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Employee representatives have an important role to play in assisting injured workers
with Workers Compensation. A worker who has been injured or health affected at
work will need your help; they are about to enter the NSW workers compensation
scheme. Dealing with workers compensation can be time consuming and frustrating
for many injured workers. You as an employee representative can provide a positive
influence on workers compensation in the workplace by providing timely information
and assistance when required.

Overview of NSW workers compensation scheme:
Workers are entitled to weekly income benefits and other payments for disability,
damage to property and death. This includes weekly payments to dependents.
Payment is also made for reasonably necessary medical, hospital and other
treatment, and for rehabilitation services.

Workers injured at work are entitled to timely, effective and meaningful treatment and
rehabilitation that assists the injured worker to return to their preinjury employment or
to other employment; this may include retraining and job placement assistance if
required. Return to work, suitable employment and injury management for the injured
worker/s must have as it‟s objective timely, safe and durable return to work.


       AMWU – NSW Branch Switchboard
       (02) 9897 2011

       OH&S / Workers Compensation Unit
       Toll Free: 1800 824 573
       Facsimile: (02) 9897 4257

       131 050


1.    Checklist

2.    Overview Workers Compensation/Injury management

3.    Assisting the worker, keeping records, seeking assistance, workers with
      special needs and investigation

4.    An injury has occurred – emergency treatment and or first aid assistance

5.    The emergency is over / first aid has been provided - what next? Notifying the

6.    Nominated Treating Doctor (NTD)

7.    Medical Certificates, Information Consents and Injury Management Plans

8.    Returning to Work-Suitable Employment (Duties)

9.    Rehabilitation-Occupational and Vocational Rehabilitation

10.   Wages and Income benefits

11.   Claims after Initial Notification to the Scheme agent (insurer), Provisional
      liability and liability

12.   Independent Medical Examinations (and Examiners) and Injury Management

13.   Conclusion

This checklist has been designed to prompt OHS delegates with questions and
answers to help their understanding of workers compensation. It will also help them
understand the particular issue/s an injured worker or group of injured workers may

This checklist should be used to audit your workplace and to check your
understanding of particular rights and responsibilities. If the injured worker/s or you
have further questions then contact the AMWU Workers Compensation officer on
1800 824 573 for advice and assistance.

Overview Workers Compensation/Injury                              Yes    No

Does your employer have a current Workers
Compensation policy?                                                     
Employers in NSW must have a current policy as per s155 of the
Workers Compensation Act 1987 (WCA 1987) unless your
employer is a self insurer.

Does your employer have an employee and union
agreed Return To Work Program?                                           
Your employer is required to develop a return to work program
with employees and any union under s52(2) of the

Is a summary of the Return To Work Program
displayed in the workplace?                                              
Appendix 1 is an example of a Summary of Return To Work
Program from the AMWU’s Model Return To Work Program.

Is the WorkCover NSW Summary of Workers
Compensation poster displayed in the workplace?                          
Your employer must have the current WorkCover poster available
in the workplace in line with s231(1) of the Workplace Injury
Management and Workers Compensation Act 1998 (WIMWCA

Is the name of your employers Return To Work
Coordinator and Scheme agent (insurer) written on the                    
Your employer is required to do this under s231(d) WIMWCA 1998.
                                                                     Yes   No

After notifying the employer of an injury do you (or
injured worker) contact the AMWU Workers                                  
Compensation Officer?
The AMWU Workers Compensation Officer can be contacted on
toll free 1800 824 573.

Does your Award and or Enterprise Bargaining
Agreement have special arrangements for Workers                           
Compensation (i.e. make-up pay)?
Many agreements have a clause relating to the payment of make-
up pay so workers aren’t disadvantaged if they go onto workers

Do injured workers keep detailed records of their
workers compensation claim including all
documentation and notes of any meeting attended?                          
Appendix 2 The injured worker should make a file note of all
meetings, conversations and telephone calls; and keep a detailed
diary with all records relevant to that injury.

Do you (and other employee representatives) keep
detailed records of your involvement in workers
compensation matters including dates, times, names                        
and outcomes?
Appendix 2 Employee representatives should make a file note of
all meetings, conversations and telephone calls; and keep a
detailed diary with all records relevant to that injury.

Are all incidents and hazards notified (reported) to the
employer?                                                                 
Appendix 3 All employers must have a Register of injury in
addition to incident and hazard reporting systems.

When people are injured, are measures taken to
prevent further injuries / illness?                                       
All injuries and illnesses require investigation that must include
the identification of hazards, the identification of risks, the
elimination of risks, the management of risks and meaningful
consultation with the employees affected during the process.

