
4.1 Seacare scheme performance overview 2004-05
4.2 Data sources used in this chapter
4.3 Methodology behind performance reports
4.4 Date of extraction of 2004-05 data
4.5 Workers compensation (claims) data relative to previous years
4.6 OHS outcomes
4.7 OHS compliance and activities of the Inspectorate
4.8 Workers compensation
4.9 Dispute resolution in the Seacare scheme
4.10 Rehabilitation/return to work performance
The Seacare scheme has demonstrated significant improvement in performance in 2004-05 relative to 2003-04 and previous years.
The key indicators which point to improved performance include:
However, this is moderated by performance indicators which suggest that there are areas where further progress needs to be made, such as:
The primary source of data used for reporting on Seacare scheme performance, including OHS performance, is workers compensation claims data. The workers compensation claims data used in this report is derived from claim forms lodged by employers with AMICA, irrespective of whether the claim is covered by the employers insurance policy. As there is no statutory obligation on an injured seafarer to lodge a workers compensation claim form if injured, it is recognised that not every injury results in a claim being made on the employer. Further, not all claims lodged by employees with their employer may be forwarded to AMICA by the employer, or to the employers insurer, though clearly the majority are.
It is nationally recognised that compensation claims data is the most reliable available proxy for reporting outcomes on both occupational health and safety and compensation.
Compensation claims data used in this report is collected and recorded by AMICA. AMICA receives data on claims lodged with an employer by employees, irrespective of whether the claim is lodged with an insurer, subject to the employer forwarding a copy of the claim form to AMICA.
The significant insurance excesses, which are a feature of workers compensation insurance policies under the Seafarers Act, mean that employers are often directly liable for the initial costs of the claim. Employer excesses range from zero to $100 000 or more (the majority are in the range $5 000 to $50 000). Where the claim cost falls within the excess, the employer generally maintains responsibility for managing the claim, rather than the insurer. However, increasingly, employers are advising insurers of compensation claims at an early stage, as part of improved claims management and injury management practice.
Commencing from this reporting year, claims data are all claims accepted in the year. While this excludes claims which are pending, in dispute, withdrawn or rejected, it includes claims in these categories from previous years that are accepted in this most recent reporting year. This provides for stability in reporting from year to year and means that this years data will not require updating next year. However, previous years data has required updating and figures in this report may differ from previous years reports.
Accepted claims are further adjusted for reporting on OHS performance in this report by excluding journey to/from work claims and property-only claims, so the claims data used reflects claims where there was an injury at work (or in training, including both on and off duty), irrespective of whether there was any time off work.
Compensation claims data used in this report for OHS reporting is complemented by data on accidents and dangerous occurrences (incidents) reported to AMSA in its capacity as the OHS Inspectorate under the OHS(MI) Act. Incidents are reportable to AMSA where there is an accident that results in a death or a serious personal injury to any person (one which requires immediate medical treatment or which results in five or more days incapacity) or where there was a dangerous occurrence.
Shipping operators covered by the OHS(MI) Act are required by the OHS(MI) Act and regulations to notify an accident or dangerous occurrence to AMSA within four hours and to report in detail on those notified accidents and dangerous occurrences within 72 hours. The initial notification is known as the OHS incident alert and the follow up report as the OHS incident report.
The Seacare Authority maintains responsibility for collecting and recording information for use in calculating injury frequency and incidence rates (denominator data) including hours worked, numbers of employees who have worked in the scheme and full time equivalent employee numbers. Employee numbers and hours worked data is collected six monthly through the Authoritys Seacare Online reporting system.
The Authority also collects ship details including the ship name, the number of days a ship is operational over the year, and ship berth details.
In recent years, comparative performance data extracted directly from the National Comparative Performance Monitoring (CPM) report, which reports comparative performance data across all Australian workers compensation schemes, as well as New Zealand data, has been included in the Authoritys Annual Report. As the 7th CPM report, which reports to 30 June 2004, will not be approved by Workplace Relations Ministers Council (WRMC) for release by the date of publication of this report, such comparative data is not included in this report. It will be available on the Seacare website www.seacare.gov.au when published.
Some return to work data used in this report is derived from the RTW Monitor 2004-05. The RTW Monitor establishes a national benchmark for measuring RTW and durability of RTW across Australian and New Zealand workers compensation schemes. In 2004-05, the RTW Monitor summarised the findings of a survey of 49 injured seafarers.
While individual or collective workplace agreements may provide for the payment of benefits based on the Seafarers Act, only data and information relating to employees covered by the Seafarers Act is included in this report.
The employee number data presented in this report, up to and including the 2003-04 annual report, has been based on the actual number of seafarers employed by each employer covered by the Seafarers Act in effect a head count of seafarers who were covered by the Act in the reporting period.
