{"id":"a-2014-11","name":"Lifetime Care and Support (Catastrophic Injuries) Act 2014","slug":"lifetime-care-and-support-catastrophic-injuries-act-2014","collection":"act","jurisdiction":"act","status":"in_force","isInForce":true,"actNumber":"11 of 2014","makingDate":null,"administeringDepartment":null,"currentVersion":{"id":23865,"registerId":"act-a-2014-11-current","compilationNumber":null,"startDate":"2026-04-01","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"4","sectionType":"section","heading":"Amendment history 80","content":"4 Amendment history 80\n","sortOrder":0},{"sectionNumber":"5","sectionType":"section","heading":"Earlier republications 86","content":"5 Earlier republications 86\n\nAn Act to provide a scheme for the lifetime care and support of people who have\nbeen catastrophically injured, and for other purposes\n\n","sortOrder":1},{"sectionNumber":"1","sectionType":"section","heading":"Name of Act","content":"1 Name of Act\nThis Act is the Lifetime Care and Support (Catastrophic Injuries)\nAct 2014.\n","sortOrder":2},{"sectionNumber":"3","sectionType":"section","heading":"Dictionary","content":"3 Dictionary\nThe dictionary at the end of this Act is part of this Act.\nNote 1 The dictionary at the end of this Act defines certain terms used in this\nAct, and includes references (signpost definitions) to other terms defined\nelsewhere.\nFor example, the signpost definition ‘legal costs—see the Legal\nProfession Act 2006, dictionary.’ means that the term ‘legal costs’ is\ndefined in that dictionary and the definition applies to this Act.\nNote 2 A definition in the dictionary (including a signpost definition) applies to\nthe entire Act unless the definition, or another provision of the Act,\nprovides otherwise or the contrary intention otherwise appears (see\nLegislation Act, s 155 and s 156 (1)).\n4 Notes\nA note included in this Act is explanatory and is not part of this Act.\nNote See the Legislation Act, s 127 (1), (4) and (5) for the legal status of notes.\n\nPreliminary Part 1\n5 Offences against Act—application of Criminal Code etc\nOther legislation applies in relation to offences against this Act.\nNote 1 Criminal Code\nThe Criminal Code, ch 2 applies to all offences against this Act (see\nCode, pt 2.1).\nThe chapter sets out the general principles of criminal responsibility\n(including burdens of proof and general defences), and defines terms used\nfor offences to which the Code applies (eg conduct, intention,\nrecklessness and strict liability).\nNote 2 Penalty units\nThe Legislation Act, s 133 deals with the meaning of offence penalties\nthat are expressed in penalty units.\n","sortOrder":3},{"sectionNumber":"6","sectionType":"section","heading":"Application of Act","content":"6 Application of Act\n(1) This Act applies only in relation to the following injuries:\n(a) an injury (a motor accident injury) suffered by a person—\n(i) as a result of a motor accident that happened or happens in\nthe ACT after 30 June 2014; and\n(ii) whether or not the person was at fault in the motor\naccident; and\n(iii) if at least 1 motor vehicle involved in the motor accident\nhad MAI cover under the MAI Act at the time of the motor\naccident;\n(b) an injury (a work injury) suffered by a worker if—\nNote Worker—see the dictionary.\n(i) the injury occurs after the later of the following:\n(A) 30 June 2016;\n\n(B) the date the Lifetime Care and Support (Catastrophic\nInjuries) Amendment Act 2016 is notified; and\n(ii) the injury arises out of, or in the course of, the worker’s\nemployment, within the meaning of the Workers\nCompensation Act 1951, section 31 (General entitlement to\ncompensation for personal injury); and\n(iii) the ACT is the Territory or State of connection in relation\nto the worker’s employment.\nNote Territory or State of connection—see the Workers\nCompensation Act 1951, s 36A.\n(2) A regulation may make provision for or in relation to limiting the\napplication of this Act to a stated class of people.\nNote 1 A reference to an Act includes a reference to a provision of an Act (see\nLegislation Act, s 7 (3)).\nNote 2 Power to make a statutory instrument (including a regulation) includes\npower to make different provision in relation to different matters or\ndifferent classes of matters, and to make an instrument that applies\ndifferently by reference to stated exceptions or factors (see Legislation\nAct, s 48).\n(3) For subsection (1) (a), a motor vehicle involved in a motor accident\nis taken to have had MAI cover under the MAI Act at the time of the\nmotor accident if—\n(a) an MAI policy was in force for the motor vehicle at that time; or\n(b) at that time—\n(i) the motor vehicle was owned by the Territory, or a territory\nauthority; and\n(ii) an MAI policy was not in force for the motor vehicle; or\n(c) a compulsory third-party insurance policy was in force for the\nmotor vehicle under the law of a jurisdiction other than the ACT\nat that time; or\n\nPreliminary Part 1\n(d) the motor vehicle was owned by the Commonwealth, or an\nentity representing the Commonwealth, at that time; or\n(e) there is a right of action against the nominal defendant under the\nMAI Act in relation to the motor accident; or\n(f) there would be a right of action against the nominal defendant\nunder the MAI Act in relation to the motor accident if the cause\nof the motor accident was the fault of the responsible person or\ndriver of the motor vehicle in the use or operation of the motor\nvehicle.\nNote For the application of the MAI Act to motor vehicles owned by the\nTerritory, the Commonwealth or a territory or commonwealth authority,\nsee the MAI Act, s 288.\n(4) For subsection (1) (b) (ii), each of the following is an injury arising\nout of, or in the course of, the worker’s employment:\n(a) an injury received by a worker on an employment-related\njourney (within the meaning of the Workers Compensation\nAct 1951, section 36 (Journey claims));\n(b) an injury that is attributable to the worker’s serious and wilful\nmisconduct (within the meaning of the Workers Compensation\nAct 1951, section 82 (When is compensation under Act\ngenerally not payable?)).\n(5) However, this Act does not apply to an injury suffered by a worker if\nthe injury—\n(a) is intentionally self-inflicted; or\n(b) is sustained as a result of the worker’s engagement in\nprofessional sporting activity.\nNote Professional sporting activity—see the Workers Compensation\nAct 1951, dictionary.\n\n","sortOrder":4},{"sectionNumber":"7","sectionType":"section","heading":"Purpose of Act","content":"7 Purpose of Act\nThe purpose of this Act is to—\n(a) provide an indemnity insurance scheme to respond to the\nreasonable and necessary treatment and care needs of people\nwho have suffered a catastrophic injury—\n(i) in a motor accident; or\n(ii) arising out of, or in the course of, their employment; and\n(b) ensure that the scheme is fully funded.\n","sortOrder":5},{"sectionNumber":"8","sectionType":"section","heading":"Terms used in other Acts","content":"8 Terms used in other Acts\n(1) A term used in the MAI Act has the same meaning in this Act.\nNote 1 A definition in an Act applies except so far as the contrary intention\nappears (see Legislation Act, s 155).\nNote 2 MAI Act—see the dictionary.\n(2) A term used in the Workers Compensation Act 1951 has the same\nmeaning in this Act.\n","sortOrder":6},{"sectionNumber":"9","sectionType":"section","heading":"Meaning of treatment and care needs etc","content":"9 Meaning of treatment and care needs etc\nIn this Act:\nexcluded treatment and care means treatment, care, support or\nservices of a kind prescribed by regulation for this definition.\n\nPurpose and important concepts Part 2\ntreatment and care needs, of a participant in the LTCS scheme—\n(a) means the participant’s needs in relation to any of the following:\n(i) medical treatment (including pharmaceutical treatment);\n(ii) dental treatment;\n(iii) rehabilitation;\n(iv) ambulance transportation;\n(v) respite care;\n(vi) attendant care services;\n(vii) aids and appliances;\n(viii) prostheses;\n(ix) education and vocational training;\n(x) home and transport modification;\n(xi) workplace and educational facility modifications;\n(xii) any other kinds of treatment, care, support or services\nprescribed by regulation; but\n(b) does not include excluded treatment and care.\n\n","sortOrder":7},{"sectionNumber":"10","sectionType":"section","heading":"Appointment of LTCS commissioner","content":"10 Appointment of LTCS commissioner\n(1) The Minister may appoint a public servant to be Lifetime Care and\nSupport Commissioner of the Australian Capital Territory (the LTCS\ncommissioner).\nNote 1 For the making of appointments (including acting appointments), see the\nLegislation Act, pt 19.3.\nNote 2 In particular, an appointment may be made by naming a person or\nnominating the occupant of a position (see Legislation Act, s 207).\n(2) The LTCS commissioner must be appointed for not longer than\n3 years.\nNote A person may be reappointed to a position if the person is eligible to be\nappointed to the position (see Legislation Act, s 208 and dict, pt 1,\ndef appoint).\n","sortOrder":8},{"sectionNumber":"11","sectionType":"section","heading":"Functions of LTCS commissioner","content":"11 Functions of LTCS commissioner\n(1) The LTCS commissioner has the following functions:\n(a) to monitor the operation of the LTCS scheme and, in particular,\nto conduct research into and collect statistics in relation to the\nscheme’s operation;\nNote A reference to an Act includes a reference to the statutory\ninstruments made or in force under the Act, including any\nregulation (see Legislation Act, s 104).\n(b) to advise the Minister about the administration, efficiency and\neffectiveness of the LTCS scheme;\n(c) to publicise and distribute information about the LTCS scheme;\n(d) to issue and monitor the LTCS guidelines;\n(e) any other function given to the LTCS commissioner under this\nAct or another territory law.\n\nLTCS commissioner Part 3\n(2) The LTCS commissioner has the following functions in relation to\nthe provision of care, treatment, rehabilitation, long-term support and\nother services for people who have sustained injuries to which this\nAct applies:\n(a) to monitor those services;\n(b) to support and fund programs that will improve delivery of those\nservices;\n(c) to support and fund research and education in relation to the\ndelivery of those services.\nNote Section 6 sets out the injuries to which this Act applies.\n","sortOrder":9},{"sectionNumber":"12","sectionType":"section","heading":"Delegation by LTCS commissioner","content":"12 Delegation by LTCS commissioner\n(1) The LTCS commissioner may delegate the LTCS commissioner’s\nfunctions under section 11 to an authorised person.\n(2) A delegate may subdelegate to an authorised person a function\ndelegated under subsection (1) if the subdelegation is authorised in\nwriting by the LTCS commissioner.\nauthorised person means—\n(a) a public employee; or\n(b) a person prescribed by regulation.\nNote Public employee—see the Legislation Act, dictionary, pt 1.\n\n","sortOrder":10},{"sectionNumber":"13","sectionType":"section","heading":"LTCS commissioner’s staff","content":"13 LTCS commissioner’s staff\n(1) The LTCS commissioner may employ staff on behalf of the Territory.\n(2) The LTCS commissioner’s staff must be employed under the Public\nSector Management Act 1994.\nNote The Public Sector Management Act 1994, div 8.2 applies to the LTCS\ncommissioner in relation to the employment of staff (see Public Sector\nManagement Act 1994, s 152).\n","sortOrder":11},{"sectionNumber":"14","sectionType":"section","heading":"Use of consultants and contractors","content":"14 Use of consultants and contractors\nThe LTCS commissioner may engage the consultants and contractors\nthat may be necessary or convenient to exercise the LTCS\ncommissioner’s functions.\n\n","sortOrder":12},{"sectionNumber":"15","sectionType":"section","heading":"Participation in LTCS scheme—eligibility","content":"15 Participation in LTCS scheme—eligibility\n(1) A person who has an injury to which this Act applies (the injured\nperson) is eligible to participate in the LTCS scheme in relation to\nthe injury if—\n(a) the injury involves—\n(i) a spinal cord injury; or\n(ii) a brain injury; or\n(iii) an amputation of a limb; or\n(iv) burns; or\n(v) permanent blindness; or\n(vi) any other injury mentioned in the LTCS guidelines; and\n(b) the injury satisfies the criteria mentioned in the LTCS\nNote 1 Section 6 sets out the injuries to which this Act applies.\nNote 2 The LTCS guidelines are made under s 93.\n(2) The person may participate in the LTCS scheme as an interim\nparticipant or lifetime participant.\nNote 1 See s 20 for eligibility criteria for interim participants.\nNote 2 See s 21 for eligibility criteria for lifetime participants.\n(3) Despite the Workers Compensation Act 1951, section 83 (No\ncompensation while imprisoned), a person with a workplace injury is\neligible to participate in the LTCS scheme even though the person is\nimprisoned.\n\n(4) However, the person is not eligible to participate in the LTCS scheme\nin relation to the injury if the person has been awarded damages,\nunder a final judgment entered by a court or a binding settlement, for\nfuture economic loss in relation to the person’s treatment and care\nneeds relating to the injury.\n(5) The LTCS guidelines may include further information in relation to\nthe person’s eligibility to participate in the LTCS scheme,\nincluding—\n(a) the criteria to be satisfied in relation to an injury for the person\nto be eligible to be a participant in the scheme; and\n(b) determining whether the injury satisfies the criteria.\n","sortOrder":13},{"sectionNumber":"16","sectionType":"section","heading":"LTCS scheme—initial application to participate","content":"16 LTCS scheme—initial application to participate\n(1) This section applies if an injured person is eligible to participate in\nthe LTCS scheme.\n(2) Any of the following people may apply to the LTCS commissioner\nfor the injured person to become a participant in the LTCS scheme in\nrelation to the person’s injury:\n(b) someone else on the injured person’s behalf;\nExamples—par (b)\n1 the injured person’s parent\n2 the injured person’s spouse\n(c) an insurer for a claim made by the injured person in relation to\nthe injury.\n\n(3) The application must be accompanied by a medical certificate.\n(4) However, the LTCS commissioner may waive the requirement for a\nmedical certificate if satisfied that—\n(a) a certificate is not needed to establish the injured person’s\neligibility to participate in the LTCS scheme; and\n(b) there are exceptional circumstances justifying the waiver.\n(5) The injured person’s consent is not needed for the insurer to make the\napplication.\n(6) The insurer may be directed to apply for the injured person to become\na participant in the LTCS scheme by—\n(a) if the injured person has a motor accident injury—the MAI\ncommission; or\n(b) if the injured person has a work injury—the Minister or director-\ngeneral responsible for the Workers Compensation Act 1951.\nNote MAI commission—see the MAI Act, dictionary.\n(7) The insurer must comply with a direction under subsection (6).\n(8) In this section:\ninsurer—\n(a) for a claim made by an injured person in relation to a motor\naccident injury, means—\n(i) if the injured person is an MAI insured person—the MAI\ninsurer for the person; or\n(ii) if the injured person is not an MAI insured person—the\nnominal defendant; or\nNote MAI insured person—see the MAI Act, s 286.\n\n(b) for a claim made by an injured person in relation to a work\ninjury, means—\n(i) if the injured person’s employer is insured—the workers\ncompensation insurer for the employer; or\n(ii) if the injured person’s employer is self-insured—the\nemployer; or\n(iii) if the injured person’s employer is not insured—the DI\nFund.\nNote DI Fund—see the Workers Compensation Act 1951,\ndictionary.