Medical and legal terms

A

ABI

Acquired brain injury

ABN

Australian Business Number

ABS

Australian Bureau of Statistics

Access

Services and programs are made available to everyone who is entitled to them and should be free of any form of discrimination on the basis of place of birth, language, culture, race, gender, religion or disability.

ACN

Australian Company Number

Act, the

Unless otherwise specified, the Workers Rehabilitation and Compensation Act 1986

Actuarial evaluation

Each June, a major study of the scheme’s claim liabilities is undertaken by an external actuary and WorkCover’s Analytical Services Unit. It is revisited at the end of December but at lesser level of detail.

Actuary

Qualified practitioner who calculates risks, premiums etc, for insurance.

ADL

Activities of Daily Living. This is an assessment done in your home and is used to identify any limitations you may have in regard to personal care , household tasks and recreational and social activities as a result of your injury.

Agent estimate

Agents are required to provide estimates on all claims (open and closed) when further payments are expected. These are an integral component in the pricing system for WorkCover.

AICM

Australian Institute of Credit Management

AIS

Agent Information System.

ALHMU

Australian Liquor Hospitality and Miscellaneous Union

Allowances

Employers are required to pay levy calculated on remuneration paid to all workers, included in this remuneration base is allowances paid to or on behalf of a worker.

Alternative or modified duties

Duties that are changed or modified to take into account any restrictions that may apply to an injured worker.

AMA

Australian Medical Association

AMA Guides

American Medical Association Guides to Evaluation of Permanent Impairment (2nd or 4th Edition).

AMWU

Australian Manufacturing Workers Union

Ancillary Unit

An ancillary unit is a location of an employer predominantly engaged in the provision of services to another location of the same or associated employers. Unlike other locations the ancillary unit is not assessed according to their own majority activity. An ancillary unit is assessed under a ’reflected‘ industry class corresponding to the predominant industry of the locations served.

ANDRG

Australian National Diagnosis Related Group

ANF

Australian Nursing Federation

Annual payer

The payment frequency of an employer. Employers are either annual or monthly payers, depending on the maximum amount of levy paid or estimated to be paid each financial year.

APA

Australian Physiotherapists Association

APHA

Australian Private Hospital Association

Apprentice

See section 3 that defines this: “Apprentice includes-

  1. a person undertaking training in a declared vocation under the Industrial and Commercial Training Act 1981;
  2. a person undertaking training in a scheme approved by the Corporation for the purposes of this definition, and "apprenticeship" has a corresponding meaning;”

ARPA (SA)

Australian Rehabilitation Providers Association (SA Branch)

APS

Australian Psychologists Society

Arise out of the use of a motor vehicle

For an injury or death to ‘arise out of the use of a motor vehicle’, there must be some physical connection with the use of a vehicle and something about the negligent use of the vehicle that is a cause of the accident. For example, if the driving of a registered forklift causes an injury, the injury arises out of the use of the vehicle. It is then a matter of determining whether the driving of the forklift was negligent to found a recovery action.

ARMS

Automated report management system

ASBA

Australian Small Business Association

ASIC

Australian Securities & Investment Commission

Associated employer

Generally refers to the situation where there is some type of relationship between one employer and another.

New registration - associated employer details are collected at initial registration to use in determining classification or if an employer location should be grouped for classification and/or bonus and penalty purposes.

Amendments - when changes are made to the field ’associated employer‘, checks are also done to ensure the change does not result in the application or non application of 'grouping' or 'ancillary rules'.

Levy - when following up outstanding levy, associated employers can also be used as a tool in establishing contact.

ASORC

Australian Society of Rehabilitation Counsellors

ASU

Australian Services Union

ATMS

Australian Traditional Medicine Society

ATO

Australian Taxation Office

Audit

An employer’s business records are examined to verify the accuracy of levy payments and reconciliations submitted to WorkCover.

Authorised Officer

Any member of staff who has an authority card bearing their name and signed by the CEO.

Average Levy Rate

The average rate per dollar ($) of remuneration that employers pay in levy (premium) to WorkCover to fund the scheme’s ‘insurance’ system; for the year 2007-08 is 3.0%.

AWE

Average Weekly Earnings. See section 4 of the Act for definition.

AWU

Australian Workers Union

B

B/O

Buy-out option. Employers are responsible for paying the first two weeks wages (per calendar year) for an injured worker. The buy-out option allows employers to remove this obligation by paying an additional amount (reviewed annually) on their levy. WorkCover then pays a worker who is absent due to a work related incident from day one.

B/P Scheme

Bonus/Penalty Scheme. This scheme adjusts the industry levy rate of a business by measuring an employer’s performance using actual claims costs incurred.

Backdating

The date of effect of an industry classification change applied to an employer’s location. Backdating can be applied at the discretion of WorkCover after considering the particular circumstances of each case.

Basic Levy

The levy calculated by multiplying an employer’s remuneration by the base rate (industry rate) prior to any adjustments.

Bizgate

A web site designed to assist businesses when dealing with the South Australian Government. Through the Bizgate site employers can make levy payments using the internet.

Board

WorkCover’s Board of Management or any properly delegated committee appointed by WorkCover’s Board.

BP

Bonus/Penalty Scheme. This scheme adjusts the industry levy rate of a business by measuring an employer’s performance using actual claims costs incurred.

B-Pay

An electronic payment system managed by the banking sector that allows bills to be paid via a telephone. Employers’ WorkCover levy can be able to be paid using b-pay.

Business review meeting (BRM)

Conducted quarterly by the Executive Management Team.

Business Rules

The term used to identify the reminder, fine and follow up of outstanding payments process. To view the current business rules calendar refer to IDEAS (Registration and Funding Portfolio Manager) fast path only available via Registration and Funding, not Claims.

