Safety, Rehabilitation and Compensation Act 1988 (Cth)
13 The long title of the Act reads as follows:
"An Act relating to the rehabilitation of employees of the Commonwealth and certain corporations and to workers' compensation for those employees and certain other persons, and for related purposes."
14 Section 68 of the Act establishes a body called Comcare which has the function, amongst others "to make determinations accurately and quickly in relation to claims and requests made to Comcare under [the] Act"(s 69).
15 Part II of the Act is concerned with compensation. Division I of Part II, which is comprised of ss 14, 15 and 16, is headed "Injuries, property loss or damage, medical expenses".
16 Section 14 provides:
"14(1) Subject to this Part, Comcare is liable to pay compensation in accordance with this Act in respect of an injury suffered by an employee if the injury results in death, incapacity for work, or impairment.
(2) Compensation is not payable in respect of an injury that is intentionally self-inflicted.
(3) Compensation is not payable in respect of an injury that is caused by the serious and wilful misconduct of the employee but is not intentionally self-inflicted, unless the injury results in death, or serious and permanent impairment."
17 Central to the operation of s 14 are the definitions of "injury" and "disease" contained in s 4 of the Act. These definitions are in the following terms:
'"injury" means:
(a) a disease suffered by an employee; or
(b) an injury (other than a disease) suffered by an employee, being a physical or mental injury arising out of, or in the course of, the employee's employment; or
(c) an aggravation of a physical or mental injury (other than a disease) suffered by an employee (whether or not that injury arose out of, or in the course of, the employee's employment), being an aggravation that arose out of, or in the course of, that employment;
but does not include any such disease, injury or aggravation suffered by an employee as a result of reasonable disciplinary action taken against the employee or failure by the employee to obtain a promotion, transfer or benefit in connection with his or her employment.'
'"disease" means:
(a) any ailment suffered by an employee; or
(b) the aggravation of any such ailment;
being an ailment or an aggravation that was to in a material degree by the employee's employment by the Commonwealth or a licensed corporation."'
18 Sections 15 and 16 of the Act provide for the payment of compensation to employees in circumstances which fall outside s 14 of the Act. Section 15 provides for compensation to be paid to an employee who has an accident arising out of and in the course of his or her employment and, although the employee suffers no injury, he or she does suffer loss or damage to property. Section 16 provides for an employee who suffers an injury to receive compensation in respect of medical expenses whether or not the injury results in death, incapacity for work, or impairment.
19 Divisions 2, 3 and 4 of Part II of the Act deal more specifically with the liability created by s 14 of the Act. Division 2, which is comprised of ss 17 and 18, is concerned with compensation for injuries resulting in death (s 17) and in respect of funeral expenses (s 18). Section 17, far as is here relevant, provides:
"17(1)This section applies where an injury to an employee results in death.
(2) Subject to this section and sections 16 and 18, if the employee dies without leaving dependants, compensation is not payable in respect of the injury.
(3) Subject to this section and to sections 16 and 18, if the employee dies leaving dependants some or all of whom were, at the date of the employee's death, wholly dependant on the employee, Comcare is liable to pay compensation in respect of the injury of $120,000 and that compensation is payable to, or in accordance with the directions of, Comcare for the benefit of all of those dependants.
(4) If the employee dies without leaving dependants who were wholly dependent on the employee at the date of the employee's death but leaving dependants who were partly dependant on the employee at that date:
(a) subject to this section and to sections 16 and 18, Comcare is liable to pay compensation in respect of the injury of such amount, not exceeding $120,000, as Comcare determines, having regard to any losses suffered by those dependants as a result of the cessation of the employee's earnings; and
(b) that compensation is payable to, or in accordance with the directions of, Comcare for the benefit of those dependants.
…"
20 Division 3 of Part II of the Act, which is comprised of ss 19 to 23, is concerned with injuries resulting in incapacity for work. Section 19 provides, so far as is here relevant:
"19(1) This section applies to an employee who is incapacitated for work as a result of an injury, other than an employee to whom section 20, 21, 21A or 22 applies.
(2) Subject to this Part, Comcare is liable to pay compensation to the employee in respect of the injury, for each of the first 45 weeks (whether consecutive or otherwise) during which the employee is incapacitated, of an amount calculated under the formula:
…
(3) Subject to this Part, Comcare is liable to pay to the employee, in respect of the injury, for each week during which the employee is incapacitated, other than a week referred to in subsection (2), compensation:
…"
21 Section 20 of the Act is concerned with the payment of compensation where the employee is in receipt of a superannuation pension. So far as is here relevant, s 20 provides:
"20(1)This section applies to an employee who, being incapacitated for work as a result of an injury, retires voluntarily, or is compulsorily retired, from his or her employment at any time after the commencement of this section and, as a result of the retirement, receives a pension under a superannuation scheme.
(2) Comcare is liable to pay compensation to the employee, in respect of the injury, in accordance with this section for each week after the date of retirement during which the employee is incapacitated.
(3) [formula for calculating the amount of compensation]."
