Where further investigation is required the self-insured employer seeks any information necessary to determine if an expense is reasonable. Reasonable associated with immediate transportation to a hospital or health practitioner for initial treatment are paid. Reasonable costs associated with property damage are paid. 2.3.2 a self-insured employer receives an s33 Documents on file demonstrate the self-insured employer has Claim files application made by a worker seeking advanced applied its procedures to ensure: approval for the provision of services, a written Workers are informed of the right to apply for future services. determination must be issued to the worker and Applications for pre-approval of services are determined within where approval is not given, state the ground for 1 of receipt in accordance with legislation. the decision and inform the worker of their right to apply to have the decision reviewed. Standard 2 Claims Management Element 4 Income Support 2.4.1. AWE entitlements are determined in accordance with Part 4, Division 4 of the Act, including income support for incapacity resulting from surgery. 2.4.2. AWE calculations are made in accordance with section 5 of the Act and copies of information used to calculate AWE are held on file. 2.4.3. AWE is appropriately adjusted in all where a worker has previously redeemed entitlement to weekly payments. 2.4.4. AWE adjustments are made in accordance with section 45 of the Act. 2.4.5. AWE Reviews are made in accordance with section 46 of the Act. 2.4.6. Reduction/discontinuance of weekly payments is made in accordance with section 48 of the Act. 2.4.7. there has been a delay in the making of weekly payments and the delay was not the fault of the worker, then the self-insured employer shall calculate and apply interest at the prescribed rate to the amount in arrears within one month, and issue a written notice to the worker setting out details of the interest applied to the amount in arrears.
Where further investigation is required the self-insured employer seeks any information necessary to determine if an expense is reasonable. Reasonable associated with immediate transportation to a hospital or health practitioner for initial treatment are paid. Reasonable costs associated with property damage are paid. 2.3.2 a self-insured employer receives an application made by a worker seeking advanced approval for the provision of services, a written determination must be issued to the worker and where approval is not given, state the ground for the decision and inform the worker of their right to apply to have the decision reviewed. s33 Documents on file demonstrate the self-insured employer has applied its procedures to ensure: Workers are informed of the right to apply for future services. Applications for pre-approval of services are determined within 1 of receipt in accordance with legislation. Claim files Standard 2 Claims Management Element 4 Income Support 2.4.1. AWE entitlements are determined in accordance with Part 4, Division 4 of the Act, including income support for incapacity resulting from surgery. 2.4.2. AWE calculations are made in accordance with section 5 of the Act and copies of information used to calculate AWE are held on file. 2.4.3. AWE is appropriately adjusted in all where a worker has previously redeemed entitlement to weekly payments. 2.4.4. AWE adjustments are made in accordance with section 45 of the Act. 2.4.5. AWE Reviews are made in accordance with section 46 of the Act. 2.4.6. Reduction/discontinuance of weekly payments is made in accordance with section 48 of the Act. 2.4.7. there has been a delay in the making of weekly payments and the delay was not the fault of the worker, then the self-insured employer shall calculate and apply interest at the prescribed rate to the amount in arrears within one month, and issue a written notice to the worker setting out details of the interest applied to the amount in arrears.
Self-Insured-Injury-Management-Standards-Guidance-Notes.docx