\n","sortOrder":14},{"sectionNumber":"17","sectionType":"section","heading":"LTCS scheme—authorisation for LTCS commissioner to","content":"17 LTCS scheme—authorisation for LTCS commissioner to\nobtain information\nThe LTCS commissioner may require an applicant for participation\nin the LTCS scheme to authorise the LTCS commissioner to obtain\ninformation and documents relevant to the applicant’s injury from\nstated people.\n","sortOrder":15},{"sectionNumber":"18","sectionType":"section","heading":"LTCS scheme—guidelines for applications","content":"18 LTCS scheme—guidelines for applications\nThe LTCS guidelines may make provision for applications for\nparticipation in the LTCS scheme, including provision for—\n(a) making and determining applications (including information to\nbe given with an application); and\n(b) requiring an insurer to pay the costs of any assessment required\nby the LTCS guidelines in relation to an application; and\n(c) imposing restrictions on the time within which an application\ncan be made or requiring the making of an application to be\ndeferred until an injury has stabilised.\n\n","sortOrder":16},{"sectionNumber":"19","sectionType":"section","heading":"LTCS scheme—acceptance as participant","content":"19 LTCS scheme—acceptance as participant\n(1) This section applies if the LTCS commissioner receives an\napplication under section 16 (LTCS scheme—initial application to\nparticipate).\n(2) If the LTCS commissioner is satisfied that the injured person is\neligible to be a participant in the LTCS scheme, the LTCS\ncommissioner must give the injured person written notice accepting\nthe person as an interim participant in the scheme.\n","sortOrder":17},{"sectionNumber":"20","sectionType":"section","heading":"LTCS scheme—interim participation","content":"20 LTCS scheme—interim participation\n(1) This section applies if the LTCS commissioner accepts an injured\nperson as an interim participant in the LTCS scheme.\n(2) The period of the injured person’s interim participation is—\n(a) for an injured person who is 3 years or older—2 years, starting\non the date of the LTCS commissioner’s determination; and\n(b) for an injured person who is under 3 years—the period starting\non the date of the LTCS commissioner’s determination and\nending on the injured person’s 5th birthday.\n(3) An injured person must not be accepted as an interim participant more\nthan once in relation to the same injury.\n(4) The end of a period of interim participation in the LTCS scheme does\nnot prevent an injured person being later accepted as a lifetime\nparticipant in the scheme.\n(5) However, if the injured person is awarded damages, under a final\njudgment entered by a court or a binding settlement, for future\neconomic loss in relation to the injured person’s treatment and care\nneeds relating to the injury during or after the end of a period of\ninterim participation, the injured person must not be accepted as a\nlifetime participant.\n\n","sortOrder":18},{"sectionNumber":"21","sectionType":"section","heading":"LTCS scheme—application for lifetime participation","content":"21 LTCS scheme—application for lifetime participation\n(1) This section applies if an injured person is or has been an interim\nparticipant in the LTCS scheme.\n(2) Any of the following people may apply to the LTCS commissioner\nfor the injured person to become a lifetime participant in the LTCS\nscheme:\n(b) someone else on the injured person’s behalf;\nExamples—par (b)\n1 the injured person’s parent\n2 the injured person’s spouse\n(c) an insurer for a claim made by the injured person in relation to\nthe injury.\n(3) The application must be accompanied by a medical certificate and\nany additional information requested under subsection (6).\n(4) The medical certificate must be completed—\n(a) not more than 2 months before the date that the application for\nlifetime participation is made; or\n(b) if the LTCS commissioner allows another time within which to\ncomplete the medical certificate—within the time allowed.\n(5) However, the LTCS commissioner may waive the requirement for a\nmedical certificate if satisfied that—\n(a) a certificate is not needed to establish the injured person’s\neligibility for lifetime participation; and\n(b) there are exceptional circumstances justifying the waiver.\n(6) The LTCS commissioner must notify the injured person and any other\ninterested party, in writing, of any additional information that must\naccompany the application.\n\n(7) If the injured person is accepted as a lifetime participant in the LTCS\nscheme, the injured person—\n(a) ceases to be an interim participant in the scheme; and\n(b) is a lifetime participant in the scheme until the end of the\nperson’s life.\n","sortOrder":19},{"sectionNumber":"22","sectionType":"section","heading":"Effect of LTCS scheme on motor accident claims etc","content":"22 Effect of LTCS scheme on motor accident claims etc\n(1) This Act does not limit or otherwise affect the application of the MAI\nAct in relation to a motor accident injury of an injured person who is,\nor is eligible to become, a participant in the LTCS scheme, except as\nprovided by that Act.\nNote MAI Act—see the dictionary.\n(2) While an injured person is an interim participant in the LTCS scheme\nin relation to a motor accident injury, time does not run for the\nMAI Act, section 268 to section 271 or a provision of the Limitation\nAct 1985 in relation to a cause of action on a claim for damages—\n(a) relating to the injury; or\n(b) relating to any other injury suffered by the person as a result of\nthe motor accident.\n","sortOrder":20},{"sectionNumber":"22A","sectionType":"section","heading":"Effect of LTCS scheme on workers compensation claims","content":"22A Effect of LTCS scheme on workers compensation claims\netc\n(1) This Act does not limit or otherwise affect the application of the\nWorkers Compensation Act 1951 in relation to a work injury of an\ninjured person who is, or is eligible to become, a participant in the\nLTCS scheme, except as provided by that Act.\n\n(2) While an injured person is an interim participant in the LTCS scheme\nin relation to a work injury, time does not run for the Workers\nCompensation Act 1951, section 120 (Time for taking proceedings\ngenerally) or a provision of the Limitation Act 1985 in relation to a\ncause of action on a claim for damages—\n(a) relating to the work injury; or\n(b) relating to any other injury suffered by the person as a result of\nthe work injury.\n\nTreatment and care needs assessment Part 5\n","sortOrder":21},{"sectionNumber":"Part 5","sectionType":"part","heading":"Treatment and care needs","content":"Part 5 Treatment and care needs\nassessment\n","sortOrder":22},{"sectionNumber":"23","sectionType":"section","heading":"Assessment of participant’s treatment and care needs","content":"23 Assessment of participant’s treatment and care needs\n(1) The LTCS commissioner must assess the treatment and care needs of\na participant in the LTCS scheme for the injury in relation to which\nthe injured person is a participant in the scheme.\n(2) The assessment must determine the participant’s treatment and care\nneeds that—\n(a) are reasonable and necessary in the circumstances; and\n(b) relate to the injury in relation to which the person is a participant\nin the LTCS scheme.\n(3) In deciding whether the participant’s treatment and care needs are\nreasonable and necessary in the circumstances, the LTCS\ncommissioner must consider the following:\n(a) the benefit that a service will have for meeting the participant’s\ntreatment and care needs;\n(b) the appropriateness of a service, or request for a service, to meet\nthe participant’s treatment and care needs;\n(c) the appropriateness of a provider of a service mentioned in\nparagraph (b);\n(d) the cost benefit of a service mentioned in paragraph (b).\nNote The LTCS guidelines may include provisions about which of an injured\nperson’s treatment and care needs are reasonable and necessary in the\ncircumstances (see s 30 (5)).\n\n(4) The assessment must be made in accordance with the LTCS\n(5) The LTCS commissioner must—\n(a) certify in writing its assessment of the participant’s treatment\nand care needs; and\n(b) include in the certificate its reasons for the findings on which the\nassessment is based; and\n(c) give a copy of the certificate to the participant.\n","sortOrder":23},{"sectionNumber":"24","sectionType":"section","heading":"Effect of assessment","content":"24 Effect of assessment\n(1) The LTCS commissioner’s assessment of a participant’s treatment\nand care needs is final and binding for this Act and any court\nproceeding under this Act.\nNote The LTCS commissioner is to revise its assessment if necessary to give\neffect to a decision by an assessor or review panel in relation to a dispute\nabout the participant’s treatment and care needs (see s 64).\n(2) The LTCS commissioner’s assessment of a participant’s treatment\nand care needs supersedes any earlier assessment by the\ncommissioner of those needs.\n","sortOrder":24},{"sectionNumber":"25","sectionType":"section","heading":"LTCS commissioner not liable for legal costs for","content":"25 LTCS commissioner not liable for legal costs for\nassessment\nprovided to a participant in the LTCS scheme in relation to an\nassessment of the participant’s treatment and care needs.\n\nTreatment and care needs assessment Part 5\n","sortOrder":25},{"sectionNumber":"26","sectionType":"section","heading":"Co-operation of participant","content":"26 Co-operation of participant\nA participant in the LTCS scheme must comply with any reasonable\nrequest made by the LTCS commissioner in relation to an assessment\nof the participant’s treatment and care needs, including a request to\nundergo a medical or other examination by a health practitioner.\n","sortOrder":26},{"sectionNumber":"27","sectionType":"section","heading":"Treatment and care needs assessment—LTCS guidelines","content":"27 Treatment and care needs assessment—LTCS guidelines\n(1) The LTCS guidelines may make provision for and in relation to the\nassessment of the treatment and care needs of a participant in the\nLTCS scheme.\n(2) In particular, the LTCS guidelines may make provision for the\n(a) the procedures to be followed for the assessment;\n(b) the intervals at which assessments are to be carried out;\n(c) the methods and criteria to be used to determine the treatment\nand care needs of participants in the LTCS scheme;\n(d) the information participants must provide for or in relation to\nassessments.\n(3) An assessment of the treatment and care needs of a participant in the\nLTCS scheme must be carried out in accordance with the LTCS\n\n","sortOrder":27},{"sectionNumber":"28","sectionType":"section","heading":"Request for treatment and care needs assessment","content":"28 Request for treatment and care needs assessment\n(1) A participant in the LTCS scheme, or someone on the participant’s\nbehalf, may request the LTCS commissioner to carry out an\nassessment of the participant’s treatment and care needs.\nNote The LTCS commissioner is not liable for any legal costs incurred by a\nparticipant for legal services provided to the participant (see s 25).\n(2) The LTCS guidelines may make provision for and in relation to when\na person mentioned in subsection (1) may request the LTCS\ncommissioner to carry out an assessment of the participant’s\ntreatment and care needs.\nNote 1 The LTCS guidelines are made under s 93.\nNote 2 Treatment and care needs, of a participant in the LTCS scheme—see s 9.\n\n","sortOrder":28},{"sectionNumber":"29","sectionType":"section","heading":"Definitions","content":"29 Definitions\nIn this Act:\napproved provider, of a service, means a person—\n(a) approved by the LTCS commissioner to provide the service; or\n(b) who is an approved provider for the Motor Accidents (Lifetime\nCare and Support) Act 2006 (NSW).\nassessed treatment and care needs, of a participant in the LTCS\nscheme, means the treatment and care needs assessed by the LTCS\ncommissioner under section 23 (Assessment of participant’s\ntreatment and care needs).\n","sortOrder":29},{"sectionNumber":"30","sectionType":"section","heading":"Payment of participants assessed treatment and care","content":"30 Payment of participants assessed treatment and care\nneeds\n(1) The LTCS commissioner must pay all the reasonable expenses (if\nany) incurred by or on behalf of an injured person in relation to the\ninjured person’s assessed treatment and care needs while the injured\nperson is a participant in the LTCS scheme.\n(2) Expenses are not payable in relation to—\n(a) excluded treatment and care; or\nNote Excluded treatment and care—see s 9.\n(b) treatment and care that is not assessed treatment and care needs.\nNote Treatment and care needs, of a participant in the LTCS scheme—\nsee s 9.\n\n(3) The LTCS commissioner may pay a participant’s expenses (if any) in\nrelation to the participant’s assessed treatment and care needs—\n(a) when the expenses are incurred; or\n(b) by giving the participant an amount to cover the expenses over\na stated period under—\n(i) a payment agreement with the participant; or\n(ii) a periodic payment agreement with the participant under\nsection 30A; or\n(iii) a lump sum agreement with the participant under\nsection 30B (Lump sum payment—foreign national\nparticipant).\n(4) The LTCS commissioner may only pay a participant’s expenses for\ntreatment and care services that the LTCS commissioner has\napproved, unless the LTCS commissioner agrees otherwise.\n(5) The LTCS guidelines may make provision for determining which of\nan injured person’s treatment and care—\n(a) are reasonable and necessary in the circumstances; and\n(b) relate to the injury in relation to which the person is a participant\nin the LTCS scheme.\n(6) This section is subject to section 31.\n(7) In this section:\npayment agreement, between the LTCS commissioner and a\nparticipant in the LTCS scheme, means an agreement the LTCS\ncommissioner has with the participant for the participant to pay the\nexpenses relating to the participant’s assessed treatment and care\nneeds.\n\n","sortOrder":30},{"sectionNumber":"30A","sectionType":"section","heading":"Periodic payment—overseas participant","content":"30A Periodic payment—overseas participant\n(1) The LTCS commissioner and an overseas participant may agree that\nthe commissioner pay the participant’s expenses under section 30 by\ngiving the participant periodic payments to cover the participant’s\nexpenses while living outside Australia (a periodic payment\nagreement).\n(2) The overseas participant’s expenses payable under section 30 must be\npaid under that section until the participant enters into the periodic\npayment agreement.\n(3) If the overseas participant returns to Australia to live before the end\nof the periodic payment agreement—\n(a) the periodic payment agreement ceases to have effect; and\n(b) section 30 (3) applies in relation to the payment of expenses in\nrelation to the participant’s treatment and care needs; and\n(c) any amount paid for the period remaining on the agreement after\nit ceases to have effect must be repaid to the LTCS\ncommissioner.\n(4) The LTCS guidelines may make provision for determining the\n(a) the period an overseas participant must live outside Australia to\nbe eligible to enter into a periodic payment agreement;\n(b) the total amount and frequency of periodic payments to an\noverseas participant under a periodic payment agreement;\n(c) the calculation of the amount to be repaid under\nsubsection (3) (c).\n\n(5) In this section:\noverseas participant means a participant in the LTCS scheme who—\n(a) is an Australian citizen or a permanent resident of Australia; and\n(b) lives outside Australia; and\n(c) intends to live outside Australia permanently or for an extended\ntime.