C

CAA

Chiropractors Association of Australia

Case Conference

This is a meeting usually organised by your claims manager to bring key parties together to discuss options and to progress your rehabilitation and return to work.

Category Rules

The category rules use combinations of claim attributes to allocate claims to segments.

CCF

Compensation claim form

CCP

Coordinated care program.

CEO

Chief Executive Officer

CEPU

Communications, Electrical, Electronics, Plumbing & Allied Services Union

Certified Agreement

Employment conditions for WorkCover employees.

CFMEU

Construction Forestry Mining Energy Union

Child

A child of the worker; can include domestic partner's children from a previous relationship. See section 3 of the Act which defines a “child" to mean: “in relation to a deceased worker, includes a person in relation to whom the worker stood, at the date of death, in loco parentis”

Circumstance reports

Reports produced by private investigators about the details of a claim.

Claimant

A person who applies for WorkCover entitlements.

Claims Liability

At a point of time, most commonly 30 June, the amount of money expected to be paid in future for all claims incurred up to that time.

Claims Manager/Case Manager

Claims managers/Case Managers are responsible for management of claims in the multidisciplinary management and long-term management segments. Claims managers/Case Managers have ultimate accountability for the management of each claim within their portfolio, and they are the primary contact for both the employer and the worker.

Claims Officer

Personnel responsible for processing claims.

Closed claims

Weekly compensation payments cannot be paid on closed claims.

CLP

Common Law Potential.

CM

Claims Manager

CMA

Claims Management Agreement

CMAP

Claims Management Action Plan. The objective of the CMAP is to provide a planning process for the CM to ensure appropriate and consistent treatment and services are provided to the worker to achieve a sustainable return to work.

Code

Abbreviated from the "Code of conduct for self-insured employers under the South Australian WorkCover Scheme". Read the performance standards and code of conduct for self-insured.

Code of Workers Righhts

The Code of workers’ rights will set out the rights of injured workers and the level of service they should expect from WorkCover and its claims agent, and self-insurers, as well as a process for dealing with breaches of the code.

 

Collection Statement

The WorkCover Worker's claim form contains a page explaining the privacy policy in relation to the management of a claim. This text is titled 'Collection of personal and health information to manage your claim'.

Common Law

As opposed to statute law. Laws or legal principles that have been established by courts over the years. May be codified into a statute or overruled by a statute passed by the Parliament.

Company Search

The Levy Group, Service Centre has access to the Australian Securities & Investment Commission (ASIC) database where a wide range of search facilities are available. A company search provides details of company information such as directors, shareholders, company activity etc. This information is often useful for establishing common ownership and finding missing employers.

Compensable disability/injury

An injury/disability that is compensable under section 30 of the Act.

Compensation

See section 3 of the Act which defines compensation: “compensation" includes any monetary benefit payable under this Act”. Payments made to a worker who has sustained a work related incident/injury may be referred to as income maintenance, but can also include payment for medical and other expenses.

Compensation Fund

The Compensation Fund administered by WorkCover according to section 64(1) of the Act

Compulsory Third Party

South Australian law requires that all registered motor vehicles be insured by a Third Party Insurer. In South Australia this is the Motor Accident Commission (MAC). Where an injury arises out of the use of a motor vehicle, recovery of compensation paid and payable on a claim should be pursued with MAC.

Confidentiality

WorkCover staff are bound by a general duty at common law preventing them from disclosing information about WorkCover’s operations. (Refer to section 112 of the Act).

Conflict of Interest

Workers compensation staff should not handle employer registrations and/or claims where there may be a conflict of interest, ie, the employer is known or related to the staff member. See your supervisor if you become aware of a potential conflict of interest.

Continuance

The number or proportion of original claims continuing to receive benefits at a selected point of time after injury.

Contract for Service

Eligibility for compensation requires a person to be a worker under the WRAC Act and working under a “contract of service”. (Refer to section 3 of the Act). Working under a “contract for service” would normally preclude a claim for compensation.

Contract of service

See section 3 of the WRAC Act which defines this: "contract of service" means-

  1. a contract under which one person (the worker) is employed by another (the employer);
  2. a contract, arrangement or understanding under which one person (the worker) works for another (the employer) in prescribed work or work of a prescribed class;
  3. a contract of apprenticeship;
  4. a contract, arrangement or understanding under which a person (the worker)-
    1. receives on-the-job training in a trade or vocation from another (the employer); and
    2. is during the period of that training remunerated by the employer;

Corresponding Law

See section 3 of the Act that defines this:

“A law of the Commonwealth or another state, territory or another country that provides for compensation for disabilities arising from employment.”

Coupon Books

Levy payment booklet sent to monthly paying employers at the beginning of each financial year. A coupon (for relevant month) is sent by the employer to WorkCover each month (7th) along with levy payment. Some employers choose other payment options (refer to Direct Debit, Levy Payment In Advance and EFT) and therefore do not use a coupon book.

CPI

Consumer Price Index

CPM

Comparative performance monitoring

CPSU

Community & Public Sector Union

Crown

The Government of South Australia and any agency of the Government

Crown Exempt Employer

Agencies and instrumentalities of the Crown (ie the State Government) that are automatically exempt employers under section 61 of the Act. WorkCover has only limited powers with respect to the administration of Crown exempt status. See also Exempt Employer.

CRS

Commonwealth Rehabilitation Services

CSA

Child Support Agency

CTP

Compulsory third party insurance.

D

DAIS

Department for Administrative and Information Services

DECS

Department of Education & Children’s Services

Deemed worker

A person who is deemed to be a worker.

