the amount of the deficit.Note—
See also chapter 2, part 3, division 3 of the Act for circumstances in which additional premiums may be payable by employers or former employers.(6)In this section—last employment period means—(a)for a former employer mentioned in subsection (1)(a)—the period mentioned in section 13(2)(c); or(b)for a former employer mentioned in subsection (1)(b)—the period that—(i)starts on 1 July last preceding the day WorkCover is satisfied the former employer stopped employing workers (the end day); and(ii)ends on the end day.
Division 2 Employer excess
15 Excess period—Act, s 65
For section 65(2) of the Act, the amount prescribed in relation to a worker who sustains an injury for which compensation is payable is the lesser of the following—(a)QOTE;(b)the amount of the weekly payment of compensation payable to the worker under chapter 3, part 9 of the Act.
Division 3 Self-insurance
16 Definitions for division
In this division—annual levy means the amount payable under section 81 of the Act.provisional annual levy see section 19(2)(a).specified date see section 18(2).
17 Application fee—Act, s 70
For section 70(c) of the Act, the fee prescribed is—(a)for a single employer—15,000 fee units; or(b)for a group employer—20,000 fee units.
18 Annual levy—Act, s 81
(1)For section 81(2) of the Act, this section prescribes the way to calculate a self-insurer’s levy for each financial year or part of a financial year of a licence.(2)The Regulator must specify a date (the specified date) for a financial year and publish the date in the gazette.(3)The self-insurer’s levy for each financial year or part of a financial year of a licence must be calculated using the formula—where—
estimated claims liability means the self-insurer’s estimated claims liability most recently agreed by the Regulator and the self-insurer under section 67, or most recently decided by the arbiter under section 102, before the specified date for the financial year.rate means the rate published by the Regulator under section 81(6) of the Act for the particular financial year.
19 Provisional annual levy—not agreed or decided
(1)This section applies in relation to a self-insurer if, on the specified date—(a)the self-insurer’s estimated claims liability for a year has been calculated by the appointed actuary under section 62; but(b)the Regulator and the self-insurer have not agreed on the amount of the self-insurer’s estimated claims liability under section 67 and the arbiter has not decided the amount of the self-insurer’s estimated claims liability under section 102.(2)The Regulator may use the amount of the self-insurer’s estimated claims liability as calculated by the appointed actuary under section 62 to—(a)calculate the self-insurer’s annual levy under section 18 (the provisional annual levy); and(b)give the self-insurer written notice of the amount of the provisional annual levy under section 81(7) of the Act.
20 Actual annual levy—agreed
(1)This section applies if—(a)the Regulator gave a self-insurer a written notice under section 19(2)(b) stating the amount of the provisional annual levy based on the amount of the self-insurer’s estimated claims liability as calculated by the appointed actuary under section 62; and(b)the Regulator and the self-insurer have agreed under section 67 on the amount of the self-insurer’s estimated claims liability.(2)The Regulator must give the self-insurer written notice of the amount of the annual levy (the actual annual levy) under section 81(7) of the Actbased on the agreed amount within 14 days after the Regulator and the self-insurer agree to the amount.(3)If the actual annual levy is more than the provisional annual levy, the self-insurer must pay the Regulator the difference between the actual annual levy and the amount paid as the provisional annual levy.(4)If the actual annual levy is less than the provisional annual levy, the Regulator must pay the self-insurer the difference between the actual annual levy and the amount paid as the provisional annual levy.
21 Actual annual levy—not agreed but decided
(1)This section applies if—(a)the Regulator gave a self-insurer a written notice under section 19(2)(b) stating the amount of the provisional annual levy based on the amount of the self-insurer’s estimated claims liability as calculated by the appointed actuary under section 62; and(b)the Regulator and the self-insurer have not agreed under section 67 on the amount of the self-insurer’s estimated claims liability; and(c)the arbiter has decided the amount of the self-insurer’s estimated claims liability under section 102 and the amount (the decided adjusted amount) is not the same as the amount of the self-insurer’s estimated claims liability used to calculate the provisional annual levy.(2)The Regulator must give the self-insurer written notice of the amount of the annual levy (the actual annual levy) under section 81(7) of the Actbased on the decided adjusted amount within 14 days after the Regulator receives notice of the amount under section 102(4).(3)If the actual annual levy is more than the provisional annual levy, the self-insurer must pay the Regulator the difference between the actual annual levy and the amount paid as the provisional annual levy.(4)If the actual annual levy is less than the provisional annual levy, the Regulator must pay the self-insurer the difference between the actual annual levy and the amount paid as the provisional annual levy.
22 Additional amount if levy not paid before due date—Act, s 82
For section 82(1) of the Act, the additional amount payable by a self-insurer in relation to the late payment of an amount of annual levy is—(a)if the amount is paid to the Regulator within 30 days after the due date—5% of the amount; or(b)if the amount is paid to the Regulator after 30 days but within 60 days after the due date—10% of the amount; or(c)if the amount is paid to the Regulator after 60 days after the due date or if the amount is not paid—10% of the amount plus interest at a rate specified by the Regulator by gazette notice for the period that—(i)starts on the due date, or a later date decided by the Regulator; and(ii)ends on the day the amount of the annual levy and the additional amount under paragraph (a) or (b) is paid to the Regulator.
23 Condition of licence—Act, s 83
For section 83(1)(a) of the Act, a self-insurer’s licence is subject to the condition that the self-insurer must give the Regulator, for each year or part of a year of the licence, a declaration in the approved form of the wages paid, or provided by, the self-insurer.
24 Premium payable after cancellation of self-insurer’s licence—Act, s 98
(1)For section 98 of the Act, the way prescribed for the calculation of the premium payable by a self-insurer whose licence is cancelled (the former self-insurer) for the first 2 periods of insurance after cancellation is according to the method and at the rate specified by WorkCover, by gazette notice under section 54 of the Act, as if the former self-insurer were insuring with WorkCover for the first time.(2)However, the rate specified under subsection (1) must not be less than the rate calculated using the formula—where—
administrative costs means the administrative costs associated with claims incurred by the former self-insurer during the final period of licence, calculated by multiplying payments + liability by 0.095.final period of licence means—(a)for a former self-insurer licensed as a self-insurer for 3 or more years immediately before cancellation of the former self-insurer’s licence—3 years; or(b)for a former self-insurer licensed as a self-insurer for less than 3 years immediately before cancellation of the former self-insurer’s licence—the period of the licence.liability means an actuarial estimate of the former self-insurer’s outstanding liability at the end of the former self-insurer’s licence for claims incurred by the former self-insurer during the final period of licence, excluding liability for the excess period.payments means the actual payments made by the former self-insurer for claims incurred during the final period of licence, less recoveries received and payments made that are the equivalent of amounts payable for the excess period.wages means the wages paid, or provided, by the self-insurer during the final period of licence.
25 Deemed levy for ascertaining appeal court—Act, s 569
For section 569(2)(a) of the Act, the deemed levy, for a self-insurer for a financial year of the self-insurer’s licence, is the amount calculated using the formula—where—
estimated claims liability means the self-insurer’s estimated claims liability mentioned in section 18(3).rate means the rate published by the Regulator under section 81(6) of the Act for the particular financial year.
Part 3 Calculation of self-insurer’s liability
Division 1 Outstanding liability
Subdivision 1 Preliminary
26 Definitions for division
In this division—application day, in relation to a self-insurer, means the day the self-insurer applied to be licensed as a self-insurer under section 70 of the Act.appointed actuary see section 28.assessment day, in relation to a self-insurer, means the last day of the financial quarter immediately before the application day.outstanding liability see section 87(1)(b) of the Act.summary report see section 32(1).
27 Calculation of outstanding liability—Act, s 87
For section 87(2) of the Act, the amount of a self-insurer’s outstanding liability must be calculated under this division.
Subdivision 2 Actuarial calculations and reports
28 Appointment of actuaries
WorkCover and the self-insurer must each appoint an actuary (each an appointed actuary) to calculate the amount of the self-insurer’s outstanding liability.
29 Regulator to give appointed actuaries information
The Regulator must give each appointed actuary the information necessary to enable the appointed actuary to calculate the amount of the self-insurer’s outstanding liability within the period mentioned in section 31(3).
30 Actuarial calculation
Each appointed actuary’s calculation of the amount of the self-insurer’s outstanding liability must—(a)be prepared under the actuarial standard; and(b)apply a central estimate of the liability; and(c)apply the risk free rate of return; and(d)include claims administration expenses of 7% of the self-insurer’s outstanding liability; and(e)not include a prudential margin; and(f)be based, to the extent practicable, on claims for compensation and damages made against the self-insurer before the self-insurer was granted a licence to become a self-insurer; and(g)be based on data that is up-to-date on the assessment day.
31 Actuarial report
(1)Each appointed actuary must prepare an actuarial report under the actuarial standard of the appointed actuary’s calculation of the amount of the self-insurer’s outstanding liability.(2)The actuarial report must state the following—(a)the amount of the self-insurer’s outstanding liability;(b)the key assumptions made by the appointed actuary for the calculation;(c)how the key assumptions made by the appointed actuary have been derived, including—(i)the average amount of a claim for compensation against the self-insurer; and(ii)the average amount of a claim for damages against the self-insurer; and(iii)the amount anticipated to have been incurred by the self-insurer in potential claims for compensation or damages for which no claim has yet been made; and(iv)the frequency of claims for compensation against the self-insurer; and(v)the frequency of claims for damages against the self-insurer; and(vi)the net amount of claims for compensation and damages against the self-insurer after allowing for future inflation (inflated value); and(vii)the net present value of the inflated value after allowing for income from assets set aside by the self-insurer to pay the amount mentioned in paragraph (a); and(viii)the rate of inflation used;(d)the nature of the data used in the calculation;
(e)the appointed actuary’s assessment of the data, including, for example, the accuracy of the data;(f)how the appointed actuary interpreted the data;(g)the actuarial model used in the calculation;(h)the results of the calculation;(i)the appointed actuary’s confidence in the results of the calculation.(3)Each appointed actuary must prepare the actuarial report within 35 days after the application day.
32 Summary report
(1)The appointed actuaries must also jointly prepare a report (the summary report) that—(a)includes each appointed actuary’s individual actuarial report; and(b)states how the reports mentioned in paragraph (a) agree or differ and the reasons for any difference.(2)The appointed actuaries must give a copy of the summary report to the Regulator, WorkCover and the self-insurer within 2 months after the application day.
33 Agreement on amount
WorkCover and the self-insurer may agree on the amount of the self-insurer’s outstanding liability having regard to the summary report.