This included seafarers engaged on Floating Storage and Offloading facilities (FSOs) and Floating Production Storage and Offloading facilities (FPSOs) who come under the Seafarers Act for short periods when the operations of such ships fall within the application provisions of the Seafarers Act (eg when delinked from the riser to avoid a cyclone or when in transit). It also included casual and temporary employees. While this is an accurate reflection of the numbers of seafarers covered, it is not an ideal number to use as a denominator in calculating the incidence rate of injuries (injuries per 1 000 seafarers), particularly in seeking to compare injury rates in the maritime sector with other industry sectors.
The Seacare Authority has agreed that a more valid seafarer number denominator for calculating incidence of injury rates is based on the following formula:
The standard complement of seafarers engaged on each ship at any one time (i.e. ship berths) X the proportion of the reporting period that the vessel was operational and/or the seafarers were covered under the Seafarers Act X the usual weekly shift hours worked on the vessel (according to the relevant industrial agreement) divided by average weekly working hours. (Note: the latest available [2004] Australian Bureau of Statistics average hours worked per week by persons employed full time is 40.4):
The 2004-05 incidence of injury rates quoted in this report are based on the above formula.
The hours worked data used in this report is based on a formula agreed by the Seacare Authority and first applied in the 2003-04 annual report. This is to allow for the continuous nature of Seafarers Act coverage during a voyage where seafarers, who are generally on board a ship for 24 hours a day, are exposed to the risk of injury for the entire time on board a vessel, whether on or off duty.
The formula is:
The standard complement of seafarers engaged on each ship at any one time (i.e. ship berths) X the number of hours (on average) per day the crew are on board, whether at work or not X the number of days the ship was operational (and was operating under the Seafarers Act) in the reporting period = hours worked:
There is now a two years time-series of injury frequency data based on this reporting methodology.
The date of extraction for 2004-05 claims data from the AMICA database is 13 July 2005. This date of extraction means that employers were given until 13 July 2005 to lodge with AMICA for data recording purposes a copy of 2004-05 claim forms received/accepted by employers during that year. AMICA worked closely with employers to ensure that a copy of all claims lodged by employees in 2004-05 was forwarded to AMICA and included in the database by the extraction date to ensure a high degree of reliability of the claims data.
The date of extraction for AMSA incident data is 30 July 2005. AMSA data includes those accidents and dangerous occurrences (incidents) notified and reported to AMSA by 30 July 2005 that occurred in the 2004-2005 year. Any accidents and dangerous occurrences which occurred in the financial year but which were not notified or reported to AMSA by 30 July 2005 are not included.
Workers compensation claims data reported to AMICA pursuant to the Seafarers Act is summarised in Table 7 below.
| No | Claim type | 2000-01 | 2001-02 | 2002-03 | 2003-04 |
2004-05
|
| 1 | Claims reported to AMICA | 204 | 169 | 166 | 208 | 164 |
| 2 | Claims accepted | 180 | 152 | 149 | 182 | 136 |
| 3 | Claims rejected | 24 | 17 | 17 | 17 | 16 |
| 4 | Claims pending | 0 | 0 | 0 | 0 | 12 |
| 5 | Claims accepted - on duty | 167 | 138 | 127 | 168 | 125 |
| 6 | Claims accepted - off duty | 10 | 10 | 18 | 9 | 6 |
| 7 | Journey claims | 2 | 3 | 2 | 3 | 3 |
| 8 | Claims while studying | 1 | 1 | 1 | 1 | 1 |
| 9 | Other | 0 | 0 | 1 | 1 | 1 |
| 10 | Claims accepted one week or more duration (excluding journey claims) | 145 | 117 | 124 | 148 | 77 |
| 11 | Claims accepted (excluding journey claims and property only claims) | 178 | 147 | 143 | 179 | 133 |
| 12 | Claims of 28 days or more | 112 | 96 | 91 | 115 | 69 |
| 13 | Medical claims only (no lost time) | 23 | 27 | 23 | 31 | 27 |
| 14 | Claims accepted excluding property claims | 180 | 150 | 145 | 182 | 136 |
| 15 | Claims accepted at workplace involving lost time | 154 | 121 | 123 | 146 | 84 |
| 16 | Claims accepted lodged with insurer | 67 | 71 | 94 | 102 | 78 |
| 17 | Work-related fatality | 0 | 0 | 0 | 0 | 0 |
Source: AMICA
Table 7 indicates that the number of claims reported to AMICA in 2004-05 has decreased significantly relative to the previous year (a decrease of 21% over 2003-04), but only a slight decrease (1.2%) from the year prior to that (2002-03). Also, the number of claims accepted has decreased significantly (25%) relative to 2003-04, but also by a more moderate amount (8.7%) from 2002-03. This indicates that claim numbers in the 2003-04 year were particularly high and standing outside the general five year decreasing trend.
