Overview
Our team has been working closely with WorkSafe VIC to support the regulatory changes, which came into effect in 2024. This article contains details on the key adjustments that have been implemented for our Self Insured Victorian clients.
Key system updates include:
Updated liability/claim status codes
Additional data captured in pages in the Claim Management tab
Payment Code changes
Additional data required in Weekly Payments
Injured Person details to be sent as part of the Submission
Changes to the Submission process
This information has been created to assist you where applicable. However, not all changes require a modification to the SolvInjury platform. We encourage you to become familiar with these adjustments to ensure compliance with all regulatory requirements.
Additional data under Claim Management
Additional data under Claim Management
There are several new tabs available under the Claim Management section to help you easily capture all the necessary data. These pages are:
Certificate of Capacities
Claim Status
Correspondances
Hospitalisations
Multiple Injuries
Return to Work
Terminations
In order to try to reduce the double entry of data, additional panels have been added to certain pages of the system when the Policy Type is Victorian Self Insurance.
This is an example from the Add Medical Certificate page:
These sections can be found on the Add Medical Certificate, Add Note, Add Claim Document and on the RTW Plan save page.
Claim Data: PIAWE
Claim Data: PIAWE
To help you capture up-to-date PIAWE values on the Claim Data page, this field has been updated to pull through data from the Compensation Calculator.
Where Compensation Calculator Weekly Entitlements have been added to a record, the PIAWE field on the Claim Data page will become read-only and will populate with the PIAWE or Ordinary Earnings value (week count dependant) used in the latest (but not future-dated) Weekly Entitlement.
Where there are no Weekly Entitlement records added, the PIAWE field will be a text field for the PIAWE value to be manually added.
Weekly Payments: Total Compensation Days
Weekly Payments: Total Compensation Days
The addition of the Payment File field 15, Total Compensation Days, to Weekly Payments has caused some confusion. Whilst Solv has sought clarification from WorkSafe VIC to provide the information below, we encourage you to seek your own information from WorkSafe VIC.
Claim File / Fields 19 & 20
Allows WorkSafe VIC to capture an overarching total number of days/weeks per claim that builds up over time (doesn’t allow a history).
Payment File / Field 15
Allows WorkSafe VIC to determine the number of days/weeks lost at the time of each weekly payment (allows WorkSafe VIC to create a history).
The primary reason that the Payment File/ Total Compensation Days field has been included is that some of WorkSafe VIC's reports/ measure calculations require us to know the ‘Number of Days Lost Per Period’. (The ability to roll this up to align to the Number of Weeks lost totals is a secondary purpose that may not be possible in all scenarios e.g. part-time employees – see further explanation below).
Weeks Lost:
While the amount a worker receives will change depending on how many hours are worked in the week, the week count will continue if there is any amount of compensation paid. The easiest way to think about it is, to imagine you have a wall calendar in front of you and you are marking off any periods of paid compensation. Regardless of how much compensation is paid (1 hour / 1 day / 1 week) that will be considered as 1 week for the purpose of counting the compensation paid weeks.
The best way to think about compensation payments and to reconcile them as follows:
Print out a calendar, select the Date of Injury (DOI) and number the weeks as they appear on the calendar from the DOI (though it is possible that incapacity/ compensation will start after the DOI, in the case of surgery for example)
Print out all Certificate of Capacities (CoC’s)
Identify any periods the worker was completely unfit or had capacity for alternative suitable work and actually worked and received Current Weekly Earnings (CWE’s).
Any period the worker received compensation, whether full or partial, is to be counted as 1 week for the purposes of legislative week count. Any period that the worker has not received compensation is not included in the legislative week count.
The week count is an aggregate period of 130 weeks, it can stop and start and it can take much longer than 2.5 years to reach 130 weeks where the worker has periods of working full time and then going off work again
Any payments of weekly compensation should be entered as weekly compensation, not earnings. Earnings (CWE) are distinct from weekly compensation payments as they relate to payment for hours worked on the RTW plan
Days Lost:
From a days lost perspective, it is basically the same, if the worker receives compensation for any hours on the day, it should be counted as one day for weekly compensation purposes. However, you would also need to take into consideration the number of days that the worker actually works to correctly calculate the number of days per period (e.g. part-timers may only work 3 or 4 days per week?).
Once again, the easiest way to think about it is, to imagine you have a wall calendar in front of you and you are marking off any periods of paid compensation, taking into consideration the number of days usually worked by the injured worker. Regardless of how much compensation is paid (1 hour/ 1 day), it will be considered as 1 day for the purpose of counting the compensation paid days.
Weekly Payments: Total Compensation Days Examples
Weekly Payments: Total Compensation Days Examples
These examples below were shared with WorkSafe VIC. WorkSafe VIC has provided the answers as detailed below.
Example 1
Worker fit for some capacity, working ‘normal hours’ but not earning above the entitled amount. The PIAWE is $1,000. The worker is paid $800 in earnings, so $150 needs to be ‘topped up'. How many Total Compensation Days are to be recorded?
Weeks Lost:
If the injured worker is working ‘normal hours’ (we assume that is full-time hours? Pre-injury hours?) then they would not be entitled to compensation as there is no loss.
