Part 5295 Disputes to which Part applies
(1) This Part applies to a dispute referred to the Commission that concerns:(a) weekly payments of compensation or medical expenses compensation, or(b) failure by an insurer, employer or worker to comply with a requirement imposed by or under Chapter 3 (Workplace injury management).(2) This Part extends to a dispute that concerns failure to commence provisional weekly payments of compensation as required by Division 1 of Part 3 (even though no claim has been made for that compensation) and so extends as if:(a) a reference in this Part to weekly payments included a reference to provisional weekly payments, and(b) initial notification of injury (as defined in Part 3) constituted a claim for the compensation.
296 Exercise of functions of Registrar
(1) The Registrar may exercise functions under this Part with respect to a dispute on the basis of the documents and information provided to the Registrar when the dispute was referred for determination by the Commission.(2) Except as provided by this Part, the exercise of any function of the Registrar under Division 2 or 3 of this Part is not subject to appeal or review.
Division 2 Disputes concerning weekly payments or medical expenses
297 Directions for interim payment of weekly payments or medical expenses compensation
(1) When a dispute to which this Part applies concerns weekly payments of compensation or medical expenses compensation, the Registrar can direct the person on whom the claim is made to pay the compensation concerned. Such a direction is referred to in this Part as an interim payment direction.(2) An interim payment direction for payment of medical expenses compensation cannot be for an amount of more than $7,500 or such other amount as may be prescribed by the regulations.(3) The Registrar is to presume that an interim payment direction for weekly payments of compensation is warranted unless it appears to the Registrar that:(a) the claim concerned has minimal prospects of success, or(b) the worker has returned to work, or(c) the injury was not reported by the worker as required by section 44 (Early notification of workplace injury), or(d) insufficient medical evidence is available concerning the period of incapacity of the worker, or(e) circumstances exist that are prescribed by the regulations as circumstances in which it is not to be presumed that such a direction is warranted.(4) If an injury management plan for the worker is in place or the insurer has accepted that the worker has received an injury (as defined in this Act), the Registrar is to presume that an interim payment direction for medical expenses compensation is warranted if satisfied that the treatment or service to which the compensation relates is reasonably necessary:(a) to prevent deterioration of the worker’s condition, or(b) to promote an early return to work, or(c) to relieve significant pain or discomfort, or(d) for such other reason as may be prescribed by the regulations.(5) Subsections (3) and (4) do not limit the circumstances in which an interim payment direction can be given.(6) An interim payment direction can be given subject to conditions.(7) A further interim payment direction or directions can be given after the expiry of any earlier direction.
298 Period for which interim payment of weekly payments can be directed
(1) An interim payment direction (or further interim payment direction) can direct the person on whom the claim is made to pay weekly payments of compensation for a period that does not exceed 12 weeks.Note. The 12-week limit applies to each direction or further direction.(2) An interim payment direction can direct payment of weekly payments during a period that is before the direction is given, but that period must not exceed 10 weeks.
299 Revocation of interim payment direction
(1) The Registrar can revoke an interim payment direction at any time.(2) When an interim payment direction is revoked, the obligation to make payments under the direction ceases.(3) The revocation of an interim payment direction does not affect the requirement to make payments before the revocation.
300 Offence of failure to comply with interim payment direction
A person who fails to comply with an interim payment direction is guilty of an offence.Maximum penalty: 50 penalty units.
301 Effect of payment under interim payment direction
(1) The payment of compensation in accordance with an interim payment direction is not an admission of liability by the insurer or employer.(2) An insurer can continue to pay compensation on the basis of the provisional acceptance of liability after the period for which payment is required by an interim payment order. The acceptance of liability on a provisional basis is not an admission of liability.
302 Rules relating to interim payment directions
The giving of interim payment directions by the Registrar is subject to relevant provisions of the Rules relating to those directions.
303 Commission can give interim payment direction
The Commission has and may exercise any function of the Registrar under this Division, in connection with a dispute referred to the Commission for determination.