Dependant

See section 3 of the Act which this: "dependant", in relation to a deceased worker, means a relative of the worker who, at the time of the worker's death-

  1. was wholly or partially dependent for the ordinary necessities of life on earnings of the worker; or
  2. would, but for the worker's disability, have been so dependent, and includes a posthumous child of the worker; and "dependent" has a corresponding meaning;”

DEWR

Department of Workplace Relations

DHS

Department of Human Services

Direct Debit

One of the preferred methods for employers to pay their monthly levy. Employers complete an application form and forward it to WorkCover. We enter the details on the system and forward the document to the Reserve Bank. The bank then arranges for a direct debit from the employer’s bank account to WorkCover’s bank account. This form of payment is currently used only for normal monthly levy payments.

Director

A person or persons chosen to control the affairs of a company or corporation. A private company (Pty Ltd) must have at least one nominated director. Remunerated working directors are covered under the Act.

Disability

See section 3 of the Act which defines this: Disability of a worker means-

  1. “any physical or mental injury including-
    1. (i) loss, deterioration or impairment of a limb, organ or part of the body, or of a physical, mental or sensory faculty; or
    2. (ii) a disease; or
    3. (iii) disfigurement; or
  2. where the context admits-the death of the worker, and includes a secondary disability;”

Disaggregation

This term is commonly used in describing the action associated with modifying one or more classes of industry. Where the grouping of activities within a particular class of industry warrant a finer dissection to reflect a difference(s) in the groupings of activities, two or more new classes may be formed from the original class. This is referred to as a disaggregation of a class of industry.

Discontinuance Rate

The rate at which claimants stop receiving benefits between two points of time, eg, between one and two years post injury.

Discount Rate

Expected investment earnings rate per annum; we often talk of the ‘real’ rate which is the discount rate excess above inflation.

Disease

See section 3 of the Act which defines this: "disease" includes-

  1. any physical or mental ailment, disorder, defect or morbid condition, whether of sudden or gradual development; and
  2. any disability to which section 31 (of the Act) applies”

DOCA

(Subject to) Deed of Company Arrangement. The employing company has been referred to external administration (usually a practising chartered accountant dealing in insolvency). The company has entered into an agreement with its creditors, WorkCover being one, and is now subject to a Deed of Company Arrangement, whereby a dividend return will be paid to creditors in full and final settlement of their debt.

DOI

Date of injury - the date a worker sustained a work-related injury/disease.

Domestic partner

Someone lived with on a genuine domestic basis, irrespective of gender or marital status.

DOWRAC

Department of Workplace Relations Advisory Committee

DR Regulations

The Workers Rehabilitation and Compensation (Dispute Resolution) Regulations

DRG

Diagnostic Review Group

DST

Department of Education, Science & Training.(Commonwealth)

Duplication (Bonus/Penalty)

Duplication of the claims and remuneration history of an employer location will automatically occur whenever an employer relocates any part of a location's activity or function, eg, administration, etc, to a new employer or another (new or existing) location of the same employer.

E

EAM

Employer Account Manager

Early intervention

The term used to describe the process used to assess and evaluate an injured worker’s needs and return to work prospects at the earliest possible point in the claim.

EEASA

Engineering Employers Association of South Australia

EETCMA

Exempt employer transfer of claims management arrangement. A pre-existing claims management agreement between WorkCover and a self-insured employer.

EFT

Electronic Funds Transfer

Employer

A person/organisation (including the Crown) that employs a worker under a contract of service, or for whom work is done by a worker under a contract of service (see 'Worker' below). This definition includes a former employer and the legal representative of a deceased employer.

The term is also defined in section 3 of the Act: “employer" means-

  1. a person by whom a worker is employed under a contract of service, or for whom work is done by a worker under a contract of service;
  2. in relation to persons of whom the Crown is, under section 103A, the presumptive employer-the Crown;
  3. in relation to persons of whom any other person is, by virtue of a provision of this Act, the presumptive employer-that other person, “

Employment

See section 3 of the Act which defines this: "employment" includes-

  1. work done under a contract of service;
  2. the work of a self-employed person to whom the Corporation has extended the protection of this Act;
  3. the work of persons of whom the Crown is, under section 103A, the presumptive employer;
  4. attendance by a worker at a place of pick-up”;

EMT

Executive Management Team

EOI

Expression of interest

EOT

Extension of time

EOY

End of year

EPMC

Electronic prescribed medical certificate submitted via the Internet

Equity

Services and programs are to be designed and delivered on the basis of fair treatment of customers who are eligible to receive them.

ERF

Employer report form

Excess of loss Insurance

A form of catastrophe insurance that private exempt employers are required to carry as a condition of exempt status. For further detail see Schedule 4 of Regulation 241 of 1999.

Exclusion criteria

Exclusion criteria determine whether the worker is eligible for participation in multi-disciplinary assessment.

Exempt Employer

See Self Insured employer – “exempt employer” is old terminology and has been replaced with the term 'self-insured' right across the WRCA.

Expiation Fee

This fee may be imposed on employers who register late (ie, beyond 14 days of commencing employment) or for not returning their end-of-year Reconciliation Statement.

F

FCA

Functional capacity assessment

FCE

Functional capacity evaluation: A series of standardised tests that measure physical and functional capabilities that relate to specific work tolerances.

Final notice

See Procol notice

Financial guarantee

A document provided to WorkCover by private exempt employers that guarantees WorkCover will be paid an amount specified in the guarantee in the event that the exempt employer fails or withdraws and leaves WorkCover with its claims liabilities. Each exempt employer’s guarantee level is fixed annually by reference to an actuarial report that is carried out at the employer’s expense. Crown exempt employers are not required to provide financial guarantees. For further detail see Schedule 4 of Regulation 241 of 1999.

Fine

Monthly employers may be fined for not paying their levy by the due date (7th of each month). Annual employers may be fined for not paying their levy by the due date (31st July each year).

FOI

Freedom of information

Fourth Schedule Reporting

Exempt employers are required under Schedule 4 of Regulation 241 of 1999 to provide WorkCover with a specified range of claims data at regular intervals. This is currently done via an Electronic Data Interchange (EDI) system.