Notably, the Seacare scheme has again recorded no work-related fatality in the reporting year. In fact, there have now been ten successive years without a work-related fatality in the maritime industry covered by Seacare scheme legislation.
| Employee (seafarer) numbers and hours worked1 |
2000-01
|
2001-02
|
2002-03
|
2003-04
|
2004-05
|
| Employees (head count) |
2 895
|
3 152
|
3 355
|
3 933
|
4 260
|
| Full Time Equivalent (FTE) Employee numbers2 |
3 000
|
3 0003
|
3 1734
|
3 2415
|
3 459
|
| Hours worked (Seafarers Act) |
5 986 832
|
6 529 685
|
7 255 196
|
14 070 5846
|
15 016 800
|
Source: Seacare Authority
1 The employee numbers and hours worked in Table 8 relate to employees covered by the Seafarers Act.
2 Introduced from this reporting year see 4.3.2 above
3 Estimated FTE for 2001-02 and 2000-01
4 Based on reported FTE numbers under the OSH(MI) Act
5 FTE number derived from reported hours worked under the Seafarers Act 6 A new hours worked figure was introduced in 2003-04 and 2004-05 see 4.3.3 above.
Table 8 shows that the number of employees (by head count) covered by the scheme have risen to 4,260 in 2004-05 an increase of 8.3% over 2003-04. However, full time equivalent employee numbers have risen by only 6.7%.
The trend in the numbers of accepted workers compensation claims by major industry sector (with claim numbers from the small number of operators in the passenger, fishing-aquaculture and dredging operators being added to the bluewater sector) are demonstrated in Figure 1 below. Claims from the offshore sector have generally increased relative to the bluewater sector over time. The claim rate per 1,000 employees, measured for the first time in 2004-05, reveals that the claim rate in the offshore sector (46.7) is higher than the rate in the bluewater sector (34.6). The nature of work in this sector may explain this difference.
The incidence of injury and frequency of injury (based on compensation claims data) are two nationally recognised high-level outcome indicators which provide a useful analysis of OHS performance and can provide a helpful indicator of high-level outcome trends in a schemes OHS performance. The injury incidence rate is derived from compensation claims per 1 000 employees, while the injury frequency rate is derived from compensation claims per one million hours worked.
The injury incidence and injury frequency rates highlighted below are based on compensation claims data which result in one week or more of compensation as reported by scheme employers to AMICA, and employee numbers and hours worked data reported to Seacare. They are similar to the key NOHSC outcome measures of accepted compensation claims (excluding journey claims).
The injury frequency rate reported in this report uses hours worked data collected from employers using the formula reported in section 4.3.3. This method produces a higher hours worked figure since 2003-04 compared to previous years because it is designed to more accurately reflect the 24 hour per day nature of seafaring work, and the fact that injuries occurring at any time while on board are potentially compensable. The decision to use this new data series emerged from comments made by employers that the divisor used by most employers in calculating the enterprise Lost Time Injury Frequency Rate (LTFIR) for seafarers is generally 24 hours. Inclusion of the new data will provide injury frequency rate data which is more meaningful to employers.
The adjusted hours worked data, where hours worked were adjusted to 12 hours and 14 hours for the bluewater and offshore fleets respectively, are used for years prior to 2003-04.
The injury incidence rate is an OHS performance measure based on compensation claims per 1 000 employees, where claims are a proxy for injuries.
Source: Seacare Authority and AMICA
Note: The compensation claims used to produce this Figure is all accepted claims except journey claims and property only claims
Figure 2 indicates the number of injuries for each 1 000 full time equivalent employees. In 2004-05, there were 22.26 injuries for each 1 000 employees covered by the Seafarers Act. This incidence rate is high by national standards (the last published national average incidence rate across all schemes and all industries is 16.1, reported for 2002-03 in the 6th CPM report of November 2004). However, the incidence rate in the Seacare scheme has shown a generally decreasing trend since 2000-01, apart from 2003-04, and a steep decrease in 2004-05.

Figure 3 indicates the number of injuries resulting in longer term incapacity for each 1 000 full time equivalent employees. In 2004-05, there were 13.30 injuries for each 1 000 employees covered by the Seafarers Act. This incidence rate is very high by national standards (the last published national average incidence rate across all schemes and all industries is 3.5, reported for 2002-03 in the 6th CPM report of November 2004), and may indicate that injuries which result in longer term claims are not declining.

Source: Seacare Authority and AMICA
Note: The compensation claim data used to produce this Figure are all accepted claims except journey claims and property only claims
Figure 4 indicates the number of injuries (based on claims accepted with one or more weeks incapacity) for each one million hours worked. In the Seacare scheme in 2004-05, there were 5.13 injuries for every one million hours worked. This frequency rate is lower (better) than the national average of 9.5 (the last published national average frequency rate across all schemes and all industries, reported for 2002-03 in the 6th CPM report of November 2004). However, it should be noted that the CPM data uses a denominator based on actual hours worked, while the Seacare data uses a denominator based on a 24 hours day - see the methodological explanation at section 4.3.3.
The injury frequency rate has also shown a declining trend since 2000-01, and has improved considerably in 2004-05 relative to 2003-04 (both are measured on the same basis, that is, using a denominator based on a 24 hours day).