\n","sortOrder":31},{"sectionNumber":"30B","sectionType":"section","heading":"Lump sum payment—foreign national participant","content":"30B Lump sum payment—foreign national participant\n(1) The LTCS commissioner and a foreign national participant may agree\nthat the commissioner pay the participant’s expenses under section 30\n(Payment of participants assessed treatment and care needs) by giving\nthe participant a lump sum payment to cover the participant’s\nexpenses (a lump sum agreement).\n(2) The foreign national participant’s expenses payable under section 30\nmust be paid under that section until the participant enters into the\nlump sum agreement.\n(3) The LTCS guidelines may make provision for determining the\n(a) the period a foreign national participant must live outside\nAustralia to be eligible to enter into a lump sum agreement;\n(b) the amount of a lump sum payable to a foreign national\nparticipant under a lump sum agreement.\n(4) If a foreign national participant receives a lump sum under a lump\nsum agreement with the LTCS commissioner, the foreign national\nparticipant—\n(a) ceases to be a participant in the LTCS scheme; and\n\n(b) is not eligible for compensation in relation to the participant’s\ntreatment and care needs under—\n(i) for a motor accident injury—the MAI Act; or\n(ii) for a work injury—the Workers Compensation Act 1951.\n(5) In this section:\nforeign national participant means a lifetime participant in the LTCS\nscheme who—\n(a) is a national of a foreign country; and\n(b) lives outside Australia.\n","sortOrder":32},{"sectionNumber":"31","sectionType":"section","heading":"Payment not required in certain circumstances","content":"31 Payment not required in certain circumstances\n(1) The LTCS commissioner is not required to make a payment in\nrelation to the following:\n(a) treatment, care, support or services provided to a participant in\nthe LTCS scheme for which the participant has not paid and is\nnot liable to pay;\nExample\nnursing care provided by a spouse or parent on a gratuitous basis\n(b) any treatment, care, support or services required to be provided\nto a participant by an approved provider but is provided by a\nperson who is not, when the treatment, care, support or services\nis given, an approved provider.\n(2) However, the LTCS commissioner may elect to make a payment in\nrelation to treatment, care, support or services mentioned in\nsubsection (1) if the LTCS commissioner considers that special\ncircumstances exist that justify making the payment.\n(3) The LTCS guidelines may make provision for working out whether\nspecial circumstances exist that justify payment in relation to\ntreatment, care, support or services mentioned in subsection (1).\n\n(4) To remove any doubt, this section applies even if the treatment, care,\nsupport or services mentioned in subsection (1) are provided in\nconnection with the assessed treatment and care needs of the\nparticipant.\n","sortOrder":33},{"sectionNumber":"32","sectionType":"section","heading":"Approved providers","content":"32 Approved providers\n(1) The following treatment, care, support or services (provided as part\nof the assessed treatment and care needs of a participant in the LTCS\nscheme) must be provided by an approved provider of the treatment,\ncare, support or services:\n(a) attendant care services;\n(b) any other treatment, care, support or services (other than the\nservices of a medical practitioner) identified in the LTCS\nguidelines as treatment, care, support or services that must be\nprovided by an approved provider.\n(2) The LTCS guidelines may make provision for the standards of\ncompetency of approved providers.\n\n","sortOrder":34},{"sectionNumber":"33","sectionType":"section","heading":"Definitions—div 7.1","content":"33 Definitions—div 7.1\neligibility assessment panel—see section 35.\neligibility assessor—see section 36.\neligibility review panel—see section 39.\n","sortOrder":35},{"sectionNumber":"34","sectionType":"section","heading":"Dispute about eligibility","content":"34 Dispute about eligibility\n(1) The following people may, by written notice to the LTCS\ncommissioner, dispute whether an injury suffered by an injured\nperson satisfies the criteria stated in this Act and the LTCS guidelines\nfor eligibility to participate in the LTCS scheme:\n(a) the injured person or someone on the injured person’s behalf;\n(b) the insurer for the injured person’s claim.\n(2) The dispute must be referred to an eligibility assessment panel within\n6 months after the date of the LTCS commissioner’s decision under\nsection 19 (LTCS scheme—acceptance as participant) about the\ninjured person’s eligibility to participate in the LTCS scheme.\n\n","sortOrder":36},{"sectionNumber":"35","sectionType":"section","heading":"Eligibility dispute—convening assessment panel","content":"35 Eligibility dispute—convening assessment panel\nIf the LTCS commissioner receives notice of a dispute under\nsection 34 (1), the LTCS commissioner must convene a panel (an\neligibility assessment panel) of 3 eligibility assessors to determine\nthe dispute.\n","sortOrder":37},{"sectionNumber":"36","sectionType":"section","heading":"Eligibility disputes—appointment of eligibility assessors","content":"36 Eligibility disputes—appointment of eligibility assessors\nThe LTCS commissioner may appoint a medical practitioner, or\nanother person the LTCS commissioner considers is suitably\nqualified, to be an assessor (an eligibility assessor) for this division.\n","sortOrder":38},{"sectionNumber":"37","sectionType":"section","heading":"Eligibility dispute—determination by assessment panel","content":"37 Eligibility dispute—determination by assessment panel\n(1) This section applies if an eligibility assessment panel is convened\nunder section 35 to determine a dispute about an injured person’s\neligibility to participate in the LTCS scheme.\n(2) The eligibility assessment panel must—\n(a) either—\n(i) confirm the LTCS commissioner’s decision (the original\ndecision) under section 19 (LTCS scheme—acceptance as\nparticipant); or\n(ii) revoke the original decision and substitute its own\ndecision; and\n(b) give the LTCS commissioner a certificate of its decision in\nrelation to the dispute, setting out the reasons for the decision.\n(3) The LTCS commissioner must give a copy of the eligibility\nassessment panel’s certificate to the injured person within 5 working\ndays after the day the LTCS commissioner receives the certificate.\n(4) The eligibility assessment panel may correct an error in the certificate\n\n","sortOrder":39},{"sectionNumber":"38","sectionType":"section","heading":"Eligibility assessment panel—review of decision","content":"38 Eligibility assessment panel—review of decision\n(1) The following people may apply to the LTCS commissioner for\nreview of a decision by an eligibility assessment panel under\nsection 37:\n(a) the injured person to whom the decision relates, or someone on\nthe injured person’s behalf;\n(b) the insurer for the injured person’s claim;\n(c) the LTCS commissioner.\n(2) An application for review of a decision under section 37 must be\nmade within 6 months after the date the decision was made.\n(3) A decision under section 37 may be reviewed on the following\ngrounds only:\n(a) a change in the injured person’s condition that happened or first\nbecame apparent after the dispute was referred for decision by\nthe eligibility assessment panel and that is capable of having a\nmaterial effect on the decision;\n(b) additional relevant information about the injured person’s injury\nthat was unavailable, or could not reasonably have been\nobtained, before the dispute was referred for decision by the\neligibility assessment panel and that is capable of having a\nmaterial effect on the decision;\n(c) the decision was not made in accordance with the LTCS\nguidelines;\n(d) the decision is demonstrably incorrect in a material respect.\n\n","sortOrder":40},{"sectionNumber":"39","sectionType":"section","heading":"Eligibility review panel","content":"39 Eligibility review panel\n(1) If the LTCS commissioner receives an application under\nsection 38 (1) for review of a decision, the LTCS commissioner must\nconvene a panel (an eligibility review panel) of 3 eligibility assessors\nto review the decision.\n(2) The eligibility review panel may include an eligibility assessor who\nwas on the eligibility assessment panel that made the decision only\nif—\n(a) the LTCS commissioner is satisfied that exceptional\ncircumstances exist that justify the assessor’s inclusion on the\nreview panel; and\n(b) the injured person to whom the application relates consents to\nthe assessor’s inclusion on the review panel.\n(3) The eligibility review panel must—\n(a) review the decision; and\n(b) either—\n(i) confirm the decision; or\n(ii) revoke the decision and substitute its own decision; and\n(c) give the LTCS commissioner and the person who referred the\ndecision for review a certificate of its decision, setting out the\nreasons for the decision.\n(4) The eligibility review panel may correct an error in the certificate that\narises from a clerical mistake or accidental slip or omission.\n\n","sortOrder":41},{"sectionNumber":"40","sectionType":"section","heading":"Decision under this division binding","content":"40 Decision under this division binding\n(1) This section applies to a decision by—\n(a) an eligibility assessment panel about whether an injury satisfies\nthe criteria stated in the LTCS guidelines for eligibility for\nparticipation in the LTCS scheme; or\n(b) if the eligibility assessment panel’s decision is reviewed under\nsection 39—an eligibility review panel about whether an injury\nsatisfies the criteria stated in the LTCS guidelines for eligibility\nfor participation in the LTCS scheme.\n(2) The decision is final and binding for this Act and any court\nproceeding under this Act.\n","sortOrder":42},{"sectionNumber":"41","sectionType":"section","heading":"LTCS commissioner liable for costs of assessment","content":"41 LTCS commissioner liable for costs of assessment\n(1) The LTCS commissioner must pay the costs of a decision and a\nreview of a decision under this division.\ncosts, of a decision or a review of a decision, include the necessary\ncosts and expenses of travel and accommodation to attend a panel for\nthe decision or review incurred by—\n(a) the injured person to whom the decision relates; and\n(b) a parent or other carer accompanying the injured person.\n\n","sortOrder":43},{"sectionNumber":"42","sectionType":"section","heading":"LTCS commissioner not liable for legal costs for decision","content":"42 LTCS commissioner not liable for legal costs for decision\nor review\nprovided to an injured person or an insurer in relation to—\n(a) a decision about a dispute under section 37 (Eligibility dispute—\ndetermination by assessment panel); or\n(b) a review of the panel’s decision by an eligibility review panel\nunder section 39 (Eligibility review panel).\n","sortOrder":44},{"sectionNumber":"43","sectionType":"section","heading":"Procedures for disputes about eligibility—LTCS","content":"43 Procedures for disputes about eligibility—LTCS\nguidelines\n(1) The LTCS guidelines may include provisions about the procedures to\nbe followed in relation to the referral of disputes for decision or\nreview under this division.\n(2) A dispute about eligibility under this division must be decided or\nreviewed in accordance with any procedures in the LTCS guidelines.\n","sortOrder":45},{"sectionNumber":"44","sectionType":"section","heading":"LTCS commissioner monitoring and oversight","content":"44 LTCS commissioner monitoring and oversight\nThe LTCS commissioner may arrange for training and information to\nbe given to eligibility assessors to promote accuracy and consistency\nin relation to decisions and reviews under this division.\n\nDisputes about injuries Division 7.2\n","sortOrder":46},{"sectionNumber":"45","sectionType":"section","heading":"Definitions—div 7.2","content":"45 Definitions—div 7.2\nclaims assessment panel—see section 49 (1).\nclaims assessor means a person appointed as a claims assessor under\nsection 46.\ninterested person—each of the following people is an interested\nperson in relation to an injury that is the subject of a decision by the\nLTCS commissioner:\n(b) the insurer of a claim made by the injured person in relation to\nthe injury;\n(c) if the injured person has a right of action against the nominal\ndefendant—the nominal defendant;\n(d) if the injured person is eligible to make a claim for payment\nagainst the DI fund—the DI fund manager.\nNote 1 Claim for payment—see the Workers Compensation Act 1951,\ns 170.\nNote 2 DI fund and DI fund manager—see the Workers Compensation\nAct 1951, dictionary.\nprincipal claims assessor means a person appointed as a principal\nclaims assessor under section 46.\n","sortOrder":47},{"sectionNumber":"46","sectionType":"section","heading":"Appointment of claims assessors and principal claims","content":"46 Appointment of claims assessors and principal claims\nassessor\nThe LTCS commissioner may appoint a person the LTCS\ncommissioner considers is suitably qualified to be a claims assessor\nor principal claims assessor for this part.\n\n","sortOrder":48},{"sectionNumber":"47","sectionType":"section","heading":"Dispute about injury—application","content":"47 Dispute about injury—application\n(1) An interested person may, by written notice to the LTCS\ncommissioner, dispute the commissioner’s decision about—\n(a) whether an injury is an injury to which this Act applies; or\n(b) for a work injury—whether the injured person is a worker.\nNote 1 Section 6 sets out the injuries to which this Act applies.\nNote 2 Worker—see the dictionary.\n(2) The interested person must give the notice within 6 months after the\nday the decision was made.\n","sortOrder":49},{"sectionNumber":"48","sectionType":"section","heading":"Dispute about injury—referral to principal claims","content":"48 Dispute about injury—referral to principal claims\nassessor\nIf the LTCS commissioner receives notice of a dispute under\nsection 47, the LTCS commissioner must refer the dispute to the\nprincipal claims assessor.\n","sortOrder":50},{"sectionNumber":"49","sectionType":"section","heading":"Dispute about injury—review panel","content":"49 Dispute about injury—review panel\n(1) If a dispute is referred to the principal claims assessor under\nsection 48, the principal claims assessor must convene a panel (the\nclaims assessment panel) of 3 claims assessors.\n(2) The claims assessment panel must—\n(a) determine the dispute; and\n(b) give the LTCS commissioner and interested person a certificate\nof its determination and reasons for the determination.\n(3) The claims assessment panel may correct an error in the certificate\n\nDisputes about injuries Division 7.2\n(4) The claims assessment panel’s determination is final and binding for\nthis Act and any court proceeding under this Act.\n","sortOrder":51},{"sectionNumber":"50","sectionType":"section","heading":"Dispute about injury—reasonable legal costs","content":"50 Dispute about injury—reasonable legal costs\n(1) This section applies if a claims assessment panel determines a dispute\nabout an injury under section 49.\n(2) The panel’s determination must include a determination of the\namount of the reasonable legal costs payable by the injured person for\nlegal services provided to the person in relation to the referral and\ndetermination of the dispute.\n(3) The LTCS commissioner must pay the injured person’s reasonable\nlegal costs.\n(4) No other legal costs are payable by the LTCS commissioner for legal\nservices provided to the injured person in relation to the dispute.\n","sortOrder":52},{"sectionNumber":"51","sectionType":"section","heading":"Dispute about injury—maximum legal costs","content":"51 Dispute about injury—maximum legal costs\n(1) A regulation may prescribe the maximum legal costs for legal\nservices provided to an injured person in relation to the referral and\ndetermination of a dispute under this division.\n(2) A legal practitioner who provided legal services to an injured person\nin relation to a dispute under this division is not entitled to be paid or\nrecover an amount exceeding the maximum legal costs for the\nservices.