FSU

Financial Services Union

Funding Ratio

Assets divided by liabilities; if assets are less than liabilities then it will be less than 1 or (100%).

FYI

For your information

G

GAB

Guardianship and Administration Board

Garnishee

The holding back from a worker who is indebted to the Commonwealth, part of the worker’s compensation payment/s.

Group

A group of self-insured employers according to Chapter 9 of the Code.

Grouping

WorkCover may group separate legal entities, where they are related, for the purpose of applying a common classification and/or bonus/penalty. Employers may be grouped if the employers are:

  1. already grouped under the Payroll Tax Act 1971,
  2. capable of being treated as members of a group under the Payroll Tax Act 1971, or
  3. related in some other way

Associated employers may also be grouped if:

  1. each of the employers are separate legal entities
  2. each has a degree of common ownership and/or
  3. there is a degree of common managerial control.

GST

Goods and Services Tax

GST-free supply

Any good or service where the GST is not applicable. For example basic food, most health services, education and water. See Division 38 of the A New Tax System (Goods and Services Tax) Act 1999 (GST Act) for a complete list.

H

HIC

Previously, Health Insurance Commission, now known as Medicare Australia (see Medicare Australia).

High risk

High risk claims

Home Assistance

This is assistance with domestic or personal services that a worker is now unable to do as a result of the injury and usually assessed as part of an Activities of Daily Living assessment.

HOSC Act

Health and Other Services (Compensation) Act 1995 (Cth)

HSR

Health and Safety Representatives

HTML

Hyper text mark up language

HWCA

Heads of Workers Compensation Authority

I

IC

Intellectual capital

IDEAS

Integrated Desktop Environment for Applications and Services - more commonly known as Desktop.

IDR

Interdisciplinary Rehabilitation

ILR

Industry Levy Rates

IM

Injury Management

IMA

Injury Management Adviser. IMAs are part of the multidisciplinary team.

IME

Independent medical examinations are impartial assessments, providing independent medical opinion. They are arranged by the claims agent to assist in determining a worker’s medical status or to clarify issues relating to injury capacity or recovery.

IME

Independent Medical Examiner

IMR

Income Maintenance Reimbursement. An employer submits an electronic reimbursement request via the Internet to their claim agent for reimbursement of income maintenance paid to an injured worker.

IMRS

Income Maintenance Reimbursements Slip. An employer completes this slip and forwards to their claims agent for reimbursement of income maintenance paid to an injured worker.

In Liquidation

The company is insolvent and is now managed by a liquidator.

Incapacity for work

Any reduction in capacity that affects the worker’s ability to sell their labour on the open market.

Income Maintenance

An injured worker who is incapacitated for work may receive income maintenance payments - calculated as average weekly earnings.

Incorporated company

An incorporated company is recognised at law as a separate legal entity from its owners or shareholders. It is treated the same as a natural person and is therefore able to employ people directly and is recognised at law as the employer.

An incorporated company usually has 'Limited' (Ltd) or 'Propriety Limited' (Pty Ltd) as part of its business name.

Input Tax Credit

An Input Tax Credit is the amount of GST a registered business is entitled to claim from the Australian Tax Office.

IPPP

Institute of Private Practicing Psychologists

ITC

Input tax credits.

ITCE %

Input tax credit entitlement. The ITCE percentage is the amount of the GST payable on the premium that an employer can claim as an input tax credit from the Australian Tax Office.

J

JD

Judicial determination

Job Analysis

An analysis of the critical physical demands of a task or occupation to ascertain if they are within the worker’s capacity

Journals

Transferring money from one employer to another or from one payment period/fine period to another within the same employer and transfer expenditure from one general ledger account to another. Also refers to transferring costs from one claim to another.

K

L

Labour Hire

Labour hire arrangements commonly involve at least two contracts. A user of labour (the client) typically contracts with a labour hire firm for the provision of labour of a specified kind. The labour hire firm does not contract to perform the work; it merely contracts with the worker and pays the worker. The worker is not an employee of the client and there is no contract between the worker and the client.

Late Registration

All employers are required to register with WorkCover within 14 days of commencing employing a worker or workers. Employers who register after 14 days are treated as a late registration.

Legal Entity

The legal structure of a business eg, partnership, private company, public company, incorporated association, unincorporated association etc. Changes to an employer’s legal entity may result in the cancellation of one registration and the creation of a new one or amending the original registration.

Levy Adjustment Scheme (gazetted 25 January 2006)

The Levy Adjustment Scheme is endorsed by the Board of WorkCover SA and regulates the implementation of either a remission of levy, or a supplementary levy allocated to an employer. The authority for a remission of levy or a supplementary levy arises from section 67 and applies to normally registered employers. The determination lists the elements (and some of the criteria) that could make up an employer's net remission or supplementary levy. Those elements are:

  • Bonus and Penalty Scheme,
  • SABS
  • 58B and 58C
  • Self-Managed Employer remission
  • OH&S supplementary levy.
  • Exit Fees

Levy Funding Rebate

A rebate on WorkCover levy paid to eligible employers. The level of the rebate is based on the funding position of WorkCover on a year by year basis. The only year in which the rebate was paid was 2000/2001, based on 1998/99 remuneration.

Levy Payment in Advance (LPIA)

Employers may pay their entire annual levy in advance for the coming financial year to receive a discount. Conditions apply.

Levy Rate

Once an employer registers a location(s) it is classified using the SAWIC. Each SAWIC has a levy rate attached to it. This is the industry levy rate. The employer’s rate may vary from the industry rate due to the following:

  • bonus/penalty adjustment (succession rules)
  • supplementary levy (imposed due to a breach of section 58B)
  • Buyout (additional levy paid to cover the first two weeksWages of an injured worker)
  • Occupational Health and Safety fee (this fee is included in the fee of all employers)

A sum of these rates (incl GST) will determine the employer's total levy rate.