The Seacare Authority adopted the National OHS Strategy targets in 2002, for application to the maritime industry. The target requires at least a 20% reduction in the injury incidence rate by 2006-07 (after five years) and at least a 40% reduction by 2011-12 (after 10 years). The year 2001-02 is the baseline year for measurement of progress against the targets.
The Seacare Authority has adopted two measures of injury for assessing performance against the target. One uses the NOHSC data set to define injuries, so Seacare can conduct national comparisons, while a second measure uses a Seacare scheme data set. The different definitions are described below.
The NOHSC definition of injury includes all accepted workers compensation claims lodged (in Seacares case, this means lodged with AMICA, the scheme data base manager) in the reference financial year that resulted in a fatality, permanent disability or temporary disability where there was at least one week or more incapacity determined (excluding journey claims) by 30 November following the reporting year. A reasonable approximation of this measure (reported in Figure 5), is any such claims which had at least one week of incapacity determined in the reference year, regardless of when the claim was lodged. Claims in this case exclude disease claims except those coded as musculo-skeletal diseases.
The Seacare definition of injury includes all accepted workers compensation claims determined in the reference financial year that resulted in a fatality, permanent disability or temporary disability where there was any time off work, (excluding journey claims).
|
2001-02 |
2002-03 | 2003-04 | 2004-05 | |
| Claims - NOHSC definition | 97 | 104 | 121 | 70 |
| Claims - Seacare definition* | 122 | 124 | 148 | 81 |
* This result is different to that reported last year where medical expense only claims were inadvertently included Source: AMICA
| 2001-02 (base year) |
2002-03 | 2003-04 | 2004-05 | 5 year target (20% reduction) | |
| 10 year target (40% reduction) | |||||
| NOHSC definition Injury incidence rate |
32.33 | 32.78 | 37.33 | 20.24 | 25.86 |
| 19.40 | |||||
| Seacare definition Injury incidence rate |
40.67 | 39.08 | 45.66 | 23.42 | 32.5 |
| 24.4 |
Source: AMICA and Seacare Authority
Table 10 indicates that, by 2004-05 (after 3 years), incidence rates for the two measures have already achieved both the 5 year target of a 20% reduction from the base year (2001-02), and in the case of the Seacare target, the 10 year target of a 40% reduction. However, as this has only been achieved in the most recent year this trend may or may not be maintained in the long term, as the data may be somewhat volatile due to the low numbers involved.
Figure 5 shows that using both the NOHSC and the Seacare data sets to define injuries, the injury incidence rate in the Seacare scheme mostly worsened in the first two years after the baseline year of 2001-02, then improved markedly and is now better than the 5 year interim target.
The following sections disaggregate claims data, enabling greater insight into the nature and origin of injuries.

Source: AMICA
Figure 6 identifies the proportion of claims and trends across the four
key occupational groupings. This figure shows an increase in the proportion
of
claims from ratings and a corresponding decrease in claims from other
occupational groups.
Source: AMICA, Seacare Authority
Figure 7 shows that 42% of seafarers are 45 years or older and this
group contributed to 50% of claims in 2004-05, while seafarers under
45 who represented 58% by number contributed 50% of claims. This appears
to be a more even-handed result than that reported last year where the
older category contributed 58% of claims and the younger category contributed
42% of claims. This may indicate that the OHS focus on older employees
by Seacare employers during 2004-05 has had some effect.
Source: AMICA
Figure 8 shows that during 2004-05 there has been a decrease in the proportion of claims arising from injuries on deck spaces and in machinery spaces compared to 2003-04.

Source: AMICA
Figure 9 indicates that the parts of a seafarers body most likely to be subject to injury are the trunk, upper limbs and lower limbs. injuries occurred to the trunk of the body, followed by lower limbs then upper limbs of seafarers.

Source: AMICA
Figure 10 shows that body stressing continues to be the most prevalent
mechanism of injury over the period. Falls, slips and trips is the next
most
prevalent mechanism of injury category.
Source: AMICA
Figure 11 shows that sprains and strains continue to be the major injury type and their proportion has risen relative to previous years. hernias have reduced relative to previous years.
