Glossary

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Accident quarter

 Refers to the financial quarter in which the occupational injury occurred or when symptoms of the occupational illness or disease were first recognised.

Accident year

  Accident year refers to the financial year in which the accident event leading to a claim occurred, irrespective of when the claim was reported, paid or finalised.

Active claims

  Active claims are those claims with one or more transaction payments in a financial year/quarter.

 Age

  A worker’s age is based on chronological age (in years) at the date of occurrence of the injury.

Agency of occurrence

 The agency of occurrence refers to the object, substance or circumstance directly involved in inflicting the injury or disease.A comprehensive list of inclusions and exclusions for each classification used is available from the National Occupational Health and Safety Commission, which is available online at http://www.safeworkaustralia.gov.au.

Average claim cost

 This represents an estimate of costs for unfinalised claims, plus the total cost of finalised claims, divided by the number of claims. Average cost is attributed to the year in which a claim was lodged.

Bodily location

 The bodily location of injury/disease identifies the part of the body affected by the most serious injury or disease.A comprehensive list of inclusions and exclusions for each classification used is available from the National Occupational Health and Safety Commission, which is available online at http://www.safeworkaustralia.gov.au.

Claims costs

 Represents an estimate of costs for unfinalised claims, and the total cost of finalised claims attributed to the year in which a claim was lodged with an insurer.

Claims data

 Information pertaining to workers’ compensation claims is reported to WorkCover WA by approved insurers and exempt employers. Information is usually collated based on the financial year in which a claim was lodged For the purposes of time-series comparisons, certain types of claims are usually excluded from claims data:

  • Journey claims between home and work
  • Asbestos-related diseases, including mesothelioma and pneumoconiosis
  • Disallowed or duplicated claims
  • Claims with less than one working day absence from work
  • Claims with less than one whole shift absence from work

Claims duration

 The number of months between the date the claim was received by the insurer and the date at which the claim was first finalised.

Claim payments
Payments direct to worker
  1. income payments (payments made for absences from work).
  2. lump sum payments (including common law):
    1. redemption payments made under Schedule 1
    2. specific injury payments made under Schedule 2
    3. fatal payments including funeral expenses
    4. common law and other Acts payments.
Payments for treatment services
  1. medical and hospital payments:
    1. medical practitioner and specialist payments
    2. hospital expenses (hospital accommodation and hospital treatment).
  2. allied health and vocational rehabilitation payments:
    1. other treatment and appliance payments
    2. vocational rehabilitation payments.
Payments for legal and other services

 

  1. legal expenses
  2. approved medical specialist service payment and third party referred report
  3. miscellaneous payments.

Closed claims

 The number of claims closed during a financial year/quarter i.e. a finalisation date is recorded.

Common Law 2004 Scheme Applications

 This refers to the Common Law 2004 Scheme that was introduced by the Workers’ Compensation Reform Act 2004. This applies to workers injured post 14 November 2005. To qualify for common law damages, an individual must be assessed to have 15% whole-of-person impairment for limited common law damages or 25% whole-of-person impairment for unlimited common law damages.

Common Law Claim

 An action for common law damages made against an employer or other party in respect of an injury; if the injury was caused by the negligence of the employer or other party and the worker has at least an agreed or assessed 15% whole person impairment.

Common Law Payment

 Represents the total economic loss component of a common law settlement or judgement after deduction of amounts for contingencies and contributory negligence. This includes any amount for pain and suffering, permanent impairment, loss of superannuation, legal expenses and future medical costs.

Disease

 Subsection 5(1) of the Workers’ Compensation and Injury Management Act 1981 (WA) defines disease as including any physical or mental ailment, disorder, defect, or morbid condition whether of sudden or gradual development. See also Injury.

Disputation Rate

 This is defined as the number of dispute applications as a proportion of all active claims for the reference year. Prior to 2009/10, the disputation rate was calculated slightly differently, with the number of dispute applications represented as a proportion of all new claims lodged in a reference year. The change to the current definition and calculation was made at a national level, across all jurisdictions, to reflect that dispute applications may occur at different stages during a claim cycle, not necessarily in the first year.