Levy Rate Review

Each year the industry levy rates attached to each SAWIC are reviewed taking into account the costs of claims incurred in each industry.

LGA

Local Government Association

Linking

The claims and remuneration details are transferred from one employer location to another, or same employer location for bonus/penalty purposes. This is applied where legal entity changes occur (eg, partnership - Pty Ltd company), an employer purchases or takes over another employers business, mergers etc. Linking is the term used when the principle of succession rules are applied.

LMA

Labour market assistance

Local government corporations

As defined in section 3(1) of the Act and Regulation 8 of Regulation 241 of 1999.

LOEC

Loss of earning capacity

Low risk

Low risk claims

LPIA

Levy payment in advance

LQMP

Legally Qualified Medical Practitioner

LSO

Levy Support Officer

LTM

Long-term management segment

M

MAC

Motor Accident Commission

Material defect

Material defects, omissions or irregularities can affect the decision to accept or reject a claim.

MBA

Master Builders Association

MBS

Medicare benefits schedule

MDA

Multidisciplinary assessment.

MDM

Multidisciplinary management segment. Claims assessed as high risk are allocated to the MDM segment for active management.

MDT

Multidisciplinary team.

Medical expert

See section 3 of the Act which defines this: "medical expert" means:

  1. a legally qualified medical practitioner
  2. a registered dentist
  3. a registered psychologist
  4. a registered optician
  5. a registered physiotherapist
  6. a registered chiropractor
  7. a registered podiatrist
  8. a registered occupational therapist
  9. a registered speech pathologist.

Medical Panel

Under the new legislation, independent medical panels will be established so that decisions on medical questions would be made by suitably experienced medical experts.

The Government will consult with stakeholders on appointments to the medical panels before panel members are appointed by the Governor and the new system becomes effective from 1 April 2009.

Medical question

See section 3 of the Act which defines this: "medical question" means any question of the nature, extent or probable duration of a disability, but does not include any question of a worker's incapacity for work or of the extent of an incapacity for work”

Medical Services

See section 3 of the Act which defines this: "medical services" means:

  1. attendance, examination or treatment by a medical expert (including the obtaining from a medical expert of a certificate or report) or
  2. any diagnostic examination or test required for the purposes of treatment by a medical expert.

Medicare Australia

Previously known as Health Insurance Commission (HIC)

MEO

Medical expenses only

Mercantile agency

A mercantile or credit agency as determined by WorkCover SA.

Minimum Levy

All registered employers are required to pay a minimum levy per financial year of $50.00. This includes employers who are registered but have not employed workers and therefore have not paid remuneration.

Minister

The South Australian Minister for Industrial Relations

Mitigating Circumstances

An employer may have a fine or fee imposed for various reasons. All employers have a right to appeal against a fine/fee. To do this they would provide WorkCover with special circumstances as to the events that led to the fine/fee being imposed. Depending on the type of fine/fee WorkCover may use its discretion to waive/cancel/reduce the fine/fee if 'mitigating circumstances' apply.

Modified or alternative duties

Duties that are changed or modified to take into account any restrictions that may apply to an injured worker.

Motor Accident Commission

The compulsory third party insurer in South Australia.

MTA

Motor Traders Association

MUA

Maritime Union of Australia

MVA

Motor vehicle accident

N

NAATI

National Accreditation Authority for Translators and Interpreters

Natural Consequences Model

The Natural Consequences Model is explained in Annexure I to the Code for the Conduct of Exempt Employers under the WorkCover scheme.

NCP

National competition policy

NEC

Not elsewhere classified.

Net Rate

Refer to Levy Rate.

NFA

No further action

Nil Returns

Every employer who is registered as a monthly payer must pay by the 7th of each month to avoid fines being imposed. In some instances, employers may not pay remuneration to workers in a particular month, however, a return is still required.

In these cases an employer must complete their monthly coupon slip by writing ’NIL’ and returning it to WorkCover. Alternatively, the employer may contact WorkCover’s Service Centre on 13 18 55 and advise that NIL wages were paid and therefore NIL levy is due for the month.

NMSG

National Medical Services Group

NOHSC

National Occupational Health & Safety Commission

Non-compliance

A breach or failure to comply with the Act or a term or condition of registration

Non-economic loss

See section 3 of the Act which defines this: "non-economic loss" means:

  1. pain and suffering
  2. loss of amenities of life
  3. loss of expectation of life
  4. any other loss or detriment of a non-economic nature.

Notional weekly earnings

See section 3 of the Act which defines this: "notional weekly earnings" in relation to a worker means:

  1. the worker's average weekly earnings or
  2. where an adjustment has been made under this Act to take account of changes in levels of earnings or in the value of money (or both)- the worker's average weekly earnings as so adjusted.

O

Occupation Classification

Classification of the Occupation of the injured worker

Occupational Health & Safety Fee

The OH&S Fee is included in an employers’ total levy rate. It provides funds for the development, promotion etc, of Occupational Health & Safety standards.

OHIG

Occupational Health Interest Group

OHS

Occupational Health and Safety

OHS&W Act

Occupational Health, Safety and Welfare Act 1986

OHS&W Regulations

The Occupational Health, Safety and Welfare Regulations, 1986

OHSAG

Occupational health & safety administrators group.

Ombudsman

The WorkCover Ombudsman is an independent office established to investigate complaints relating to the operation of the WorkCover Scheme.

OR

Occupational Rehabilitation (OR) services are essentially utilised on the basis of assisting more difficult cases back to work and are able to offer many varying services depending on the needs of each individual.

Ordinary Levy

The WorkCover levy referred to in clause 6.4 of the Code

Ordinary time earnings

What the claimant would have earned in their pre-injury position without shift allowance or overtime.