34 Referral to arbiter if no agreement on amount
(1)This section applies if WorkCover and the self-insurer do not agree on the amount of the self-insurer’s outstanding liability.(2)WorkCover and the self-insurer must, by written notice, tell the Regulator that WorkCover and the self-insurer do not agree on the amount of the self-insurer’s outstanding liability.(3)If the Regulator receives a written notice under subsection (2), the Regulator must refer the summary report to the arbiter to decide the amount of the self-insurer’s outstanding liability.Note—
See sections 102 to 104 in relation to the arbiter’s decision.
35 Payment of amount
(1)WorkCover must pay to the self-insurer the amount of the self-insurer’s outstanding liability (the final amount)—(a)agreed to by WorkCover and the self-insurer; or(b)if there is no agreement—decided by the arbiter under section 102(2)(b)(ii).(2)WorkCover must pay the self-insurer—(a)75% of the final amount on the day the self-insurer’s licence starts; and(b)the balance of the final amount within 1 month after the day the self-insurer’s licence starts.(3)However, the final amount paid by WorkCover must be adjusted by WorkCover’s appointed actuary to take into account—(a)the amount of compensation and damages, if any, paid by the self-insurer during the final period; and(b)claims for compensation and damages, if any, lodged against the self-insurer during the final period.(4)In this section—final period, in relation to a self-insurer, means the period that—(a)starts on the assessment day; and(b)ends on the day the self-insurer becomes liable for the self-insurer’s outstanding liability.
36 Transfer of claims information
WorkCover must, before the day the self-insurer’s licence starts, give the self-insurer all the information in WorkCover’s possession about the claims for compensation and damages that relate to the self-insurer’s outstanding liability.
Division 2 Total liability
Subdivision 1 Preliminary
37 Definitions for division
In this division—appointed actuary see section 39.assessment day, in relation to a member, means the last day of the financial quarter immediately before the day the old insurer applied to the Regulator under section 89 of the Actfor a change in the group membership on the old insurer’s licence.consent day, in relation to a member, means the day the Regulator approved the old insurer’s application under section 89 of the Actfor a change in the group membership on the old insurer’s licence.member means a member to whom section 90 of the Actapplies.new insurer see section 38.old insurer see section 38.summary report see section 43(1).
38 Calculation of total liability after change in self-insurer’s membership—Act, s 90
For section 90(9)(a) of the Act, when a member leaves a self-insurer that is a group employer (the old insurer) and becomes part of another self-insurer (the new insurer) the amount of the member’s total liability must be calculated under this division.
Subdivision 2 Actuarial calculations and reports
39 Appointment of actuaries
The old insurer and the new insurer must each appoint an actuary (each an appointed actuary) to calculate the amount of the member’s total liability.
40 Insurers to give appointed actuaries information
The old insurer and the new insurer must give each appointed actuary, in the approved form, the information necessary to enable the appointed actuary to calculate the amount of the member’s total liability within the period mentioned in section 42(3).
41 Actuarial calculation
Each appointed actuary’s calculation of the amount of the member’s total liability must—(a)be prepared under the actuarial standard; and(b)apply a central estimate of the liability; and(c)apply the risk free rate of return; and(d)include claims administration expenses of 7% of the member’s total liability; and(e)not include a prudential margin; and(f)be based, to the extent practicable, on claims for compensation and damages made against the member; and(g)be based on data that is up-to-date on the assessment day.
42 Actuarial report
(1)Each appointed actuary must prepare an actuarial report under the actuarial standard of the appointed actuary’s calculation of the amount of the member’s total liability.(2)The actuarial report must state the following—(a)the amount of the member’s total liability;(b)the key assumptions made by the appointed actuary for the calculation;(c)how the key assumptions by the appointed actuary have been derived, including—(i)the average amount of a claim for compensation against the member; and(ii)the average amount of a claim for damages against the member; and(iii)the amount anticipated to have been incurred by the member in potential claims for compensation or damages for which no claim has yet been made; and(iv)the frequency of claims for compensation against the member; and(v)the frequency of claims for damages against the member; and(vi)the net amount of claims for compensation and damages against the member after allowing for future inflation (inflated value); and(vii)the net present value of the inflated value after allowing for income from assets set aside by the member to pay the amount mentioned in paragraph (a); and(viii)the rate of inflation used;(d)the nature of the data used in the calculation;(e)the appointed actuary’s assessment of the data, including, for example, the accuracy of the data;(f)how the appointed actuary interpreted the data;(g)the actuarial model used in the calculation;(h)the results of the calculation;(i)the appointed actuary’s confidence in the results of the calculation.(3)Each appointed actuary must prepare the actuarial report within 35 days after the consent day.
43 Summary report
(1)The appointed actuaries must also jointly prepare a report (the summary report) that—(a)includes each appointed actuary’s individual actuarial report; and(b)states how the reports mentioned in paragraph (a) agree or differ and the reasons for any difference.(2)The appointed actuaries must give a copy of the summary report to the Regulator, the old insurer and the new insurer within 2 months after the consent day.
44 Agreement on amount
The old insurer and the new insurer may agree on the amount of the member’s total liability having regard to the summary report.
45 Referral to arbiter if no agreement on amount
(1)This section applies if the old insurer or the new insurer do not agree on the amount of the member’s total liability.(2)The old insurer and the new insurer must, by written notice, tell the Regulator that the old insurer and the new insurer do not agree on the amount of the member’s total liability.(3)If the Regulator receives a written notice under subsection (2), the Regulator must refer the summary report to the arbiter to decide the amount of the member’s total liability.Note—
See sections 102 to 104 in relation to the arbiter’s decision.
46 Payment of amount
(1)The old insurer must pay to the new insurer the amount of the member’s total liability (the final amount)—(a)agreed to by the old insurer and the new insurer; or(b)if there is no agreement—decided by the arbiter under section 102(2)(b)(ii).(2)The old insurer must pay the final amount—(a)within 3 months after the consent day; or(b)on or before a later day agreed to by the old insurer and the new insurer.(3)However, the final amount paid by the old insurer must be adjusted by the old insurer’s appointed actuary to take into account—(a)the amount of compensation and damages, if any, paid by the member during the final period; and(b)claims for compensation and damages, if any, lodged against the member during the final period.(4)The old insurer must, by written notice, tell the Regulator the following information not later than the day the final amount is paid to the new insurer—(a)the final amount paid, as adjusted under subsection (3);(b)the day the new insurer assumes liability for compensation and damages claimed against the member;(c)the name and contact details of the old insurer, the new insurer and the member.(5)In this section—final period, in relation to a member, means the period that—(a)starts on the assessment day; and(b)ends on the day the new insurer assumes liability for the member’s total liability.
47 Transfer of claims information
The old insurer must, not later than the day the final amount is paid to the new insurer under section 46, give the new insurer all the information in the old insurer’s possession about the claims for compensation and damages that relate to the member’s total liability.
Division 3 Liability after cancellation of self-insurer’s licence
Subdivision 1 Preliminary
48 Definitions for division
In this division—appointed actuary see section 50.assessment day, in relation to a former self-insurer, means the last day of the financial quarter immediately before the cancellation day.cancellation day, in relation to a former self-insurer, means the day the former self-insurer’s licence was cancelled.former self-insurer means a self-insurer whose licence has been cancelled.summary report see section 54(1).
49 Calculation of liability after cancellation—Act, s 102
For section 102(3) of the Act, the amount of a former self-insurer’s liability under sections 68C and 87(1) of the Actmust be calculated under this division.
Subdivision 2 Actuarial calculations and reports
50 Appointment of actuaries
WorkCover and the former self-insurer must each appoint an actuary (each an appointed actuary) to calculate the amount of the former self-insurer’s liability under sections 68C and 87(1) of the Act.
51 Former self-insurer to give appointed actuaries information
The former self-insurer must give each appointed actuary, in the approved form, the information necessary to enable the appointed actuary to calculate the amount of the former self-insurer’s liability under sections 68C and 87(1) of the Actwithin the period mentioned in section 53(3).
52 Actuarial calculation
Each appointed actuary’s calculation of the amount of the former self-insurer’s liability under sections 68C and 87(1) of the Actmust—(a)be prepared under the actuarial standard; and(b)apply a central estimate of the liability; and(c)apply the risk free rate of return; and(d)include claims administration expenses of 7% of the former self-insurer’s liability under sections 68C and 87(1) of the Act; and(e)not include a prudential margin; and(f)be based, to the extent practicable, on claims for compensation and damages made against the former self-insurer before the self-insurer was granted a licence to become a self-insurer; and(g)be based on data that is up-to-date on the assessment day.
53 Actuarial report
(1)Each appointed actuary must prepare an actuarial report under the actuarial standard of the appointed actuary’s calculation of the amount of the former self-insurer’s liability under sections 68C and 87(1) of the Act.(2)The actuarial report must state the following—(a)the amount of the former self-insurer’s liability under sections 68C and 87(1) of the Act;(b)the key assumptions made by the appointed actuary for the calculation;(c)how the key assumptions made by the appointed actuary have been derived, including—(i)the average amount of a claim for compensation against the former self-insurer; and(ii)the average amount of a claim for damages against the former self-insurer; and(iii)the amount anticipated to have been incurred by the former self-insurer in potential claims for compensation or damages for which no claim has yet been made; and(iv)the frequency of claims for compensation against the former self-insurer; and(v)the frequency of claims for damages against the former self-insurer; and(vi)the net amount of claims for compensation and damages against the former self-insurer after allowing for future inflation (inflated value); and(vii)the net present value of the inflated value after allowing for income from assets set aside by the former self-insurer to pay the amount mentioned in paragraph (a); and(viii)the rate of inflation used;(d)the nature of the data used in the calculation;(e)the appointed actuary’s assessment of the data, including, for example, the accuracy of the data;(f)how the appointed actuary interpreted the data;(g)the actuarial model used in the calculation;(h)the results of the calculation;(i)the appointed actuary’s confidence in the results of the calculation.(3)Each appointed actuary must prepare the actuarial report within 35 days after the cancellation day.
54 Summary report
(1)The appointed actuaries must also jointly prepare a report (the summary report) that—(a)includes each appointed actuary’s individual actuarial report; and(b)states how the reports mentioned in paragraph (a) agree or differ and the reasons for any difference.(2)The appointed actuaries must give a copy of the summary report to the Regulator, WorkCover and the former self-insurer within 2 months after the cancellation day.
55 Agreement on amount
WorkCover and the former self-insurer may agree on the amount of the former self-insurer’s liability under sections 68C and 87(1) of the Acthaving regard to the summary report.
56 Referral to arbiter if no agreement on amount
(1)This section applies if WorkCover and the former self-insurer do not agree on the amount of the former self-insurer’s liability under sections 68C and 87(1) of the Act.(2)WorkCover and the former self-insurer must, by written notice, tell the Regulator that WorkCover and the former self-insurer do not agree on the amount of the former self-insurer’s liability under sections 68C and 87(1) of the Act.(3)If the Regulator receives a written notice under subsection (2), the Regulator must refer the summary report to the arbiter to decide the amount of the former self-insurer’s liability under sections 68C and 87(1) of the Act.Note—
See sections 102 to 104 in relation to the arbiter’s decision.