The Australian Maritime Safety Authority (AMSA) performs the occupational health and safety Inspectorate function under the OHS(MI) Act. It also has functions to:
AMSA marine surveyors, who are trained in OHS, are appointed as inspectors under the OHS(MI) Act and as required, perform a range of functions under the Act, including investigations of accidents and dangerous occurrences, issuing prohibition notices, issuing improvement notices and advising employers of their duty of care as well as on approaches to safety prevention. The following provides a summary of the activities of the Inspectorate.
|
2000-
01 |
2001-
02 |
2002-
03 |
2003-
04 |
2004-
05 |
|
| Incidents reported to AMSA7 |
69
|
61
|
78
|
78
|
49
|
| Dangerous occurrences notified8 |
8
|
5
|
13
|
6
|
1
|
| Incidents minus dangerous occurrences |
61
|
56
|
65
|
72
|
48
|
| Investigations under s87 (re compliance with, or contravention of, Act or regulations; accidents and dangerous occurrences) |
12
|
14
|
12
|
10
|
45
|
| Prohibition Notices issued under s93 |
0
|
2
|
2
|
1
|
9
|
| Improvement Notices issued under s98 |
0
|
3
|
0
|
1
|
6
|
| Taking possession of plant, substances or things s91 |
0
|
0
|
0
|
0
|
0
|
| Directions given s92 |
0
|
0
|
0
|
0
|
1
|
| Appeals instituted against inspectors decision s100 |
0
|
0
|
0
|
0
|
0
|
| Directions given by the Minister s114 |
0
|
0
|
0
|
0
|
0
|
| AMSA staff trained as OHS inspectors |
0
|
21
|
40
|
50
|
54
|
| Prosecutions commenced |
0
|
0
|
0
|
0
|
1
|
| Prosecutions completed |
0
|
0
|
0
|
0
|
0
|
Source: AMSA
Table 11 indicates that the total number of incidents reported to AMSA in 2004-05 (49) was down on that reported in 2003-04 and the previous year. This reduction is consistent with the reduction in reported numbers of claims with incapacity of one week or more in the year under the Seafarers Act (there were 78). However, as not all incidents will result in a claim, the reported number of incidents (49) would represent a degree of under-reporting.
7 Incidents reported to AMSA include where the employee is incapacitated for five or more successive working days; where the employee sustains a serious personal injury; death or a dangerous occurrence.
8 A dangerous occurrence is where there is an incident at the workplace that resulted from operations that arose from an undertaking conducted by or for the operator of the workplace and could have caused death or serious personal injury or incapacity of an employee for five or more successive working days.
AMSA reviews all incidents reported and when considered necessary, conducts an investigation pursuant to its investigation powers under the OHS(MI) Act. Three reactive investigations were conducted by AMSA in 2004-05, compared to 10 in 2003-04. However, AMSA conducted an additional 42 investigations or OHS specific audits under s 87 of the OHS(MI) Act as part of its program of proactive investigations. This has resulted in an increase in the number of Prohibition Notices and Improvement Notices issued in the reporting year. AMSA intends to continue this proactive program aiming to cover, each year, all ships to which the OHS(MI) Act applies.
|
2000-01
|
2001-02
|
2002-03
|
2003-04
|
2004-05
|
|
| Number of incidents |
69
|
61
|
78
|
78
|
49
|
| Number of seafarers (FTE) under the OHS(MI) Act |
2 850
|
3 000
|
3 173
|
3 474
|
3 371
|
| Ratio (incidents per 1,000 seafarers) |
24.2
|
20.3
|
24.6
|
22.5
|
14.5
|
| Number of reported incidents involving an incapacity of 5 or more successive days |
61
|
56
|
65
|
72
|
48
|
| Ratio (incidents involving 5 or more days incapacity per 1,000 seafarers) |
21.4
|
18.7
|
20.5
|
20.7
|
14.2
|
Source: AMSA and Seacare Authority
Table 12 indicates that the reported incident rate, measured using all incidents reported to AMSA as a proportion of seafarers, decreased in 2004-05 compared to 2003-04. The incident rate based on incidents resulting in incapacity of five or more successive days also improved in 2004-05 relative to 2003-04. This improvement seems to be consistent with the lower number of compensation claims reported in 2004-05.

Source: Seacare Authority, AMSA and AMICA
Figure 12 indicates that the fall in the number of claims in 2004-05 is generally reflected in a decline in the number of serious personal incidents reported to the Inspectorate. The reduction in claims is greater than the reduction in reportable incidents.
Scheme employers are required to have insurance arrangements in place indemnifying them for the cost of Seafarers Act workers compensation claims. Typically this involves employers paying a yearly premium to an insurer at the start of a year to fund the future costs of all claims incurred in that year including injuries incurred but not yet reported in that year. These policies typically include a claim excess or deductible. This serves to lower the premium payable but requires the employer to meet the costs of claims up to the deductible amount. Each year, the Seacare Authority arranges for an actuary to report on these insurance premium arrangements. This year, actuaries Taylor Fry Pty Ltd made the following observations on Seacare 2003-04 Scheme insurance arrangements.