Orphan child

See section 3 of the Act which defines this: “Orphan child means a child whose natural or adoptive parents are dead and includes a child, one of whose natural or adoptive parents is dead and who has no reasonable prospect of being supported by the surviving natural or adoptive parent”.

OT

Occupational Therapist.

OT Australia

Occupational Therapists Australia Association

OT/SA

Overtime and Shift Allowance

OTA

Occupational Therapists Association

Outworker

A person engaged for the purposes of another’s trade or business to process articles in a place other than a business premises.

P

Parent

See section 3 of the Act which defines this: "parent", in relation to a deceased worker, includes a person who stood in loco parentis to the worker at the time of the worker's death.

PAYE

Pay as you earn

Payment Arrangements

In some cases employers may fall behind in their levy payments or are not able to pay all outstanding fines in one payment. We can offer these employers (providing they have a good payment history) a payment arrangement which allows them to pay by instalments over an agreed period of time.

Payment Frequency

Annual payers <$1000 levy per annum
Monthly payers >$1000 levy per annum

This term relates to the number of times the employer makes payments throughout the year.

Payment Options

The preferred method of payment for monthly employers is through the use of Direct Debit. Employers may also choose to pay their entire year’s levy in advance to receive a discount, however, for this method their payment must be made prior to 30 June for the next financial year. For this reason, LPIA is mainly promoted with the EOY process and Bonus/Penalty mailouts.

Payment Period

Can be known as a 'bucket' or instalment due. It is the period for which a payment is due or received.

PBN

Parliamentary Briefing Note

Pecuniary loss

A loss of earning capacity.

Penalty interest

Penalty interest awarded to an injured worker when there is a delay in the payment of compensation.

PF

Participation factor

PHA

Private Hospitals Association

PI

Performance index

PI

Private investigator

PIA

Printing Industries Association

PIR

Post Implementation Review (conducted after a change has been implemented) or Policy Implementation and Review.

Place of employment

See section 3 of the Act which defines this: "place of employment" means a place where a worker is required to carry out duties of employment and, if the place is a building, includes land within the external boundaries of the land on which the building is situated;”

PMAC

Performance Measurement Advisory Committee

PMC

Prescribed medical certificate

PMRTS

Professional Massage and Remedial Therapy Society

PPE

Personal protection equipment

PPIG

Premium-pay implementation group

PPR

Private patient rate

PRC

Potential recovery claim

Predominant Activity

The predominant class of industry or predominant activity of an employer’s location means the class of industry which attracts the greatest number of workers/time and aggregate remuneration.

Premiums Adjustment Scheme

The application of either a remission of levy or a supplementary levy to an employer location. Under section 67 of the Act an employer, at any time, can only have one remission of levy or one supplementary levy. The determination lists the elements (and some of the criteria) that could make up an employer's remission or supplementary levy. Those elements are:

  • Bonus and penalty scheme
  • SABS
  • 58B and 58C
  • Self-Managed Employer remission
  • OH&S supplementary levy.

Prescribed allowance

See section 3 of the Act which defines this: “prescribed allowance", in relation to the earnings of a worker, means any amount received by the worker from an employer-

  1. by way of an allowance to cover special expenses incurred by the worker in the course of employment
  2. by way of special rates paid to the worker on an irregular basis to compensate for occasional disabilities under which work is performed (not being rates that are paid during a period of leave with pay)
  3. History: Subsection (c) struck out by 4/1991, s3(b). Operative 8/4/91.
  4. by way of site allowance
  5. by way of any other allowance or benefit prescribed for the purposes of this definition.

Prescribed Class

Class of work prescribed by Regulation 5 of Regulation 241 of 1999 in which a subcontractor, independent contractor and some volunteers may be deemed workers.

Prescribed number of workers

The minimum number of workers a self-insured employer requires, as prescribed by Regulation 9 of Regulation 241 of 1999.

Prescribed Sum

In claims management terms, refers to a series of figures that are set by various sections of the Act to compensate workers for a stated expense. These amounts generally (but not all of them) change in line with CPI at the start of each year. In Premium terms, it is an amount prescribed by Regulation which:

  • Exempts certain domestic employers from registering and paying levy.
  • Excludes certain building subcontractors from the deeming provisions. However, consideration must be given that a contract of service may still apply.
  • Excludes certain sporting professionals from coverage.

Previous position earnings

The ordinary time earnings the worker would now be earning in the same position had no injury occurred.

Primary disability

This is not used in the Act, but means a personal injury arising out of a trauma, which is defined in the Act (see Trauma).

Private employer

Any employer that is not a Crown employer.

Private self-insured employer

Any self-insured employer that is not a Crown self-insured employer.

PROCOL Notice

If a payment remains outstanding then a PROCOL Collection Agency Notice may be prepared and sent to the employer. This is similar to a final notice and advises the employer that legal action may be taken if the debt remains unpaid.

Provisional Liability

A process in which WorkCover begins paying income and medical costs for a claim within seven days rather than waiting for the claim to be determined.

PSA

Public Service Association

PSFC

Preventive Strategies Facilitation Committee

Q

Q Master

Software based call handling system used by the Service Centre and Help Desk to handle incoming telephone calls.

R

R & F Portfolio Manager

IDEAS Registration and Funding database, a tool used to manage employers registration details. It also includes a portfolio management tool for users.

RA Regulations

The Workers Rehabilitation and Compensation (Reviews and Appeals) Regulations

RACGP

Royal Australian College of General Practitioners

RAS

Risk assessment system

Rateable Remuneration

See Remuneration

Ratings Agency

Standard & Poors or Moody’s and any other such agency as determined by WorkCover.

RBA

Reserve Bank of Australia

Reallocation request

Proposal to move a claim from one claims management segment to another.