Assisting the worker, keeping records,                                Yes   No
seeking assistance, workers with special
needs and investigation

If a worker has a disability (hearing, sight, mental
health) are they provided with appropriate assistance to                   
understand and participate in the „Workers
Compensation Scheme‟?
An injured worker is entitled to appropriate and timely assistance.
This should be a component of the employers Return to Work

 If a worker with a non English speaking background
(i.e. poor English, literacy, numeracy or comprehension                    
skills) is injured at your workplace are they provided with
appropriate assistance to understand and participate in
the „Workers Compensation Scheme‟?
A worker is entitled to translator assistance to allow them to
understand and participate in the Workers Compensation system in
a meaningful manner. This should be a component of the
employers Return to Work Program.

Do you contact all injured members as soon as possible
after becoming aware that an injury has occurred to                        
offer your assistance?
This means keeping in touch on a regular basis with your injured
workmate, maybe through a conversation at work, phone calls or
home visits. It also means following up what is happening with
whoever deals with these issues for the employer; in NSW this
means primarily the Return To Work Coordinator amongst others.

If you or an injured worker need information or
assistance with workers compensation do you know                           
who to contact in the union?
The AMWU Workers Compensation Officer is Alan Mansfield and
can be contacted on toll free 1800 824 573.

Are you or other employee representatives involved in
the investigation of all incidents?                                        
Employers are required under the Occupational health and Safety
Act 2000 (OHS Act) to investigate all incidents and consult
employees as part of the investigation. OHS Delegates have a legal
right under the Act to conduct their own investigation if required.

                                                                       Yes   No

When an injured worker is notified of a factual
investigation by the employer/scheme agent (insurer) is                     
the union always notified?
Call 1800 824 573.

Are injured workers always offered a support person
during any factual investigation?                                           
Injured workers may take a support person to a factual
investigation. If in doubt contact the AMWU 1800 824 573.

Are injured workers treated differently from other
workers in your workplace including denied
opportunities for overtime or other opportunities that                      
might arise?
Injured workers must remain within any restrictions on the med/cert,
however injured workers also have a legal right to be treated the
same as any other worker as per the Employment and the Disability
Discrimination Act 1992 (EDDA 1992).

An injury has occurred – emergency                                    Yes   No
treatment and or first aid assistance required

Is the employers procedure of „what to do if there is an
injury‟, displayed in your work area?                                      
Employers are required to display their procedure for managing
injuries sustained in the workplace via the return to work program.
Appendix 1

Does the employer have in place procedures for
emergencies i.e. provisions for first aid and /or medical                  
The employer is required to provide for emergencies c17 and
provide first aid facilities and personnel c20 OHS Regulation 2001.
Appendix 4

The emergency is over / first aid has been                                Yes   No
provided what next? Notifying the injury!

Do all employees, managers, supervisors and
contractors know how to report an injury to the                                
Employers are obligated to inform all new and existing staff of how
to notify of a workplace injury as part of induction. It should also be
displayed as part of the return to work program.

Do workers report injuries as soon as possible to the                          
Workers are obligated to notify the employer as soon as possible of
all workplace injuries s44(1) WIMWCA 1998.

Does your employer accept all injuries reported?                               
Your employer must notify the agent(insurer) or WorkCover within
48 hours in line with s44(2) of the WIMWCA 1998.

Are all injuries recorded in the Register of Injuries?                         
The register of injuries is mandated under the workers
compensation legislation. A pro-forma can be found in
Appendix 3

Are injured workers or anyone acting on their behalf
able to enter particulars of injuries into the injury                          
Under s 63(2) of the WIMWCA 1998 the injuries register must be
accessible to all.

Are injured workers provided with a notification number
within 48 hours of notifying the employer?                                     
An injured worker (or their representative) is entitled to the
notification number in line with c6.1 of the WorkCover Guidelines
for Claiming Compensation Benefits.

Nominated Treating Doctor (NTD)                                           Yes   No

Do injured workers go to the Doctor of their choice for
emergency, casualty or routine treatment?                                      
An injured worker is required to nominate their treating doctor in line
with s47(3) of the WIMWCA 1998.

Is a worker entitled to privacy when receiving clinical
treatment?                                                                     
An injured worker is legally entitled to absolute privacy during
treatment or an examination.

Does your employer respect an injured workers right to
select their own nominated treating doctor (NTD)?                              
An employer has no legal right to interfere with an injured workers
selection of a NTD.

Can an injured worker change Nominated Treating
Doctor?                                                                        
An injured worker can do so after obtaining the approval of the
insurer.They must explain in writing why they want to change NTD.