\nNote Legal practitioner—see the Legislation Act, dictionary, pt 1.\n\n","sortOrder":53},{"sectionNumber":"52","sectionType":"section","heading":"Dispute about injury—legal costs not payable","content":"52 Dispute about injury—legal costs not payable\n(1) This section applies if a legal practitioner provided legal services to\nan injured person in relation to a dispute under this division.\n(2) The legal practitioner is not entitled to recover legal costs for a legal\nservice or matter that a court or costs assessor determines were\nunreasonably incurred.\n","sortOrder":54},{"sectionNumber":"53","sectionType":"section","heading":"Inconsistency between Act and Legal Profession","content":"53 Inconsistency between Act and Legal Profession\nAct 2006\n(1) This division prevails if there is an inconsistency between this section\nand the Legal Profession Act 2006.\nNote A reference to an Act includes a reference to the statutory instruments\n(2) An assessment under the Legal Profession Act 2006 of legal costs that\nare the subject of a regulation under this division must be made in\naccordance with the regulation.\n","sortOrder":55},{"sectionNumber":"Div 7","sectionType":"division","heading":"3 Disputes about treatment and care","content":"Division 7.3 Disputes about treatment and care\nneeds assessments\n","sortOrder":56},{"sectionNumber":"54","sectionType":"section","heading":"Definitions—div 7.3","content":"54 Definitions—div 7.3\ntreatment and care assessor means—\n(a) a person appointed under section 57; or\n(b) a person appointed under the Motor Accidents (Lifetime Care\nand Support) Act 2006 (NSW), section 24 (3) (Dispute about\nauthority’s assessment—determination by assessor).\ntreatment and care review panel—see section 62.\n\n","sortOrder":57},{"sectionNumber":"55","sectionType":"section","heading":"Dispute about LTCS commissioner’s assessment","content":"55 Dispute about LTCS commissioner’s assessment\n(1) A participant in the LTCS scheme may, by written notice to the LTCS\ncommissioner, dispute an assessment, or part of an assessment, made\nin relation to the participant’s treatment and care needs under part 5\n(Treatment and care needs assessment).\n(2) A notice under subsection (1) must be given to the LTCS\ncommissioner within 28 days after the day the LTCS commissioner\ngives the participant a copy of the LTCS commissioner’s certificate\nof assessment under section 23 (5) (Assessment of participant’s\ntreatment and care needs).\n","sortOrder":58},{"sectionNumber":"56","sectionType":"section","heading":"Assessment dispute—referral to assessor","content":"56 Assessment dispute—referral to assessor\nIf the LTCS commissioner receives a notice under section 55 (1), the\nLTCS commissioner must refer the dispute to a treatment and care\nassessor to determine the dispute.\n","sortOrder":59},{"sectionNumber":"57","sectionType":"section","heading":"Appointment of treatment and care assessors","content":"57 Appointment of treatment and care assessors\nThe LTCS commissioner may appoint a health practitioner, or\nanother person the LTCS commissioner considers is suitably\nqualified, to be a treatment and care assessor for this part.\n","sortOrder":60},{"sectionNumber":"58","sectionType":"section","heading":"Treatment and care assessor’s decision—LTCS","content":"58 Treatment and care assessor’s decision—LTCS\nguidelines\n(1) The LTCS guidelines may make provision for determining a dispute\nabout a participant’s treatment and care needs.\n\n(2) The guidelines may include provisions about the following:\n(a) the procedures to be followed by a treatment and care assessor\nfor assessing the dispute and the participant’s treatment and care\nneeds;\n(b) the methods and criteria to be used to determine the dispute.\n(3) A treatment and care assessor must determine a dispute about a\nparticipant’s treatment and care needs in accordance with the LTCS\n","sortOrder":61},{"sectionNumber":"59","sectionType":"section","heading":"Treatment and care assessor—cooperation of participant","content":"59 Treatment and care assessor—cooperation of participant\netc\n(1) A participant in the LTCS scheme and, if the participant has a work\ninjury, the participant’s employer, must comply with any reasonable\nrequest made to the participant by a treatment and care assessor in\nrelation to an assessment of the participant’s treatment and care\nneeds, including a request to undergo a medical or other examination\nby a health practitioner.\nemployer, of a participant in the LTCS scheme with a work injury—\nsee the Workers Compensation Act 1951, section 87 (2).\n","sortOrder":62},{"sectionNumber":"60","sectionType":"section","heading":"Treatment and care assessor’s determination—certificate","content":"60 Treatment and care assessor’s determination—certificate\n(1) This section applies if a treatment and care assessor determines a\ndispute about a participant’s treatment and care needs.\n(2) The treatment and care assessor must give the LTCS commissioner\nand the participant a certificate of the assessor’s determination,\nsetting out the reasons for the findings on which the determination is\nbased.\n\n(3) The treatment and care assessor may correct an error in the certificate\n","sortOrder":63},{"sectionNumber":"61","sectionType":"section","heading":"Treatment and care assessor’s determination—review","content":"61 Treatment and care assessor’s determination—review\n(1) The LTCS commissioner or a participant in the LTCS scheme may\nrefer a determination (the original determination) by a treatment and\ncare assessor about the participant’s treatment and care needs to a\ntreatment and care review panel for review.\n(2) The determination must be referred for review within 28 days after\nthe day the certificate of the determination is given to the LTCS\ncommissioner and the participant under section 60.\n(3) The determination may be referred for review on the following\ngrounds only:\n(a) that additional relevant information about the participant’s\ntreatment and care needs that was unavailable or could not\nreasonably have been obtained when the assessor made the\ndetermination, and that is capable of having a material effect on\nthe determination, has become available;\n(b) the treatment and care assessor’s determination was not made in\naccordance with the LTCS guidelines;\n(c) the treatment and care assessor’s determination is demonstrably\nincorrect in a material respect.\n","sortOrder":64},{"sectionNumber":"62","sectionType":"section","heading":"Review by treatment and care review panel","content":"62 Review by treatment and care review panel\n(1) If a determination (the original determination) by a treatment and\ncare assessor is referred under section 61 to a treatment and care\nreview panel for review, the LTCS commissioner must convene a\npanel (a treatment and care review panel) of 3 treatment and care\nassessors to review the determination.\n(2) The treatment and care review panel must not include the treatment\nand care assessor who made the original determination.\n\n(3) The treatment and care review panel must—\n(a) review the original determination; and\n(b) either—\n(i) confirm the original determination; or\n(ii) revoke the original determination and substitute its own\ndetermination; and\n(c) give the LTCS commissioner and the participant a certificate of\nits determination and reasons for any findings on which the\ndetermination is based.\n(4) The treatment and care review panel may correct an error in the\ncertificate that arises from a clerical mistake or accidental slip or\nomission.\n(5) In conducting its review of the original determination, the treatment\nand care review panel must take into account any written\nsubmissions—\n(a) prepared by or on behalf of the participant; and\n(b) submitted to the panel.\n","sortOrder":65},{"sectionNumber":"63","sectionType":"section","heading":"Review panel procedure—LTCS guidelines","content":"63 Review panel procedure—LTCS guidelines\n(1) The LTCS guidelines may make provision for reviewing a treatment\nand care assessor’s determination under this division.\n(2) The guidelines may include provisions about the following:\n(a) the procedures to be followed by a treatment and care review\npanel in relation to the review;\n(b) the methods and criteria to be used in relation to the review.\n\n(3) A treatment and care review panel must review a treatment and care\nassessor’s determination about a participant’s treatment and care\nneeds in accordance with the LTCS guidelines.\n","sortOrder":66},{"sectionNumber":"64","sectionType":"section","heading":"Assessed treatment and care to be revised","content":"64 Assessed treatment and care to be revised\n(1) This section applies if a treatment and care assessor or review panel\nmakes a determination about a dispute relating to the treatment and\ncare needs of a participant in the LTCS scheme.\n(2) The LTCS commissioner must revise its assessment of the\nparticipant’s treatment and care needs to include the changes that are\nneeded (if any) to give effect to the determination of the assessor or\nreview panel.\n(3) The LTCS commissioner may correct an error in its assessment that\narises from a clerical mistake or accidental slip or omission.\n(4) The LTCS commissioner’s revised assessment of a participant’s\ntreatment and care needs replaces an earlier assessment of those\nneeds.\n","sortOrder":67},{"sectionNumber":"65","sectionType":"section","heading":"LTCS commissioner not liable for legal costs for dispute","content":"65 LTCS commissioner not liable for legal costs for dispute\nor review\nprovided to a participant in the LTCS scheme in relation to—\n(a) a treatment and care assessor’s determination in relation to a\ndispute about the participant’s treatment and care needs; or\n(b) a review of the assessor’s determination by a treatment and care\nreview panel.\n\nPart 8 Communicating with injured person or LTCS participant\nPart 8 Communicating with injured\nperson or LTCS participant\n66 Contacting injured person or LTCS participant\n(1) The LTCS commissioner or an insurer for an injured person’s claim\nmay contact the injured person directly (whether or not the injured\nperson has legal representation) in the following circumstances:\n(a) to give the injured person information about the LTCS scheme,\nincluding how to apply to be a participant in the scheme, the\nexpenses covered by the scheme and information about\ntreatment and care the injured person may receive before the\nperson’s treatment and care needs are assessed;\nNote Treatment and care needs, of a participant in the LTCS scheme—\nsee s 9.\n(b) if the injured person has asked the LTCS commissioner or the\ninsurer for the person’s claim to contact the injured person\ndirectly.\n(2) The LTCS commissioner or an insurer for a participant’s claim may\ncontact the participant directly (whether or not the participant has\nlegal representation) in the following circumstances:\n(a) if the participant has asked the LTCS commissioner or the\ninsurer for the participant’s claim to contact the participant\ndirectly;\n(b) to advise the participant of assessment, treatment and care\nappointments;\n(c) to discuss the participant’s treatment and care needs;\n(d) to discuss a request made under the LTCS scheme in relation to\nthe participant’s treatment and care needs;\n(e) in response to a complaint by the participant.\n\nCommunicating with injured person or LTCS participant Part 8\n(3) The LTCS commissioner may contact the hospital where a participant\nis being cared for to discuss matters relating to the participant’s\ninvolvement in the LTCS scheme.\n","sortOrder":68},{"sectionNumber":"66A","sectionType":"section","heading":"Contacting former LTCS interim participant","content":"66A Contacting former LTCS interim participant\n(1) This section applies to a person (a former participant) who—\n(a) has been an interim participant in the LTCS scheme; and\n(b) because of the level of improvement in the person’s health, is\nnot eligible to be accepted as a lifetime participant.\n(2) The LTCS commissioner may contact the former participant directly\n(whether or not the former participant has legal representation) in\nrelation to treatment or care the former participant received as a\nparticipant in the LTCS scheme, including for the purpose of\nassessing the effectiveness and efficiency of the scheme.\n","sortOrder":69},{"sectionNumber":"67","sectionType":"section","heading":"Contacting participant’s legal representative","content":"67 Contacting participant’s legal representative\n(1) This section applies if the LTCS commissioner or an insurer for a\nparticipant’s claim—\n(a) sends correspondence about the participant to the participant’s\nlawyer; and\n(b) has had no response to the correspondence within 20 days after\nthe date the correspondence was sent; and\n(c) has attempted to confirm that the lawyer received the\ncorrespondence.\n(2) The LTCS commissioner or insurer may contact the participant\ndirectly.\n\n","sortOrder":70},{"sectionNumber":"Part 9","sectionType":"part","heading":"Payments to hospitals, doctors","content":"Part 9 Payments to hospitals, doctors\nand others\n","sortOrder":71},{"sectionNumber":"68","sectionType":"section","heading":"Definitions—pt 9","content":"68 Definitions—pt 9\nIn this part:\nbulk billing arrangements means an arrangement between the LTCS\ncommissioner and the following people for the LTCS commissioner\nto pay expenses at the rate mentioned in the arrangement:\n(a) the Health Minister;\n(b) services providers or others acting on their behalf.\nHealth Minister means the Minister responsible for administering the\nHealth Act 1993.\n","sortOrder":72},{"sectionNumber":"69","sectionType":"section","heading":"Bulk billing arrangements for hospital, ambulance and","content":"69 Bulk billing arrangements for hospital, ambulance and\nother expenses\n(1) The LTCS commissioner may enter into bulk billing arrangements in\nrelation to the following:\n(a) the payment of expenses incurred in relation to the treatment of\nparticipants in the LTCS scheme at hospitals;\n(b) the payment of expenses incurred in transporting participants in\nthe LTCS scheme by ambulance;\n(c) the payment of other expenses incurred in relation to other\ntreatment for participants in the LTCS scheme.\n\nPayments to hospitals, doctors and others Part 9\ntransport, of participants in the LTCS scheme, includes transport of\npeople classified as participants in the scheme under a bulk billing\narrangement.\ntreatment, of participants in the LTCS scheme, includes treatment of\npeople classified as participants in the scheme under a bulk billing\narrangement.\n","sortOrder":73},{"sectionNumber":"70","sectionType":"section","heading":"Payment of hospital, ambulance, medical and other","content":"70 Payment of hospital, ambulance, medical and other\nexpenses not covered by bulk billing arrangement\n(1) This section applies to each payment mentioned in subsection (2) if\npayment for the expenses to which the payment relates—\n(a) has not been made; and\n(b) is not required to be made under a bulk billing arrangement.\n(2) For subsection (1), the payments are the following:\n(a) payment for the treatment of participants in the LTCS scheme at\nhospitals;\n(b) payment for conveying participants in the LTCS scheme by\nambulance;\n(c) payment for any medical or dental treatment of, or rehabilitation\nservices provided to, participants in the LTCS scheme.\n(3) The rate at which a payment mentioned in subsection (2) must be\nmade by the LTCS commissioner is as follows:\n(a) for treatment at a public hospital—the rate determined by the\nMinister for Health;\n(b) for treatment or a service for which a maximum rate is fixed\nunder section 71—the maximum rate fixed under section 71;\n\n(c) in any other case—the rate reasonably appropriate to the\ntreatment or service, having regard to the customary charge\nmade in the community for the treatment or service.