004_ACC_April_2016

Recommendations

Info

BACK To meet the circumstances for obtaining cover an ‘event’ is described as: • An event that is sudden; or • A direct outcome of a sudden event; or • A series of events that arise from the same cause or circumstance and together comprise a single incident or occasion A gradual process is excluded from being considered an ‘event’. DATE ON WHICH WORK-RELATED MENTAL INJURY SUFFERED The date on which the work-related mental injury will be considered to have been suffered will be the date on which the person first receives treatment for that injury. MONETARY ENTITLEMENTS Monetary entitlements provided under the Act are: • employer-paid first week compensation; • weekly compensation after the first week; • lump sum compensation for permanent impairment; • funeral grants, survivors’ grants, weekly compensation for the surviving spouse, children and other dependants, and child care payments, where a claimant dies as the result of a personal injury. Injured employees are also entitled to rehabilitation, comprising treatment and, where necessary, social and vocational rehabilitation. Entitlements for workrelated personal injuries are funded by a levy on employers which is paid into a Work Account. Claimant’s responsibilities A claimant who has received any entitlement, if reasonably asked to do so by the Corporation, must: • provide a certificate from a registered health professional or treatment provider; • provide any other information required; • authorise the Corporation to obtain medical and other information relevant to the claim; • be assessed, at the Corporation’s expense, by a registered health professional specified by the Corporation; • undergo assessment at the Corporation’s expense; • co-operate with the Corporation in the development and implementation of an individual rehabilitation plan, where necessary; • have present and likely capabilities assessed for rehabilitation purposes, at the Corporation’s expense; • participate in rehabilitation; • provide a written statement about any matters relating to any entitlement. (The Corporation may ask for this in the form of a statutory declaration.) First week compensation Anyone who was employed immediately before being incapacitated as the result of a work-related personal injury is entitled to 80 per cent of all earnings lost during the first week of incapacity. This first week payment will be paid by the employer at whose workplace the injury occurred. The Corporation pays any subsequent weekly earnings-related compensation except where an employer has chosen to become an ‘accredited employer’. Again payment is at the rate of 80 per cent of previous earnings (see under ‘Calculation of weekly earnings’ for the way in which these are calculated) but to a set maximum. The employer is liable to pay all the first week compensation for a work-related personal injury, including one suffered in a motor vehicle accident which, though not classified as work-related, carries an entitlement to employer-paid first week compensation. (See under ‘Work-related personal injuries’. These are injuries incurred while working in a place that itself moves or though which the employee moves, or while having a break from work for rest or refreshment at the place of employment). In all other respects such injuries will come into the motor vehicle category and be paid for from the Motor Vehicle Account. To challenge a decision by <strong>ACC</strong> that an injury is work-related, an employer should follow the disputes resolution process outlined later in this guide. 8
BACK The employer at whose workplace the injury occurred also pays 80 per cent of any earnings the employee has lost from any other job, if the employee has more than one job. In calculating first week compensation it is presumed that the amount lost because of incapacity is the difference between earnings in the 7 days before the incapacity commenced and earnings in the first week of incapacity. For example, if an employee earned $500 in the 7 days prior to incapacity and $100 in the week of incapacity, the amount lost, and therefore payable by the employer, is 80 per cent of $400. However, this presumption can be rebutted by proof to the contrary, as in the case of a shift worker injured on the first day of a new shift after several days when not required to work. Earnings in the previous seven days will be less than the employee would normally receive, making the presumption inappropriate. Evidence of the employee’s situation will rebut the presumption so that first week compensation can then be calculated as 80 per cent of shift work earnings. Similarly, a part-time employee may not have worked and earned as much as usual in the 7 days prior to incapacity. Here, too, evidence of the employee’s usual pattern of earnings can be used to rebut the presumption. Before paying first week compensation the employer may reasonably require the employee to produce independent evidence of the personal injury, for example, by providing a certificate from a registered health professional whom the employer nominates and pays for. The term registered health professional covers: chiropractors, clinical dental technicians, medical laboratory technologists, medical radiation technologists, midwives, nurses, occupational therapists, optometrists, pharmacists, physiotherapists, podiatrists, and registered medical practitioners all of whom can provide initial certificates of injury. However, for some later purposes, for example, when the Corporation is determining whether someone is incapacitated for work (see below), the employee will need to get a certificate from a registered medical practitioner or nurse practitioner. First week compensation is payable for the purposes of the Act itself, the Income Tax Act, the Tax Administration Act, the laws relating to insolvency, receivership and the liquidation of companies, and section 131 of the Employment Relations Act (relating to wage arrears). It is an offence for an employer not to pay first week compensation. The maximum fine is $500. Entitlement to weekly compensation Weekly compensation is payable to any eligible person who was an earner when the personal injury was suffered or who was on unpaid parental leave. To determine eligibility the Corporation must decide whether the injured employee cannot, because of the injury, continue to do the work he or she was doing when the injury occurred. An employee who cannot continue is considered ‘incapacitated’ for employment. This also applies to self-employed people and to anyone who has applied to purchase weekly compensation while still employed, or within one month of ceasing employment, to cover a period when not employed—as anyone continuously employed for the previous 12 months is entitled to do. In determining incapacity, the Corporation must consider a registered medical practitioners or nurse practitioner’s assessment. It may also obtain professional, technical, specialised, or other advice from some other appropriate person. The Corporation may from time to time reconsider the situation of an employee who is receiving weekly compensation. If it decides the employee is no longer incapacitated, entitlement to weekly compensation will be lost three months after the Corporation has notified the employee of its decision. 9
Page 1 and 2: 1 ACCIDENT COMPENSATION Empowering
Page 3 and 4: VOCATIONAL INDEPENDENCE............
Page 5 and 6: BACK INTRODUCTION New Zealand has h
Page 7: BACK An employee who deliberately m
Page 11 and 12: BACK If an employee was in permanen
Page 13 and 14: BACK Holiday entitlements PUBLIC (S
Page 15 and 16: BACK Vocational rehabilitation The
Page 17 and 18: BACK Changing circumstances Vocatio
Page 19 and 20: BACK Claims must be lodged within 1
Page 21 and 22: BACK A review hearing must be condu
Page 23 and 24: BACK Once an appeal notice is recei
Page 25 and 26: BACK Because the experience rating
Page 27 and 28: BACK Employers are required to: •
Page 29 and 30: BACK COVER FOR NON-WORK RELATED PER
Page 31 and 32: BACK Employer ‘Employer’ means:
Page 33 and 34: BACK APPENDIX Occupational diseases

004_ACC_April_2016

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?