Does your employer demand that injured workers see
their company doctor?                                                          
The involvement of company doctors is limited to the WorkCover
Guidelines and must not compromise the right of a worker to
choose their own nominated treating doctor. Refer to Independent
Medical Examination and Injury Management Consultants for
Doctors that the employer/scheme agent (insurer) can refer to.

Medical Certificates, Information Consents                               Yes   No
and Injury Management Plans

Do injured workers obtain WorkCover Medical
Certificates at your workplace following a workplace                          
Workers should obtain one as soon as possible; scheme agents are
expected to make allowances for workers in remote areas or where
a hospital has issued a regular medical certificate as examples.

Do injured workers provide WorkCover Medical
Certificates to the employer as soon as they are able to?                     
Injured workers should do this as soon as possible. Many Doctors
surgeries will fax Certificates to the insurer and employer. This is a
good practice if they are willing to do this.

Does the employer pass on Medical Certificates to their
scheme agent (insurer) within 7 days?                                         
An employer must pass all documentation on within 7 days in line
with s 264 of the WIMWCA 1998.

Has the employer/scheme agent (insurer) attempted to
change a WorkCover medical certificate (by bullying the                       
This is not acceptable. They are obliged to communicate in an open
and meaningful way with the NTD and the injured worker. Contact
the AMWU on 1800 824 573 if this occurs.

Does the employers‟ return to work coordinator always
abide by the information provided in the WorkCover                            
medical certificate?
A return to work coordinator (RTW coordinator) must always
comply with the medical advice found on a WorkCover Authority
(WCA) medical certificate in line with c15(j) of the Workers
Compensation Regulation 2003 (WCR 2003).

Does your employer accept all WCA medical certificates
provided by injured workers?                                                  
Employers are legally obligated to abide by a WCA medical
certificate. Should your employer have a concern that could affect
successful return to work, the employers’ RTW coordinator is
entitled to seek clarification from the NTD.

                                                                         Yes   No

Do injured workers complete an employer consent form
to access information relevant to the injury?                                 
An injured worker is required to give consent for relevant
information to be exchanged between the parties regarding the
workers return to work. Appendix 5

Does your employers scheme agent (insurer) develop
an Injury Management Plan for each worker who will be
incapacitated (either partially or totally) for longer than 7                 
calendar days?
Under s45 of the WIMWCA 1998 commencement of the
development of an Injury Management Plan must start within 3
days of the notification of a significant injury.

If a worker requires Domestic Assistance for personal
needs/responsibilities at home is it provided-temporarily
or permanently by the employer‟s scheme agent                                 
This is an entitlement that an injured worker may have if the injured
worker’s NTD identifies it on the WCA medical certificate in line with
s60AA of the WCA 1987.

Returning to Work –                                                     Yes   No
Suitable Employment (Duties)

Do all injured workers who cannot return to pre-injury
employment (duties) receive an offer of suitable
employment via a current Return To Work plan?                                
An employer must at the request of an injured worker provide
suitable duties (as far as is reasonably practicable) under s49(1) of
the WIMWCA 1998.

Are suitable duties in line with the current WorkCover
Medical Certificate?                                                         
Suitable duties must be provided in line with the WCA medical
certificate as per s 43A of the WCA 1987.

Are meaningful suitable employment (duties) offered?
Suitable duties offered must be meaningful in line with s43A(3) of           
the WCA 1987.

Are you involved when an injured worker returns to work
in either suitable duties or preinjury duties?                               
Injured workers are entitled to have representation at all stages of
return to work.

Rehabilitation –                                                      Yes   No
Occupational and Vocational Rehabilitation

Does the employer have an agreed list of Rehabilitation
Providers for the worker to choose from?                                   
This information must be provided within the return to work
program. Appendix 1

Do workers get to choose their Rehabilitation Provider at
your workplace?                                                            
Workers have a legal right to select the professionals involved in
their case including rehabilitation providers as per the WorkCover
Guidelines for Employers Return to Work Programs 2003.

Are modifications made to the workplace to allow
workers to work in temporary or permanently modified                       
suitable employment?
Reasonable modifications are a requirement under s49(2) of the
WIMWCA 1998.

Are injured workers provided with timely and appropriate
training for temporary or permanent suitable                               
Injured workers are entitled to receive timely and appropriate
training that should be identified and described in the workers
current Injury Management Plan as per s45(6) of the WIMWCA
1998 and s43A(2) of the WCA 1987.

Does your employer offer permanently modified duties
to all workers who cannot return to their pre-injury                       
The hierarchy of return to work goals must be followed in line with
the WorkCover Guidelines for Employers Return to Work Programs

Wages and Income benefits                                        Yes   No

Do you understand the weekly benefits that a worker is
entitled to whilst on workers compensation?                           
For further information go to Appendix 6

Does your workplace or a workgroup in the workplace
have concerns about how income benefits are                           
Refer to Appendix 7 for a workplace survey, if it appears that
workers have been underpaid contact the union immediately.

