Accident Leave and Weekly Compensation Policy and Procedures


Background


The University has joined the Full Self Cover Plan of the ACC Accredited Employer Programme, and is responsible for the following in the case of work related injury claims:

  • medical costs to the levels provided for in the Accident Compensation Act 2001
  • weekly compensation where time off work is required and
  • case management and rehabilitation services

A third party provider, has been engaged to administer medical costs on the University’s behalf and to provide case management and rehabilitation services.

The Accident Compensation Corporation (ACC) is the insurer for a non-work related injury. ACC is responsible for:

  • medical costs to the levels provided for in the Accident Compensation Act 2001
  • weekly compensation where time off work is required and
  • case management and rehabilitation services

The University has an agreement with ACC to pay weekly compensation on their behalf so that staff members’ earnings are not disrupted.

Application


All permanent, fixed term and casual staff members of the University.

Purpose


The University’s position on the management and application of entitlements, leave, weekly compensation, claims management for work related and non-work ACC injury claims.

Policy


Accident leave

1.    Staff members absent from work because of a work related injury will be placed on accident leave

2.    Staff members absent from work because of a non-work related injury will be placed on sick leave for the first week of absence and thereafter on accident leave

3.    Sick leave may go into deficit with the approval of the HR manager when there is insufficient sick leave to cover time off work for the first week only

4.    Staff members on accident leave are entitled to weekly compensation in lieu of salary or wages

5.    ACC medical certificates (ACC45) are required to validate all injury related absences

6.    Professional staff leave returns must show accident leave as being work or non-work related

7.    Academic staff on accident leave must be reported to the payroll manager fortnightly by the academic head clearly noting whether it is work or non-work related

Weekly compensation

In law, staff on accident leave are entitled to weekly compensation based on 80% of normal earnings, but no entitlement to compensation for the first week of a non-work injury

8.    The University practice is to exceed statutory entitlements by providing for 100% of normal earnings for work related accident leave and for the use of sick leave entitlements for non-work related accident leave, as shown below:

Injury Absence                

Week 1

Week 2 onwards

Work Related

Accident Leave

Weekly Compensation @100% normal earnings

Accident Leave

Weekly Compensation @ 100% normal earnings

 

Non-Work Related

Paid Sick Leave

Normal Salary

Accident Leave

Weekly compensation @ 80% normal earnings, plus 20% paid sick leave

(If insufficient sick leave, staff may elect to take 20% Annual Leave or receive Weekly Compensation @ 80% normal earnings)

Acceptance of claims

9.    Decisions on accepting a claim as work related, will only be made when the injured person completes and supplies the following documentation to the Health, Safety and Wellbeing Manager (or appropriate delegated authority):

  • accident/incident Report
  • ACC Accident Treatment Certificate (ACC45)
  • Accident Insurance Claim Form

10.    Claims and time off work will be assumed to be non-work related in the absence of the required documentation

11.    The University will ensure that injured employees requiring time off work will be paid compensation for the first 4 weeks to allow resolution of any uncertainty as to cover

12.    Should a claim be declined as being work related, or a decision still be delayed or in dispute after 4 weeks, the claim will be treated as non- work related and leave records adjusted accordingly

Disputes

13.    The University will attempt to resolve any disputes regarding claims, costs, weekly compensation, rehabilitation, etc., internally with staff members and/or their representatives

14.    Where agreement cannot be reached, the reviews and appeals provisions of the Claims Management and Rehabilitation Manual will be used

Medical treatment costs for work injuries

15.    In the case of work injuries, the University will pay through a third party provider,  the costs of approved medical treatment up to the maximum levels provided for by the Accident Compensation Act 2001  

16.    The University, through a third party provider, will normally approve any additional costs in excess the schedule amounts.

17.    Staff members seeking medical treatment should instruct the medical practitioner to invoice the full cost of treatment to the third party provider, in the first instance

18.    Should a medical practitioner require a staff member to pay costs above the schedule amounts, these will be reimbursed, on the presentation of receipts, by Human Resources

Budgetary provisions – work related injuries

19.    Academic units are to make budgetary provision for prescribed ACC levies to be paid into the University of Auckland Accident Compensation budget

20.    Expenses relating to managing work related injuries will be met from this budget, including:

  • medical treatment costs
  • rehabilitation costs
  • weekly compensation
  • third party admnistrator fees
  • ACC charges – stop loss insurance, administration, audits

21.   After an injured staff member has been off work for 4 weeks for a work related injury their department will be reimbursed 80% normal earnings (ie statutory weekly compensation) from this budget

Budgetary provisions – non-work related injuries met by ACC

22.    Expenses relating to managing non-work related injuries are met by ACC. These include:

  • medical treatment costs
  • rehabilitation costs
  • weekly compensation

23.    Weekly compensation at 80% normal earnings is reimbursed by ACC for non-work related injury absence and is credited directly by Payroll into departmental accounts

Definitions


The following definitions apply to this document:

Accredited Employer means an employer who has entered into an accreditation agreement; and includes the Corporation while it is accredited under section 186 of the Accident Compensation Act 2001

Non-work related injury means a personal injury that occurred to an individual that occurred in their personal time and not whilst undertaking any University-sanctioned activity

Staff member refers to an individual employed on a full time or part time basis

Third party organisation is the specialist service provider that has been engaged to administer medical costs on the University’s behalf and to provide case management and rehabilitation services

Weekly compensation is the weekly income amount for loss of earnings, or loss of potential earning capacity, and compensation for the spouse or partner, child, or other dependant of a deceased claimant, that is payable by the Corporation

Work related injury means an injury that occurs when the employee is: at a place for the purpose of working, having a break from work for a meal or a rest , in a vehicle that transports them to/from work, provided the vehicle is supplied by and under the direction of the employer or travelling to/from treatment for a previous work-related personal injury

University means the University of Auckland and includes all subsidiaries 

Document management and control


Content manager: Associate Director, Health and Safety

Owner: Director, Human Resources

Approval date:  26 November 2014

Review date: 1 July 2016