COMCARE OPERATIONAL ADVICE NO. 46
CALCULATION OF INCAPACITY ‑ SECTIONS 19 TO 21
Branch Managers
State Managers
Manager, Operations
Manager, Review
Manager, Risk Management
State Executive Officer
Incapacity calculations have been standardised and will come into effect with the release of Compense Version 3.0. This standardisation is necessarily due to the requirements of the Compense program, legislation and policy.
The method of calculation contained in Compense will apply to ALL incapacity processed after the release date of Compense Version 3.0 regardless of when the incapacity occurred (except for incapacity periods prior to 1/12/88). This includes redetermining incapacity originally determined prior to Compense Version 3.0.
This Operational Advice provides guidelines for the standardised method of calculation used by Compense, and should be read in conjunction with the Compense Version 3.0 Incapacity Handout and Operational Advice No. 45 regarding 45 weeks calculations and duration of incapacity.
Agency Advice #6 will be issued to inform agencies of the changed information requirements, and to explain the options available to them in providing such information.
Options
From 31/7/89, two options have been given to employers for the provision of information relating to incapacity payments under the Act. These options are considered to give both the employer and Comcare more flexibility in determining incapacity payments. Employers will be able to EITHER:
1 — Provide Comcare with the employee's NWE and duration of incapacity; OR
2 — Provide Comcare with the total amount which would have been payable over the duration of the incapacity.
Option 1
- Given this information, Comcare will calculate the Weekly Rate, and the Total Liability for the claimed incapacity.
Option 2
- The Total Liability as advised by the employer will be determined as the amount payable.
Compense Calculation ‑ Option 1
The incapacity calculation done by Compense under section 19 will be based on a calculated "weekly rate" figure multiplied by the duration of an employee's incapacity.
Formula:
TOTAL LIABILITY = WEEKLY RATE X DURATION OF INCAPACITY
The TOTAL LIABILITY figure is the amount payable as compensation over the claimed period of incapacity.
The WEEKLY RATE is a figure which the employee would be paid if the duration of incapacity equalled one week. Where the duration of incapacity is other than one exact week, a proportion of the "WEEKLY RATE" is payable.
The WEEKLY RATE is a figure calculated by Compense based on the following information:
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NWE |
- |
needed in all cases for this calculation; |
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Duration of incapacity |
- |
needed in all cases for this calculation; |
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AE |
- |
needed in any case where the employee is on GRTW; |
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Hours: |
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. standard hrs/wk |
- |
needed in all cases for this calculation |
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. actual hours worked (AHW) |
- |
needed for post 45 week calculations where the employee is on GRTW; |
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. Average Overtime Hours |
- |
needed for post 45 week calculations where the employee is on GRTW; |
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. % of normal hours worked |
- |
needed for post 45 week calculations where employee is on GRTW; |
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Super amount (SA) |
- |
needed in cases where employee retires on or after 1/12/89 |
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Super contribution (SC) |
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WEEKLY RATE
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Formula: |
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WEEKLY RATE = %NWE‑‑AE‑‑SWA |
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%NWE |
- |
will be 100%NWE in first 45 weeks; |
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- |
will be %NWE specified in sub section 19(3)(a) to (f) dependent upon the number of hours the employee has returned to work after the first 45 weeks; |
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the %NWE after the first 45 weeks will ALWAYS be 75% UNLESS the employee is on GRTW or is working full hours but not earning full NWE. |
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AE |
- |
Actual earnings/ability to earn; |
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- |
AE will ALWAYS be NIL UNLESS the employee is on GRTW or is working 100% of hours and not earning 100% of NWE, in which cases, the AE will be what the employee has earned in a week; |
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- |
In cases where sub‑section 19(3A) applies ie where the employee has been redeployed and is in receipt of super, the Government Financed Portion of the super pension will be included in SWA. |
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THE MAIN DISTINCTION IN THE CALCULATION OF WEEKLY RATE IS WHETHER THE EMPLOYEE IS ON GRTW OR NOT. WHERE EMPLOYEE IS NOT ON GRTW OR IS NOT WORKING 100% OF HOURS, AE WILL BE NIL. |
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SWA |
- |
Superannuation Weekly Amount: |
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- |
Consists of - |
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. |
Weekly Government financed portion of either pension or lump sum; and |
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Weekly amount that the employee would have continued to have pay as contributions had he remained employed. |
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- |
This figure will be NIL where the claimant is still employed by the Commonwealth EXCEPT where the employee has been redeployed and is in receipt of a partial super pension. (This must be taken into account having regard to sub-section 19(3A) - refer Example 7.) |
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DURATION OF INCAPACITY
Employers will be requested to advise Comcare on the duration of an employee's incapacity.
It is necessary for the employer to supply the duration, as the period of incapacity claimed by the employee, may not be the same as the duration of the incapacity for payment purposes.
Example:
- Medical certificate may cover period 7/8/89 to 18/8/89 inclusive.
- This would normally be seen to be a duration of 2 weeks incapacity.
- If the employee would have had a rostered day off during that time and would not have received any wages for that day, the DURATION of the incapacity for our purposes would be 9 days (1.8 weeks), and this is what the employer will tell us.
Full information on establishing duration of incapacity is contained in Operational Advice No. 45.
Examples of this method of calculation are contained in the Compense Version 3.0 Incapacity Handout.
Total Liability Given By Agency ‑ Option 2
Where an employer provides one figure, being the amount that would have been paid but for the incapacity, that amount should be the amount determined as the Total Liability for the duration of the incapacity.
The duration of incapacity will still need to be provided by the employer for the 45 weeks calculation
Refer to Compense Version 3.0 Incapacity Handout for examples.
Subsequent Incapacity Claim Forms
In order to obtain the required information from an agency in relation to a period of incapacity claimed by an employee, two claim forms have been developed. These will be issued with Agency Advice #6.
Claim for Time Off Work:
- This form is for use where the employee is absent from work and the absence is not part of a GRTW program eg absence to seek medical treatment etc.
Claim for Compensation for Reduced Hours
- This form will be used where the employee is either on GRTW or has returned to work full time but is not earning full NWE.
Printed stocks of these forms will be made available as soon as possible. In the meantime, photocopies should be used.
A copy of the Claims for Time Off Work and Compensation for Reduced Hours forms will be included in Agency Advice #6, however, it will still be necessary to provide agencies with some assistance in its completion in the early stages of its operation.
Any enquiries should be made to Operations Branch,
Co‑ordination Section on (062) 75 0078.
SUE HAMILTON
Deputy Chief Executive
1 August 1989
** THE TWO FORMS REFERRED TO ON THIS PAGE [P5] NAMELY
1. “CLAIM FOR TIME OFF WORK” &
2. “CLAIM FOR COMPENSATION FOR REDUCED HOURS”
ARE NOT INCLUDED AND CAN BE OBTAINED FROM Q.A. GROUP