If the Commission subsequently determines that a person is not liable to make the weekly payments of compensation that have been paid in accordance with an interim payment direction, the following provisions apply:(a) the worker or other person who received those payments is not required to refund those payments unless the Commission otherwise orders under paragraph (b),(b) if the Commission is satisfied that the claim for compensation was wholly or partly fraudulent or made without proper justification, the Commission may order the worker or other person concerned to refund the whole or a specified part of those payments,(c) the Commission may (instead of making an order for a refund) order any other person whom it determines was liable for the whole or any part of those payments to reimburse the person who made those payments,(d) those payments are to be excluded from any determination of the claims experience of the employer for the purposes of calculating the premium payable by the employer for a policy of insurance.
Division 2A Disputes concerning past weekly payments
304A Disputes to which Division applies
(1) This Division applies in respect of a dispute that concerns weekly payments of compensation if the payments are for a period (not exceeding 12 weeks) before the dispute is referred to the Commission, being a period in respect of which an interim payment direction under this Part may not be made.(2) A dispute that also relates to medical expenses may be dealt with partly under this Division (in relation to weekly payments) and partly under Division 2 (in relation to medical expenses).
304B Registrar may deal with dispute
(1) The Registrar may determine the dispute instead of the Commission.(2) For the purposes of determining the dispute and subject to the regulations, the Registrar has all the functions of the Commission constituted by an Arbitrator under the Workers Compensation Acts and any determination of the Registrar is taken to be the determination of the Commission constituted by an Arbitrator.(3) This Division does not affect any jurisdiction of the Commission to determine a dispute involving weekly payments of compensation.(4) To avoid doubt, the Registrar may, under section 371, delegate a function conferred on the Registrar under subsection (1) or (2).
Division 3 Disputes about non-compliance with Chapter 3
305 Disputes to which Division applies
This Division applies in respect of a dispute that concerns a failure by a party to the dispute to comply with an obligation imposed by or under Chapter 3.
306 Ways in which dispute can be dealt with
The Registrar may deal with the dispute:(a) by conciliating in connection with the dispute (to bring the parties to agreement having proper regard to relevant entitlements and obligations under the Workers Compensation Acts), or(b) by directing that an injury management consultant or other suitably qualified person (paid for by the employer) conduct a workplace assessment in connection with the dispute, or(c) by referring the dispute to the Authority, or(d) by making a recommendation as provided for by this Division.Note. The Registrar can refer the dispute to the Commission for determination if action under this Division is not successful.
307 Registrar can recommend certain action
(1) The Registrar can deal with the dispute by recommending that a party to the dispute take specified action, being action that the Registrar considers necessary or desirable to remedy the failure with which the dispute is concerned.(2) If the dispute concerns failure to comply with an obligation imposed by an injury management plan, the Registrar can recommend compliance with the injury management plan subject to such modifications as the Registrar considers appropriate.(3) If the dispute concerns the provision of suitable employment for the worker, the Registrar is to have regard to the requirements of section 49 in making a recommendation with respect to the provision of suitable employment.
308 Compliance with recommendations of Registrar
(1) A party to the dispute to whom a recommendation is made by the Registrar must, within 14 days (or such longer period as the Registrar may allow in a particular case):(a) comply with the recommendation, or(b) request the Registrar to refer the dispute to the Commission for determination.Maximum penalty: 50 penalty units.
(2) If a worker’s failure to comply with the Registrar’s recommendation constitutes a failure to comply with this section, the worker has no entitlement to weekly payments of compensation during any period that the failure to comply with the recommendation continues.(3) If an employer’s failure to comply with the Registrar’s recommendation constitutes a failure to comply with this section, the employer’s insurer is entitled to recover from the employer (despite the terms of the relevant policy of insurance) the amount of weekly payments of compensation paid by the insurer in respect of any period that failure to comply with the recommendation continues.
309 Employers—representation and admissions
(1) At any conference or hearing before the Registrar for the purposes of this Division:(a) an employer is entitled to separate representation if the employer requests separate representation, and(b) an employer is not prevented by the terms of any relevant policy of insurance from making any admission of liability in respect of the injury or claim concerned.(2) Evidence of an admission made by the employer at any conference or hearing before the Registrar for the purposes of this Division is not admissible in other proceedings before the Commission.
310 Referral of dispute to Commission
If the dispute is referred to the Commission for determination, the Commission may make orders with respect to any matter that can be the subject of a recommendation by the Registrar under this Division.