\n(4) A determination under subsection (3) (a) is a notifiable instrument.\n(5) If the LTCS commissioner does not make a payment mentioned in\nsubsection (2), the body or person who provided the treatment or\nservice to which the payment relates may recover the payment from\nthe LTCS commissioner as a debt in a court of competent jurisdiction\nor the ACAT.\n","sortOrder":74},{"sectionNumber":"71","sectionType":"section","heading":"Maximum amount payable for certain treatment and","content":"71 Maximum amount payable for certain treatment and\nservices\n(1) This section applies to a payment (a LTCS-related payment) payable\nby the LTCS commissioner for the following treatment or services\ngiven to a participant in the LTCS scheme:\n(a) medical treatment;\n(b) dental treatment;\n(c) rehabilitation services;\n(d) attendant care services.\n(2) This section also applies to the payment payable to a private hospital\nfor any treatment at the hospital.\n(3) However, this section does not apply to a payment for treatment or a\nservice mentioned in subsection (1) if—\n(a) the treatment or service is given to the participant at a public\nhospital (whether as an inpatient or outpatient); and\n(b) the payment is payable to the public hospital, and not the\ntreatment or service provider.\n\nPayments to hospitals, doctors and others Part 9\n(4) The Minister may determine the maximum amount the LTCS\ncommissioner is liable for in relation to a claim for a LTCS-related\npayment.\n(5) A determination under subsection (4) is a disallowable instrument.\n(6) A LTCS-related payment may be determined by reference to—\n(a) fees recommended by the Australian Medical Association or\nother health professional association; or\n(b) a schedule of fees.\n(7) A regulation may prescribe the way in which the LTCS commissioner\nmust pay a LTCS-related payment.\n(8) The LTCS guidelines may make provision for the maximum amount\npayable for LTCS-related payments that are not determined by the\nMinister.\n\n","sortOrder":75},{"sectionNumber":"72","sectionType":"section","heading":"Definitions—div 10.1","content":"72 Definitions—div 10.1\ncontribution period, for which a required fund contribution is\ndetermined—see section 73 (1).\nLTCS fund—see section 74.\nLTCS fund banking account—see section 76 (1).\nLTCS fund investment guidelines—see section 81.\nLTCS levy—see section 84.\nrequired fund contribution for motor accident injuries—see\nsection 83 (1).\nrequired fund contribution for work injuries—see section 83 (2).\nreturns, in relation to an investment—see the Financial Management\nAct 1996, dictionary.\n","sortOrder":76},{"sectionNumber":"73","sectionType":"section","heading":"Meaning of contribution period—div 10.1","content":"73 Meaning of contribution period—div 10.1\n(1) For this division, a contribution period, for which a required fund\ncontribution is determined, in writing, is a financial year or other\nperiod (not longer than 12 months) determined by the LTCS\ncommissioner to be a contribution period for section 83\n(Determination of amounts to be contributed to LTCS fund).\n\n(2) The LTCS commissioner—\n(a) may determine a contribution period that overlaps with another\ncontribution period; but\n(b) must not determine successive contribution periods with gaps\nbetween the periods.\n","sortOrder":77},{"sectionNumber":"74","sectionType":"section","heading":"Lifetime Care and Support Fund","content":"74 Lifetime Care and Support Fund\nThe Lifetime Care and Support Fund (the LTCS fund) is established.\n","sortOrder":78},{"sectionNumber":"75","sectionType":"section","heading":"LTCS fund directorate","content":"75 LTCS fund directorate\nThe Treasurer must, under the Financial Management Act 1996,\ndictionary, definition of directorate, paragraph (b), establish and keep\na directorate for the LTCS fund.\n","sortOrder":79},{"sectionNumber":"76","sectionType":"section","heading":"LTCS fund banking accounts","content":"76 LTCS fund banking accounts\n(1) The director-general must open and keep 1 or more banking accounts\n(an LTCS fund banking account) solely for the management of the\nLTCS fund.\n(2) An LTCS fund banking account is a directorate banking account of\nthe LTCS fund directorate.\n","sortOrder":80},{"sectionNumber":"77","sectionType":"section","heading":"Closure of LTCS fund banking accounts","content":"77 Closure of LTCS fund banking accounts\nIf an LTCS fund banking account is closed, any amount standing to\nthe credit of the account immediately before it is closed must be paid\ninto another LTCS fund banking account.\n\n","sortOrder":81},{"sectionNumber":"78","sectionType":"section","heading":"Appropriation of certain amounts for LTCS fund","content":"78 Appropriation of certain amounts for LTCS fund\nThe following amounts, whether paid before or after the\ncommencement of this Act, are appropriated for the purposes of the\nLTCS fund:\n(a) fund levies paid under this part in relation to the issue of MAI\npolicies;\nNote MAI policy—see the MAI Act, s 286.\n(b) fund levies paid under this part in relation to work injuries;\nNote Section 84B deals with fund levies payable under this part in\nrelation to work injuries.\n(c) amounts paid under this part in relation to a motor accident\ninjury suffered in an accident involving a motor vehicle owned\nby the Territory, or a territory authority, at the time of the\naccident;\n(d) the returns from the investment of the fund;\n(e) money required to be paid into the fund under this Act or any\nother Act;\n(f) all other money received by the LTCS commissioner and not\notherwise appropriated.\n","sortOrder":82},{"sectionNumber":"79","sectionType":"section","heading":"Payments from LTCS fund banking accounts","content":"79 Payments from LTCS fund banking accounts\n(1) The following amounts only are to be paid out of the LTCS fund\nbanking account:\n(a) all payments required to be made by the LTCS commissioner\nunder part 6 (Payments under LTCS scheme);\n(b) the remuneration, allowances, office accommodation and other\nassociated costs of the LTCS commissioner and the\ncommissioner’s staff;\n\n(c) all payments required to meet expenditure incurred in relation to\nthe LTCS commissioner’s functions, if money is not otherwise\nprovided for that purpose;\n(d) all other money required by or under this Act or any other\nterritory law to be paid from the LTCS fund.\n(2) To remove any doubt, a payment required to be made by the LTCS\ncommissioner under part 6 in relation to an injury to which this Act\napplies is paid from the total amount appropriated under section 78\nfor the purposes of the LTCS fund.\n","sortOrder":83},{"sectionNumber":"80","sectionType":"section","heading":"Investment of amounts in LTCS fund banking accounts","content":"80 Investment of amounts in LTCS fund banking accounts\n(1) An amount in an LTCS fund banking account that is not immediately\nneeded for a purpose mentioned in section 79 may be invested—\n(a) by the Treasurer, for the LTCS fund banking account, in an\ninvestment mentioned in the Financial Management Act 1996,\nsection 38 (1) (a) to (e); or\n(b) in any other way prescribed by the LTCS fund investment\n(2) For subsection (1) (a), the investment must be consistent with any\ninvestment prescribed by the LTCS fund investment guidelines.\n(3) Transfers between the territory banking account and LTCS fund\nbanking accounts to facilitate investment may be made without\nappropriation.\n(4) Returns received by the Territory for the investment of amounts from\nan LTCS fund banking account must be paid into an LTCS fund\nbanking account.\n(5) Any fees or expenses reasonably incurred in making or managing an\ninvestment of an amount from an LTCS fund banking account may\nbe deducted from the investment.\n\n(6) Returns that must be paid into an LTCS fund banking account under\nsubsection (4) may be paid into the account directly or through the\nterritory banking account.\n(7) If returns to be paid to an LTCS fund banking account are paid into\nthe territory banking account under subsection (6), the returns may be\npaid to the LTCS fund banking account from the territory banking\naccount without further appropriation.\n","sortOrder":84},{"sectionNumber":"81","sectionType":"section","heading":"LTCS fund investment guidelines","content":"81 LTCS fund investment guidelines\n(1) The Treasurer may make guidelines (the LTCS fund investment\nguidelines) prescribing how an amount in an LTCS banking account\nthat is not immediately needed for a purpose mentioned in section 79\nmay be invested.\n(2) The LTCS fund investment guidelines are a disallowable instrument.\n","sortOrder":85},{"sectionNumber":"82","sectionType":"section","heading":"Returns on amounts of LTCS levy","content":"82 Returns on amounts of LTCS levy\n(1) An LTCS levy is taken to be—\n(a) the amount paid as the levy; and\n(b) any returns received on the investment of the amount, or any\npart of it, under this division.\n(2) Returns received by the Territory on an investment under this division\nof an amount from an LTCS levy must be applied for the purposes for\nwhich the amount invested was appropriated.\n(3) Any fees or expenses reasonably incurred in making or managing an\ninvestment of an amount from an LTCS levy may be deducted from\nthe investment.\n\n","sortOrder":86},{"sectionNumber":"83","sectionType":"section","heading":"Determination of amounts to be contributed to LTCS fund","content":"83 Determination of amounts to be contributed to LTCS fund\n(1) Before the beginning of each contribution period relating to motor\naccident injuries, the LTCS commissioner must determine, in writing,\nthe amount needed to be contributed to the LTCS fund in the\ncontribution period (the required fund contribution for motor\naccident injuries)—\nrelation to people who become participants in the scheme\nbecause of motor accident injuries suffered during the\ncontribution period (other than people in relation to whom\nsection 83A applies); and\nthan payments under part 6) during the contribution period; and\n(2) Before the beginning of each contribution period relating to work\ninjuries, the LTCS commissioner must determine, in writing, the\namount needed to be contributed to the LTCS fund in the contribution\nperiod (the required fund contribution for work injuries)—\nrelation to people who become participants in the scheme\nbecause of work injuries suffered during the contribution period;\nand\nthan payments under part 6) during the contribution period; and\n\n(3) The amount needed to fully fund the present and likely future liability\nof the LTCS commissioner under part 6 is an amount sufficient to\nprovide an amount of money that together with anticipated\ninvestment income is equal to the best estimate of the cost of meeting\nthe liability (in inflated dollars) when the liability becomes payable.\n(4) The LTCS commissioner’s determination of the required fund\ncontribution for motor accident injuries or work injuries for a\ncontribution period must be made in accordance with the report of an\nindependent actuary.\n","sortOrder":87},{"sectionNumber":"83A","sectionType":"section","heading":"Determination of amount to be contributed to LTCS","content":"83A Determination of amount to be contributed to LTCS\nfund—motor accidents involving ACT government-owned\nvehicles\n(1) This section applies if—\n(a) a person is catastrophically injured in a motor accident involving\na motor vehicle owned by the Territory, or a territory authority,\nat the time of the accident; and\n(b) an MAI policy was not in force for the motor vehicle at the time\nof the motor accident; and\n(c) as a consequence of the injuries suffered in the motor accident,\nthe person becomes a participant in the LTCS scheme.\n\n(2) The LTCS commissioner must determine, in writing, the amount\nACTIA needs to contribute (the required fund contribution)—\nrelation to the injuries suffered by the person; and\nthan payments under part 6) in relation to the person; and\nNote 1 Power to make the determination includes power to make different\nNote 2 ACTIA—see the dictionary.\n(3) The amount needed to fully fund the present and likely future liability\nof the LTCS commissioner under part 6 in relation to the injuries\nsuffered by the person is an amount sufficient to provide an amount\nof money that together with anticipated investment income is equal\nto the best estimate of the cost of meeting the liability (in inflated\ndollars) when the liability comes payable.\n(4) The LTCS commissioner’s determination of the required fund\ncontribution for the injuries suffered by the person must be made in\naccordance with—\n(a) the report of an independent actuary; and\n(b) if the motor accident involved more than 1 motor vehicle—the\ncommissioner’s apportionment of liability attributed to the\nmotor vehicle owned by the Territory or territory authority; and\n\n(c) the LTCS guidelines for determining the required fund\ncontribution.\n","sortOrder":88},{"sectionNumber":"83B","sectionType":"section","heading":"Contributions to fund by ACTIA","content":"83B Contributions to fund by ACTIA\n(1) ACTIA must make the required fund contribution determined for a\nperson under section 83A by lump sum payment to the LTCS\ncommissioner.\nNote ACTIA—see the dictionary.\n(2) If the person is not accepted as a lifetime participant in the LTCS\nscheme, the LTCS commissioner must refund to ACTIA the part of\nthe lump sum paid under subsection (1) that is not needed as a result\nof the person not being accepted as a lifetime participant.\n(3) The LTCS guidelines may make provision for the following:\n(a) the resolution of disputes between ACTIA and the LTCS\ncommissioner about the amount to be paid under subsection (1);\n(b) the calculation of the amount to be refunded under\nsubsection (2);\n(c) the application of returns received on the investment of lump\nsums received under this section, including in relation to fees\nthat may be charged, or deductions that may be made, for\nmaking or managing the investment of a lump sum.\n\n","sortOrder":89},{"sectionNumber":"84","sectionType":"section","heading":"Determination of LTCS levy","content":"84 Determination of LTCS levy\n(1) The LTCS commissioner must determine a levy (a LTCS levy) for\neach of the following:\n(a) the contribution period for which a required fund contribution is\ndetermined in relation to motor accident injuries (other than\ninjuries suffered by people in relation to whom section 83A\napplies);\n(b) the contribution period for which a required fund contribution is\ndetermined in relation to work injuries.\n(2) A determination is a notifiable instrument.\n(3) For subsection (1), each LTCS levy must be an amount that the LTCS\ncommissioner reasonably believes will result in the required fund\ncontribution for the contribution period being contributed to the fund.\n","sortOrder":90},{"sectionNumber":"84A","sectionType":"section","heading":"Determination of LTCS levy—motor accident injuries","content":"84A Determination of LTCS levy—motor accident injuries\n(1) The LTCS commissioner may determine a LTCS levy relating to\nmotor accident injuries for a contribution period as any of the\n(a) a fixed amount;\n(b) a percentage of the premium payable for an MAI policy;\n(c) a combination of a fixed amount and percentage of the premium\npayable for an MAI policy.\n\n(2) A LTCS levy may be determined to differ according to any\nclassification or other criteria for the determination of premiums for\nMAI policies as provided for by the MAI guidelines.\nNote 1 Power to make a statutory instrument in relation to a matter includes\npower to make a provision in relation to a class of matter (see Legislation\nAct, s 48 (2)).\nNote 2 MAI guidelines—see the MAI Act, dictionary.\nMAI policy—see the MAI Act, s 286.