57 Payment of amount
(1)The former self-insurer must pay to WorkCover the amount of the former self-insurer’s liability under sections 68C and 87(1) of the Act(the final amount)—(a)agreed to by WorkCover and the former self-insurer; or(b)if there is no agreement—decided by the arbiter under section 102(2)(b)(ii).(2)However, the final amount paid by the former self-insurer must be adjusted by the former self-insurer’s appointed actuary to take into account—(a)the amount of compensation and damages, if any, paid by the former self-insurer during the final period; and(b)claims for compensation and damages, if any, lodged against the former self-insurer during the final period.(3)In this section—final period, in relation to a former self-insurer, means the period that—(a)starts on the assessment day; and(b)ends on the cancellation day.
Division 4 Estimated claims liability for lodgement of security
Subdivision 1 Preliminary
58 Definitions for division
In this division—appointed actuary see section 60.second appointed actuary see section 66(1).self-insurer’s data means data that will enable the calculation of the amount of the self-insurer’s estimated claims liability.
59 Calculation of estimated claims liability—Act, s 84
For section 84(4)(b) of the Act, the amount of a self-insurer’s estimated claims liability must be calculated under this division.
Subdivision 2 Actuarial calculations and reports
60 Appointment of actuary
The Regulator must appoint an actuary (the appointed actuary) to calculate the amount of the self-insurer’s estimated claims liability.
61 Self-insurer to give Regulator and appointed actuary information
The self-insurer must give the Regulator and the appointed actuary, in the approved form, the information necessary to enable the appointed actuary to calculate the amount of the self-insurer’s estimated claims liability.
62 Actuarial calculation
The appointed actuary’s calculation of the amount of the self-insurer’s estimated claims liability must—(a)be prepared under the actuarial standard; and(b)apply a central estimate of the liability; and(c)apply the risk free rate of return; and(d)include claims administration expenses of 7% of the self-insurer’s estimated claims liability; and(e)not include a prudential margin; and(f)be based, to the extent practicable, on claims for compensation and damages made against the self-insurer; and(g)be based on data that is up-to-date on—(i)for a calculation in relation to the renewal of the self-insurer’s licence—the last day of the financial quarter immediately before the day the renewed licence starts; or(ii)otherwise—the day immediately before the amount is calculated.
63 Actuarial report
(1)The appointed actuary must prepare an actuarial report under the actuarial standard of the appointed actuary’s calculation of the amount of the self-insurer’s estimated claims liability.(2)The actuarial report must state the following—(a)the amount of the self-insurer’s estimated claims liability;(b)the key assumptions made by the appointed actuary for the calculation;(c)how the key assumptions made by the appointed actuary have been derived, including—(i)the average amount of a claim for compensation against the self-insurer; and(ii)the average amount of a claim for damages against the self-insurer; and(iii)the amount anticipated to have been incurred by the self-insurer in potential claims for compensation and damages for which no claim has yet been made; and(iv)the frequency of claims for compensation against the self-insurer; and(v)the frequency of claims for damages against the self-insurer; and(vi)the net amount of claims for compensation and damages against the self-insurer after allowing for future inflation (inflated value); and(vii)the net present value of the inflated value after allowing for income from assets set aside by the self-insurer to pay the amount mentioned in paragraph (a); and(viii)the rate of inflation used;(d)the nature of the data used in the calculation;(e)the appointed actuary’s assessment of the data, including, for example, the accuracy of the data;(f)how the appointed actuary interpreted the data;(g)the actuarial model used in the calculation;(h)the results of the calculation;(i)the appointed actuary’s confidence in the results of the calculation.
64 Appointed actuary must give copy of report to Regulator and self-insurer
The appointed actuary must give a copy of the actuarial report to the Regulator and the self-insurer before—(a)the day stated by the Regulator; or(b)a later day agreed to by the Regulator and the appointed actuary.
65 Regulator to tell self-insurer whether agreement on amount
Within 35 days after the appointed actuary gives the Regulator a copy of the actuarial report, the Regulator must give the self-insurer a written notice stating whether the Regulator agrees or does not agree with the appointed actuary’s assessment of the self-insurer’s estimated claims liability.
66 Referral to second appointed actuary if no agreement on amount
(1)After receiving a copy of the appointed actuary’s report, the Regulator may ask another actuary appointed by the Regulator (the second appointed actuary) to—
(a)calculate the amount of the self-insurer’s estimated claims liability under section 62; and(b)give the Regulator an actuarial report under section 63(2).(2)The Regulator must give the second appointed actuary the appointed actuary’s report and the self-insurer’s data.
67 Agreement on amount
If, at any time, the Regulator and the self-insurer agree on the self-insurer’s estimated claims liability, having regard to the appointed actuary’s actuarial report or the second appointed actuary’s actuarial report, the self-insurer’s estimated claims liability is the amount agreed to by the Regulator and the self-insurer.
68 Referral to arbiter if no agreement on amount
(1)This section applies if the Regulator and the self-insurer do not agree under section 67 on the amount of the self-insurer’s estimated claims liability.(2)The Regulator must refer the appointed actuary’s actuarial report, the self-insurer’s data and any second appointed actuary’s actuarial report to the arbiter to decide the amount of the self-insurer’s estimated claims liability.Note—
See sections 102 to 104 in relation to the arbiter’s decision.(3)The Regulator must make the referral within 14 days after the day the Regulator gives the self-insurer a written notice under section 65 stating that the Regulator does not agree with the appointed actuary’s assessment of the self-insurer’s estimated claims liability.
Division 5 Self-insurers who become non-scheme employers
Subdivision 1 Preliminary
69 Definition for division
In this division—cancellation day, in relation to a non-scheme employer, means the day the non-scheme employer’s continued licence is cancelled under section 105E of the Act.Note—
Under section 105F(d) of the Act, on cancellation of the continued licence, WorkCover replaces the non-scheme employer, for any proceeding taken by a claimant or worker against the non-scheme employer, as insurer.
70 Calculation of non-scheme employer’s liability—Act, s 105I
(1)For section 105I(2) of the Act, the amount of a non-scheme employer’s liability under section 105B(3) of the Actmust be calculated by—(a)estimating the amount under subdivision 2; and(b)finalising the amount under subdivision 3.(2)The amount of the non-scheme employer’s liability under section 105B(3) of the Actis the finalised amount calculated under subdivision 3.(3)The non-scheme employer’s liability under section 105B(3) of the Actis finalised for section 105I(5) of the Actwhen—(a)the finalised amount is calculated under subdivision 3; or(b)if the finalised amount is different to the final amount paid under section 79—the amount payable by the non-scheme employer under section 88(2) or by WorkCover under section 88(3) is paid.
Subdivision 2 Estimating non-scheme employer’s liability
71 Definitions for subdivision
In this subdivision—appointed actuary see section 72.summary report see section 76(1).
72 Appointment of actuaries
WorkCover and the non-scheme employer must each appoint an actuary (each an appointed actuary) to estimate the amount of the non-scheme employer’s liability under section 105B(3) of the Act.
73 Non-scheme employer to give appointed actuaries information
The non-scheme employer must give each appointed actuary, in the approved form, the information necessary to enable the appointed actuary to estimate the amount of the non-scheme employer’s liability under section 105B(3) of the Actwithin the period mentioned in section 75(3).
74 Actuarial calculation
Each appointed actuary’s calculation of the estimated amount of the non-scheme employer’s liability under section 105B(3) of the Actmust—(a)be prepared under the actuarial standard; and(b)apply a central estimate of the liability; and(c)apply the risk free rate of return; and(d)include claims administration expenses of 7% of the non-scheme employer’s liability under section 105B(3) of the Act; and(e)not include a prudential margin; and(f)be based, to the extent practicable, on claims for compensation and damages made against the non-scheme employer; and(g)be based on data that only relates to the period before the non-scheme employer’s exit date.
75 Actuarial report
(1)Each appointed actuary must prepare an actuarial report under the actuarial standard of the appointed actuary’s calculation of the estimated amount of the non-scheme employer’s liability under section 105B(3) of the Act.(2)The actuarial report must state the following—(a)the estimated amount of the non-scheme employer’s liability under section 105B(3) of the Act;(b)the key assumptions made by the appointed actuary for the calculation;(c)how the key assumptions made by the appointed actuary have been derived, including—(i)the average amount of a claim for compensation against the non-scheme employer; and(ii)the average amount of a claim for damages against the non-scheme employer; and(iii)the amount anticipated to have been incurred by the non-scheme employer in potential claims for compensation or damages for which no claim has yet been made; and(iv)the frequency of claims for compensation against the non-scheme employer; and(v)the frequency of claims for damages against the non-scheme employer; and(vi)the net amount of claims for compensation and damages against the non-scheme employer after allowing for future inflation (inflated value); and(vii)the net present value of the inflated value after allowing for income from assets set aside by the non-scheme employer to pay the amount mentioned in paragraph (a); and(viii)the rate of inflation used;(d)the nature of the data used in the calculation;(e)the appointed actuary’s assessment of the data, including, for example, the accuracy of the data;(f)how the appointed actuary interpreted the data;(g)the actuarial model used in the calculation;(h)the results of the calculation;(i)the appointed actuary’s confidence in the results of the calculation.(3)Each appointed actuary must prepare the actuarial report within 35 days after the cancellation day.
76 Summary report
(1)The appointed actuaries must also jointly prepare a report (the summary report) that—(a)includes each appointed actuary’s individual actuarial report; and(b)states how the reports mentioned in paragraph (a) agree or differ and the reasons for any difference.(2)The appointed actuaries must give a copy of the summary report to the Regulator, WorkCover and the non-scheme employer within 2 months after the cancellation day.
77 Agreement on amount
WorkCover and the non-scheme employer may agree on the estimated amount of the non-scheme employer’s liability under section 105B(3) of the Acthaving regard to the summary report.
78 Referral to arbiter if no agreement on amount
(1)This section applies if WorkCover and the non-scheme employer do not agree on the estimated amount of the non-scheme employer’s liability under section 105B(3) of the Act.(2)WorkCover and the non-scheme employer must, by written notice, tell the Regulator that WorkCover and the non-scheme employer do not agree on the estimated amount of the non-scheme employer’s liability under section 105B(3) of the Act.(3)If the Regulator receives a written notice under subsection (2), the Regulator must refer the summary report to the arbiter to decide the estimated amount of the non-scheme employer’s liability under section 105B(3) of the Act.Note—
See sections 102 to 104 in relation to the arbiter’s decision.