In 2003-04, $13,656,000 in premium income was collected against declared total scheme remuneration of $263,400,000, yielding an effective average premium rate of 5.19%. However, this was inclusive of deductibles which range from $0 to over $100,000. Standardising the level of deductibles to the equivalent of 5 days incapacity ($1,550) would have required a combined premium income of some $24,257,000, or a premium rate of 9.21%. However, this includes cover for potential liabilities under the Navigation Act as well as under the Seafarers Act. Those policies which do not include the Navigation Act cover have an average premium of 7.28%. The following demonstrates the increase in premiums over the 5 year period 1999-00 to 2003-04.
| 1999-00 | 2000-01 | 2001-02 | 2002-03* | 2003-04 | |
| Average raw or unadjusted premium rate | 3.48% | 4.12% | 3.75% | 5.17% | 5.19% |
| Average 5 day deductible premium equivalent rate | 6.43% | 6.64% | 6.19% | 8.01% | 9.21% |
| Premium collected, or premium income (million) | $6. 951 | $8. 636 | $9. 730 | $13. 594 | $13. 656 |
| Wages pool (remuneration) (million) | $199. 843 | $209. 679 | $273. 328 | $273. 134 | $263. 400 |
* varies from figures reported last year due to data correction Source: Taylor Fry Pty Ltd
Table 13 shows only a very small increase in the premium rate in 2003-04 relative to 2002-03. However, based on the 5 day deductible premium equivalent rate there is a 15% increase. One explanation for this apparent rise in this premium rate is that the premium payments negotiated by employers and insurers contain a higher deductible in 2003-04 than in the previous year.
Taylor Fry have also provided a claim payment summary on the components of claim costs that have been paid to injured seafarers over the four year period to 2003-04. Payments for weekly benefits (time off work) remain the largest component of costs.
| Payment type | Total $ paid | Proportion |
| Weekly benefits | 13,665,813 | 69% |
| Lump sums | 1,722,146 | 9% |
| Medical and like | 2,442,441 | 12% |
| Hospital | 650,272 | 3% |
| Rehabilitation | 270,221 | 1% |
| Investigation and assessment | 244,635 | 1% |
| Legal | 706,617 | 4% |
| Other | 243,986 | 1% |
| Total | 19,946,130 | 100% |
Source: Taylor Fry Pty Ltd
Last year, for the first time, the Seacare Authority published claims management duration data highlighting a number of measures identified to show the performance of employers and employees in managing claims. The first of these measures shows improvement in 2004-05 relative to 2003-04. The data is reported in Tables 15 to 18.
| Injury occurrence to lodgement of claim with theemployer | % claims lodged in first month | % claims lodgedbetween 1 and 3months | % claims lodgedbetween 3 and 12months | % claims lodgedafter 12 months |
| 2003-04 | 51% | 35% | 12% | 2% |
| 2004-05 | 93% | 4% | 2% | 1% |
Source: AMICA
Table 15 shows a dramatic improvement in employee performance in the early lodgement of claims with employers, especially as the majority of the 93% lodged in the first month were in fact lodged within 7 days. Early claims lodgement is generally regarded as a prerequisite for early intervention by the employer.
| Time claim received by employer to time of rehabilitation assessment |
%
assessed between 1-7 days |
%
assessed between 8-14 days |
%
assessed between 15-21 days |
%
assessed between 22-31 days |
%
assessed between 1-3 months |
%
assessed between 4-12 months |
%
unknown |
| 2003-04 |
40%
|
3%
|
3%
|
17%
|
13%
|
20%
|
4%
|
| 2004-05 |
52%
|
0%
|
4%
|
0%
|
22%
|
13%
|
9%
|
Source: AMICA
Table 16 shows that while a greater proportion of injured employees (52%) were assessed (the employer made an assessment of the employees capability of undertaking rehabilitation) within 7 days in 2004-05, a lower proportion (56% compared to 63% last year) were assessed within 31 days (the statutory time is 28 days).
| Date employer received claim to compensation end date (proxy for return to work) | 0-14 days | 15-31 days | 1-3 months | 4-12 months | >12 months |
| 2003-04 | 40% | 13% | 27% | 20% | 0% |
| 2004-05 | 28% | 6% | 29% | 28% | 9% |
Source: AMICA
Table 17 shows that in 34% of cases, compensation had ceased within one month and 63% ceased within 3 months of the date of receipt of the claim by the employer. The increase in the proportion of claims taking longer than 3 months to return to work is a poorer result than that achieved in 2003-04.
The AAT is the second tier review for seafarer disputed claims (the first tier is reconsiderations by the employer with the assistance of Comcare). The AAT review process usually operates as follows. Firstly, an AAT conference is held to enable applicants to discuss with their employer, together
with an AAT member or conference registrar (an AAT official), why they think the employer determination is wrong. The conference gives the parties an opportunity to agree on a decision. If at the end of the conference process a matter has not been settled, then a compulsory conciliation conference will be listed. If the matter fails to settle at a conciliation conference, the matter will proceed to a hearing unless both parties and the AAT agree that mediation should be held.