Dispute

 This is in relation to a dispute over a worker’s compensation claim by parties involved (e.g. insurer, employer, worker). A dispute can occur at any stage of a claim in relation to a number of matters.

Durable Return to Work

 An injured worker who returned to work and is still working 13 weeks from time of recommencement.

Duration

 The duration of a claim is usually calculated in working days, and is based on estimates for unfinalised claims and actuals for finalised claims.

Employer Lodgement Period

 Refers to the number of days between occurrence of a work-related injury or diagnosis of a work-related disease and lodgement of a worker’s compensation claim with an employer.

Estimated Claim Cost

 The total estimated incurred claim costs, exclusive of development estimate and incurred but not reported (IBNR) amounts. Estimated costs are not adjusted for inflation and are attributed to the year in which a claim was lodged with an insurer.

Exempt Employer

 An exempt employer is an employer exempted under section 164 of the Workers’ Compensation and Injury Management Act 1981 (WA) from the obligation to insure. Also commonly referred to as a Self-Insurer.

Frequency Rate

 Frequency rate is the number of lost-time claims per million hours worked and indicates the prevalence of workers’ compensation claims. It is based on the number of hours worked for employed persons covered by workers’ compensation.

Full Return to Work

 An injured worker who returns to work at an equivalent level of pay and hours and is not receiving workers’ compensation payments.

Incidence Rate

 The incidence rate is the number of lost time claims per hundred employees (part-time, full-time, casual, and seasonal) in Western Australia. Employee numbers are based on the Australian Bureau of Statistics Labour Force data CAT No 6202.0.

Industry

 Industry classification is based on the Australian and New Zealand Standard Industrial Classification (ANZSIC) system 1993, published by the Australian Bureau of Statistics. The ANZSIC system groups together businesses that carry out similar economic activities and is structured into a hierarchy of units reflecting different levels of description.

Initial Liability Decision for Approved Insurers

 After receiving a worker’s compensation claim from an employer, an approved insurer within the WA workers’ compensation scheme is required to make an initial decision as to whether to accept or decline liability for the claim within 14 days. See S.57A (3) Workers’ Compensation and Injury Management Act 1981.

Initial Liability Decision for Self-Insurers

 After receiving a worker’s compensation claim, a self-insurer within the WA workers’ compensation scheme is required to make an initial decision as to whether to accept or decline liability for the claim within 17 days. See S.57B (2) Workers’ Compensation and Injury Management Act 1981.

Injured Worker

 A worker who made a workers’ compensation claim.

Injury

 Injury is defined under subsection 5(1) of the Workers’ Compensation and Injury Management Act 1981 (WA) as:

  1. A personal injury by accident arising out of or in the course of employment or while acting on the employer’s instructions.
  2. A disabling industrial disease (e.g., poisoning, lung disease, etc.).
  3. A disease contracted in the course of employment or the recurrence or aggravation of a pre-existing disease where the employment contributed to a significant degree.

See also Disease.

Injury Management

 Injury management is a recommended framework involving the injured worker, employer and treating medical practitioner working together to assist the worker to stay at work or return to work following a workplace injury.From 14 November 2005 injury management was incorporated into the Workers’ Compensation and Injury Management Act 1981 (WA).

Insurer

 Insurers comprise of those insurers approved or formerly approved under section 161 of the Act and also the Insurance Commission of Western Australia (formerly the State Government Insurance Commission).

Insurer Lodgement Period

 After receiving a worker’s compensation claim, an employer (whose worker is covered by the Workers’ Compensation and Injury Management Act 1981) is required to lodge the received claim with their insurer within five working days. See S.57A (2) Workers’ Compensation and Injury Management Act 1981.

Insurer Received Quarter

 Refers to a three month period where new workers’ compensation claims were lodged with an insurer (approved insurer or self-insurer).