79 Payment of amount
(1)The non-scheme employer must pay to WorkCover the estimated amount of the non-scheme employer’s liability under section 105B(3) of the Act(the final amount)—(a)agreed to by WorkCover and the non-scheme employer; or(b)if there is no agreement—decided by the arbiter under section 102(2)(b)(ii).(2)However, the final amount paid by the non-scheme employer must be adjusted by the non-scheme employer’s appointed actuary to take into account—(a)the amount of compensation and damages, if any, paid by the non-scheme employer during the final period; and(b)claims for compensation and damages, if any, lodged against the non-scheme employer during the final period.Note—
See section 105I(3)(b) of the Actfor when the final amount must be paid.(3)In this section—assessment day means the last day of the financial quarter immediately before the cancellation day.final period, in relation to a non-scheme employer, means the period that—(a)starts on the assessment day; and(b)ends on the cancellation day.
Subdivision 3 Finalising non-scheme employer’s liability
80 Definitions for subdivision
In this subdivision—appointed actuary see section 81(1).summary report see section 85(1).
81 Appointment of actuaries
(1)WorkCover and the non-scheme employer must each appoint an actuary (each an appointed actuary) to finalise the amount of the non-scheme employer’s liability under section 105B(3) of the Act.(2)The appointment must be made within 20 business days after the day that is 4 years after the cancellation day.
82 WorkCover to give appointed actuaries information
WorkCover must give each appointed actuary the information necessary to enable the appointed actuary to finalise the amount of the non-scheme employer’s liability under section 105B(3) of the Actwithin the period mentioned in section 84(3).
83 Actuarial calculation
Each appointed actuary’s calculation of the finalised amount of the non-scheme employer’s liability under section 105B(3) of the Actmust—(a)be prepared under the actuarial standard; and(b)apply a central estimate of the liability; and(c)apply the same risk free rate of return that was used in estimating under subdivision 2 the non-scheme employer’s liability under section 105B(3) of the Act; and(d)include claims administration expenses of 7% of the non-scheme employer’s liability under section 105B(3) of the Act; and(e)not include a prudential margin; and(f)be based, to the extent practicable, on claims for compensation and damages made against the non-scheme employer; and(h)have regard to payments for compensation and damages made in relation to the non-scheme employer’s liability under section 105B(3) of the Actduring the period (the 4 year period) that—(i)starts on the cancellation day; and(ii)ends 4 years after the cancellation day; and(i)be based on data that—(i)is up-to-date on the last day of the last financial quarter of the 4 year period for which data is available; and(ii)only relates to the period before the non-scheme employer’s exit date.
84 Actuarial report
(1)Each appointed actuary must prepare an actuarial report under the actuarial standard of the appointed actuary’s calculation of the finalised amount of the non-scheme employer’s liability under section 105B(3) of the Act.(2)The actuarial report must state the following—(a)the finalised amount of the non-scheme employer’s liability under section 105B(3) of the Act;(b)the key assumptions made by the appointed actuary for the calculation;(c)how the key assumptions made by the appointed actuary have been derived, including—(i)the average amount of a claim for compensation against the non-scheme employer; and(ii)the average amount of a claim for damages against the non-scheme employer; and(iii)the amount anticipated to have been incurred by the non-scheme employer in potential claims for compensation or damages for which no claim has yet been made; and(iv)the frequency of claims for compensation against the non-scheme employer; and(v)the frequency of claims for damages against the non-scheme employer; and(vi)the net amount of claims for compensation and damages against the non-scheme employer after allowing for future inflation (inflated value); and(vii)the net present value of the inflated value after allowing for income from assets set aside by the non-scheme employer to pay the amount mentioned in paragraph (a); and(viii)the rate of inflation used;(d)the nature of the data used in the calculation;(e)the appointed actuary’s assessment of the data, including, for example, the accuracy of the data;(f)how the appointed actuary interpreted the data;(g)the actuarial model used in the calculation;(h)the results of the calculation;(i)the appointed actuary’s confidence in the results of the calculation.(3)Each appointed actuary must prepare the actuarial report within 35 days after the day that is 4 years after the cancellation day.
85 Summary report
(1)The appointed actuaries must also jointly prepare a report (the summary report) that—(a)includes each appointed actuary’s individual actuarial report; and(b)states how the reports mentioned in paragraph (a) agree or differ and the reasons for any difference.(2)The appointed actuaries must give a copy of the summary report to the Regulator, WorkCover and the non-scheme employer within 2 months after the day that is 4 years after the cancellation day.
86 Agreement on amount
WorkCover and the non-scheme employer may agree on the finalised amount of the non-scheme employer’s liability under section 105B(3) of the Acthaving regard to the summary report.
87 Referral to arbiter if no agreement on amount
(1)This section applies if WorkCover and the non-scheme employer do not agree on the finalised amount of the non-scheme employer’s liability under section 105B(3) of the Act.(2)WorkCover and the non-scheme employer must, by written notice, tell the Regulator that WorkCover and the non-scheme employer do not agree on the finalised amount of the non-scheme employer’s liability under section 105B(3) of the Act.(3)If the Regulator receives a written notice under subsection (2), the Regulator must refer the summary report to the arbiter to decide the finalised amount of the non-scheme employer’s liability under section 105B(3) of the Act.Note—
See sections 102 to 104 in relation to the arbiter’s decision.
88 Payment of amount
(1)This section applies if the finalised amount of the non-scheme employer’s liability under section 105B(3) of the Actis—(a)agreed to by WorkCover and the non-scheme employer under section 86; or(b)if there is no agreement—decided by the arbiter under section 102(2)(b)(ii).(2)If the finalised amount is more than the final amount paid under section 79 (the interim payment), the non-scheme employer must, within 20 business days after the agreement or decision mentioned in subsection (1), pay WorkCover—(a)the difference between the finalised amount and the interim payment; and(b)interest on the difference, from the day the whole of the interim payment was paid, at the same risk free rate of return mentioned in section 83(c).(3)If the finalised amount is less than the final amount paid under section 79 (the interim payment), WorkCover must, within 20 business days after the agreement or decision mentioned in subsection (1), pay the non-scheme employer—(a)the difference between the interim payment and the finalised amount; and(b)interest on the difference, from the day the whole of the interim payment was paid, at the same risk free rate of return mentioned in section 83(c).
Division 6 Total liability—member of group employer who becomes non-scheme employer
Subdivision 1 Preliminary
89 Definitions for division
In this division—appointed actuary see section 91(1).assessment day, in relation to a non-scheme member, means the last day of the financial quarter immediately before the final day.final day, in relation to a non-scheme member, means the day the non-scheme member stopped being a member of the old self-insurer under section 105M of the Act.old self-insurer, in relation to a non-scheme member, means the self-insurer of which the non-scheme member was a member immediately before becoming a non-scheme employer.summary report see section 95(1).
90 Calculation of non-scheme member’s total liability—Act, s 105O
For section 105O(3)(a) of the Act, the amount of a non-scheme member’s total liability must be calculated under this division.
Subdivision 2 Actuarial calculations and reports
91 Appointment of actuaries
(1)WorkCover and the old self-insurer must each appoint an actuary (each an appointed actuary) to calculate the amount of the non-scheme member’s total liability.(2)The actuary appointed by the old self-insurer must be approved by the non-scheme member.
92 WorkCover and old self-insurer to give appointed actuaries information
WorkCover and the old self-insurer must give each appointed actuary, in the approved form, the information necessary to enable the appointed actuary to calculate the amount of the non-scheme member’s total liability within the period mentioned in section 94(3).
93 Actuarial calculation
Each appointed actuary’s calculation of the amount of the non-scheme member’s total liability must—(a)be prepared under the actuarial standard; and(b)apply a central estimate of the relevant liability; and(c)apply the risk free rate of return; and(d)include claims administration expenses of 7% of the non-scheme member’s total liability; and(e)not include a prudential margin; and(f)be based, to the extent practicable, on claims for compensation and damages made against the non-scheme member; and(g)be based on data that is up-to-date on the assessment day.
94 Actuarial report
(1)Each appointed actuary must prepare an actuarial report under the actuarial standard of the appointed actuary’s calculation of the amount of the non-scheme member’s total liability.(2)The actuarial report must state the following—(a)the amount of the non-scheme member’s total liability;(b)the key assumptions made by the appointed actuary for the calculation;(c)how the key assumptions made by the appointed actuary have been derived, including—(i)the average amount of a claim for compensation against the non-scheme member; and(ii)the average amount of a claim for damages against the non-scheme member; and(iii)the amount anticipated to have been incurred by the non-scheme member in potential claims for compensation or damages for which no claim has yet been made; and(iv)the frequency of claims for compensation against the non-scheme member; and(v)the frequency of claims for damages against the non-scheme member; and(vi)the net amount of claims for compensation and damages against the non-scheme member after allowing for future inflation (inflated value); and(vii)the net present value of the inflated value after allowing for income from assets set aside by the non-scheme member to pay the amount mentioned in paragraph (a); and(viii)the rate of inflation used;(d)the nature of the data used in the calculation;(e)the appointed actuary’s assessment of the data, including, for example, the accuracy of the data;(f)how the appointed actuary interpreted the data;(g)the actuarial model used in the calculation;(h)the results of the calculation;(i)the appointed actuary’s confidence in the results of the calculation.(3)Each appointed actuary must prepare the actuarial report within 35 days after the final day.
95 Summary report
(1)The appointed actuaries must also jointly prepare a report (the summary report) that—(a)includes each appointed actuary’s individual actuarial report; and(b)states how the reports mentioned in paragraph (a) agree or differ and the reasons for any difference.(2)The appointed actuaries must give a copy of the summary report to the Regulator, WorkCover and the old self-insurer within 2 months after the final day.
96 Agreement on amount
WorkCover and the old self-insurer may agree on the amount of the non-scheme member’s total liability having regard to the summary report.
97 Referral to arbiter if no agreement on amount
(1)This section applies if WorkCover and the old self-insurer do not agree on the amount of the non-scheme member’s total liability.(2)WorkCover and the old self-insurer must, by written notice, tell the Regulator that WorkCover and the old self-insurer do not agree on the amount of the non-scheme member’s total liability.(3)If the Regulator receives a written notice under subsection (2), the Regulator must refer the summary report to the arbiter to decide the amount of the non-scheme member’s total liability.Note—
See sections 102 to 104 in relation to the arbiter’s decision.
98 Payment of amount
(1)The old self-insurer must pay to WorkCover the amount of the non-scheme member’s total liability (the final amount)—(a)agreed to by the old self-insurer and WorkCover; or(b)if there is no agreement—decided by the arbiter under section 102(2)(b)(ii).(2)The old self-insurer must pay the final amount—(a)within 3 months after the final day; or(b)on or before a later day agreed to by the old self-insurer and WorkCover.(3)However, the final amount paid by the old self-insurer must be adjusted by the old self-insurer’s appointed actuary to take into account—(a)the amount of compensation and damages, if any, paid by the non-scheme member during the final period; and(b)claims for compensation and damages, if any, lodged against the non-scheme member during the final period.(4)The old self-insurer must, by written notice, tell the Regulator the following information not later than the day the final amount is paid to WorkCover—(a)the final amount paid, as adjusted under subsection (3);(b)the name and contact details of the old self-insurer and the non-scheme member.(5)In this section—final period, in relation to a non-scheme member, means the period that—(a)starts on the assessment day; and(b)ends on the final day.