Does your employer pass on workers compensation
payments promptly?                                                    
Workers compensation payments must be paid at the usual times
that wages would be paid as per s 84 of the WCA 1987.

Claims after initial notification to the scheme                        Yes   No
agent (insurer), provisional liability and

7 days after the scheme agent (insurer) receives                            
notification do they send the worker an acceptance or
declination of provisional liability letter?
The scheme agent (insurer) has 7 days once notified to make a
decision to accept or reject provisional liability as per c 6 of the
WorkCover Guidelines for Claiming Compensation Benefits.

Does the scheme agent (insurer) tell the worker how
they may correct the reasonable excuse to decline                           
provisional liability?
The agent (insurer) must describe the reasonable excuse they are
relying upon. If the reasonable excuse relied upon is satisfied the
agent (insurer) must commence weekly payments as per c12.3 of
the WorkCover Guidelines for Claiming Compensation Benefits.

Do you or the injured worker contact the AMWU if the
scheme agent (insurer) has claimed a “reasonable
excuse” or “failed” to decide Provisional liability within 7                
It is important that the injured worker contact the AMWU Workers
Compensation Officer so weekly payments can commence or a
dispute initiated.

If the scheme agent (insurer) has declined provisional
liability do they provide a claim form with the notice?                     
A claim form must be provided as per c7.8 of the WorkCover
Guidelines for Claiming Compensation Benefits.

If the worker requests a claim form does the employer or                    
scheme agent (insurer) provide it promptly?
Employers/agents (insurers) are legally obliged to provide a claim
form when asked under the WorkCover Guidelines for Employers
Return to Work Programs 2003.

Does the scheme agent (insurer) advise the worker that
the claim has not been duly made i.e. essential
information like a WorkCover Medical certificate has not                    
been provided?
This is required under Part 2, c5 of the WorkCover Guidelines for
Claiming Compensation Benefits.

Independent Medical Examinations (and                                Yes   No
Examiners) and Injury Management

Referral for an independent medical examination is only
appropriate when information from the treating medical
practitioner(s) is inadequate, unavailable or inconsistent
and where the referrer has been unable to resolve the
issues related to the problem directly with the                           
A worker must attend a properly notified and arranged IME.
However, they are entitled to be notified correctly and treated

Are workers provided with a minimum of 10 days notice
of an independent medical examination?                                    
This is a mandatory notice. Examinations should not be attended if
this notice is not provided.

Is the following information provided to workers when
requested to attend an independent medical

       the reason for the examination                                    
       the likely duration of the examination                            
       name, specialty and qualifications of the
        examiner                                                          
       date, time and location of the appointment and
        contact details of the examiner‟s offices and
        appropriate travel directions                                     
       the need to be punctual                                           
       what to take, e.g. x-rays, reports of
        investigations/tests, comfortable clothing to
        enable an appropriate examination to be
        conducted                                                         
       how costs are to be paid                                          
       that a failure to attend the examination or an
        obstruction of the examination may lead to –
         a suspension of weekly compensation and/or                      
         the right to recover compensation under
           the1987 Act                                                    
       that the worker may be accompanied by a person
        other than their legal representative with the
        agreement of the independent medical examiner,
        however, the accompanying person must not
        participate in the examination and may be
        required to withdraw from the examination if the
        the examiner requests it                                           
       that no one may be present during the actual
        physical/psychological examination of the injured
        worker, unless invited by the worker and agreed
        to by the medical examiner                                         
       whether the travel costs for an accompanying
        person will be met (this usually only applies if the
        worker requires an attendant as a result of the                    
       how complaints are to be managed                                   
       that the workers compensation legislation gives
        the worker or a nominee a right to a copy of any
        report relevant to a decision made by a referrer to
        dispute liability for, or reduce, compensation                     
       A WorkCover brochure about independent
        medical examinations                                               
All of the above information must be provided under the WorkCover
Independent Medical Examinations and Reports Guidelines. Should
any of the above information be missing contact the union

Are all referrals for independent medical examinations
arranged at reasonable times and dates?                                    
Medical examination must be arranged at times that are suitable to
the injured worker. Should the appointment interfere with child care,
other meetings etc. contact the referrer immediately and request a

Have workers at your workplace been referred to an
Injury Management Consultant - IMC?                                        
Barriers in relation to return to work and difficulties in
communicating with a treating doctor might best be resolved
through use of an Injury Management Consultant. An IMC is a
Doctor who may receive a referral to facilitate understanding
between to the Nominated Treating Doctor, the employer, the
insurer and the worker. Referrals are made by the employer or
insurer. Contact the AMWU for further information regarding IMCs
they have a different and more practical role in Injury Management
than IMEs in facilitating the resolution of workplace issues.

