ByLawyers News and Updates

500-page limit – PIC – NSW

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A 500-page limit applies for documents lodged with most applications or replies in the Personal Injury Commission (PIC) from 25 November 2024.

The Personal Injury Commission deals with disputes about injuries sustained in motor accidents and workplaces in New South Wales.

Intent of the rule

The new rule is intended to assist the Personal Injury Commission in conducting its proceedings justly, quickly, cost effectively and with as little formality as possible.

It will focus the parties’ attention on the real issues in dispute and will ensure that the process is efficient which will reduce process trauma for claimants.

The rule will also reduce the amount of highly personal information that is filed with the Commission which in turn will assist the Commission with its approach to cyber security.

Exclusions

The 500-page limit does not apply:

For motor vehicle accident claims, in certain:

  • medical review panel proceedings;
  • merit review panel proceedings;
  • merit review proceedings; and
  • settlement approvals;

For workers compensation claims, in certain:

  • expedited assessment proceedings;
  • medical appeal panel proceedings;
  • presidential proceedings; and
  • work injury damages and related proceedings.

Additional documents

If additional documents are relevant to the real issues in dispute in a matter before the PIC, they may be able to be lodged either by consent if the proceedings relate to medical assessments, or otherwise with leave on application.

Application to lodge additional documents

Applications to lodge additional documents must be made no later than 14 days before a medical assessment, or no later than 3 working days before any conference or hearing for any other dispute type. Only one application is permissible in proceedings unless leave is granted.

Transition period

There is no transition period. The new rule applies from 25 November.

The By Lawyers Workers Compensation (NSW) and Motor Vehicle Accidents (NSW) – Accidents from 1 December 2017 publications have been updated to reflect the new rule.

Pathway – NSW

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The launch of the NSW Personal Injury Commission’s Pathway portal for workers compensation claims brings the process for workers compensation disputes into line with that used for motor accident claims since June 2023.

Workers compensation claims go first to the insurer, then to internal review by the insurer, and then to the Personal Injury Commission (PIC), then if necessary to court.

From 12 June 2024 all applications to the Personal Injury Commission must be lodged via Pathway.

The Pathway portal will digitise the claims process, enabling practitioners to view documents electronically.

Service will also occur via the Pathway portal. Service of applications by the applicant on the respondent will no longer be necessary. Applications will be served by the Commission sending an email to the respondent, with an invitation for them to view the claim online. Respondents will receive a reply request in the same way.

The By Lawyers Workers Compensation (NSW) guide has been updated to reflect this new process.

The Personal Injury Commission website provides a link to Pathway and information for practitioners.

The Pathway portal is used to lodge workers compensation disputes involving:

  • weekly benefits, if the period is more than 12 weeks;
  • medical expenses;
  • domestic assistance;
  • compensation for property damage;
  • lump sum compensation when liability is disputed;
  • suitable duties following a work injury;
  • compensation for the death of a worker;
  • lump sum compensation when the degree of permanent impairment is disputed;
  • threshold for work injury damages when the degree of whole person impairment is disputed.

All relevant information and documents on which the applicant intends to rely need to be included and noted as attachments to the application.

 

Compensation indexation – NSW

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Various amendments for compensation indexation have been applied to the By Lawyers Injuries publications in New South Wales.

Each year on 1 October the various statutory compensation schemes and legislative caps have indexation applied to the maximum amounts recoverable by injured persons.  For 2022 these changes are contained in the following pieces of subordinate legislation:

  • Civil Liability (Non-economic Loss) Amendment Order 2022
  • Motor Accident Injuries (Indexation) Amendment Order (No 2) 2022
  • Motor Accidents (Determination of Non-Economic Loss) Amendment Order 2022
  • Motor Accidents Compensation (Determination of Loss) Order 2022
  • Workers Compensation (Indexation) Amendment Order (No 3) 2022

Wherever applicable, the commentary and precedents – particularly the Retainer instructions precedents – have been updated for these changes in the following By Lawyers publications:

By Lawyers always update our publications for statutory indexing. This typically occurs in most jurisdictions on 1 January, 1 July, and, as in the case of NSW injuries legislation, 1 October each year.

Workers compensation legislation – NSW

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There have been a number of small but important amendments to New South Wales workers compensation legislation.

Relevant provisions of the Motor Accidents and Workers Compensation Legislation Amendment Act 2021 commenced on 16 June 2022.