99 Transfer of claims information
The old self-insurer must, not later than the day the final amount is paid to WorkCover under section 98, give WorkCover all the information in the old self-insurer’s possession about the claims for compensation and damages that relate to the non-scheme member’s total liability.
Division 7 Actuarial arbiter
100 Appointment of arbiter
(1)The Regulator must appoint an actuarial arbiter (the arbiter).(2)The person appointed under subsection (1) must—(a)be a Fellow or Accredited Member of the Actuaries Institute; and(b)be selected by a selection panel consisting of—(i)2 individuals nominated by the Regulator; and(ii)2 individuals nominated by WorkCover; and(iii)2 individuals nominated by the Association of Self Insured Employers of Queensland.(3)The arbiter is appointed on the terms and conditions, not provided for by this regulation, decided by the Regulator.
101 Functions of arbiter
The functions of the arbiter are—(a)to consider reports referred to the arbiter under this part; and(b)to decide on amounts of liability mentioned in this part.
102 Arbiter must decide amount of liability
(1)This section applies if—(a)under section 34(3), 45(3), 56(3), 78(3), 87(3) or 97(3), the Regulator refers a summary report about an amount of liability to the arbiter; or(b)under section 68(2), the Regulator refers an appointed actuary’s actuarial report, the self-insurer’s data and a second appointed actuary’s actuarial report, if any, about an amount of liability to the arbiter.(2)The arbiter must—(a)for a referral mentioned in subsection (1)(a)—(i)consider the individual reports included in the summary report; and(ii)decide—(A)the central estimate for the liability; and(B)the amount of the liability; or(b)for a referral mentioned in subsection (1)(b)—(i)consider the documents mentioned in subsection (1)(b); and(ii)decide—(A)if an appointed actuary’s actuarial report and a second appointed actuary’s report is referred—the central estimate for the liability; and(B)the amount of the liability.(3)The amount of the liability decided under subsection (2)(a)(ii)(B) must not be—(a)more than the higher of the amounts of liability stated in the individual reports; or(b)less than the lower of the amounts of liability stated in the individual reports.(4)The arbiter must give a written statement of the arbiter’s decision, and the reasons for the decision, to the Regulator within 21 days after the referral to the arbiter is made.
103 Arbiter’s decision is final
Unless the Supreme Court decides a decision of the arbiter under section 102 is affected by jurisdictional error, the decision—(a)is final and conclusive; and(b)can not be challenged, appealed against, reviewed, quashed, set aside or called in question in any other way under the Judicial Review Act 1991 or otherwise (whether by the Supreme Court, another court, a tribunal or another entity); and(c)is not subject to any declaratory, injunctive or other order of the Supreme Court, another court, a tribunal or another entity on any ground.
104 Arbiter’s costs
The costs of an arbiter incurred in deciding an amount of liability under section 102 are to be paid in equal amounts by the following entities—(a)for a decision about an amount of liability under division 1—WorkCover and the self-insurer;(b)for a decision about an amount of liability under division 2—the old insurer and the new insurer;(c)for a decision about an amount of liability under division 3—WorkCover and the former self-insurer;(d)for a decision about an amount of liability under division 4—the Regulator and the self-insurer;(e)for a decision about an amount of liability under division 5, subdivision 2 or 3—WorkCover and the non-scheme employer;(f)for a decision about an amount of liability under division 6—WorkCover and the old self-insurer.
Part 4 Compensation
Division 1 Calculation of normal weekly earnings
105 Calculation of NWE—Act, s 106
This division prescribes, for section 106(3) of the Act, the way in which to calculate a worker’s NWE in the 12 months immediately before the day the worker sustained an injury.
106 What amounts may be taken into account
(1)In calculating the worker’s NWE, amounts paid to the worker by way of overtime, higher duties, penalties and allowances, in relation to work required by the worker’s employer, may be taken into account but only if the amounts—(a)are of a regular nature; and(b)would have continued if not for the worker’s injury.(2)However, amounts mentioned in the Act, schedule 6, definition wages, paragraphs (a) to (d) must not be taken into account in calculating the worker’s NWE.
107 NWE if impracticable to calculate worker’s earnings
(1)This section applies if it is impracticable to calculate the worker’s earnings in the 12 months immediately before the day the worker sustained the injury because of—(a)the period for which the worker has been employed; or(b)the terms of the worker’s employment.(2)In calculating the worker’s NWE, regard must be had to—(a)the NWE, in the 12 months immediately before the day the worker sustained the injury, of a person employed by the same employer who—(i)is employed under the same or a comparable industrial agreement or the same or comparable terms and conditions as the worker; and(ii)performs the same or comparable work as the worker; or(b)if paragraph (a) does not apply—the NWE, in the 12 months immediately before the day the worker sustained the injury, of a person employed by another employer who—(i)is employed under the same or a comparable industrial agreement or the same or comparable terms and conditions as the worker; or(ii)performs the same or comparable work as the worker and receives the same or comparable earnings as the worker.
108 NWE if worker employed by 2 or more employers
(1)This section applies if, at the time the worker’s injury was sustained, the worker was employed under concurrent contracts of service with 2 or more employers.(2)The worker’s NWE is to be calculated as if earnings under all the contracts were earnings in the employment of the employer for whom the worker was working when the injury was sustained.
109 NWE if insurer considers calculation unfair
(1)This section applies if an insurer considers that the calculation of a worker’s NWE under this division would be unfair.(2)The worker’s NWE may be calculated in a way the insurer considers to be fair, and the calculation under this subsection is taken to be the worker’s NWE.
Division 2 Application for compensation
110 Evidence and particulars for application for compensation—Act, s 132
For section 132(3)(b) of the Act, an application for compensation for a worker’s injury must be accompanied by evidence and particulars of—(a)the injury and its cause; and(b)the nature, extent and duration of incapacity resulting from the injury; and(c)if the injury is, or results in, the death of the worker—(i)the identity of the worker; and(ii)the worker’s death; and(iii)the relationship to the worker, and dependency, of persons claiming to be the worker’s dependants; and(d)if the injury is a latent onset injury that is a terminal condition and the worker has dependants—the relationship to the worker of persons claiming to be the worker’s dependants.
111 Evidence and particulars for assessment of DPI—Act, s 132A
For section 132A(3)(c)(ii) of the Act, an application to have a worker’s injury assessed under section 179 of the Actmust be accompanied by evidence and particulars of—(a)the injury and its cause; and(b)the nature, extent and duration of incapacity resulting from the injury.
112 Evidence and particulars for certificate of dependency—Act, s 132B
For section 132B(3)(c)(ii) of the Act, an application for the issue of a certificate stating a person is a dependant of a deceased worker must be accompanied by evidence and particulars of—(a)the injury and its cause; and(b)the identity of the worker; and(c)the worker’s death; and(d)the relationship to the worker, and dependency, of the person claiming to be the worker’s dependant.
113 Doctor, nurse practitioner or registered dentist required to give medical certificate not available
(1)This section applies if—(a)a person (the applicant) makes an application to an insurer under section 132, 132A or 132B of the Act; and(b)the application is not accompanied by a medical certificate; and(c)a doctor, nurse practitioner or registered dentist required or permitted to give the medical certificate was not available to attend the worker for the purpose of giving the certificate.(2)The applicant must give the insurer a declaration in the approved form stating—(a)that a doctor, nurse practitioner or registered dentist was not available to attend the worker for the purpose of giving the medical certificate; and(b)the details of the worker’s injury.(3)For a non-fatal injury, the declaration—(a)may be accepted by the insurer as proof of incapacity of the worker only once for injury to the worker in any 1 event; and(b)is acceptable proof of incapacity of the worker for not more than 3 days.(4)The declaration is taken to be a certificate in the approved form for section 132(3)(a), 132A(3)(c)(i) or 132B(3)(c)(i) of the Act.
114 Doctor, nurse practitioner or registered dentist required to give medical certificate outside Queensland
(1)This section applies if—(a)a person (the applicant) makes an application to an insurer under section 132, 132A or 132B of the Act; and(b)the application is not accompanied by a medical certificate; and(c)the worker sustained the injury outside Queensland.(2)The applicant may give the insurer a document, that is substantially to the same effect as the medical certificate, prepared by a person who holds a qualification corresponding to a doctor, nurse practitioner or registered dentist who attends the worker for the purpose of giving the document.(3)The document is taken to be a certificate in the approved form for section 132(3)(a), 132A(3)(c)(i) or 132B(3)(c)(i) of the Act.(4)Also, the insurer may—(a)ask the person who gave the document to give a detailed report on the worker’s condition to the insurer within 10 days after receiving the request; and(b)pay an amount to the person who gave the document for the report that the insurer considers reasonable having regard to the table of costs.
115 Requirement to submit to personal examination by registered person—Act, ss 135 and 510
(1)A requirement by an insurer under section 135 or 510 of the Act for a claimant or worker to submit to a personal examination by a registered person must be made by written notice.(2)The notice must state—(a)the name of the registered person engaged to make the examination; and(b)if the registered person is a specialist—the field of specialty; and(c)the day, time and place of the examination.(3)The registered person stated under subsection (2)(a) must not be employed by the insurer giving the notice.(4)A registered person who examines a claimant or worker under subsection (2) must, within 10 days after the examination, give the insurer—(a)a written report of the examination; and(b)an itemised account for the examination.(5)The insurer must pay the registered person the costs of performing the examination, and giving the report, that the insurer considers reasonable having regard to the table of costs.
Division 3 Entitlement to compensation for permanent impairment—generally
116 Additional lump sum compensation for workers with terminal latent onset injuries—Act, s 128B
For section 128B(2)(c) of the Act, the additional lump sum compensation, and graduated scale, stated in schedule 2 are prescribed.
117 Calculation of lump sum compensation—Act, s 180
For section 180(1) of the Act, the lump sum compensation for a worker’s DPI is calculated by multiplying the maximum statutory compensation by the worker’s DPI.Example—
A worker’s DPI is assessed as 10%. The maximum statutory compensation is $422,295. The lump sum compensation is $42,229.50.
118 Additional lump sum compensation for workers with DPI of 30% or more—Act, s 192
For section 192(2) of the Act, the additional lump sum compensation, and graduated scale, stated in schedule 3 are prescribed.
119 Occupational therapist’s assessment of level of dependency and day to day care requirements—Act, ss 193 and 224
(1)This section prescribes—(a)the way for assessing a worker’s level of dependency for section 193(4) of the Act; and(b)the way for assessing a worker’s level of dependency and day to day care requirements for section 224(3) of the Act.(2)The way is the way stated in the modified barthel index.