Conclusion                                                 Yes   No
If you are going to help someone you
should ask yourself these broad questions
about your workplace:

Are all incidents (including near misses) whether they
result in an injury or not notified (reported) to the           

Are all incidents investigated from an OH&S
perspective? See the OH&S Section of the handbook               

Does your employer have a register of injuries?                 

Does your employer have a Return To Work Program
that employees and the AMWU were consulted about
when it was developed? Is the Program respected and             

Does your employer have other Injury Management
and / or Rehabilitation policies or programs that assist        
workers return to work?

Are these programs understood, taught, respected and
followed?                                                       

Have you been to the union‟s training course on
Workers Compensation?                                           

If a serious incident occurs is it reported to the Union
and WorkCover NSW?                                              

                                                             Yes        No

Does the employer have the current WorkCover
information poster on display where all workers can
see it?                                                                

Does the above poster have the name of the
Employers Return To Work Coordinator, Scheme
agent (insurer) and Rehabilitation Providers written                   
upon it?

Following a case through!
It makes sense for one person to follow through any
case. This might be the delegate, OHS Representative
/ Committee Member or an interested (capable)
member who wants to help out. The important thing is
that your member who has been injured has support at
a vulnerable time and is able to deal with the
complexities involved in compensation and

Keep in touch with injured workers, try to understand their concerns, try to positively
influence return to work (or suitable employment) outcomes and seek assistance
early. Be prepared to ask questions.
Sometimes the most important thing an employee representative can do for an
injured worker is for them to contact the union to ensure that when an injury has
occurred the first steps are carried out correctly. The AMWU NSW OH&S/Workers
Compensation Unit can be contacted on 1800 824 573.

    Appendix 1
                      Summary of Workplace Return to Work Program
                        Extracted from the AMWU Model Program
                             (Attach to the OHS notice board)

This program has been developed in consultation with employees through their occupational
health and safety committee, OHS representatives and relevant unions of the employees.
This program is consistent with the scheme agent‟s Injury Management Program.

1. Commitments of this Workplace

    To consult with employees regarding all aspects of health and safety including the risk
     assessment, policy and procedures.
    To prevent injury and illness by providing a safe and healthy working environment.
    To ensure that occupational return-to-work activities commence as soon as possible after
    To make every effort to provide suitable and meaningful duties consistent with medical
     advice and nature of the illness.
    To provide support throughout the return-to-work process to minimise the effects of the
     injury and ensure that an early return to work is normal expected practice.
    To consult with workers and any union representing them to ensure that our Return to
     Work Program operates effectively.
    To provide any employee with a full copy of the return to work program upon request.
    To ensure that participation in a Return to Work Plan will not, of itself, prejudice an
     injured worker.

2. Procedures for Action When Injury Occurs

    An injured worker (or a person acting on his/her behalf) must notify the employer that the
     worker has received a workplace injury as soon as possible after the injury happens.
    Once an injury is notified the employer will ensure that the injured person receives
     appropriate first aid and/or medical treatment as soon as possible and will conduct an
     investigation with worker representatives to prevent a reoccurrence.
    The workers compensation agent (insurer) will be notified of any potential compensable
     injury within 48 hours of receiving a report.
    At all stages an injured worker will have the right to have representation present.

3. Follow-up after injury

    The designated return-to-work coordinator is: ___________________ who will ensure
     that the injured worker receives appropriate and timely return-to-work.
    The injured worker and the worker‟s nominated treating doctor will be contacted by the
     insurer within 3 working days of being notified of the injury and the Injury Management
     Plan will be instigated.

4. Suitable duties

    When the injured worker is, according to medical judgment, capable of return to work, an
     individual return-to-work plan will be developed including suitable employment (duties)
     which will be identified after consultation with relevant parties. Appropriate assistance will

    be given to workers from a non-English speaking background, those requiring assistance
    with a disability and to those permanently unable to return to pre-injury duties.
   The company will provide a return-to-work plan for injured workers in accordance with
    this Return to Work Program.

5. Involving an Approved Workplace Rehabilitation Provider

   An approved workplace rehabilitation provider is available to assist when required in the
    return to work of those workers who suffer a workplace injury or illness.
   Injured workers retain the right to nominate an approved workplace rehabilitation provider
    of their own choice.