The amendments include:

  • Changes to the Workers Compensation Act 1987 with regard to deemed diseases. These are certain specified diseases and medical conditions which are deemed to be caused by certain employment, such as asbestosis. The Act has been amended so that minimum periods of service in specified employment and minimum exposure requirements can now be included on the list of deemed diseases in the regulations.
  • Additional entitlements for volunteer firefighters, emergency and rescue workers under the Workers Compensation (Bush Fire, Emergency and Rescue Service) Act 1987. This amendment brings the compensation entitlements of these volunteer workers into line with those of paid workers. The new entitlements for volunteers include funeral expenses and funds management fees for dependent children of deceased volunteer workers.

The By Lawyers Workers Compensation publication has been amended accordingly.

A further provision of the amending Act awaits proclamation. This relates to an additional entitlement to compensation for any dependent children of a deceased worker. The fees charged by the NSW Trustee and Guardian to manage the dependent child’s lump sum entitlement will be a separate benefit claimable and paid by the insurer, so that a lump sum compensation amount paid to a dependent child of a deceased worker will not be eroded by fees. This amendment will be incorporated in the By Lawyers publication when it commences.

Amendment of the PIC rules – NSW

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Recent amendment of the PIC rules impacts procedure for motor accident claims and workers compensation claims in the Personal Injury Commission.

The Personal Injury Commission Rules 2021 govern proceedings in both of the Commission’s divisions. The rules have received their first review since the PIC commenced operations. The review has resulted in a number of relatively minor tweaks and additions, and one substantial change.

The minor amendments include:

  • provision for consistency across the divisions as to the material that is lodged in applications;
  • provision for compliance with notices for production across divisions;
  • procedure for lodgment and admission of surveillance recordings;
  • provision for SIRA to intervene in Merit Review Panel proceedings;
  • clarification that an application to refer a medical dispute for assessment can be may be made at any time.

Amendment to time limits for appeals

The substantial amendment relates to time limits. An anomaly in the legislation that established the PIC meant that there has until now been no discretion for the Commission to extend the time for an application or appeal beyond the 28-day period provided in the Act. The legislation has now amended to alleviate that situation, and a new Rule 133A is included in this amendment of the PIC rules to enable the time for applications and appeals to be extended where necessary.

The criteria for extension of time under the new rule is that, for the applicant to lose the right to lodge would result in demonstrable and substantial injustice.

The commentaries in By Lawyers Motor Accident Claims – from 1 December 2017 and Workers Compensation publications have been amended accordingly.

Personal Injury Commission – NSW

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Overview

From 1 March 2021 the Personal Injury Commission (PIC) became the ‘one-stop shop’ for dispute resolution for workers compensation and motor accident claims in NSW.

The PIC has two divisions with a single point of entry via an online portal. The PIC takes over from the Workers Compensation Commission, which has been abolished. The PIC also takes over most of the dispute resolution functions from the State Insurance Regulatory Authority (SIRA) regarding motor accident claims.

The idea of the consolidation is to gain efficiencies via a single entity, especially with medical assessments and medical dispute determination. Medical assessors for both workers compensation and motor accidents claims, along with merit reviewers for motor accident matters and mediators for workers compensation matters, are appointed by the President of the PIC and operate under the PIC legislation.

The substantive law does not change.

The By Lawyers Workers Compensation and Motor Accidents publications – both Prior to 1 December 2017 and From 1 December 2017 – have all been be amended.

Legislation

Personal Injury Commission Act 2020;

Personal Injury Commission Regulation 2020; and

Personal Injury Commission Rules 2021.

What the PIC does

The PIC is not a court but is headed by a President, who is a judge of a court of record. The PIC will publish its decisions.

The two divisions, Motor Accidents and Workers Compensation, have a common registry, and common practice and procedure wherever possible.

The PIC replaces the Workers Compensation Commission and determines all disputes under the Workplace Injury Management and Workers Compensation Act 1998 and the Workers Compensation Act 1987.

Disputes in relation to claims under the Motor Accidents Injuries Act 2017 (MAIA) and the Motor Accidents Compensation Act 1999 (MACA) previously managed and resolved by SIRA are now dealt with by the Personal Injury Commission. The PIC also takes over from the Motor Accidents Claims Assessment and Resolution Service (CARS) and the Medical Assessment Service (MAS).

The Act requires the PIC to deal with proceedings justly, quickly, cost-effectively and with as little formality as possible.

The rules of evidence do not apply and proceedings must be as informal as possible, including telephone conferences instead of formal hearings.