Rec/Man

Receiver/Manager

Recognised medical expert

See section 3 of the Act which defines this: "recognised medical expert" means-

  1. a legally qualified medical practitioner or
  2. in relation to disabilities of a particular kind-a medical expert who is recognised by the Corporation as having specialised knowledge of, and experience in the treatment of, disabilities of that kind”.

Reconciliation (Rec)

At the end of each financial year all employers are required to reconcile their account. Each registered location receives a reconciliation statement. Employers declare their total remuneration for the financial year. Monthly payers make any necessary adjustments and must return the statement by 31 August. Annual payers pay their total yearly levy payment at this time and must lodge reconciliation and levy payment by 31 July.

Redemption

A payment made to a worker under section 42 to 'buy out' WorkCover’s liability for future weekly payments and/or compensation under section 32.

REG

Registered Employers Group

Registered employer

An employer registered with WorkCover SA under section 59 of the Act.

Regs

Regulations

Regulations, the

The Workers Rehabilitation and Compensation (Claims and Registration) Regulations.

Related Corporations

Related corporations for the purposes of the Corporations Act 2001 (Cth)

Relative

See section 3 of the Act which defines this: "relative", in relation to a deceased worker, means a spouse, parent, grandparent, step-parent, child, grandchild, stepchild, brother, sister, stepbrother, stepsister, half-brother or half-sister of the worker.

Remuneration

Remuneration is more than just payroll and includes:

  • gross wages and salaries (including overtime and loadings)
  • bonuses and commissions
  • fringe benefits superannuation
  • wages and all other allowances/benefits paid to workers.

Levy is calculated using an employer’s total remuneration. Termination pay and workers compensation payments are excluded from levy calculation.

Re-reconciliation

Should an employer provide revised remuneration figures for a particular financial year their account will be re-reconciled.

Residence

See section 3 of the Act which defines this: "residence" in relation to a worker includes a place-

  1. at which the worker resides in pursuance of the terms of the worker's employment or at the request of the employer or
  2. at which it is necessary or convenient for the worker to reside temporarily for the purposes of employment”.

Retraining

A series of activities focused on establishing appropriate training for workers so that they are able to acquire new skills to perform suitable duties.

Return to work

A return to work as a settled or established member of the wage-earning workforce.

RF

Rating factor

Risk

The probability of the worker not returning to work is known as the risk or risk factor. For example, if a worker is likely to return to work, the claim is categorised as low risk.

RSR

The regulation relating to rehabilitation programs and rehabilitation and return to work plans – Regulation 9 of 1996 - The Workers Rehabilitation and Compensation (Rehabilitation Standards and Requirements) Regulations.

RTW

Return to work

RTW Fund

Under the legislative reform package, a $15 million return to work fund will be established to improve rehabilitation and retraining activities, and to fund projects and research to improve return to work outcomes.

RTW Inspectorate

Under the legislative reform package, a return to work inspectorate will be established to oversee WorkCover’s and employers’ responsibilities in relation to return to work. It will provide advice and enforce employer’s obligations to return injured workers to work.

RTW Plan

Rehabilitation and return to work plan. Early and sustainable return to work is a fundamental objective of the WorkCover scheme and employers have specific legal obligations. While an employer is responsible for preparing, monitoring and reviewing a RTW plan, and ensuring all action necessary to do this are undertaken, an agent also has responsibilities:

  • reminding employers of their obligations
  • assisting the employer and worker to achieve a full and effective RTW outcome: and
  • monitoring to ensure the plan is implemented against timelines and goals.

RRTW

Rehabilitation & return to work

S

S58B

Section 58B. An employer’s obligation to provide suitable employment to an injured worker is outlined in this section. There are exceptions under section (2). If an employer is found to be in breach of section 58B a supplementary levy may be imposed (Policy & Procedures Manual, Chapter 4 -Supplementary Levy)

S58C

Section 58C. An employer’s obligation to provide the claims agent and the worker with 28 days notice of their intention to terminate the worker’s contract of employment. Federal industrial provisions for the notice period over rides the state requirements in relation to the notice period. If an employer is found to be in breach of section 58C a supplementary levy may be imposed (Policy & Procedures Manual, Chapter 4 - Supplementary Levy)

S72

Section 72. This section of the Act provides an independent avenue for employers to apply for a review of their levy where they consider certain decisions of WorkCover to be unreasonable. Policy & Procedures Manual, Chapter 7 - Miscellaneous - Section 72 Review.

SABS

Safety Achiever Business Systems is a program for employers encouraging the implementation of effective, OHS&W, rehabilitation and claims management systems. This program which was introduced in late 1991 provides an opportunity for eligible employers to earn better discounts to their industry levy rates. Refer to SABS information on this website.

SAECCI

South Australian Employers Chamber of Commerce & Industry. Refer to Business SA.

SAFF

South Australian Farmers Federation

SAIT

South Australian Institute of Teachers

Sale of Business Statement

A Sale of Business statement (SOB) can be issued to a prospective purchaser of a business (or their representative) provided an authority for release of this information has been received from the current owner. The SOB statement gives the claims history of a particular employer and the current levy rate including any bonus/penalty adjustment.

SAMTA

South Australian Massage Therapists Association

SAPMEA

South Australia Post Graduate Medical Education Association

SAWCT

South Australian Workers Compensation Tribunal

SAWIC

South Australian WorkCover Industrial Classification. SAWIC is the tiered system of industrial classification. The system is industry based meaning that an employer location will attract a classification which reflects the location’s main activity. An employer may employ workers who are involved in different occupations (eg, sales, manufacturing, administration, managers etc.). However, if the main business is manufacturing the SAWIC will reflect that.

SC

Supreme Court

Schedule 4

Schedule 4 to the Regulation 239 of 1999 and/or Regulation 241 of 1999.

Scheme

The South Australian Workers Compensation Scheme, administered by WorkCover.