\n","sortOrder":91},{"sectionNumber":"84B","sectionType":"section","heading":"Determination of LTCS levy—work injuries","content":"84B Determination of LTCS levy—work injuries\n(1) The LTCS commissioner may determine a LTCS levy relating to\nwork injuries for a contribution period payable by a workers\ncompensation insurer or licensed self-insurer as any of the following:\n(a) a fixed amount;\n(b) a percentage of—\n(i) for a workers compensation insurer—the gross written\npremiums for the insurer; and\n(ii) for a licensed self-insurer—the notional gross written\npremium for the licensed self-insurer;\n(c) a combination of a fixed amount and percentage of the gross or\nnotional gross written premiums.\n(2) The LTCS guidelines may make provision in relation to the\nmethodology for apportionment to be used for determining a LTCS\nlevy relating to work injuries for a contribution period.\n\n(3) A LTCS levy relating to work injuries determined for a contribution\nperiod may differ according to any classification or other criteria for\nthe determination of premiums for workers compensation policies as\nprovided for by the Workers Compensation Act 1951.\nNote 1 A reference to an Act includes a reference to the statutory instruments\nNote 2 Power to make a statutory instrument in relation to a matter includes\npower to make provision in relation to a class of matter (see\nLegislation Act, s 48 (2)).\nNote 3 Gross written premiums, notional gross written premium and licensed\nself-insurer—see the Workers Compensation Act 1951, dictionary.\nNote 4 Workers compensation insurer—see the dictionary.\n","sortOrder":92},{"sectionNumber":"84C","sectionType":"section","heading":"Notice of LTCS levy—work injuries","content":"84C Notice of LTCS levy—work injuries\n(1) If the LTCS commissioner determines a LTCS levy under\nsection 84B, the commissioner must give each workers compensation\ninsurer and licensed self-insurer a written notice—\n(a) setting out the details of the levy; and\n(b) requiring the workers compensation insurer or licensed\nself-insurer to pay the amount of the levy payable by the workers\ncompensation insurer or licensed self-insurer within the time\nstated in the notice.\n(2) If no time for payment is stated in the notice, payment must be made\nnot later than 30 days after the day the workers compensation insurer\nor licensed self-insurer receives the notice.\n\n(3) If a workers compensation insurer or licensed self-insurer does not\npay the levy payable by the insurer or licensed self-insurer within the\ntime required under the notice given to the insurer or licensed\nself-insurer, or within the time required under subsection (2), the\namount of the levy is a debt owing to the Territory by the insurer or\nlicensed self-insurer.\nNote An amount owing under a law may be recovered as a debt in a court of\ncompetent jurisdiction or the ACAT (see Legislation Act, s 177).\n(4) The LTCS commissioner may amend or revoke a notice given under\nthis section.\n","sortOrder":93},{"sectionNumber":"85","sectionType":"section","heading":"Contributions to fund by MAI policy holders","content":"85 Contributions to fund by MAI policy holders\nThe required fund contribution for a contribution period must be\nmade by payment to the LTCS commissioner of the LTCS levy by\neach person to whom an MAI policy is issued during the contribution\nperiod.\n","sortOrder":94},{"sectionNumber":"86","sectionType":"section","heading":"Cancellation of LTCS levy","content":"86 Cancellation of LTCS levy\nThe MAI Act, part 6.6 (Cancellation of MAI policies) applies in\nrelation to an LTCS levy payable in relation to the issue of an MAI\npolicy in the same way it applies to the premium payable for the MAI\npolicy.\n","sortOrder":95},{"sectionNumber":"87","sectionType":"section","heading":"Refund of LTCS levy","content":"87 Refund of LTCS levy\n(1) This section applies if an MAI policy issued to a person is cancelled\non the cancellation of the registration of the motor vehicle to which\nthe policy relates.\n(2) The LTCS commissioner must refund to the person, on a\nproportionate basis, the LTCS levy paid in relation to the MAI policy.\n\nRecovery of lifetime care and support payments Division 10.2\n","sortOrder":96},{"sectionNumber":"Div 10","sectionType":"division","heading":"2 Recovery of lifetime care and support","content":"Division 10.2 Recovery of lifetime care and support\npayments\n","sortOrder":97},{"sectionNumber":"88","sectionType":"section","heading":"Meaning of present value of treatment and care","content":"88 Meaning of present value of treatment and care\nliabilities—div 10.2\npresent value of the LTCS commissioner’s treatment and care\nliabilities, in relation to a participant in the LTCS scheme, is worked\nout as follows:\nA + B\nA means the amount paid by the LTCS commissioner under part 6\n(Payments under LTCS scheme) in relation to the participant’s\ntreatment and care needs associated with the participant’s injury.\nB means the present value of the amounts the LTCS commissioner\nestimates will become payable by the LTCS commissioner in the\nfuture under part 6 in relation to the participant’s treatment and care\nneeds associated with participant’s injury.\n","sortOrder":98},{"sectionNumber":"89","sectionType":"section","heading":"Recovery of LTCS payments—entitlement","content":"89 Recovery of LTCS payments—entitlement\n(1) The LTCS commissioner is entitled to recover from the appropriate\nperson the present value of its treatment and care liabilities in relation\nto a motor accident injury suffered by a participant in the LTCS\nscheme if the injury is an injury to which the MAI Act, chapter 5\n(Motor accident injuries—common law damages) applies.\nNote MAI Act—see the dictionary.\n(2) However, if the participant’s injury was the result partly of the\nparticipant’s contributory negligence, the amount the LTCS\ncommissioner is entitled to recover under this division is reduced in\nproportion to the participant’s share in the responsibility for the\ninjury.\n\nappropriate person, from whom the LTCS commissioner is entitled\nto recover, means—\n(a) if the motor vehicle was at the time of the motor accident subject\nto coverage under a policy of compulsory third-party personal\ninjury insurance or a compulsory motor vehicle accident\ncompensation scheme under the law of a place other than the\nACT or under a law of the Commonwealth—the insurer of that\npolicy or the person liable under that scheme; or\n(b) in any other case—the responsible person for the motor vehicle\nat the time of the accident, or the driver of the vehicle, or both.\n","sortOrder":99},{"sectionNumber":"90","sectionType":"section","heading":"Recovery of LTCS payments from responsible person or","content":"90 Recovery of LTCS payments from responsible person or\ndriver\n(1) This section applies if the motor accident injury of a participant in the\nLTCS scheme is caused by a motor accident involving an uninsured\nmotor vehicle.\nNote Uninsured motor vehicle—see the MAI Act, s 325.\n(2) This section does not apply if, when the motor accident happened—\n(a) an unregistered vehicle permit was in force for the uninsured\nmotor vehicle; or\n(b) the registration provisions did not apply to the uninsured motor\nvehicle because of the Road Transport (Vehicle Registration)\nRegulation 2000, part 2.2 (Vehicles not subject to registration\nprovisions); or\n(c) the uninsured motor vehicle was exempted from the operation\nof the MAI Act, section 289 (Offence—use uninsured motor\nvehicle on road or road related area) by regulation.\n\nRecovery of lifetime care and support payments Division 10.2\n(3) The LTCS commissioner may recover as a debt from the responsible\nperson for the uninsured motor vehicle, or the driver of the uninsured\nmotor vehicle, or both, the present value of its treatment and care\nliabilities in relation to the participant’s motor accident injury.\n(4) It is a defence to a proceeding under this section against the\nresponsible person for the uninsured motor vehicle if the responsible\nperson proves that—\n(a) the motor vehicle was driven without the authority of the\nresponsible person; or\n(b) the responsible person believed on reasonable grounds that the\nmotor vehicle was insured.\n(5) It is a defence to a proceeding under this section against the driver of\nthe uninsured motor vehicle if the driver proves that the driver\nbelieved on reasonable grounds that—\n(a) the driver had the responsible person’s consent to drive the\nmotor vehicle; and\n(b) the motor vehicle was insured.\n","sortOrder":100},{"sectionNumber":"90A","sectionType":"section","heading":"Recovery of LTCS payments from uninsured employer","content":"90A Recovery of LTCS payments from uninsured employer\n(1) This section applies if—\n(a) a participant in the LTCS scheme has a work injury; and\n(b) when the work injury happened, the participant’s employer was\nuninsured.\n(2) The LTCS commissioner may recover as a debt from the employer\nthe present value of the commissioner’s treatment and care liabilities\nin relation to the participant’s work injury.\n\nemployer does not include a licensed self-insurer.\nuninsured—an employer of a participant with a work injury is\nuninsured if the employer does not have a compulsory insurance\npolicy that applies to the participant in relation to the participant’s\nwork injury.\nNote Compulsory insurance policy—see the Workers Compensation\nAct 1951, s 144.\nLicensed self-insurer—see the Workers Compensation Act 1951,\ndictionary.\n","sortOrder":101},{"sectionNumber":"91","sectionType":"section","heading":"Recovery of LTCS payments from other person","content":"91 Recovery of LTCS payments from other person\n(1) This section applies if the motor accident injury of a participant in the\nLTCS scheme was caused by the fault of someone other than the\nresponsible person for a motor vehicle involved in the motor accident\nor a driver of the vehicle.\n(2) The LTCS commissioner may recover as a debt from the person a\nproportion of the present value of its treatment and care liabilities in\nrelation to the participant’s injury as corresponds to the person’s share\nin the responsibility for the injury.\n","sortOrder":102},{"sectionNumber":"92","sectionType":"section","heading":"Recovery of LTCS payments—evidentiary certificate","content":"92 Recovery of LTCS payments—evidentiary certificate\n(1) This section applies to a court proceeding under this division.\n(2) A certificate that appears to be signed by or on behalf of the LTCS\ncommissioner and states any matter relevant to the present value of\nthe LTCS commissioner’s treatment and care liabilities in relation to\na motor accident injury of a participant in the LTCS scheme is\nevidence of the matter.\n\nMiscellaneous Part 11\n","sortOrder":103},{"sectionNumber":"93","sectionType":"section","heading":"LTCS guidelines","content":"93 LTCS guidelines\n(1) The LTCS commissioner may make LTCS guidelines about any\nmatter required or permitted by this Act to be included in the\n(2) The LTCS guidelines may make provision in relation to any matter\nrequired or permitted by this Act.\n(3) The LTCS guidelines may apply, adopt or incorporate an instrument,\nas in force from time to time.\nNote A reference to an instrument includes a reference to a provision of an\ninstrument (see Legislation Act, s 14 (2)).\n(4) The Legislation Act, section 47 (5) and (6) does not apply to an\ninstrument mentioned in subsection (3).\nNote An instrument applied, adopted or incorporated by the LTCS guidelines\ndoes not need to be notified under the Legislation Act because s 47 (6)\ndoes not apply (see Legislation Act, s 47 (7)).\n(5) An LTCS guideline is a disallowable instrument.\n","sortOrder":104},{"sectionNumber":"94","sectionType":"section","heading":"Exchange of information","content":"94 Exchange of information\n(1) The LTCS commissioner may exchange information about the\ntreatment and care needs of a participant in the LTCS scheme with\nthe following people:\n(a) a licensed insurer within the meaning of the MAI Act;\n(b) a workers compensation insurer;\n(c) the DI Fund;\nNote DI Fund—see the Workers Compensation Act 1951, dictionary.\n(d) a hospital where the participant receives treatment and care for\nthe participant’s injury;\n\n(e) the NSW LCS authority;\n(f) the MAI commission;\n(g) the nominal defendant;\n(h) a person approved in writing by the LTCS commissioner.\n(2) If a participant in the LTCS scheme has a work injury, the LTCS\ncommissioner may exchange information about the participant’s\ntreatment and care needs with the participant’s employer only if the\ninformation relates to the employer’s obligations under—\n(a) the LTCS commissioner’s assessment of the participant’s\ntreatment and care needs under section 23 (Assessment of\nparticipant’s treatment and care needs); or\n(b) the Workers Compensation Act 1951.\n(3) The exchange of information under this section must be in accordance\nwith the LTCS guidelines.\n(4) In this section:\ninformation, about the treatment and care needs of a participant in\nthe LTCS scheme, includes—\n(a) information used to make an assessment under section 23 about\nthe participant’s treatment and care needs; and\n(b) the expenses paid or payable by the LTCS commissioner under\nthe scheme in relation to the treatment and care.\n","sortOrder":105},{"sectionNumber":"95","sectionType":"section","heading":"Protection of assessors from liability","content":"95 Protection of assessors from liability\n(1) An assessor is not civilly liable for conduct engaged in honestly and\nwithout recklessness—\n(a) in the exercise of a function under this Act; or\n\nMiscellaneous Part 11\n(b) in the reasonable belief that the conduct was in the exercise of a\nfunction under this Act.\n(2) An assessor is, in any legal proceeding, competent but not\ncompellable to give evidence or produce documents in relation to any\nmatter in which the assessor was involved in the course of exercising\nthe assessor’s functions.\n(3) Any civil liability that would, apart from this section, attach to the\nassessor attaches instead to the Territory.\n(4) In this section:\nassessor means the following:\n(a) a claims assessor;\n(b) a principal claims assessor;\n(c) an eligibility assessor;\n(d) a treatment and care assessor.\n","sortOrder":106},{"sectionNumber":"96","sectionType":"section","heading":"Disapplication of Civil Law (Wrongs) Act 2002","content":"96 Disapplication of Civil Law (Wrongs) Act 2002\nThe Civil Law (Wrongs) Act 2002 does not apply in relation to the\nLTCS scheme.\n","sortOrder":107},{"sectionNumber":"97","sectionType":"section","heading":"Determination of fees","content":"97 Determination of fees\n(1) The Minister may determine fees for this Act.\n(2) A determination is a disallowable instrument.\n","sortOrder":108},{"sectionNumber":"98","sectionType":"section","heading":"Approved forms","content":"98 Approved forms\n(1) The LTCS commissioner may approve forms for this Act.\n(2) If the LTCS commissioner approves a form for a particular purpose,\nthe approved form must be used for that purpose.\n(3) An approved form is a notifiable instrument.\n\n","sortOrder":109},{"sectionNumber":"99","sectionType":"section","heading":"Regulation-making power","content":"99 Regulation-making power\n(1) The Executive may make regulations for this Act.\n(2) A regulation may create offences and fix maximum penalties of not\nmore than 20 penalty units for the offences.\nNote A reference to an Act includes a reference to the statutory instruments\n\n(see s 3)\nNote 1 The Legislation Act contains definitions and other provisions relevant to\nthis Act.\nNote 2 For example, the Legislation Act, dict, pt 1, defines the following terms:\n• corporation\n• disallowable instrument (see s 9)\n• financial year\n• health practitioner\n• legal practitioner\n• notifiable instrument (see s 10)\n• person (see s 160)\n• public employee\n• territory authority\n• under.