6. List of Agreed WorkCover Approved Workplace Rehabilitation Providers

   Workers Health Centre
    Postal address
    PO Box 524, Lidcombe NSW 1825
    Street address
    2nd floor, 12 Railway Street, Lidcombe NSW 2141
    Phone:             (02) 9749 7666
    Facsimile:         (02) 9749 7666
    Email -

   Workers Health Centre
    Newcastle Trades Hall Council
    1st Floor, Devonshire House,
    406-408 King Street,
    Newcastle West NSW 2302
    Phone:            (02) 4929 4748
    Facsimile:        (02) 4929 4783

   WorkCover website:

7. Consultation

   Workers will be informed of their rights and responsibilities and of the (insert company)
    Return to Work Program.
   Consultation will be effected through the insurer, return-to-work coordinator, supervisor,
    worker, nominated treating doctor, union or OHS representative, and the rehabilitation
   (Insert Company) will provide injury management and return to work assistance in
    accordance with the insurers‟ Injury Management Plan.

8. Training

   A certified Return-to-Work Coordinator will be employed by (Insert Company)

   Workers will be informed of their rights and responsibilities and of the (Insert Company)
    Return to Work Program.
   All employees, including immediate supervisors, supervisors and management will be
    provided with training to ensure that the legislative obligations of (Insert Company) are
    met. The training will include appropriate training in the policy and procedures of this
   (Insert Company) will ensure that training provides practical and detailed information to
    ensure legislation is followed.

9. Dismissal

The company will only terminate an employee with a long-term disability after the return-to-
work process and all avenues have been explored and it is apparent the employee will not be
able to return to the pre-injury position or any other position available within the organisation.
It is noted that the company is not compelled to terminate an injured worker and all efforts
will be made to accommodate these employees before making a decision to terminate. The
Union will be given a minimum of a fortnights‟ notice prior to the company terminating one of
its members. Notification to workers shall be as per the relevant award (agreement).

10. Dispute Resolution

(Insert Company) recognises one of the aims of the NSW Workplace Injury Management and
Workers Compensation Act 1998 is to reduce the level of disputation. In line with this (Insert
Company) will take all possible measures to avoid creating disputes. Where disputes arise all
parties will work towards a mutually acceptable outcome by adhering to the following
resolution steps:

1. Negotiation between the rehabilitation team including injured worker and their union,
   nominated treating doctor/specialist, OH&S committee representative, return to work
   coordinator, supervisor and management.

2. If a resolution is not achieved a third party may become involved to provide additional
   advice and assist liaison between the disagreeing parties (e.g. rehabilitation provider to
   assess duties or injury management consultant to facilitate and assist the parties in
   finding solutions).

    Note: both parties will agree on the injury management consultant prior to them being

3. Where steps 1&2 have failed a worker will have the following options:

        Contact their union or Unions NSW if they have not done so already
        Unions NSW OHS and Workers Compensation Division – 9264 1691
        AMWU Workers Compensation Officer – 1800 824 573, or
        Contact WorkCover‟s Claims Assistance Service – 131050, or
        Refer the dispute to the Workers Compensation Commission – 9243 8800
         (country - 1300 368 040)

4. In order to allow for the peaceful resolution of disputes, the status relating to any
   identified issue(s) that existed directly prior to the dispute arising shall be maintained so
   long as such practices do not present a risk of injury or illness and the parties abide by
   this procedure. Such status will be maintained until the issue(s) are resolved or by mutual
   agreement of the parties.

11. Review Process for the Return to Work Program

   This program will be reviewed 12 months from implementation, and at least every 2 years
   Revision and amendment of the program may occur within these time frames, subject to
   legislative change and the agreement of key parties including but not limited to:

          The employees
          The OHS committee
          Employee representatives
          Relevant Unions

These policies and procedures will come into effect as of the _______ day of _________ and
will be reviewed subject to discussion and agreement with relevant parties but no later than
two years from the date above.

Signed ____________________________
       (Employer Representative)

Signed ___________________________
       (OHS Representative)

Signed ____________________________
       (Return-to-work Coordinator)

Signed ___________________________
       (Union Delegate)

Signed ____________________________
       (Union (AMWU))

Appendix 2
(copy as needed)

File Note Workers Compensation

Date:                                  Circle one:   Phone call in or out meeting
                                                     conversation other

Participants / Attendees:


Employee-Surname:                                    First name:
Phone:                Mobile:                        Email:
Employer:                                            Location:
Team Leader:                                         Section:
Date of Injury:                                      Notification Date:
Notification No / Claim No:
Employers Return to Work Coordinator:
Rehabilitation Provider:                                            Phone:
Insurer:                        Insurer contact:                    Phone:

Name: _________________Signature:____________________

Date ___/___/___      Page No

Attachments –

File Note Workers Compensation

Notes: ___________________________________ Page No: ______________________________

Name: ________________ Signature: __________________

Date __/__/__             Page No

Attachments –

Appendix 3 –

Register of Injury & Industrial Deafness Forms
Register of injuries

Form 2 Workers Compensation Regulation 2003


Name of injured worker:


Age:           Occupation:

Industry in which worker was engaged:

Operation in which worker was engaged at time of injury:

Date (or deemed date) of injury: /             /      Hour:                   am/pm

Nature of injury:

Cause of injury:





[Entries in this book should, if practicable, be made in ink.]