22 Division 4 of the Part II of the Act, which is comprised of ss 24 to 28, is headed "Injuries resulting in impairment". Each of the sections within the division is concerned with permanent impairment. Section 24, so far as is here relevant, provides:
"24(1)Where an injury to an employee results in a permanent impairment, Comcare is liable to pay compensation to the employee in respect of the injury.
(2) For the purpose of determining whether an impairment is permanent, Comcare shall have regard to:
(a) the duration of the impairment;
(b) the likelihood of improvement in the employee's condition;
(c) whether the employee has undertaken all reasonable rehabilitative treatment for the impairment; and
(d) any other relevant matters.
(3) Subject to this section, the amount of compensation payable to the employee is such amount, as is assessed by Comcare under subsection (4), being an amount not exceeding the maximum amount at the date of the assessment.
(4) The amount assessed by Comcare shall be an amount that is the same percentage of the maximum amount as the percentage determined by Comcare under subsection (5).
(5) Comcare shall determine the degree of permanent impairment of the employee resulting from an injury under the provision of the approved Guide.
…
(9)For the purposes of this section, the maximum amount is $80,000."
23 Section 25 of the Act allows for the payment, in certain circumstances, of interim compensation for permanent impairment. It provides, so far as is here relevant:
"25(1)Where Comcare:
(a) makes a determination that an employee is suffering from a permanent impairment as a result of an injury; and
(b) is satisfied that the degree of impairment is equal to or more than 10% but has not made a final determination of the degree of impairment;
Comcare shall, on the written request of the employee made at any time before the final determination is made, make an interim determination of the degree of permanent impairment under section 24 and assess an amount of compensation payable to the employee.
(2) The amount assessed by Comcare under subsection (1) shall be an amount that is the same percentage of the maximum amount specified in subsection 24(9) as the percentage determined by Comcare under subsection (1) to be the degree of permanent impairment to the employee.
(3) Where, after an amount of compensation has been paid to an employee following the making of an interim determination, Comcare makes a final determination of the degree of permanent impairment of the employee, there is payable to the employee an amount equal to the difference (if any) between the amount payable under section 24 on the making of the final determination and the amount paid to the employee under this section.
…"
24 Section 26 of the Act is concerned with the timing of the payments of an amount of compensation "payable to an employee under s 24 or 25."
25 Divisions 5 and 6 of Part II of the Act are respectively concerned with "Household and attendant care services" and "Miscellaneous" matters. It is not necessary for present purposes to further consider the provisions of these divisions.
26 We have set out this large number of statutory provisions to illustrate what we see as the intended structure of Part II of the Act.
27 As Finn J noted, s 14 is the central provision of the Act so far as the liability of Comcare to pay compensation is concerned. Section 14 creates a liability in Comcare in respect of injuries suffered by employees which result in death, incapacity for work or impairment. However, the liability in Comcare created by s 14 is qualified in two ways. First, such liability is a liability "[s]ubject to" Part II of the Act. That is, it is a liability limited in its extent by other provisions of Part II of the Act (see, for example, s 17(2)). Secondly, the liability is a liability to pay compensation "in accordance with" the Act. That is, it is a liability to pay the compensation for which the statute provides, as required by the Act (see, for example, ss 17(3)(4) and (5), 19, 20, 24 and 25).
28 A consideration of the provisions of Parts V and VI of the Act tends, in our view, to confirm the above construction of s 14 of the Act.
29 Part V relates to claims for compensation. Section 53(1) is concerned to ensure that appropriate notice of injuries is given. Section 54 makes the right to receive compensation under the Act dependant upon the making of a claim. So far as is here relevant s 54 provides:
"54(1) Compensation is not payable to a person under this Act unless a claim for compensation is made by or on behalf of the person under this section.
(2) A claim shall be made by giving the relevant authority;
(a) a written claim in accordance with the form approved by Comcare for the purposes of this paragraph; and
(b) except where the claim is for compensation under section 16 or 17 - a certificate by a legally qualified medical practitioner in accordance with the form approved by Comcare for the purposes of this paragraph.
…"
30 It is clear that Part V of the Act envisages first, the giving of notice of an injury and separately, and in most cases it may be assumed subsequently, the making of a claim for compensation in accordance with an approved form. The claim for compensation envisaged by s 54 is not, it would seem, necessarily a claim for compensation under a particular section, or particular sections, of the Act. The form approved by Comcare as required by s 54(2)(a) reflects the generic nature of a claim under the section. It is headed "Claim for Rehabilitation and Compensation". It requires the provision of detailed information concerning the injury and time taken off work because of the injury, but it does not provide for the provision of information of the kind that would be necessary before a determination could be made under, for example, ss 16, 17, 18, 20, 21, 24 and 25 of the Act.
31 The claim, and the claim form, envisaged by s 54 of the Act reflects the practical reality that a claim for compensation is likely to be made relatively soon after the suffering of an injury, particularly if incapacity for work or significant medical expenses result from the injury. At the time that this initial claim is made it may be quite impossible for the employee to provide details of, for example, the fact or extent of any permanent impairment. For the reasons expressed below, the determination which is made on a claim, as required by s 54 of the Act, will ordinarily be a determination under s 14 of the Act.