SDAEA

Shop Distributive and Allied Employees’ Association

SDF

Specified Duties Form

Secondary Disability

See section 3 of the Act which defines this: “Secondary disability means a disability that is, or results from, the aggravation, acceleration, exacerbation, deterioration or recurrence of a prior disability;”

These claims are currently excluded from an employer’s total claims cost when calculating their bonus/penalty adjustment(s).

Section 36

The section of the Act about discontinuance of weekly payments. It outlines the reasons why weekly payments can be stopped.

Self Insurer

An employer that has obtained a grant of self insured status from Work Cover’s Board. Self Insured employers pay a reduced levy and manage and fund their own workers compensation claims. They remain subject to the operation of the Act.

Self-insured employer

An employer that is registered by WorkCover as a self insured employer according to Part 5 Division1 of the Act.

SIERA

The Self-insured Employer Reserve Account, formerly known as the Exempt Employer Reserve Account or ‘EERA’.

SISA

Self Insurers of South Australia

Spouse

See section 3 of the Act which defines this: "spouse", in relation to a worker, includes a person who is cohabiting with the worker as the de facto husband or wife of the worker if-

    1. the person has been so cohabiting with the worker continuously for the preceding period of 5 years; or
    2. the person has during the preceding period of 6 years cohabitated with the worker for periods aggregating not less than 5 years; or
    3. although neither subparagraph (i) nor (ii) applies, the person has been cohabiting with the worker for a substantial part of a period referred to in either of those subparagraphs and the Corporation considers that it is fair and reasonable that the person be regarded as the spouse of the worker for the purposes of this Act; or
  1. a child, of whom the worker and the person are the parents, has been born (whether or not the child is still living)”;

Sprains and Strains

The Sprains and Strains Care Model is an evidence based injury management tool designed to assist in health care management of sprain and strain injuries, by providing the right care at the right time. The care model includes both multidisciplinary assessment (MDA) and interdisciplinary rehabilitation (IDR).

Stakeholder Contact

Contact involves the agent initiating and continuing regular contact with the worker, employer and the worker’s treating health practitioner. This develops a relationship between the parties, allowing the collective gathering of information and the relay of strategies and goals.

Suitable duties

Suitable duties are those duties for which the worker is fit, and which forms part of a rehabilitation and return to work plan. These duties may then lead to a contract of employment in accordance with section 58B.

Suitable employment

Suitable employment involves a contract of employment and provides suitable work for which the worker is fit, and which is similar or equivalent to the worker’s pre-injury employment. Depending on the circumstances it may be full-time or part-time. The obligation to provide suitable employment is as soon as the worker has capacity to return to work even though the worker may continue to carry a disability. To identify what is suitable employment the issues below require consideration:

  • the nature and extent of the worker’s disability
  • the worker’s work experience
  • the workers age, level of education and skills
  • the worker’s work experience
  • the worker’s capacity
  • other relevant factors.

SWI

SafeWork Incentive

T

Taxable supply

The term is widely defined to include most supplies including goods and or services provided by a supplier.

Therapeutic appliance

See section 3 of the Act which defines this: “Therapeutic appliance means-

  1. spectacles or contact lenses
  2. a hearing aid
  3. false teeth
  4. a prosthesis
  5. a crutch or wheelchair or
  6. any other appliance or aid for reducing the extent of a disability or enabling a person to overcome in whole or part the effects of a disability”.

Third Party

In the context of recovery and workers compensation, a party (other than the worker or employer) who can have liability attributed to the work injury.

TOOCS coding

Type of occurrence classification – The NOHSC defined coding (currently in version 3.0) used to classify the claim consisting of

  • Body location of Injury – classification of part of the body affected by the most severe injury
  • Mechanism (Agency) of accident – classification of the cause of the accident
  • Mechanism (Agency) of injury – classification of the cause of the Injury
  • Accident type – type of accident (e.g. Falls, trips, etc)
  • Nature of injury – classification of the Injury/disease

Trauma

Trauma is defined in section 3 of the Act and “means an event, or series of events, out of which a compensable disability arises”;

U

Unjust enrichment

Where a party has received compensation payments for an injury from WorkCover, and recovers or receives damages or further payments from another source.

Unrepresentative disability

See section 3 of the Act which defines this: "unrepresentative disability" means a disability arising from an attendance mentioned in section 30(3) or a journey mentioned in section 30(5)(b)”;

V

Valid Tax Invoice

A tax invoice is a document generally issued by the supplier/service provider. A valid tax invoice is required to claim an input tax credit.

Vocational assessment

An assessment to evaluate the worker’s ability, skills, aptitudes and competencies taking into account the worker’s disability and then match them to appropriate employment or career options.

VWA

Victorian WorkCover Authority

W

WCA

WorkCover Corporation Act 1994

WCAT

Workers Compensation Appeals Tribunal

Withholding Tax

Withholding Tax is applicable where the provider does not have an Australian Business Number.

WLRP

WorkCover Levy Review Panel

Work related

An injury/disease may be work related if it arose out of or in the course of employment.

WorkCover

WorkCover SA

Worker

See section 3 of the Act which defines this: "worker" means-

  1. a person by whom work is done under a contract of service (whether or not as an employee)
  2. a person who is a worker by virtue of section 103A
  3. a self-employed worker

and includes a former worker and the legal personal representative of a deceased worker”.

Workers Rehabilitation and Compensation Scheme

The South Australian Workers Compensation Scheme, administered by WorkCover.

Workplace assessment

An evaluation of the workplace to assess if duties may be suitable for a worker.

WRCA

Workers Rehabilitation and Compensation Act 1986

WRCAC

Workers Rehabilitation and Compensation Advisory Committee

WRMC

Workplace Relations Ministers' Council

Wrongdoer

Is the negligent party from which the injured party is entitled to claim damages.

X

Y

Z