What the PIC does not do

Disputed common law damages claims still go to the District or Supreme Court. However, the PIC must mediate the dispute first and/or provide a certificate before proceedings can be commenced.

As it is not a court, the PIC cannot determine matters that involve federal jurisdiction. The PIC Act provides a mechanism to send proceedings that involve federal jurisdiction to the District Court.

The Workers Compensation Independent Review Office (WIRO) is now known as the Independent Review Office (IRO). It continues to manage disputes regarding insurers previously managed by WIRO, with the addition of CTP insurers for motor accident claims. IRO also continues WIRO’s previous responsibility for the funding of workers compensation claims via the existing ILARS grants.

No change to the substantive law

The establishment of the PIC and the transfer to it of dispute resolution functions does not affect the underlying substantive law.

There is no change to the entitlements of injured persons to damages, benefits and entitlements under either workers compensation or motor accidents legislation.

Transitional provisions

Transitional provisions are set out in the Personal Injury Commission Regulation 2020.

For existing matters – that is, claims lodged before the commencement of the PIC on 1 March 2021 – the PIC deals with disputes and medical assessments. However it does so under the previous legislative framework – so the Workers Compensation Commission Rules 2011 and the existing provisions of the motor accidents legislation. That includes appeals, so for any arbitrated decision that was heard before 1 March 2021, but which is appealed after 1 March 2021, the appeal proceeds on the basis of the pre-existing legislation.

By Lawyers keeps you up to date!

All relevant By Lawyers publications have been updated in line with the commencement of the Personal Injury Commission. Commentary and precedents have been amended, replaced or added wherever required in our Workers Compensation, Motor Accidents and District Court publications.

Out of time claims – Workers Comp – NSW

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Out of time claims under the Workers Compensation Act 1987 were considered in the recent Supreme Court decision of Hole v Gregory Ronald Lyons trading as Greg Lyons Building Constructions [2020] NSWSC 102.

Section 151D (2) of the Act provides that common law claims must be brought within 3 years of the date of injury. Out of time claims require the leave of the court in which the claim is brought. In Hole, Button J granted leave to commence proceedings some four years out of time on the basis that the plaintiff had adequately explained the delay.

Interestingly, the essence of the explanation was the plaintiff’s extended engagement in the claims process under the Workplace Injury Management and Workers Compensation Act 1998. The Court noted that: ‘…there is a whole structure, external to the Court in which litigation is to commence, in which one must engage in an effort to have the matter resolved away from Court.’

In that context, the Court also noted that this was not a case where anybody involved in the litigation was ‘taken by surprise‘, or prejudiced by the delay.

In its consideration of the matter the Court followed the principles relating to a grant of leave for out of time claims set out in Smith v Grant [2006] NSWCA 244.

These helpful cases have been added to the By Lawyers Workers Compensation (NSW) Guide. A link to s 151D has also been added to the Retainer Instructions precedent on the matter plan in that Guide.

Workers Compensation guide – NSW

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The By Lawyers Workers Compensation guide has received an extensive author review. The matter plan has been amended in accordance with the commentary updates. This reflects recent amendments to the Workers Compensation Act 1987. New precedents have also been added.

The following are excerpts from the updated commentary in our NSW Workers Compensation guide:

Interaction with the Motor Accident Injuries Act 2017

For clients who have suffered injuries which require significant ongoing treatment into the future, or who have an established entitlement to payment of ongoing weekly income benefits, the value of ongoing and future benefits must be considered and explained to the client so that instructions to finalise the MAIA claim and therefore finalise all future workers compensation benefits are given on a fully informed basis. The advice given and the instructions received must be fully recorded in a file note and the client required to sign a written authority to settle on that basis.

There is a precedent Authority to settle available on the matter plan.

Entitlement to weekly benefits

The extent of any entitlement to weekly benefits is assessed with regard to the capacity of the injured worker to undertake some form of employment and is reviewed by a twenty-eight-day cycle. This entitlement to weekly benefits cannot be regarded as fixed and final until retirement age even where the worker has suffered a serious injury.

An injured worker is required to provide to the insurer a Certificate of Capacity from the treating doctor. This certificate is required to contain the opinion of the doctor about work capacity even where work which is stated to be within the capacity of the injured worker is not available.

The insurer is not required to accept the treating doctor’s opinion and may adopt the opinion of its own doctor.

The insurer is required to make a Work Capacity Decision based upon available, proper information.

Precedent letters to the client’s treating and specialist doctors, requesting the doctor’s opinion about work capacity, are available on the matter plan.

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