Note: The employer‟s full name and address, together with the name of the employer‟s insurer and
the insurer’s address, should be written up in ink on the inside of the cover of the book.

Industrial Deafness Notification
Form 1 Workers Compensation Regulation 2003

1.   Name and address of worker:

2.   Age and occupation of worker:

3.   Name and address of employer to whom notice of injury is given:

4.   If not employed by the above employer at the date that this notice of injury is
     given, date of last day of employment with the employer:

5.   Has the worker been paid any compensation for loss of hearing in Australia or

     If YES, give details:

6.   Using the following list, give the worker’s complete work history in any noisy work
     in Australia or elsewhere, including work as an employee, in any business carried
     on by the worker (either alone or with anyone else), in military service or
     otherwise. Include work in the list even if unsure about how noisy the work was.

                  State whether                 Name & address of         Period of
Type of
                  employee/own                  employer, business or     work
                  business/other (specify)      other

(Signature of worker)


Appendix 4
For your information the following extracts from the NSW OH&S Regulations are provided.
These are not the complete clauses - they are the Emergency and First Aid Clause.

Employer to provide for emergencies

17 Employer to provide for emergencies
(1) An employer must ensure that, in the event of an emergency at any place of work at
    which the employer‟s undertaking is conducted, arrangements have been made for:
    (a) the safe and rapid evacuation of persons from the place of work, and
    (b) emergency communications; and
    (c) appropriate medical treatment of injured persons.

If the employer does not have control, or has only limited control, of the place of work, the
duty under this subclause applies only to the matters over which the employer has control.

(2) In making arrangements for the purposes of this clause, an employer must take the
    following into account:
    (a) the nature of the hazards at the place of work,
    (b) the size and location of the place of work,
    (c) the number, mobility and capability of persons at the place of work.

(3) If employees work at a fixed place of work, the employer must ensure that:
    (a) adequate arrangements are made for the shutting down and evacuation of the place
        of work in the event of an emergency, and
    (b) details of the arrangements for any such evacuation are kept on display in an
        appropriate location or locations at the place of work, and
    (c) one or more persons are appointed and appropriately trained to oversee any such
        evacuation and, if appropriate, in the use of on-site fire fighting equipment.
    Maximum penalty: Level 4.

Note: Also see clause 13 (2) (b) which requires an employer to provide any person who may
be exposed to a risk to health and safety at the employer‟s place of work with any
information, instruction and training necessary to ensure the person‟s health and safety.

Employer to provide first aid facilities and personnel

20 Employer to provide first aid facilities and personnel
(1) In this clause:
    "construction site" means the site of construction work.
    "trained first aid personnel" means:
    (a) a person who holds a current first aid certificate issued after successful completion of
         a WorkCover approved first aid course, or
    (b) a person who holds a current occupational first aid certificate issued after successful
         completion of a WorkCover approved occupational first aid course, or
    (c) a level 3 or greater New South Wales ambulance officer, or
    (d) a registered nurse, or
    (e) a medical practitioner.

(2) An employer must provide at each place of work:
    (a) first aid facilities that are adequate for the immediate treatment of injuries and
         illnesses that may arise at the place of work, and
    (b) if more than 25 persons are employed at a place of work-trained first aid personnel.

(3) An employer must have regard to the location of the place of work, the number of
    employees at a particular location and the type of work being undertaken in determining
    the nature, number and location of the first aid facilities and the number of trained first aid
    personnel that are required. Subclauses (4)-(7) prescribe the minimum facilities and
    personnel that are required at various sites or places of work….”

Note: A register of injuries is required to be kept under the Workplace Injury Management
and Workers Compensation Act 1998 .
See the NSW OH&S Regulations for further information.

