National Injury Insurance Scheme (NIIS) Return to Work Conference 2017 Janene Hillhouse A/Senior Director – Workers’ Compensation Services Office of Industrial Relations
National Injury Insurance Scheme • The National Injury Insurance Scheme (NIIS) is a companion scheme to the National Disability Insurance Scheme • Designed to ensure people who sustain the most catastrophic personal injuries ( serious personal injuries ) have access to no-fault lifetime treatment, care and support.
National Injury Insurance Scheme • The NIIS workplace and motor accident streams were implemented in Queensland from 1 July 2016. • Both NIIS streams are based on a consistent framework and entitlements. • National Injury Insurance Agency Queensland (NIISQ) has been established to administer the scheme for motor accidents, and provides a service platform for the workplace accident stream.
NIIS - Workplace accidents stream • The workers’ compensation scheme already provided short-tail no-fault statutory compensation benefits • NIIS provides lifetime treatment, care and support payments for workers with serious personal injuries • Interim and lifetime eligibility assessments • Access to common law damages if employer is at fault • Insurers will engage NIISQ for claims management
NIIS – Workplace accidents stream • The workplace accident NIIS does not apply to: – Journey claims – Ordinary recess claims – Serious and wilful misconduct – Claimants other than workers
Injuries covered by NIIS Traumatic brain injury Permanent spinal injury Severe burns Serious brachial plexus injury Permanent blindness High level or multiple amputations
NIIS - Estimated injuries • Motor vehicle accidents – estimate 140 people in 2016-17 • Workplace accidents – estimate 11 people per year • Most common injuries estimated for workplace accidents: – Brain injury – 78 per cent – Spinal cord injury – 14 per cent – Other – 8 per cent
NIIS - Entitlements Medical treatment Rehabilitation Prostheses, aids Care; respite and appliances attendant and domestic assistance Ambulance transportation Dental Pharmaceuticals Educational and Home (Work)/ vocational training transport modifications
NIISQ - Guiding principles
How does it work? 1.Hospitalised 6. Plan 2. Notification monitoring and and maintenance application Injured Worker (or Participant) 5. Plan 3. Eligibility funded, facilitated and confirmed delivered 4. Support plan developed
Where are we at? • New administrative arrangements between workers’ compensation insurers and NIISQ • Workplace accidents stream - limited claims experience • Motor accident stream - 43 accepted cases to date • Key challenge for insurers is effectively managing dual service delivery and dual liability where work-related motor vehicle accidents
NIISQ - Stakeholder Engagement • medical and health services • community service providers • disability groups • legal profession • insurers (workers’ compensation/ CTP) • researchers
Stakeholder Engagement in North QLD • NIISQ is building relationships with: – Townsville and Cairns Hospital Rehab Units – Primary health networks – Far North Queensland Allied Health Network
Further information worksafe.qld.gov.au niis.qld.gov.au
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