|
2002-03
|
2003-04
|
2004-05
|
|
| Matters to be dealt with | |||
| Undetermined matters registered by AAT in reporting year | 50 | 44 | 58 |
| New matters recorded by AAT for review of reviewable decisions | 41 | 66 | 62 |
| Total | 91 | 110 | 120 |
| Matters finalised by consent of parties | |||
| Decision affirmed | 17 | 19 | 21 |
| Decision set aside | 5 | 14 | 20 |
| Decision varied | 3 | 1 | 2 |
| Application dismissed or withdrawn by consent of parties | 1 | 1 | 8 |
| Total | 26 | 35 | 51 |
| Matters heard and determined by the AAT (under s43 of AAT Act) | |||
| Decision of employer affirmed | 3 | 1 | 0 |
| Decision set aside | 9 | 3 | 2 |
| Decision varied | 0 | 0 | 1 |
| Total | 12 | 4 | 3 |
| Other finalisations | |||
| Application withdrawn by applicant | 8 | 13 | 15 |
| Application dismissed by AAT | 0 | 0 | 1 |
| Application dismissed by AAT as AAT had no jurisdiction | 1 | 0 | 0 |
| Total Matters Finalised | 47 | 52 | 70 |
| Timeframes | |||
| Average time taken from lodgement to resolution (days) | 495 | 352 | 293 |
Source: AAT
| 2001-02 | 2003-04 | 2004-05 | |
| Dispute rate | 25% | 32% | 38% |
Source: AAT and Seacare Authority
While total number of matters to be dealt with by the AAT has increased from 110 in 2003-04 to 120 in 2004-05, new matters have declined from 66 to 62. The majority of matters continue to be finalised by consent of the parties (51) as opposed to only a small and declining number (3) which proceed to be heard and determined by the AAT under s.43 of the AAT Act. This has undoubtedly contributed to the improvement in the average time taken from lodgement to resolution which in 2004-05 stands at 293 days.
The total number of claims reported to AMICA in 2004-05 was 164 and 62 new applications were made to the AAT for review of a decision. The number of applications relative to claims made is a useful indicator of the propensity to use the AAT, and is generally regarded as the most effective measure of a dispute rate. Using this analysis, 38% of claims made by seafarers resulted in an application to the AAT for a review of a decision. This compares to 32% in 2003-04 and 25% in 2002-03.
Under subsection 78(4) of the Seafarers Act an employer must, upon receipt of a request by an employee for a reconsideration of a determination (of a claim), arrange for an industry panel, or for a Comcare officer, to assist in reconsidering a determination made about a claim for compensation. This review is tier one of a two tier review process under the Seafarers Act. As there are no industry panels established pursuant to section 78 of the Seafarers Act, Comcare conducts all such reviews for employers. In 2004-05 Comcare reviewed 38 such cases from 40 requests lodged. In the majority of cases (34) Comcare recommended that the employers determination be affirmed with only four recommendations being made to vary the determination.
While it would be expected that there would be a lower number of tier two (AAT) reviews (in that some disputes would be resolved at the tier one stage) the data shows the contrary. The key explanations for this are: firstly, that AAT matters can arise from claims made in earlier financial years so the application year will not necessarily match reconsiderations arising from claims lodged in a particular financial year; and secondly, AAT matters can arise from decisions other than an employee requested reconsideration (eg an employer initiated reconsideration which does not require a Comcare assisted review), or can arise from an employer decision to refuse a request for additional time to complete the request for a reconsideration (eg. the AAT matter arises from a procedural issue associated with the operation of section 78 of the Seafarers Act). AAT matters can also arise from the application of section 91 of the Seafarers Act (cost of proceedings before the AAT).
|
2000-01
|
2001-02
|
2002-03
|
2003-04
|
2004-05
|
|
| Accepted Claims | 180 | 152 | 149 | 182 | 136 |
| Claims of 28 days or more | 112 | 96 | 91 | 115 | 69 |
| Number of claimants assessed for a rehabilitation program | 50 | 15 | 27 | 30 | 23 |
| Number of claimants commencing a rehabilitation program | 38 | 13 | 19 | 18 | 20 |
| Number of claimants commencing a rehabilitation program and who returned to work | 33 | 7 | 14 | 10 | 10 |
Source: AMICA
Table 20 indicates that in 2004-05 there were 69 employees (51% of employees with accepted claims) whose incapacity lasted for 28 days or more. Under s49 of the Seafarers Act the employer is required to arrange for an assessment of the employees capability of undertaking a rehabilitation program in such cases. However, of those, only 23, or 33% (up from 26% in 2003-04) were assessed by employers for their capability of undertaking a rehabilitation program.
Table 20 also indicates that of those employees commencing a rehabilitation program, 10, or 50% returned to work. It should be noted that more than 10 injured seafarers returned to work, but most returned to work without having undertaken a rehabilitation program.
|
2000-01
|
2001-02
|
2002-03
|
2003-04
|
2004-05
|
|
Full duties |
136
|
83
|
100
|
124
|
72
|
| Light duties |
9
|
11
|
6
|
6
|
3
|
| Same position |
139
|
85
|
99
|
125
|
72
|
| Other position |
6
|
8
|
7
|
4
|
3
|
| Full time |
142
|
84
|
104
|
129
|
74
|
| Part time |
3
|
3
|
2
|
0
|
1
|
| Ship |
140
|
89
|
100
|
125
|
73
|
| Land |
5 |
7
|
6
|
4
|
2
|
Source: AMICA
Table 21 indicates that the majority of seafarers return to the same position on full duties when they return to work after injury. The data nevertheless indicates that some graduated return to work opportunities (in supernumerary positions or on shore-based duties) are being arranged for returning seafarers as part of the rehabilitation process.