Appendix 5
                                Pro forma Information Consent Form
                          from the Model AMWU Return To Work Program

                                    Information Consent Form

                                                                                         Claim No: ______________________

  I ___________________________________ (name) authorise _______________________________ (name)

  (Title) of ____________________________________________________ (name of employer/provider) to:

  OBTAIN information either verbal or written, in relation to my injury management from (insert specific names):

  (a) Doctor:     ___________________________________________________________________________

  (b) Hospital:   ____________________________________________________________________________

  (c) Rehabilitation Provider: __________________________________________________________________

  (d) Employer: __________________________________________________________________________

  (e) Other:      _____________________________________________________________________________

  I ________________________________ (name) authorise __________________________________ (name)

  _______________________________________ (Title), of _________________________________________
  (Name of employer/provider) to:

  RELEASE information concerning relevant aspects of my injury management to, and discuss that information with,
  representatives of the agencies nominated below (insert specific names):

  (a) Rehabilitation Provider: ____________________________________________________________

  (b) Employer:     ______________________________________________________________________

  (c) Doctor:       ______________________________________________________________________

  (d) Union:            ____________________________________________________________________

  (e) Worker‟s Solicitor: _________________________________________________________________

  (f) Employment Service: _______________________________________________________________

  (g) Other:            ____________________________________________________________________

  The information provided will only be of a factual nature concerning rehabilitation.
  I understand that I may change or cancel this authority at any time however my injury management and/or
  Workers Compensation benefits could be affected.

   Signature: ________________________________________                  Date:        /        /

   Signature of Interpreter: _____________________________ Name: ________________________________

  Some organisations are legally entitled to receive rehabilitation information about an injured worker who is claiming
  workers compensation - insurers and their legal advisers, the WorkCover Authority, a NSW Court of Law and the
  NSW Workers Compensation Commission.

Appendix 6 –
Summary of weekly income benefits

 Fitness for           Totally                Fit for but not        Fit for and
 work and work         incapacitated          working in             working in
 status                                       suitable duties        suitable duties

 Paid under                    s36                    s38                    s40
 section ( ) of
 the WCA 1987

 Weekly                Award rate of pay      Award rate of pay      Average weekly
 benefits (first              or                                     earnings (award
 26 weeks)             80% of non-                                   + makeup pay
                       award rate of pay                             capped at the
                                                                     award rate)

 Weekly                Statutory rate of      80% of the award       Average weekly
 benefits (27-52       pay                    rate of pay            earnings (award
 weeks)                                                              + makeup pay
                                                                     capped at the
                                                                     stautory rate)


Maximum amount payable in weekly benefits: as of the 1st April 2008 = $1594.00

Award rate: is a workers Award, EBA, AWA or other registered industrial agreement rate.

Non-award rate: Workers not on an award rate receive 80% of their normal weekly pay.

Statutory Rate: as of the 1st April 2008 = $374.90

Makeup pay: is the difference between the worker‟s normal gross weekly wages before the
injury (including overtime, shift work, payments for special expenses and penalty rates) and
the actual weekly earning after the injury (i.e. the value of duties worked).

Indexation: Benefits including statutory rate and maximum benifit are indexed to inflation
twice a year on the 1st of April and October. For the latest benefits guide go to -

The above table is meant as a summary of the principal wage income benefits
available under the NSW Workers Compensation Scheme. It is not a definitive guide
and if you or an injured worker have questions you should contact the AMWU
Workers Compensation Officer on 1800 824 573.

Appendix 7
Survey s40 Workers Compensation Payments (make-up pay)
Have you returned to pre-injury duties from workers compensation within the
last 7 years or are currently on workers compensation?

Yes  No 
If you ticked No, you do not have a claim and should not proceed

Member Name: _________________________________________________

Union Membership Number: ________________________________________

Employers Name: ________________________________________________

Employers Address: ______________________________________________

Members Position: _______________________________________________
(Job Description)

Date of injury: _ _/_ _/_ _ _ _
(As close to)

Period worked suitable duties (return to work plan): _______________________
(If dates aren‟t available then provide calendar estimates i.e. first quarter of 2005)

Date re-commenced pre-injury duties (or permanently modified duties):

_ _/_ _/_ _

The Workers Compensation Act 1987 requires;
      “If a worker returns to work on partial duties and earns less than before
      the injury – because they may be working part-time or the suitable duties are
      at a lower pay rate than their pre-injury job – then an additional amount, called
      „make-up‟ pay, will be paid.

       „Make-up‟ pay is the difference between the worker‟s normal gross weekly
       wages before the injury (including overtime, shift work, payments for
       special expenses and penalty rates) and the actual weekly earning
       after the injury (i.e. the value of duties worked). The amount of „make-up‟
       pay is limited to the award rate for the first 26 weeks of partial fitness for
       work and to the statutory rate (capped at a maximum amount) for any weeks
       of partial fitness for work beyond 26 weeks.”

Anyone who has been on workers compensation in NSW and has worked suitable duties
(light duties) for any period of time is entitled to make-up pay.

Have you received make-up pay as per the definition above?

Yes  No 
If you answered No, then you have a claim against the employer.
The AMWU will assist all members in making a claim and ensuring full workers
compensation entitlements are being properly paid.


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