Journey Claims

 Up to 24 December 1993, workers’ compensation claims could be lodged for injuries sustained while travelling to and from work. Journey claims have since been excluded from claims data.

Jurisdiction

 Refers to the compensation authority that has responsibility for a population of injured workers. It generally refers to individual states and territories. Within Australia, two other entities exist, Comcare, which is responsible for Commonwealth agencies, and Seacare, which is responsible for seafarers.

Long Duration Claims

 Workers’ compensation claims for which the injury or disease results in an absence from work of at least 60 days or shifts.

Lost Time Claims

 Lost time claims are claims for which the injury or disease results in an absence from work of at least one day or shift.

Manual-Handling Injuries

 Manual-handling injuries are a component of the ‘body stressing’ group in the mechanism of injury or disease classification.Manual handling includes muscular stress while lifting, carrying or putting down objects, muscular stress while handling objects other than lifting, carrying or putting down, and repetitive movements with low muscle loading.

Mechanism of Injury or Disease

 The mechanism of injury or disease refers to the action, exposure or event that best describes the circumstances that resulted in the most serious injury or disease.A comprehensive list of inclusions and exclusions for each classification used is available from the National Occupational Health and Safety Commission, which is available online at http://www.safeworkaustralia.gov.au.

Memorandum of Agreements

 A legal instrument which, if registered with the Conciliation and Arbitration Services of WorkCover WA, records a statutory settlement of a worker’s compensation claim.See section 76 of the Workers’ Compensation and Injury Management Act 1981.

Nature of Injury

 The nature of injury classification is intended to identify the most serious injury or disease suffered by the worker. The injury or disease suffered is generally physical, although the classification includes categories for mental illness. Injury results from a single traumatic event where the harm or hurt is immediately apparent (e.g. burns resulting from an acid splash) or conversely, disease resulting from repeated or long-term exposure to an agent (e.g. noise-induced hearing loss).A comprehensive list of inclusions and exclusions for each classification used is available from the National Occupational Health and Safety Commission, which is available online at http://www.safeworkaustralia.gov.au.

New to Closed Claims Ratio

 Shows the relationship between the number of new claims lodged and the number of closed claims for a given quarter.

No Return to Work

 An injured worker who is not working and is not deriving an income from employment.

Non-Durable Return to Work

 Refers to a worker who returned to work for a period of time but had to stop work again due to their work related injury.

Number of Claims

 This includes all claims lodged during a given quarter. It includes claims where no payment has been recorded at the date of data extract.

Ongoing Claims

 Ongoing claims are claims lodged in a previous year, which are still open at the beginning of the current year of interest.Ongoing claims are usually organised by the financial year of lodgement and exclude journey claims, no-lost-time claims and asbestos-related diseases. See also: Active Claims.

Outstanding Estimated Claim Costs

 Amount of liability that is yet to be paid for each incurred claim and as estimated by insurers.

Partial Return to Work

 An injured worker who returns to work in a part-time or reduced capacity and is still receiving workers’ compensation payments.

Payment Year or Payment Period or Payment Quarter

 Refers to the year, period or quarter for when payments were made for workers’ compensation claims.

Payments

 Also see claim payments. Payments are adjusted for inflation to allow meaningful comparisons over time.

Pending Claims

 Where a decision to accept or decline liability for a worker’s compensation claim is extended by an insurer until further information is obtained (e.g. medical information or details about a worker’s weekly earnings).

Return to Work (RTW)

 An injured worker who has had time off work as a result of their work related injury and has returned to work.

Section 92(F) Settlements

 Refers to a lump sum payment for damages against the employer without proceeding to court; no further claim can be made. See Section 92(f) of the Workers’ Compensation and Injury Management Act 1981.

Self-Insurer

 See exempt employer.

Step-down

 A step-down refers to the point at which weekly payments to an injured worker are reduced, currently from the 14th week after payments begin.

Transaction Quarter

 Refers to the date of when a payment was processed.

Young Workers

 Young workers are those between the ages of 15 to 24 years at the date of injury.