The RTW Monitor 2004-05 reports on a survey of injured workers who have had more than 10 days of compensation paid. It is undertaken by an independent research company, Campbell Research and Consulting, in all Australian workers compensation jurisdictions (with the exception of
Western Australia) and New Zealand. It aims to establish a national/international benchmark for measuring RTW, and durability of RTW, across Australian and New Zealand workers compensation schemes. In 2004-05, it surveyed 2,995 injured workers by confidential interview of whom 49 were in the Seacare Scheme.
The RTW Monitor also includes a range of survey questions asked to ascertain injured workers perceptions about the way their compensation claim was managed, and their rehabilitation and return to work experience.
Some of the key outcomes which compare Seacare scheme performance with national outcomes are reported below:
| RTW Outcomes | Seacare | National | Seacare performance to National |
| RTW rate % | 75% | 85% | worse |
| Durable RTW rate % | 62% | 76% | worse |
| Non durable RTW % | 13% | 9% | * |
| Mean length of durable RTW (average days) | 193 | 154 | better |
| Compensation payment status at time of interview (still receiving weekly payments) | 25% | 21% | * |
| Full RTW (income from employment only) % | 56% | 63% | * |
| Partial RTW (income from employment and other source at the time of interview) % | 9% | 15% | * |
| Non-durable RTW / no RTW (income from all other sources except employment) | 35% | 22% | worse |
| Continuity of Employer | 93% | 84% | better |
| Returned to same duties by time of interview | 85% | 76% | * |
| RTW / Claim Process Measures | |||
| Work importance; satisfaction; valued | 4.7; 4.5; 4.2 | 4.4; 4.2; 3.9 | better |
| Ease of claim information; lodging claim (mean rating) | 85%; 84% | 81%; 73% | better |
| Development of RTW | 20% | 50% | worse |
| Involved in development of RTW plan | 50% | 79% | worse |
| Demographics / claim characteristics | |||
| Proportion males; mean age | 95%; 46 | 62%; 42 | * |
| Mean days compensation paid | 92 | 56 | worse |
| Mean claim cost | $23,827 | $10,594 | worse |
| Participation in rehabilitation | 18% | 48% | worse |
| Average rehabilitation costs | $2,279 | $1,586 | * |
The following points summarise other RTW Monitor outcome results for
Seacare against the national results:
In terms of rehabilitation process measures and employees perceptions, the Monitor reported the following key points:
The RTW Monitor has collected demographic and claim characteristics of the survey population. The key features are as follows:
The RTW Monitor also tracks performance against its measures over time. While the following table summarises this performance, the small survey numbers involved may mean that year to year variations in performance are simply volatile rather than indicating improvement or deterioration.
| RTW Outcomes |
2000-01
|
2001-02
|
2002-03
|
2003-04
|
2004/05
|
| RTW rate % |
79
|
87
|
77
|
86
|
75
|
| Durable RTW rate % |
74
|
73
|
67
|
81
|
62
|
| Non durable RTW % |
20
|
18
|
17
|
15
|
25
|
| Mean length of durable RTW (average days) |
221
|
222
|
210
|
184
|
193
|
| Compensation payment status at time of interview (still receiving weekly payments) % |
20
|
18
|
17
|
15
|
25
|
| Full RTW (income from employment only) % |
60
|
67
|
59
|
63
|
56
|
| Partial RTW (income from employment and other source at the time of interview) % |
14
|
8
|
8
|
21
|
9
|
| Non-durable RTW / no RTW (income from all other sources except employment % ) |
26
|
25
|
33
|
17
|
35
|
| Continuity of Employer % |
88
|
88
|
96
|
83
|
93
|
| Returned to same duties by time of interview |
94
|
90
|
87
|
87
|
85
|
| RTW / Claim Process Measures | |||||
| Ease of claim lodgement (mean rating % simple) |
71
|
68
|
75
|
75
|
84
|
| Development of RTW % |
23
|
16
|
17
|
18
|
20
|
| Involved in development of RTW plan % |
80
|
87
|
77
|
77
|
49
|
| Demographics / claim characteristics | |||||
| Mean days compensation paid |
73
|
92
|
86
|
83
|
92
|
| Mean claim cost |
$16,041
|
$22,424
|
$14,717
|
$19,745
|
$23,827
|
| Participation in rehabilitation % |
23
|
14
|
9
|
14
|
18
|
| Average rehabilitation costs |
$1,662
|
$798
|
$809
|
$930
|
$2,279
|