120 Occupational therapist’s assessment report—Act, ss 193 and 224
(1)This section prescribes—(a)information to be included in an assessment report relating to a worker’s level of dependency for section 193(5)(b) of the Act; and(b)information to be included in an assessment report relating to a worker’s level of dependency and day to day care requirements for section 224(4)(b) of the Act.(2)The information is the following—(a)whether day to day care of the same level was provided to the worker before the worker sustained the injury;(b)whether day to day care of the same level would ordinarily be provided at the worker’s home;(c)whether day to day care of the same level is likely to continue to be provided at the worker’s home;(d)the number of hours of day to day care required by the worker.
121 Additional lump sum compensation for gratuitous care—Act, s 193(6)
(1)For section 193(6) of the Act, the additional lump sum compensation, and graduated scale, stated in schedule 4 are prescribed.(2)For section 193(6)(c) of the Act, the occupational therapist’s report given under section 193(5) of the Actis prescribed.
Division 4 Entitlement to additional compensation for permanent impairment—Act, s 193A
Subdivision 1 Preliminary
122 Purpose of division
For section 193A of the Act, this division prescribes the following—(a)the amount of section 193A compensation for an injury;(b)the condition to which an entitlement to section 193A compensation is subject;(c)the process for deciding whether the condition mentioned in paragraph (b) is satisfied for a worker to whom section 193A of the Act applies;(d)the establishment of a panel to review decisions made by insurers about section 193A compensation.
123 Definitions for division
In this division—injury means an injury mentioned in section 193A(1) of the Act.panel means the panel established under section 141.qualifying condition means the condition prescribed by section 126.section 193A compensation, for an injury, means the additional lump sum compensation mentioned in section 193A(2) of the Act for the injury.section 193A notice see section 129(1).
124 Application of division
This division applies only to a worker to whom section 193A of the Act applies.
Subdivision 2 Amount and condition of entitlement
125 Amount of compensation—Act, s 193A
For section 193A(2)(a) of the Act, the amount of section 193A compensation for an injury sustained by a worker in relation to whom the qualifying condition is satisfied is the amount under schedule 5.
126 Qualifying condition—Act, s 193A
(1)For section 193A(2)(b) of the Act, this section prescribes the condition applying to an entitlement to section 193A compensation for an injury sustained by a worker.(2)The worker is entitled to section 193A compensation only if—(a)the insurer is satisfied, on the balance of probabilities, that the worker’s employer is, or would have been, liable to pay damages to the worker; but(b)the worker can not seek damages because of the application of former section 237(1)(a)(i).(3)In this section—former section 237(1)(a)(i) means section 237(1)(a)(i) of the Act, as in force from 15 October 2013 until 31 January 2015.
Subdivision 3 Process for deciding qualifying condition
127 Application of subdivision
This subdivision applies if a worker’s DPI has been decided.Notes—
1Section 193A of the Act applies only if a worker’s DPI has been decided—see section 191 of the Act.2Also, see chapter 3, part 10 of the Act for provisions about—•assessing a worker’s injury to decide if the injury has resulted in a DPI; and•giving the worker a notice of assessment stating the DPI for the injury; and•an insurer making an offer of compensation to the worker.
128 Insurer to consider qualifying condition
An insurer must decide—(a)whether the insurer has enough information to decide whether the qualifying condition is satisfied for the worker; and(b)if the insurer decides it has enough information—whether the qualifying condition is satisfied for the worker.
129 Notification
(1)After deciding the matters mentioned in section 128, the insurer must give the worker a notice (a section 193A notice) in the approved form.(2)If the insurer decides the qualifying condition is satisfied for the worker, the section 193A notice must state the amount of section 193A compensation to which the worker is entitled for the worker’s injury.(3)If the insurer decides the qualifying condition is not satisfied for the worker, the section 193A notice must state—(a)the insurer’s decision; and(b)that the worker may ask the insurer for written reasons for the decision; and(c)that the worker may apply to the panel for a review of the decision only if the worker has asked the insurer for written reasons for the decision.(4)If the insurer decides it does not have enough information to decide whether the qualifying condition is satisfied for the worker, the section 193A notice must state—(a)the insurer’s decision; and(b)that the worker may, within the period mentioned in section 131(2)(a), give the insurer information to enable the insurer to decide whether the qualifying condition is satisfied for the worker; and(c)that, if the worker does not give the insurer the information within the period mentioned in paragraph (b)—(i)the qualifying condition will be taken not to be satisfied for the worker; and(ii)the worker will not be entitled to section 193A compensation; and(iii)the worker will not have a right to apply to the panel for a review of the matters mentioned in subparagraphs (i) and (ii).
130 Worker may request reasons
(1)This section applies if an insurer has given the worker a section 193A notice stating the insurer has decided the qualifying condition is not satisfied for the worker.(2)The worker may, within 10 business days after receiving the notice, ask the insurer for written reasons for the decision.(3)The insurer must give the worker the reasons for the decision within 10 business days after receiving the worker’s request.
131 Giving information
(1)This section applies if the insurer has given the worker a section 193A notice stating the insurer does not have enough information to decide whether the qualifying condition is satisfied for the worker.
Class | Level of impairment | Examples of indicators of level of impairmentNote— These examples must be had regard to under schedule 15, section 4(3)(a)(i). | Percentage impairment rangesNote— These ranges may be had regard to under schedule 15, section 4(3)(b). |
Class 1 | Little or no impairment | • can work full-time in the position (the pre-injury position) in which the injured worker worked immediately before the injury | 0 to 3% |
• the injured worker’s duties at work and performance of the duties are consistent with the worker’s education and training | |||
• can cope with the normal demands of the job | |||
Class 2 | Mild impairment | • can work in the pre-injury position, but for no more than 20 hours a week, for example, because the injured worker is no longer happy to work with particular persons | 4 to 10% |
• can work full-time in a different position where performance of the relevant duties requires the use of comparable skill and intellect to that required to perform the duties of the pre-injury position | |||
Class 3 | Moderate impairment | • can not work at all in the pre-injury position | 11 to 30% |
• only able to work less than 20 hours a week in a different position where performance of the relevant duties requires less skill or is otherwise less demanding, for example, less stressful | |||
Class 4 | Severe impairment | • can not work more than 1 or 2 days at a time | 31 to 60% |
• works less than 20 hours a fortnight | |||
• the pace at which work is done is reduced | |||
• attendance at work is erratic | |||
Class 5 | Totally impaired | • needs constant supervision and assistance within an institutional environment | more than 60% |
Schedule 17 General damages calculation provisions
section 189
Table 1—For an injury sustained from 1 July 2010 to 30 June 2011 (dates inclusive) | |||
Item | Injury scale value | Base amount | Variable amount |
1 | 5 or less | — | Injury scale value x $1,180 |
2 | 10 or less but more than 5 | $5,900 | (Injury scale value - 5) x $1,410 |
3 | 15 or less but more than 10 | $12,950 | (Injury scale value - 10) x $1,650 |
4 | 20 or less but more than 15 | $21,200 | (Injury scale value - 15) x $1,880 |
5 | 25 or less but more than 20 | $30,600 | (Injury scale value - 20) x $2,120 |
6 | 30 or less but more than 25 | $41,200 | (Injury scale value - 25) x $2,360 |
7 | 35 or less but more than 30 | $53,000 | (Injury scale value - 30) x $2,590 |
8 | 40 or less but more than 35 | $65,950 | (Injury scale value - 35) x $2,830 |
9 | 50 or less but more than 40 | $80,100 | (Injury scale value - 40) x $3,040 |
10 | 60 or less but more than 50 | $110,500 | (Injury scale value - 50) x $3,250 |
11 | 70 or less but more than 60 | $143,000 | (Injury scale value - 60) x $3,460 |
12 | 80 or less but more than 70 | $177,600 | (Injury scale value - 70) x $3,680 |
13 | 90 or less but more than 80 | $214,400 | (Injury scale value - 80) x $3,890 |
14 | 100 or less but more than 90 | $253,300 | (Injury scale value - 90) x $4,120 |
Table 2—For an injury sustained from 1 July 2011 to 30 June 2012 (dates inclusive) | |||
Item | Injury scale value | Base amount | Variable amount |
1 | 5 or less | — | Injury scale value x $1,210 |
2 | 10 or less but more than 5 | $6,050 | (Injury scale value - 5) x $1,450 |
3 | 15 or less but more than 10 | $13,300 | (Injury scale value - 10) x $1,700 |
4 | 20 or less but more than 15 | $21,800 | (Injury scale value - 15) x $1,930 |
5 | 25 or less but more than 20 | $31,450 | (Injury scale value - 20) x $2,180 |
6 | 30 or less but more than 25 | $42,350 | (Injury scale value - 25) x $2,430 |
7 | 35 or less but more than 30 | $54,500 | (Injury scale value - 30) x $2,660 |
8 | 40 or less but more than 35 | $67,800 | (Injury scale value - 35) x $2,910 |
9 | 50 or less but more than 40 | $82,350 | (Injury scale value - 40) x $3,130 |
10 | 60 or less but more than 50 | $113,650 | (Injury scale value - 50) x $3,340 |
11 | 70 or less but more than 60 | $147,050 | (Injury scale value - 60) x $3,560 |
12 | 80 or less but more than 70 | $182,650 | (Injury scale value - 70) x $3,780 |