\nNote 3 The Motor Accident Injuries Act 2019 contains definitions relevant to this\nAct. For example, the following terms are defined in the Motor Accident\nInjuries Act 2019, dictionary:\n• MAI commission\n• MAI commissioner\n• MAI guidelines\n• MAI insured person (see s 286)\n• MAI insurer (see s 287)\n• MAI policy (see s 286)\n• MAI premium (see s 314)\n• motor accident (see s 10)\n• motor accident claim (see s 228)\n• nominal defendant (see s 16)\n• personal injury (see s 9)\n• uninsured motor vehicle (see s 325)\n\nNote 4 The Workers Compensation Act 1951 contains definitions relevant to this\nAct. For example, the following terms are defined in the Workers\nCompensation Act 1951, dictionary:\n• claim for payment\n• compulsory insurance policy (see s 144)\n• DI fund\n• DI fund manager\n• gross written premiums\n• licensed self-insurer\n• notional gross written premium\n• professional sporting activity\n• Territory or State of connection (see s 36A)\n• worker.\nACTIA means the Australian Capital Territory Insurance Authority\nestablished under the Insurance Authority Act 2005.\napproved provider, of a service—see section 29.\nassessed treatment and care needs, of a participant in the LTCS\nscheme—see section 29.\nattendant care services, for a person who is a participant in the LTCS\nscheme, means services that aim to give the person assistance with\neveryday tasks.\nExamples\n• personal assistance\n• nursing\n• home maintenance\n• domestic services\nbulk billing arrangements, for part 9 (Payments to hospitals, doctors\nand others)—see section 68.\n\nclaim, in relation to an injury, means—\n(a) for a motor accident injury—a motor accident claim; or\n(b) for a work injury—a workers compensation claim.\nNote Motor accident claim, for a motor accident—see the MAI Act, s 228.\nclaims assessment panel, for division 7.2 (Disputes about injuries)—\nsee section 49 (1).\nclaims assessor, for division 7.2 (Disputes about injuries)—see\nsection 45.\ncontribution period for which a required fund contribution is\ndetermined, for division 10.1 (Funding the LTCS scheme)—see\nsection 73 (1).\neligibility assessment panel, for division 7.1 (Disputes about\neligibility)—see section 35.\neligibility assessor, for division 7.1 (Disputes about eligibility)—see\nsection 36.\neligibility criteria, for participation in the LTCS scheme, means the\ncriteria stated in the LTCS guidelines for eligibility to participate in\nthe LTCS scheme.\neligibility review panel, for division 7.1 (Disputes about eligibility)—\nsee section 39.\nexcluded treatment and care—see section 9.\nHealth Minister, for part 9 (Payments to hospitals, doctors and\nothers)—see section 68.\ninjured person—see section 15 (1).\ninjury means an injury to which this Act applies.\nNote Section 6 sets out the injuries to which this Act applies.\n\ninsurer, for an injured person’s claim, means—\n(a) if the injured person has a motor accident injury—an MAI\ninsurer; or\n(b) if the injured person has a work injury—a workers\ncompensation insurer or licensed self-insurer.\ninterested person, for division 7.2 (Disputes about injuries)—see\nsection 45.\ninterim participation, in the LTCS scheme, means a person accepted\nas an interim participant in the LTCS scheme under section 20.\nlegal costs—see the Legal Profession Act 2006, dictionary.\nlegal services—see the Legal Profession Act 2006, dictionary.\nlifetime participant, in the LTCS scheme, means a person accepted\nas a lifetime participant in the LTCS scheme under section 21.\nLTCS commissioner means the Lifetime Care and Support\ncommissioner appointed under section 10.\nLTCS fund, for division 10.1 (Funding the LTCS scheme)—see\nsection 74.\nLTCS fund banking account, for division 10.1 (Funding the LTCS\nscheme)—see section 76 (1).\nLTCS fund investment guidelines, for division 10.1 (Funding the\nLTCS scheme)—see section 81.\nLTCS guidelines means guidelines made by the LTCS commissioner\nunder section 93.\nLTCS levy, for division 10.1 (Funding the LTCS scheme)—see\nsection 84.\n\nLTCS scheme means the scheme provided for by this Act for the\nlifetime care and support of people who have suffered a catastrophic\ninjury—\n(a) in a motor accident; or\n(b) arising out of, or in the course of, their employment.\nMAI Act means the Motor Accident Injuries Act 2019.\nmotor accident injury, in relation to a person, means an injury the\nperson has as a result of a motor accident.\nNSW LCS authority means the Lifetime Care and Support Authority\nof New South Wales, constituted under the Motor Accidents (Lifetime\nCare and Support) Act 2006 (NSW), section 33.\nparticipant, in the LTCS scheme, means a person accepted as an\ninterim or lifetime participant in the scheme under section 19.\npresent value of the LTCS commissioner’s treatment and care\nliabilities, for division 10.2 (Recovery of lifetime care and support\npayments)—see section 88.\nprincipal claims assessor, for division 7.2 (Disputes about\ninjuries)—see section 45.\nrequired fund contribution for motor accident injuries, for\ndivision 10.1 (Funding the LTCS scheme)—see section 83 (1).\nrequired fund contribution for work injuries, for division 10.1\n(Funding the LTCS scheme)—see section 83 (2).\nreturns, in relation to an investment, for division 10.1 (Funding the\nLTCS scheme)—see section 72.\ntreatment and care assessor, for division 7.3 (Disputes about\ntreatment and care needs assessments)—see section 54.\ntreatment and care needs, of a participant in the LTCS scheme—see\nsection 9.\n\ntreatment and care needs assessment means an assessment under\npart 5 (Treatment and care needs assessment) of the treatment and\ncare needs of a participant in relation to the participant’s motor\naccident injury.\ntreatment and care review panel, for division 7.3 (Disputes about\ntreatment and care needs assessments)—see section 62.\nworker, in relation to a work injury—see the Workers Compensation\nAct 1951, chapter 3 (Meaning of worker).\nworkers compensation claim means a claim for compensation for a\nwork injury under the Workers Compensation Act 1951.\nworkers compensation insurer, in relation to a workers\ncompensation claim, means a licensed insurer within the meaning of\nthe Workers Compensation Act 1951.\nwork injury means an injury to a worker arising out of, or in the\ncourse of, the worker’s employment.\n\nAbout the endnotes 1\n1 About the endnotes\nAmending and modifying laws are annotated in the legislation history and the\namendment history. Current modifications are not included in the republished law\nbut are set out in the endnotes.\nNot all editorial amendments made under the Legislation Act 2001, part 11.3 are\nannotated in the amendment history. Full details of any amendments can be\nobtained from the Parliamentary Counsel’s Office.\nUncommenced amending laws are not included in the republished law. The details\nof these laws are underlined in the legislation history. Uncommenced expiries are\nunderlined in the legislation history and amendment history.\nIf all the provisions of the law have been renumbered, a table of renumbered\nprovisions gives details of previous and current numbering.\nThe endnotes also include a table of earlier republications.\n","sortOrder":110},{"sectionNumber":"2","sectionType":"section","heading":"Abbreviation key","content":"2 Abbreviation key\nA = Act NI = Notifiable instrument\nAF = Approved form o = order\nam = amended om = omitted/repealed\namdt = amendment ord = ordinance\nAR = Assembly resolution orig = original\nch = chapter par = paragraph/subparagraph\nCN = Commencement notice pres = present\ndef = definition prev = previous\nDI = Disallowable instrument (prev...) = previously\ndict = dictionary pt = part\ndisallowed = disallowed by the Legislative r = rule/subrule\nAssembly reloc = relocated\ndiv = division renum = renumbered\nexp = expires/expired R[X] = Republication No\nGaz = gazette RI = reissue\nhdg = heading s = section/subsection\nIA = Interpretation Act 1967 sch = schedule\nins = inserted/added sdiv = subdivision\nLA = Legislation Act 2001 SL = Subordinate law\nLR = legislation register sub = substituted\nLRA = Legislation (Republication) Act 1996 underlining = whole or part not commenced\nmod = modified/modification or to be expired\n\n3 Legislation history\n3 Legislation history\nLifetime Care and Support (Catastrophic Injuries) Act 2014 A2014-11\nnotified LR 17 April 2014\ns 1, s 2 commenced 17 April 2014 (LA s 75 (1))\nremainder commenced 1 July 2014 (s 2)\nas amended by\nStatute Law Amendment Act 2014 (No 2) A2014-44 sch 1 pt 1.2\nnotified LR 5 November 2014\ns 1, s 2 commenced 5 November 2014 (LA s 75 (1))\nsch 1 pt 1.2 commenced 19 November 2014 (s 2)\nLifetime Care and Support (Catastrophic Injuries) Amendment Act\n","sortOrder":111},{"sectionNumber":"2016","sectionType":"section","heading":"A2016-25","content":"2016 A2016-25\nnotified LR 12 May 2016\ns 1, s 2 commenced 12 May 2016 (LA s 75 (1))\nremainder commenced 13 May 2016 (s 2)\nLifetime Care and Support (Catastrophic Injuries) Amendment\nAct 2016 (No 2) A2016-35\nnotified LR 21 June 2016\ns 1, s 2 commenced 21 June 2016 (LA s 75 (1))\nremainder commenced 22 June 2016 (LA s 73 (1) (a) and see\nLA s 75B (1))\nPublic Sector Management Amendment Act 2016 A2016-52 sch 1\npt 1.48\nnotified LR 25 August 2016\ns 1, s 2 commenced 25 August 2016 (LA s 75 (1))\nsch 1 pt 1.48 commenced 1 September 2016 (s 2)\nStatute Law Amendment Act 2017 A2017-4 sch 1 pt 1.3\nnotified LR 23 February 2017\ns 1, s 2 commenced 23 February 2017 (LA s 75 (1))\nsch 1 pt 1.3 commenced 9 March 2017 (s 2)\n\nLegislation history 3\nStatute Law Amendment Act 2017 (No 2) A2017-28 sch 3 pt 3.8\nnotified LR 27 September 2017\ns 1, s 2 commenced 27 September 2017 (LA s 75 (1))\nsch 3 pt 3.8 commenced 11 October 2017 (s 2)\nMotor Accident Injuries Act 2019 A2019-12 sch 3 pt 3.5\nnotified LR 31 May 2019\ns 1, s 2 commenced 31 May 2019 (LA s 75 (1))\nsch 3 pt 3.5 commenced 1 February 2020 (s 2 (1) and CN2019-13)\nStatute Law Amendment Act 2019 A2019-42 sch 1 pt 1.3\nnotified LR 31 October 2019\ns 1, s 2 commenced 31 October 2019 (LA s 75 (1))\nsch 1 pt 1.3 commenced 14 November 2019 (s 2 (1))\nEmployment and Workplace Safety Legislation Amendment Act 2020\nA2020-30 sch 1 pt 1.2 (as am by A2020-42 s 70)\nnotified LR 9 July 2020\ns 1, s 2 commenced 9 July 2020 (LA s 75 (1))\nsch 1 pt 1.2 commenced 9 January 2021 (s 2 (2) (as am by A2020-42\ns 70) and LA s 79)\nJustice Legislation Amendment Act 2020 A2020-42 s 70\nnotified LR 27 August 2020\ns 1, s 2 commenced 27 August 2020 (LA s 75 (1))\ns 70 commenced 28 August 2020 (s 2 (9))\nNote This Act only amends the Employment and Workplace Safety\nLegislation Amendment Act 2020 A2020-30.\nStatute Law Amendment Act 2025 A2025-29 sch 4 pt 4.114\nnotified LR 6 November 2025\ns 1, s 2 commenced 6 November 2025 (LA s 75 (1))\nsch 4 pt 4.114 commenced 26 December 2025 (s 2 (7))\n\nCommencement\ns 2 om LA s 89 (4)\nApplication of Act\ns 6 am A2014-44 amdt 1.2; pars renum R2 LA\nsub A2016-25 s 6\nam A2016-35 s 4, s 5; pars renum R4 LA; A2019-12\namdt 3.39, amdt 3.40\nPurpose of Act\ns 7 am A2016-25 s 5\nTerms used in other Acts\ns 8 hdg sub A2016-25 s 6\ns 8 am A2016-25 s 7; A2019-12 amdt 3.41, amdt 3.42\nFunctions of LTCS commissioner\ns 11 am A2016-25 s 8, s 9\nLTCS commissioner’s staff\ns 13 sub A2016-52 amdt 1.132\nParticipation in LTCS scheme—eligibility\ns 15 am A2016-25 ss 10-16; ss renum R3 LA\nLTCS scheme—initial application to participate\ns 16 am A2016-25 ss 17-22; A2019-12 amdts 3.43-3.45; A2025-29\namdt 4.114\nLTCS scheme—authorisation for LTCS commissioner to obtain information\ns 17 am A2016-25 s 23\nLTCS scheme—interim participation\ns 20 am A2016-25 s 23\nLTCS scheme—application for lifetime participation\ns 21 am A2016-25 s 23, s 24; A2025-29 amdt 4.114\nEffect of LTCS scheme on motor accident claims etc\ns 22 hdg sub A2016-25 s 25\ns 22 am A2019-12 amdts 3.46-3.48\nEffect of LTCS scheme on workers compensation claims etc\ns 22A ins A2016-25 s 26\nAssessment of participant’s treatment and care needs\ns 23 am A2016-25 s 27\n\nRequest for treatment and care needs assessment\ns 28 am A2025-29 amdt 4.114\nPayment of participants assessed treatment and care needs\ns 30 am A2016-25 s 27; A2016-35 s 6\nPeriodic payment—overseas participant\ns 30A ins A2016-35 s 7\nLump sum payment—foreign national participant\ns 30B ins A2016-35 s 7\nam A2019-12 amdt 3.49\nDispute about eligibility\ns 34 am A2016-25 ss 28-30; A2025-29 amdt 4.114\nEligibility assessment panel—review of decision\ns 38 am A2016-25 s 31, s 32; A2025-29 amdt 4.114\nDecision under this division binding\ns 40 am A2016-25 s 33\nDisputes about injuries\ndiv 7.2 hdg sub A2016-25 s 34\nDefinitions—div 7.2\ns 45 def interested person am A2016-25 s 35\nDispute about injury—application\ns 47 hdg sub A2016-25 s 36\ns 47 am A2016-25 s 37, s 38; A2025-29 amdt 4.114\nDispute about injury—referral to principal claims assessor\ns 48 hdg sub A2016-25 s 39\nDispute about injury—review panel\ns 49 hdg sub A2016-25 s 39\nDispute about injury—reasonable legal costs\ns 50 hdg sub A2016-25 s 39\nDispute about injury—maximum legal costs\ns 51 hdg sub A2016-25 s 39\nDispute about injury—legal costs not payable\ns 52 hdg sub A2016-25 s 39\nDispute about LTCS commissioner’s assessment\ns 55 am A2025-29 amdt 4.114\n\nTreatment and care assessor—cooperation of participant etc\ns 59 sub A2016-25 s 40\nTreatment and care assessor’s determination—review\ns 61 am A2016-25 s 41; A2025-29 amdt 4.114\nContacting former LTCS interim participant\ns 66A ins A2016-25 s 42\nPayment of hospital, ambulance, medical and other expenses not covered by\nbulk billing arrangement\ns 70 am A2016-25 s 43; A2025-29 amdt 4.114\nMaximum amount payable for certain treatment and services\ns 71 am A2025-29 amdt 4.114\nDefinitions—div 10.1\ns 72 def required fund contribution om R3 LA\ndef required fund contribution for motor accident injuries\nins A2016-25 s 45\ndef required fund contribution for work injuries ins\nA2016-25 s 45\ndef returns ins A2019-42 amdt 1.17\nMeaning of contribution period—div 10.1\ns 73 am A2016-25 s 46, s 47; A2025-29 amdt 4.114\nAppropriation of certain amounts for LTCS fund\ns 78 am A2016-25 s 48; pars renum R3 LA; A2016-35 s 8; pars\nrenum R4 LA; A2019-42 amdt 1.18; A2019-12 amdt 3.50\nPayments from LTCS fund banking accounts\ns 79 am A2016-25 s 49\nInvestment of amounts in LTCS fund banking accounts\ns 80 am A2016-25 s 50, s 51; A2019-42 amdts 1.19-1.25; ss renum\nR8 LA\nLTCS fund investment guidelines\ns 81 am A2025-29 amdt 4.114\nReturns on amounts of LTCS levy\ns 82 hdg sub A2019-42 amdt 1.26\ns 82 am A2019-42 amdts 1.27-1.29\nDetermination of amounts to be contributed to LTCS fund\ns 83 hdg sub A2016-25 s 52\ns 83 am A2016-25 ss 53-55; ss renum R3 LA; A2016-35 s 9;\nA2025-29 amdt 4.114\n\nDetermination of amount to be contributed to LTCS fund—motor accidents\ninvolving ACT government-owned vehicles\ns 83A ins A2016-35 s 10\nam A2019-12 amdt 3.51; A2025-29 amdt 4.114\nContributions to fund by ACTIA\ns 83B ins A2016-35 s 10\nam A2019-42 amdt 1.30\nDetermination of LTCS levy\ns 84 sub A2016-25 s 56\nam A2016-35 s 11; A2025-29 amdt 4.114\nDetermination of LTCS levy—motor accident injuries\ns 84A ins A2016-25 s 57\nam A2019-12 amdts 3.51-3.53\nDetermination of LTCS levy—work injuries\ns 84B ins A2016-25 s 57\nam A2020-30 amdt 1.2, amdt 1.3\nNotice of LTCS levy—work injuries\ns 84C ins A2016-25 s 57\nam A2020-30 amdt 1.4\nContributions to fund by MAI policy holders\ns 85 hdg sub A2019-12 amdt 3.54\ns 85 am A2019-12 amdt 3.55\nCancellation of LTCS levy\ns 86 sub A2019-12 amdt 3.56\nRefund of LTCS levy\ns 87 am A2019-12 amdt 3.57, amdt 3.58\nMeaning of present value of treatment and care liabilities—div 10.2\ns 88 am A2016-25 s 58\nRecovery of LTCS payments—entitlement\ns 89 am A2019-12 amdt 3.59, amdt 3.60\nRecovery of LTCS payments from responsible person or driver\ns 90 am A2019-12 amdt 3.61, amdt 3.62\nRecovery of LTCS payments from uninsured employer\ns 90A ins A2016-25 s 59\nam A2020-30 amdt 1.5. amdt 1.6\nLTCS guidelines\ns 93 am A2025-29 amdt 4.114\n\nExchange of information\ns 94 am A2016-25 ss 60-63; ss and pars renum R3 LA; A2017-4\namdt 1.16; pars renum R6 LA; A2019-12 amdt 3.63;\nA2020-30 amdt 1.7\nDetermination of fees\ns 97 am A2025-29 amdt 4.114\nApproved forms\ns 98 am A2014-44 amdt 1.3; A2025-29 amdt 4.114\nRegulation-making power\ns 99 am A2025-29 amdt 4.114\nReview of Act\ns 100 exp 1 July 2021 (s 100 (3))\nConsequential amendments\npt 12 hdg om LA s 89 (3)\nLegislation amended—sch 1\ns 101 om LA s 89 (3)\nRoad Transport (Third-Party Insurance) Act 2008—Consequential\namendments\nsch 1 om LA s 89 (3)\ndict am A2016-25 s 64, s 65; A2016-35 s 12; A2017-4 amdt 1.17;\nA2017-28 amdt 3.24, amdt 3.25; A2019-12 amdt 3.64;\nA2020-30 amdt 1.8, amdt 1.9\ndef ACTIA ins A2016-35 s 13\ndef claim ins A2016-25 s 66\nam A2019-12 amdt 3.65\ndef CTP Act om A2019-12 amdt 3.66\ndef CTP insurer ins A2016-25 s 66\nom A2019-12 amdt 3.66\ndef injury ins A2016-25 s 66\ndef insurer ins A2016-25 s 66\nam A2019-12 amdt 3.67; A2020-30 amdt 1.10\ndef lifetime participant ins A2016-35 s 13\ndef lifetime participation om A2016-35 s 14\ndef LTCS scheme sub A2017-4 amdt 1.18\ndef MAI Act ins A2019-12 amdt 3.68\ndef required fund contribution om A2016-25 s 67\ndef required fund contribution for motor accident injuries\nins A2016-25 s 68\ndef required fund contribution for work injuries ins\nA2016-25 s 68\ndef returns ins A2019-42 amdt 1.31\n\ndef worker ins A2016-25 s 68\ndef workers compensation claim ins A2016-25 s 68\ndef workers compensation insurer ins A2016-25 s 68\nsub A2020-30 amdt 1.11\ndef work injury ins A2016-25 s 68\n\n5 Earlier republications\n5 Earlier republications\nSome earlier republications were not numbered. The number in column 1 refers to\nthe publication order.