WorkCover WA has made changes to the Claim Status Codes, which include the retirement of two values, renaming one, and adding four new values. The Claim Status Code is equivalent to the 'Current Liability Status' list on the Claim Data page.

Claim Status Codes Pre-Change (1981 Act)

01 Accepted

02 Pending

03 Rejected

04 Withdrawn

05 Invalid

06 Paid Without Prejudice

Once our team configures your account (following an accepted June submission), the Current Liability Status list will update to show the new Claim Status codes and values.

Claim Status Codes Post 1 July 2024 (2023 Act)

00 Received

01 Accepted

03 Not accepted

04 Withdrawn

05 Invalid

07 Decision deferred

08 Deemed accepted

09 Liability decision in dispute

Source: WA NIDS v1.3

As per WorkCover WA's requirements, a liability decision notice must be given within 14 days of receiving a claim. If a liability decision cannot be made, the injured worker must be given a deferred decision notice.

To ensure you meet the relevant deadlines, two new system tasks have been created. The tasks will remind you to make a liability decision and send a notice to the injured worker. The tasks are triggered differently and details are outlined below:

The 'Notification of Pended Claim Required [SI] (WA)' task is triggered when a claim has a liability status of 'Received' or 'Pending'. The system will determine the due date by adding 13 days from the 'Claim Received by Employer' field on the Claim Data page.

The 'Deferred Liability Decision required [SI]' task is triggered when the current liability status is 'Decision Deferred'. The due date will be determined by adding 119 days to either the Employer Received Claim or Insurer Notified Claim date (Claim Data page) whichever is the lesser.

The above system tasks are in addition to the below-existing system task.

Liability Decision Required [SI] (WA)

Injury

This task is triggered when an injury has a Claim Received date set (Injury Details page). The system will determine the due date by adding 13 days from the Claim Received At date.

Claim

This task is triggered when a claim has a liability status of 'Received' or 'Pending'. The system will determine the due date by adding 13 days to either the Claim Received by Employer or Date Insurer Notified of Claim date (Claim Data page) whichever is the lesser.

Four letter templates have been created to assist with meeting the regulatory requirements to provide notice to workers. The templates can be downloaded by clicking on the links at the bottom of this article. The fields have been configured using relevant system fields, but you can change them if needed. The following WorkCover WA notices have been created;

Some things to consider:

Once the templates have been configured, users can access them in a claim file by using Quick Key 'L' from the Summary page or selecting 'Letter Templates' from the Add Information Dropdown.

WorkCover WA has amended the accepted payment codes, which include the retirement of three values, renaming four, and adding five new values. This change impacts the buckets available when adding new estimates to the system for WA self-insured claims.

The key change you'll notice when adding new Estimates post 1 July 2024, is that the 'Redemption' bucket does not exist and some fields have been added.

Estimate buckets Pre-Change (1981 Act)

Estimate buckets Post 1 July 2024 (2023 Act)

The key in-system changes to keep an eye out for are:

If there was an existing Estimate on a claim with a Redemption value, this will still appear in the Current Estimate tile (Financials > Summary Page) as well as in the Estimated - Total field on the Estimates page, however, the specific Redemption field will not be visible. The total Estimate will retain the Redemption estimate value until a NEW estimate is added to the claim.

Renamed Estimate 'buckets' (Workplace Rehabilitation, Settlement and NIHL) should be reviewed for accuracy and relevancy to the claim.

Our recommendation is to complete an estimate review on your open claims as soon as possible (once your account has been configured to the new 2023 Act) to ensure you meet the new requirements.

Reporting on historical estimate is available via the in-system reporting tool if required.

As mentioned above, WorkCover WA has made amendments to the accepted payment codes/categories that a payment belongs to. This includes the retirement of three values, renaming four, and adding five new values.

Updated Payment Type Codes are:

New Payment Type Codes are:

The following Payment Type Codes remain unchanged:

All historical payments will retain the previously selected Payment Code/Category.

The above codes will apply to any new payment entered into the system (post 1 July 2024).

Source: WA NIDS v1.3

WorkCover WA has made changes to the Employee Claim Form and these new forms are available from their website. In most cases, this form would be completed by the worker and not generated from within the system. The new form versions have not been built into the system, however, you can upload the completed form as an attachment.

When using the in-system functionality for the Employee Claim Form, you will need to select the Upload Claim Form option and upload it as an attachment, instead of generating it.

Changes to the Workers Compensation and Injury Management Act 2023 have changed how compensation is calculated. Mainly, which rate would be used to calculate compensation and the introduction of a 'step-down' that takes place after the 26-week mark.

We have introduced a tickbox in the Claim Payroll Details section of the Payroll page called 'Pre July/2024 Entitlement'. This dictates what fields appear at the top of the Compensation Calculator page, and how the system will calculate compensation.

When checked, the system will show the Average Weekly Earnings (13wks) & Average Weekly Earnings (14wks+) fields for you to complete (as per the requirements of the 1981 Act).

When not checked, the system will show a single 'Pre-Injury Weekly Rate of Income' field (as per the requirements of the 2023 Act).

Your Insurer will provide guidance on what entitlement to apply.

WorkCover WA has released a Return to Work Program template to be used from 1 July 2024.

The WorkCover WA RTW template is not available as an in-system form and you will need to manage the completion of the template externally to the system. Once completed, you can use the Attach RTW Plan option when adding an RTW plan via the Rehab sub-menu.

Alternatively, you can convert the WorkCover WA RTW Plan into a Letter Template to pre-populate some fields directly from the system. To assist with this, we have converted the WorkCover WA template. It can be downloaded by clicking on the document link at the bottom of this article.