If there is a loss due to shift or OT allowance that would only drop off after 52 weeks.
As there has been some form of compensation paid in the week, it should be counted as 1 week.
Days Lost:
As these payments are being paid to the injured worker to compensate them for their weekly earnings, they would be deemed to be applicable to every day of the week the Injured Worker would usually work.
For a full-time injured worker, this should be counted as 5 days per week (or 10 days for a fortnightly payment period).
For a part-time injured worker, this should be counted as the number of days usually worked during the payment period (e.g. 3 days per week, and/or 6 days for a fortnightly payment period).
Example 2
Worker fit for some capacity. Usually works 8 hours a day, only able to work 7 hours per day. There is effectively 5 hours lost over 5 days. How many Total Compensation Days are to be recorded?
Weeks Lost:
In answering this, we have assumed that the 5 days were lost within the same calendar week (e.g. not split across 2 different weeks?).
As there has been some form of compensation paid in the week, it should be counted as 1 week.
Days Lost:
In answering this, we have assumed that this is a full-time employee who works 5 days a week, and that it continues for a full (fortnightly?) payment period?
For a full-time injured worker, this should be counted as 5 days (or 10 days for a fortnightly payment period).
Example 3
The Payment record is not a ‘week’, but multiple weeks added, such as a monthly pay.
Worker fit for some capacity. Some days are ‘lost’, but some are worked. In this example, two days are lost per week of the month. Is this the correct way to record this?
Weeks Lost:
As there has been some form of compensation paid in the week, it should be counted as 1 week, as the legislative weekly count has nothing to do with pay cycles.
Days Lost:
The primary reason that we are collecting the Payment File / Total Compensation Days field has been included is that some of our reports/ measure calculations require us to know the ‘Number of Days Lost Per Period’. We agree that rolling this up to calculate/ align to the Number of Weeks lost totals (secondary purpose) may not be possible in all scenarios (e.g. part-time employees).
In answering this, we have assumed that this is a part-time employee who works 2 days a week, and that payment periods are monthly (as per the example above).
For a part-time injured worker, this should be counted as the number of calendar days usually worked during the monthly payment period = we assume your 9-day count would be correct (based on April 2024 spanning across 4.5 calendar weeks).
Example 4
How should an additional payment be recorded? For example, if there was a payment made previously, and a further payment for the same period of time is being added (if there was an underpayment or it was determined further payment is required). How many Total Compensation Days are to be recorded?
Days & Weeks Lost:
This is a great question and one that it took us a while to work through with the ITSS & IMF data teams.
In answering this, we have assumed that something has happened to change the PIAWE so that additional payments are made to the already processed payments?
There are 2 options for handling this:
You can use the deletions process to reverse the previous payment and re-enter the corrected amount. (Null and replace in Solv)
Or (probably more correct for accounting adjustments), you could enter the additional payments, with a 0-day lost count. (Worksafe VIC confirmed with their ITSS team that our data validation will allow a zero value to be submitted).
Submission Process
Submission Process
Submissions are submitted directly to WorkSafe VIC via a direct SFTP connection between Solv and WorkSafe VIC. Simply generate your file and then select Upload to WorkSafe Victoria SFTP.
Each separate submission file you send to WSV needs to have a Version Number. The first file for each month that is sent to WSV needs to be number 1, the second file needs to be number 2, and so on.
The system will automatically increase the Version Number for you, but please check this. If you have generated a file but not submitted it, the Version Number may need to be adjusted.
Submission Errors
Your return file from WSV containing any errors that you need to work through will be loaded into the Submission Errors section of Solv automatically. You will now see this in your account.
You will find your VIC Policy in the tabs at the top. Any errors that you need to work through will be displayed in the top table. The return files are listed in the bottom table.
Notification that an Error File has been returned
The system can send a notification email to up to two recipients when an error or success file has been returned. This file is returned overnight after you have sent your submission file.
Person Record
Person Record
To ensure that a Person Record is linked to your claim, check the Injured Person Tile on the Injury Summary Page. If this is green, there is a linked Person Record.
If this is red, simply click the tile to navigate through selecting/ adding the correct Injured Person.
EDT 5.5.1 Updates
Additional updates have been made to the system to meet the requirements of the 5.5.1 Specifications.
New Fields
New Fields
New fields have been included to capture additional information.
Payment Service Provider Name: Found on the Payment page
Impairment Determination (%): Found on the Claim Data and Multiple Injuries pages
Additional fields on the Claim Data page have been updated to be mandatory when certain conditions are met. These have been updated to help reduce the risk of submission data errors.
Eligibilities
Eligibilities
A new page under the Claim Management heading has been added where Eligibility records can be captured.
Depending on the Eligibility Type selected, different Eligibility Outcomes show, and different mandatory requirements are set.
These records are included in your submission in the Eligibility File.
Multiple Injuries
Multiple Injuries
An update has been made so that only one Multiple Injury record can be flagged as the Primary.
The Solv-specific concept of Principal Injury has been removed. This had been added to allow for more than one Multiple Injury record to be flagged as Primary.