13 | 90 or less but more than 80 | $220,450 | (Injury scale value - 80) x $4,000 |
14 | 100 or less but more than 90 | $260,450 | (Injury scale value - 90) x $4,240 |
Table 3—For an injury sustained from 1 July 2012 to 30 June 2013 (dates inclusive) | |||
Item | Injury scale value | Base amount | Variable amount |
1 | 5 or less | — | Injury scale value x $1270 |
2 | 10 or less but more than 5 | $6,350 | (Injury scale value - 5) x $1,530 |
3 | 15 or less but more than 10 | $14,000 | (Injury scale value - 10) x $1,790 |
4 | 20 or less but more than 15 | $22,950 | (Injury scale value - 15) x $2,030 |
5 | 25 or less but more than 20 | $33,100 | (Injury scale value - 20) x $2,300 |
6 | 30 or less but more than 25 | $44,600 | (Injury scale value - 25) x $2,560 |
7 | 35 or less but more than 30 | $57,400 | (Injury scale value - 30) x $2,800 |
8 | 40 or less but more than 35 | $71,400 | (Injury scale value - 35) x $3,070 |
9 | 50 or less but more than 40 | $86,750 | (Injury scale value - 40) x $3,300 |
10 | 60 or less but more than 50 | $119,750 | (Injury scale value - 50) x $3,520 |
11 | 70 or less but more than 60 | $154,950 | (Injury scale value - 60) x $3,750 |
12 | 80 or less but more than 70 | $192,450 | (Injury scale value - 70) x $3,980 |
13 | 90 or less but more than 80 | $232,250 | (Injury scale value - 80) x $4,210 |
14 | 100 or less but more than 90 | $274,350 | (Injury scale value - 90) x $4,470 |
Table 4—For an injury sustained from 1 July 2013 to 30 June 2014 (dates inclusive) | |||
Item | Injury scale value | Base amount | Variable amount |
1 | 5 or less | — | Injury scale value x $1,310 |
2 | 10 or less but more than 5 | $6,550 | (Injury scale value - 5) x $1,580 |
3 | 15 or less but more than 10 | $14,450 | (Injury scale value - 10) x $1,840 |
4 | 20 or less but more than 15 | $23,650 | (Injury scale value - 15) x $2,090 |
5 | 25 or less but more than 20 | $34,100 | (Injury scale value - 20) x $2,370 |
6 | 30 or less but more than 25 | $45,950 | (Injury scale value - 25) x $2,640 |
7 | 35 or less but more than 30 | $59,150 | (Injury scale value - 30) x $2,880 |
8 | 40 or less but more than 35 | $73,550 | (Injury scale value - 35) x $3,160 |
9 | 50 or less but more than 40 | $89,350 | (Injury scale value - 40) x $3,400 |
10 | 60 or less but more than 50 | $123,350 | (Injury scale value - 50) x $3,620 |
11 | 70 or less but more than 60 | $159,550 | (Injury scale value - 60) x $3,860 |
12 | 80 or less but more than 70 | $198,150 | (Injury scale value - 70) x $4,100 |
13 | 90 or less but more than 80 | $239,150 | (Injury scale value - 80) x $4,340 |
14 | 100 or less but more than 90 | $282,550 | (Injury scale value - 90) x $4,600 |
Table 5—For an injury sustained from 1 July 2014 to 30 June 2015 (dates inclusive) | |||
Item | Injury scale value | Base amount | Variable amount |
1 | 5 or less | — | Injury scale value x $1,360 |
2 | 10 or less but more than 5 | $6,800 | (Injury scale value - 5) x $1,640 |
3 | 15 or less but more than 10 | $15,000 | (Injury scale value - 10) x $1,910 |
4 | 20 or less but more than 15 | $24,550 | (Injury scale value - 15) x $2,170 |
5 | 25 or less but more than 20 | $35,400 | (Injury scale value - 20) x $2,460 |
6 | 30 or less but more than 25 | $47,700 | (Injury scale value - 25) x $2,740 |
7 | 35 or less but more than 30 | $61,400 | (Injury scale value - 30) x $2,990 |
8 | 40 or less but more than 35 | $76,350 | (Injury scale value - 35) x $3,280 |
9 | 50 or less but more than 40 | $92,750 | (Injury scale value - 40) x $3,530 |
10 | 60 or less but more than 50 | $128,050 | (Injury scale value - 50) x $3,760 |
11 | 70 or less but more than 60 | $165,650 | (Injury scale value - 60) x $4,010 |
12 | 80 or less but more than 70 | $205,750 | (Injury scale value - 70) x $4,260 |
13 | 90 or less but more than 80 | $248,350 | (Injury scale value - 80) x $4,500 |
14 | 100 or less but more than 90 | $293,350 | (Injury scale value - 90) x $4,770 |
Table 6—For an injury sustained from 1 July 2015 to 30 June 2017 (dates inclusive) | |||
Item | Injury scale value | Base amount | Variable amount |
1 | 5 or less | — | Injury scale value x $1,390 |
2 | 10 or less but more than 5 | $6,950 | (Injury scale value - 5) x $1,680 |
3 | 15 or less but more than 10 | $15,350 | (Injury scale value - 10) x $1,960 |
4 | 20 or less but more than 15 | $25,150 | (Injury scale value - 15) x $2,220 |
5 | 25 or less but more than 20 | $36,250 | (Injury scale value - 20) x $2,520 |
6 | 30 or less but more than 25 | $48,850 | (Injury scale value - 25) x $2,810 |
7 | 35 or less but more than 30 | $62,900 | (Injury scale value - 30) x $3,060 |
8 | 40 or less but more than 35 | $78,200 | (Injury scale value - 35) x $3,360 |
9 | 50 or less but more than 40 | $95,000 | (Injury scale value - 40) x $3,620 |
10 | 60 or less but more than 50 | $131,200 | (Injury scale value - 50) x $3,850 |
11 | 70 or less but more than 60 | $169,700 | (Injury scale value - 60) x $4,110 |
12 | 80 or less but more than 70 | $210,800 | (Injury scale value - 70) x $4,360 |
13 | 90 or less but more than 80 | $254,400 | (Injury scale value - 80) x $4,610 |
14 | 100 or less but more than 90 | $300,500 | (Injury scale value - 90) x $4,890 |
Table 7—For an injury sustained from 1 July 2017 to 30 June 2018 (dates inclusive) | |||
Item | Injury scale value | Base amount | Variable amount |
1 | 5 or less | — | Injury scale value x $1,410 |
2 | 10 or less but more than 5 | $7,050 | (Injury scale value - 5) x $1,710 |
3 | 15 or less but more than 10 | $15,600 | (Injury scale value - 10) x $1,990 |
4 | 20 or less but more than 15 | $25,550 | (Injury scale value - 15) x $2,260 |
5 | 25 or less but more than 20 | $36,850 | (Injury scale value - 20) x $2,560 |
6 | 30 or less but more than 25 | $49,650 | (Injury scale value - 25) x $2,860 |
7 | 35 or less but more than 30 | $63,950 | (Injury scale value - 30) x $3,110 |
8 | 40 or less but more than 35 | $79,500 | (Injury scale value - 35) x $3,420 |
9 | 50 or less but more than 40 | $96,600 | (Injury scale value - 40) x $3,680 |
10 | 60 or less but more than 50 | $133,400 | (Injury scale value - 50) x $3,920 |
11 | 70 or less but more than 60 | $172,600 | (Injury scale value - 60) x $4,180 |
12 | 80 or less but more than 70 | $214,400 | (Injury scale value - 70) x $4,440 |
13 | 90 or less but more than 80 | $258,800 | (Injury scale value - 80) x $4,690 |
14 | 100 or less but more than 90 | $305,700 | (Injury scale value - 90) x $4,970 |
Table 8—For an injury sustained from 1 July 2018 to 30 June 2019 (dates inclusive) | |||
Item | Injury scale value | Base amount | Variable amount |
1 | 5 or less | — | Injury scale value x $1,450 |
2 | 10 or less but more than 5 | $7,250 | (Injury scale value - 5) x $1,760 |
3 | 15 or less but more than 10 | $16,050 | (Injury scale value - 10) x $2,050 |
4 | 20 or less but more than 15 | $26,300 | (Injury scale value - 15) x $2,330 |
5 | 25 or less but more than 20 | $37,950 | (Injury scale value - 20) x $2,640 |
6 | 30 or less but more than 25 | $51,150 | (Injury scale value - 25) x $2,950 |
7 | 35 or less but more than 30 | $65,900 | (Injury scale value - 30) x $3,210 |
8 | 40 or less but more than 35 | $81,950 | (Injury scale value - 35) x $3,530 |
9 | 50 or less but more than 40 | $99,600 | (Injury scale value - 40) x $3,790 |
10 | 60 or less but more than 50 | $137,500 | (Injury scale value - 50) x $4,040 |
11 | 70 or less but more than 60 | $177,900 | (Injury scale value - 60) x $4,310 |
12 | 80 or less but more than 70 | $221,000 | (Injury scale value - 70) x $4,580 |
13 | 90 or less but more than 80 | $266,800 | (Injury scale value - 80) x $4,830 |
14 | 100 or less but more than 90 | $315,100 | (Injury scale value - 90) x $5,120 |
Table 9—For an injury sustained from 1 July 2019 to 30 June 2020 (dates inclusive) | |||
Item | Injury scale value | Base amount | Variable amount |
1 | 5 or less | — | Injury scale value x $1,490 |
2 | 10 or less but more than 5 | $7,450 | (Injury scale value - 5) x $1,810 |
3 | 15 or less but more than 10 | $16,500 | (Injury scale value - 10) x $2,110 |
4 | 20 or less but more than 15 | $27,050 | (Injury scale value - 15) x $2,400 |
5 | 25 or less but more than 20 | $39,050 | (Injury scale value - 20) x $2,720 |
6 | 30 or less but more than 25 | $52,650 | (Injury scale value - 25) x $3,040 |
7 | 35 or less but more than 30 | $67,850 | (Injury scale value - 30) x $3,310 |
8 | 40 or less but more than 35 | $84,400 | (Injury scale value - 35) x $3,640 |
9 | 50 or less but more than 40 | $102,600 | (Injury scale value - 40) x $3,900 |
10 | 60 or less but more than 50 | $141,600 | (Injury scale value - 50) x $4,160 |
11 | 70 or less but more than 60 | $183,200 | (Injury scale value - 60) x $4,440 |
12 | 80 or less but more than 70 | $227,600 | (Injury scale value - 70) x $4,720 |
13 | 90 or less but more than 80 | $274,800 | (Injury scale value - 80) x $4,980 |
14 | 100 or less but more than 90 | $324,600 | (Injury scale value - 90) x $5,270 |
Table 10—For an injury sustained on or after 1 July 2020 | ||
Item | Injury scale value | General damages |
1 | 0 | 0 |
2 | 1 | 0.95 times QOTE |
3 | 2 | 1.90 times QOTE |
4 | 3 | 2.84 times QOTE |
5 | 4 | 3.79 times QOTE |
6 | 5 | 4.74 times QOTE |
7 | 6 | 5.89 times QOTE |
8 | 7 | 7.04 times QOTE |
9 | 8 | 8.19 times QOTE |
10 | 9 | 9.34 times QOTE |
11 | 10 | 10.49 times QOTE |
12 | 11 | 11.83 times QOTE |
13 | 12 | 13.17 times QOTE |
14 | 13 | 14.51 times QOTE |
15 | 14 | 15.85 times QOTE |
16 | 15 | 17.19 times QOTE |
17 | 16 | 18.72 times QOTE |
18 | 17 | 20.24 times QOTE |
19 | 18 | 21.76 times QOTE |
20 | 19 | 23.29 times QOTE |
21 | 20 | 24.81 times QOTE |
22 | 21 | 26.54 times QOTE |
23 | 22 | 28.27 times QOTE |
24 | 23 | 30.00 times QOTE |
25 | 24 | 31.73 times QOTE |
26 | 25 | 33.45 times QOTE |
27 | 26 | 35.39 times QOTE |
28 | 27 | 37.32 times QOTE |
29 | 28 | 39.25 times QOTE |
30 | 29 | 41.18 times QOTE |
31 | 30 | 43.11 times QOTE |
32 | 31 | 45.21 times QOTE |
33 | 32 | 47.32 times QOTE |
34 | 33 | 49.42 times QOTE |
35 | 34 | 51.52 times QOTE |
36 | 35 | 53.63 times QOTE |
37 | 36 | 55.94 times QOTE |
38 | 37 | 58.25 times QOTE |
39 | 38 | 60.56 times QOTE |
40 | 39 | 62.88 times QOTE |
41 | 40 | 65.19 times QOTE |
42 | 41 | 67.67 times QOTE |