\nSince 12 September 2001 every authorised republication has been published in\nelectronic pdf format on the ACT legislation register. A selection of authorised\nrepublications have also been published in printed format. These republications are\nmarked with an asterisk (*) in column 1. Electronic and printed versions of an\nauthorised republication are identical.\nRepublication\nNo and date\nEffective Last\namendment\nmade by\nRepublication\nfor\n1 July 2014–\n18 Nov 2014\nnot amended new Act\n19 Nov 2014\n19 Nov 2014–\nA2014-44 amendments by\nA2014-44\n13 May 2016–\nA2016-25 amendments by\nA2016-25\n22 June 2016–\n31 Aug 2016\nA2016-35 amendments by\nA2016-35\n1 Sept 2016\n1 Sept 2016–\nA2016-52 amendments by\nA2016-52\n9 Mar 2017\n9 Mar 2017–\n10 Oct 2017\nA2017-4 amendments by\nA2017-4\n11 Oct 2017\n11 Oct 2017–\n13 Nov 2019\nA2017-28 amendments by\nA2017-28\n14 Nov 2019\n14 Nov 2019–\n31 Jan 2020\nA2019-42 amendments by\nA2019-42\n1 Feb 2020\n1 Feb 2020–\n8 Jan 2021\nA2019-42 amendments by\nA2019-12\n9 Jan 2021\n9 Jan 2021–\nA2020-42 amendments by\nA2020-30 as\namended by\nA2020-42\n2 July 2021–\n25 Dec 2025\nA2020-42 expiry of provision\n(s 100)\n","sortOrder":112}],"analysis":{"issue_detection":{"absurdities":[],"contradictions":[]},"kimi_summary":{"_metrics":{"provider":"moonshot","completionTokens":1799},"content_quality":"ok","complexity_score":6,"scope_assessment":{"changed":true,"description":"The legislation has expanded significantly beyond its original purpose. When enacted in 2014, the scheme covered only catastrophic injuries from motor vehicle accidents. Amendments in 2016 extended the scheme to cover workplace injuries, effectively doubling the scope to include the workers compensation system. This required inserting parallel provisions throughout the Act for work injuries (e.g., sections 6(1)(b), 22A, 83A-84B) and creating interactions with the Workers Compensation Act 1951."},"complexity_factors":["Approximately 40 defined terms in the Dictionary, with extensive signpost definitions referencing other Acts (MAI Act, Workers Compensation Act 1951, Legal Profession Act 2006)","Three distinct dispute resolution pathways (Division 7.1 for eligibility, 7.2 for injury classification, 7.3 for care assessments), each with different assessors, panels, and procedural rules","Dual application framework with different commencement dates and rules for motor accident injuries versus work injuries, requiring cross-reference to separate compensation schemes","Complex funding mechanics involving actuarial calculations of 'present value of treatment and care liabilities' and contribution periods","Recovery provisions allowing the Commissioner to recover costs from multiple categories of responsible parties (drivers, employers, other insurers) with specific defences and apportionment rules","Nested exceptions for eligibility (e.g., self-inflicted injuries, professional sporting activities, and prior damages awards for future economic loss)","Special payment mechanisms for overseas participants and foreign nationals with different eligibility triggers and repayment obligations"],"plain_english_summary":"The Act creates the Lifetime Care and Support (LTCS) no-fault scheme in the ACT for people with catastrophic injuries (eg spinal cord, traumatic brain injury, amputation, severe burns, permanent blindness) from motor vehicle crashes (after 30 June 2014) or workplace accidents (after mid‑2016). It funds lifetime “reasonable and necessary” care—medical, rehabilitation, attendant care, home mods, prosthetics, vocational support—via insurance and workers’ compensation levies. Applicants enter as interim participants before becoming lifetime participants; disputes go to specialist panels. Special exit/payment rules apply for people leaving Australia."},"flash_summary":{"complexity_score":8,"scope_assessment":{"changed":true,"description":"Since the Act’s initial framing as a motor-accident lifetime care scheme, its scope has expanded. Notable scope enlargements include: the explicit inclusion of qualifying work injuries (inserts and amendments from 2016: s 6(1)(b), s 22A); creation of funding mechanics for Territory-owned vehicles and a requirement for ACTIA lump-sum contributions where Territory vehicles without MAI cover cause catastrophic injury (ss 83A–83B); and added levy and funding rules for work injuries and more complex levy structures (ss 83–85, 84B–84C). The Act also introduced overseas/foreign-national settlement options (ss 30A–30B) and broadened administrative and guideline powers for the LTCS Commissioner (s 93). These changes extend the law beyond a single-source motor-accident entitlement to a multi-source, cross-system funding and recovery regime with broader administrative discretion and funding instruments."},"complexity_factors":["Multiple substantive Parts and Divisions (11 Parts; Divisions within Part 7 and 10) creating separate procedural tracks","Numerous cross-references to other Acts (Motor Accident Injuries Act 2019; Workers Compensation Act 1951; Legal Profession Act 2006; Financial Management Act 1996) throughout","Large number of defined terms and signpost definitions in the dictionary (extensive linkage to external definitions)","Three distinct dispute-resolution streams (eligibility, injury status, treatment/care) with 3-person panels and review mechanisms (Divs 7.1–7.3)","Significant delegated rule-making through LTCS guidelines, ministerial determinations and instrument types (LTCS guidelines, determinations, disallowable and notifiable instruments) (s 93, ss 81, 84)","Actuarial-dependent funding model requiring independent actuary reports and periodic levy determinations (ss 83–84, 83A–83B)","Multiple conditional payment mechanisms (per-claim payments, periodic overseas payments, lump-sum for foreign nationals) with repayment and eligibility consequences (ss 30–30B)","Recovery regime based on present-value calculations and different liable categories (insurers, responsible persons, uninsured employers) (ss 88–91)","Discretionary approvals (approved providers) and prescribed maximum payment settings (ss 32, 71)","Exceptions and exclusions (excluded treatment and care, interplay with prior court awards or settlements) producing nested eligibility rules (ss 9, 15(4), 30B(4))"],"plain_english_summary":"**What this law does (mechanics)\n\n- Establishes a Territory-run Lifetime Care and Support (LTCS) scheme to provide indemnity-style funding for \"reasonable and necessary\" lifetime treatment and care for people with catastrophic injuries arising from certain motor accidents and work injuries (ss 6, 7, 9, 29–30).\n\n- Creates an LTCS Commissioner to run the scheme, make assessments of participants' treatment and care needs, set guidelines, convene assessors and panels, and determine funding/levy settings (ss 10–14, 23–24, 93).\n\n- Sets a two-stage participation process: preliminary \"interim\" participation (short term) and an application process to become a \"lifetime\" participant (ss 15–21). While interim, limitation periods for common-law claims are paused in prescribed ways (ss 22, 22A).\n\n- Requires the Commissioner to assess and certify each participant’s \"assessed treatment and care needs\" (what the scheme will pay for), and to pay reasonable expenses for those assessed needs, subject to exclusions and approved-provider rules (ss 23–32).\n\n- Provides dispute-resolution tracks with independent assessors and 3-person panels for: eligibility (Div 7.1), whether an injury falls under the Act (Div 7.2), and disputes about treatment and care assessments (Div 7.3). Panel decisions are final and binding under the Act (ss 34–41, 45–51, 55–65).\n\n- Establishes the LTCS Fund as a dedicated fund and prescribes how it is to be financed and invested. The Commissioner must determine, on actuarial advice, the amount required for each contribution period and set levies to raise that amount (ss 72–84, 83–84A). Levies may be fixed amounts, percentages of insurance premiums, or combinations (ss 84, 84A, 84B).\n\n- Allocates who pays: levies are collected from MAI (motor accident) policyholders and from workers compensation insurers and licensed self-insurers, and special lump‑sum arrangements apply in limited cases (ss 83–87, 84B, 85, 83B).\n\n- Allows the Commissioner to recover the present value of LTCS liabilities from appropriate third parties in specified circumstances (e.g. insurers, responsible persons, uninsured drivers or employers) (ss 88–92).\n\n- Gives the Commissioner powers to exchange information with insurers, hospitals and other bodies, and protects assessors from civil liability when acting honestly and without recklessness (ss 94–95).\n\n\nWho it affects (straight facts)\n\n- Injured persons: people catastrophically injured in qualifying motor accidents (from 1 July 2014) and qualifying work injuries (from specified dates in 2016) can apply to enter the scheme (s 6, s 15).\n\n- Insurers and policyholders: motor accident insurance policyholders (MAI policies) carry a levy to fund the scheme; workers compensation insurers and licensed self-insurers may be levied for work-related funding (ss 84–85, 84B–84C).\n\n- Employers: uninsured employers can be required to repay the Commissioner for liabilities related to a participant’s work injury (s 90A); employers’ obligations may intersect with workers compensation law (s 94(2)).\n\n- Health and service providers: the Commissioner may require certain services to be delivered by \"approved providers\" (s 32), set maximum payment rates (s 71), and enter bulk‑billing arrangements with hospitals or ambulance services (ss 68–70).\n\n- Territory bodies: ACTIA may be required to make lump-sum contributions where Territory-owned vehicles without MAI cover cause catastrophic injuries (ss 83A–83B).\n\n\nWhy it matters (stated purpose and immediate trade-offs)\n\n- The Act explicitly aims to provide a fully funded indemnity-style scheme for lifetime care of people with catastrophic injuries (s 7). That requires upfront actuarial planning and ongoing levy-setting (ss 83–84).\n\n- Who pays: the scheme transfers the long-run cost of catastrophic care onto a mix of (a) MAI policyholders and (b) workers compensation insurers / self-insurers via levies; and in specific cases onto identified third parties, uninsured drivers or employers via recovery actions (ss 83–87, 88–91). The LTCS Commissioner decides levy design and contribution periods (ss 73–84).\n\n- Behavioural and contractual effects: participation as a lifetime participant can foreclose future awards for future treatment and care where those future losses have been the subject of a final judgment or binding settlement (s 15(4), s 21(7)). Interim participation pauses some statutory limitation periods for damages claims (ss 22, 22A). Approved‑provider rules and maximum fee settings influence provider market access, prices and payment flows (ss 32, 71).\n\n- Administrative and implementation trade-offs: the scheme centralises decision‑making with the LTCS Commissioner and delegates significant discretion to make guidelines, determine levies, approve providers, and adopt external instruments (ss 11, 81, 93). That makes delivery efficient in some ways but concentrates decision authority (and rule‑making) in the executive.\n\n\nCosts, incentives and implementation risks (mechanisms, not verdicts)\n\n- Funding risk: actuarial estimates drive required fund contributions (s 83). Investment returns and levy collection variability create risk that levies may need adjustment; the Commissioner sets levies to ‘reasonably’ meet required contributions (ss 80–84).\n\n- Concentrated vs diffuse costs: costs are concentrated on insurance premium payers and workers compensation insurers (who may pass costs to employers or policyholders), while benefits are concentrated on catastrophic-injury participants (ss 84–85).\n\n- Administrative burden: insurers must comply with levy notices and may be obliged to apply for participants and supply information; the Commissioner has duties to convene panels and manage disputes—these activities require staffing, actuarial and legal resources (ss 16, 35–37, 46, 72–79).\n\n- Substitution and access effects: participants who accept lump sums (foreign national) or who received damages for future care forfeiture may be excluded from the scheme (ss 30B(4), 15(4)), which changes private settlement incentives.\n\n- Recovery and fairness mechanics: the Commissioner can recover present-value liabilities from third parties (ss 88–92). Recovery rules allocate loss to uninsured drivers/employers and other at-fault persons, and allow defences in limited circumstances (ss 90–90A).\n\n\nKey statutory levers and who decides\n\n- LTCS Commissioner: administers scheme operations, assessments, levies (ss 10–11, 23–24, 83–84, 93).\n- Minister/Treasurer: appoints Commissioner (s 10), determines some fees and maximum payment amounts and approves investment guidelines (ss 71, 81, 75).\n- Independent actuary: required input to the required fund contribution determinations (s 83(4)).\n\n\nPractical points to watch (implementation friction points)\n\n- Accuracy of actuarial estimates and investment returns influence levy volatility (s 83).\n- Interaction with MAI Act and Workers Compensation Act: scheme overlaps with, and sometimes displaces, private claims and other entitlements (ss 22, 22A, dictionary references).\n- Dispute-resolution complexity: three separate dispute tracks and binding panel outcomes mean legal certainty but also administrative process and potential delays (Div 7.1–7.3).\n\n\nPrincipal statutory citations for the above summary: ss 6–9, 10–14, 15–21, 22–24, 29–32, 33–65, 68–71, 72–87, 88–92, 93–95.\n"},"flash_summary_failed":{"failed":true,"reason":"A positive credit balance is required for all requests, including BYOK, so fallback providers remain available. Add credits at https://vercel.com/d?to=%2F%5Bteam%5D%2F%7E%2Fai%3Fmodal%3Dtop-up to continue.","source":"analysis-cron"}},"importantCases":[],"_links":{"self":"/api/acts/lifetime-care-and-support-catastrophic-injuries-act-2014","history":"/api/acts/lifetime-care-and-support-catastrophic-injuries-act-2014/history","analysis":"/api/acts/lifetime-care-and-support-catastrophic-injuries-act-2014/analysis","conflicts":"/api/acts/lifetime-care-and-support-catastrophic-injuries-act-2014/conflicts","importantCases":"/api/acts/lifetime-care-and-support-catastrophic-injuries-act-2014/important-cases","documents":"/api/acts/lifetime-care-and-support-catastrophic-injuries-act-2014/documents"}}