43 | 42 | 70.14 times QOTE |
44 | 43 | 72.62 times QOTE |
45 | 44 | 75.10 times QOTE |
46 | 45 | 77.58 times QOTE |
47 | 46 | 80.06 times QOTE |
48 | 47 | 82.53 times QOTE |
49 | 48 | 85.01 times QOTE |
50 | 49 | 87.49 times QOTE |
51 | 50 | 89.97 times QOTE |
52 | 51 | 92.61 times QOTE |
53 | 52 | 95.25 times QOTE |
54 | 53 | 97.90 times QOTE |
55 | 54 | 100.54 times QOTE |
56 | 55 | 103.18 times QOTE |
57 | 56 | 105.82 times QOTE |
58 | 57 | 108.47 times QOTE |
59 | 58 | 111.11 times QOTE |
60 | 59 | 113.75 times QOTE |
61 | 60 | 116.40 times QOTE |
62 | 61 | 119.22 times QOTE |
63 | 62 | 122.04 times QOTE |
64 | 63 | 124.86 times QOTE |
65 | 64 | 127.68 times QOTE |
66 | 65 | 130.50 times QOTE |
67 | 66 | 133.32 times QOTE |
68 | 67 | 136.14 times QOTE |
69 | 68 | 138.96 times QOTE |
70 | 69 | 141.78 times QOTE |
71 | 70 | 144.60 times QOTE |
72 | 71 | 147.60 times QOTE |
73 | 72 | 150.60 times QOTE |
74 | 73 | 153.60 times QOTE |
75 | 74 | 156.60 times QOTE |
76 | 75 | 159.60 times QOTE |
77 | 76 | 162.60 times QOTE |
78 | 77 | 165.60 times QOTE |
79 | 78 | 168.59 times QOTE |
80 | 79 | 171.59 times QOTE |
81 | 80 | 174.59 times QOTE |
82 | 81 | 177.76 times QOTE |
83 | 82 | 180.92 times QOTE |
84 | 83 | 184.08 times QOTE |
85 | 84 | 187.25 times QOTE |
86 | 85 | 190.41 times QOTE |
87 | 86 | 193.58 times QOTE |
88 | 87 | 196.74 times QOTE |
89 | 88 | 199.90 times QOTE |
90 | 89 | 203.07 times QOTE |
91 | 90 | 206.23 times QOTE |
92 | 91 | 209.58 times QOTE |
93 | 92 | 212.93 times QOTE |
94 | 93 | 216.28 times QOTE |
95 | 94 | 219.62 times QOTE |
96 | 95 | 222.97 times QOTE |
97 | 96 | 226.32 times QOTE |
98 | 97 | 229.67 times QOTE |
99 | 98 | 233.02 times QOTE |
100 | 99 | 236.36 times QOTE |
101 | 100 | 239.71 times QOTE |
Schedule 18 Dictionary
section 3
actuarial standard means the document called ‘Professional Standard 302—Valuations of general insurance claims’ issued by the Actuaries Institute.
actuary means an actuary approved by the Regulator.
adverse psychological reaction does not include a mental disorder.
AMA 5 means the 5th edition of the Guides to the evaluation of permanent impairment published by the American Medical Association.
ankylosis means fixation of a joint in a specific position.
annual levy, for part 2, division 3, see section 16.
application day, in relation to a self-insurer, for part 3, division 1, see section 26.
appointed actuary—
(a)for part 3, division 1, see section 28; or
(b)for part 3, division 2, see section 39; or
(c)for part 3, division 3, see section 50; or
(d)for part 3, division 4, see section 60; or
(e)for part 3, division 5, subdivision 2, see section 72; or
(f)for part 3, division 5, subdivision 3, see section 81(1); or
(g)for part 3, division 6, see section 91(1).
arbiter means the actuarial arbiter appointed under section 100.
assessed premium, for an employer, means premium calculated using the employer’s wages for a period of insurance.
assessment day—
(a)in relation to a self-insurer, for part 3, division 1, see section 26; or
(b)in relation to a member, for part 3, division 2, see section 37; or
(c)in relation to a former self-insurer, for part 3, division 3, see section 48; or
(d)in relation to a non-scheme member, for part 3, division 6, see section 89.
cancellation day—
(a)in relation to a former self-insurer, for part 3, division 3, see section 48; or
(b)in relation to a non-scheme employer, for part 3, division 5, see section 69.
category, for schedule 6, see schedule 6, section 2(1)(b).
children’s functional independence measure, for part 6, division 1, see section 151.
claim means—
(a)an application for compensation; or
(b)a claim for damages.
consecutive categories, for schedule 6, see schedule 6, section 3.
consent day, in relation to a member, for part 3, division 2, see section 37.
corresponding score, for a category, for schedule 6, see schedule 6, section 1.
decision, of an insurer, for part 4, division 4, subdivision 4, see section 134.
digestive system—
(a)means the organs and other parts of the body forming the alimentary tract, and includes the tongue, throat and abdominal wall; but
(b)does not include an organ or other part of the body mentioned in the injury column of schedule 14.
dominant injury, of multiple injuries, means—
(a)the injury of the multiple injuries having the highest range; or
(b)if 2 or more of the injuries have the highest range—the injury (of those 2 or more injuries) that is selected as the dominant injury by a court assessing an ISV.
DPI amount, for schedule 5, see schedule 5, section 1(a).
DSM 4 means the 4th edition of the Diagnostic and statistical manual of mental disorders, text revision (DSM-IV-TR) published by the American Psychiatric Association in 2000.
estimated claims liability has the same meaning as in section 84(8) of the Act.
final day, in relation to a non-scheme member, for part 3, division 6, see section 89.
financial quarter means a period of 3 months beginning on 1 January, 1 April, 1 July or 1 October.
former self-insurer, for part 3, division 3, see section 48.
functional independence measure, for part 6, division 1, see section 151.
further premium, for an employer, means an amount, other than assessed premium or provisional premium, payable by an employer to WorkCover under the Act, and includes the following—
(a)arrears of premium;
(b)additional premium under section 8(3);
(c)interest on premium under section 10(2);
(d)an amount of unpaid premium or a payment or penalty payable under section 57(2) of the Act;
(e)additional premium for late payment under section 61 or 62 of the Act;
(f)additional premium under section 63 of the Act.
highest range means the range of ISVs having the highest maximum ISV.
household worker means a person employed solely in and about, or in connection with, a private dwelling house or the grounds of a private dwelling house.
injured worker means a worker who has sustained an injury.
injury, for part 4, division 4 and schedule 5, see section 123.
ISV means injury scale value.
Le Fort I fracture means a horizontal segmented fracture of the alveolar process of the maxilla.
Le Fort II fracture means a unilateral or bilateral fracture of the maxilla—
(a)in which the body of the maxilla is separated from the facial skeleton and pyramidal in shape; and
(b)that may extend through the body of the maxilla down the midline of the hard palate, through the floor of the orbit and into the nasal cavity.
Le Fort III fracture means a fracture in which the entire maxilla and 1 or more facial bones are completely separated from the brain case.
legal cost amount, for schedule 5, see schedule 5, section 1(b).
licence, in relation to a self-insurer, means a licence to be a self-insurer mentioned in section 71 or 72 of the Act.
medical certificate means—
(a)in relation to an application under section 132 of the Act—(i)a certificate given by a doctor or nurse practitioner as required under section 132(3)(a) of the Act; or(ii)a certificate given by a registered dentist as permitted under section 132(4) of the Act; or
(b)in relation to an application under section 132A of the Act—(i)a certificate given by a doctor as required under section 132A(3)(c)(i) of the Act; or(ii)a certificate given by a registered dentist as permitted under section 132A(4) of the Act; or
(c)in relation to an application under section 132B of the Act—a certificate given by a doctor as required under section 132B(3)(c)(i) of the Act.
medical expert, for an assessment of a PIRS rating, means a person—
(a)who is appropriately qualified to perform the assessment, including, for example, a psychologist, neuropsychologist or psychiatrist; and
(b)who has had appropriate training in the use of the PIRS.
medical specialty means a branch of medicine that is a recognised specialty under the Health Practitioner Regulation National Law.
member, for part 3, division 2, see section 37.
mental disorder means a mental disorder recognised under DSM 4.
modified barthel index means the guidelines and modified scoring of the barthel index stated in the article ‘Improving the sensitivity of the barthel index for stroke rehabilitation’ by S Shah, F Vanclay and B Cooper published in the Journal of Clinical Epidemiology, 1989, vol 42 no 8, pp 703-709.
new insurer, for part 3, division 2, see section 38.
nurse means a person registered under the Health Practitioner Regulation National Law to practise in the nursing profession, other than as a student.
old insurer, for part 3, division 2, see section 38.
old self-insurer, for part 3, division 6, see section 89.
outstanding liability, for part 3, division 1, see section 26.
panel, for part 4, division 4, see section 123.
PIRS means the psychiatric impairment rating scale stated in schedule 16.
PIRS rating, for a mental disorder, means a rating on the PIRS for the permanent impairment caused by the mental disorder.
pre-existing, in relation to an injury, means existing at the time immediately before the injury.
premium includes assessed premium, provisional premium and further premium.
provisional annual levy, for part 2, division 3, see section
19(2)(a).
provisional premium, for an employer, means premium calculated using a reasonable estimate of wages for a period of insurance.
qualifying condition, for part 4, division 4, see section 123.
range, in relation to an ISV for an injury, means the range of ISVs for the injury stated in schedule 14.
reading, of a chest x-ray, for schedule 6, see schedule 6, section 2.
second appointed actuary, for part 3, division 4, see section 66(1).
section 193A compensation, for an injury, for part 4, division 4, see section 123.
section 193A notice, for part 4, division 4, see section 129(1).
self-insurer’s data, for part 3, division 4, see section 58.
specialty medical assessment tribunal see section 197(b).
specified date, for part 2, division 3, see section 18(2).
summary report—
(a)for part 3, division 1, see section 32(1); or
(b)for part 3, division 2, see section 43(1); or
(c)for part 3, division 3, see section 54(1); or
(d)for part 3, division 5, subdivision 2, see section 76(1); or
(e)for part 3, division 5, subdivision 3, see section 85(1); or
(f)for part 3, division 6, see section 95(1).
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