32 Part VI of the Act is headed "Reconsideration and Review of Determinations". It establishes a three tiered decision-making process: the original decision or determination to be made by an authorised person within Comcare or a licensed authority, a reconsidered determination to be made within the same authority as the original decision - but ordinarily by a fresh decision-maker, and a decision of the AAT reviewing the reconsidered determination.
33 Section 60 contains definitions, amongst others, of "determination", "determining authority" and "reviewable decision". These definitions are in the following terms:
'"determination" means a determination, decision or requirement made under section 8, 14, 15, 16, 17, 18, 19, 20, 21, 21A, 22, 24, 25, 27, 29, 30, 31, 34, 36, 37 or 39, under paragraph 114B(5)(a) or under Division 3 of Part X;
"determining authority", in relation to a determination, means the person who made the determination;
"reviewable decision" means a decision made under subsection 38(4) or section 62.'
34 The definition of "determination" makes it plain that it is part of the scheme of the Act for determinations to be made under the various sections referred to therein. In particular, the definition reveals that a determination may be made under s 14 of the Act. A determination under s 14 cannot amount to more than a determination that Comcare "is liable to pay compensation in accordance with this Act" in respect of a particular injury. The amount of compensation which Comcare will be liable to pay, the person or persons to whom the compensation will be payable and the time or times at which Comcare's liability will give rise to a present obligation to make payments are, as the above examination of the structure of the Act reveals, all matters to be determined under other provisions of the Act.
35 This is not to say that a determination under s 14 is without real significance. Such a determination will involve findings on the following matters. First, that an appropriate notice of injury has been given to the relevant authority as required by s 53 of the Act; secondly, that a claim for compensation has been made as required by s 54 of the Act; thirdly, that the person who made the claim or on whose behalf the claim was made was an "employee" at the time of the alleged injury (ss 4 and 5); fourthly, that the employee suffered an injury (s 4); and finally, that the injury has resulted in death, incapacity for work or impairment.
36 Section 61 requires a determining authority, as soon as practicable after making a determination, to serve on the claimant a notice in writing setting out the terms of the determination and the reasons for it.
37 Section 62 is concerned with the reconsideration of determinations (ie. with the second tier decision-making process). Section 62(1) provides for a determining authority to reconsider a determination made by it on its own motion, or to cause such a determination to be reconsidered by an authorised person, not being a person involved in the making of the determination. Section 62(2) authorises certain persons, authorities or corporations affected by a determination to request a determining authority to reconsider a determination made by it. Where such a request is made the reconsideration is undertaken by an authorised person who was not involved in the making of the determination. Section 62(5) provides for the person undertaking the reconsideration to affirm, revoke or vary the determination in such a manner as the person thinks fit.
38 Section 64 of the Act establishes the third tier of the decision-making process established by the Act. It provides:
"64.(1) Application to the Administrative Appeals Tribunal for review of a reviewable decision may be made by:
(a) the claimant; or
(b) if the decision affects the Commonwealth - the Commonwealth; or
(c) if the determination affects a Commonwealth authority that is not a licensed authority - the Commonwealth or that authority; or
(d) if the determination affects a licensed authority that holds a Class 1 Licence under Part VIIIA - the licensed authority; or
(e) if the determination affects a licensed authority that holds a Class 2 Licence under Part VIIIA:
(i) the Commonwealth; and
(ii) in the circumstances mentioned in subsection (2) - the licensed authority; or
(f) if the determination affects a licensed authority that holds a Class 3 Licence under Part VIIIA and the circumstances mentioned in subsection (2) apply - the licensed authority; or
(g) if the determination affects a licensed corporation that holds a Class A Licence under Part VIIIB - the licensed corporation; or
(h) if the determination affects a licensed corporation that holds a Class B Licence under Part VIIIB and the circumstances mentioned in subsection (2) apply - the licensed corporation.
(2) The circumstances mentioned in subparagraph (1)(e)(ii) and paragraphs (1)(f) and (h) are that the licence is subject to a condition referred to in subparagraph 107G(3)(d)(ii) or paragraph 108H(4)(d), as the case may be.
(3) Despite section 27 of the Administrative Appeals Tribunal Act 1975, a person may not make an application to the Administrative Appeals Tribunal for a review of a reviewable decision except as provided by subsection (1) of this section.
39 In considering the extent of the power of the AAT when reviewing decisions under the Act, it is to be noted, first, that the AAT is authorised by s 64 of the Act to review only reviewable decisions - that is, for present purposes, second tier or reconsideration decisions made under s 62 of the Act. Decisions under s 62 of the Act are the result of the reconsideration by Comcare or a licensed authority of a determination, as defined by s 60 of the Act, concerning which a claimant will have received a notice in writing setting out the terms of the determination and the reasons for the determination (s 61(1)). Secondly, it is to be noted that the powers of the AAT under s 43(1) of the AAT Act are powers "[f]or the purpose of reviewing" the reviewable decision, not powers that may be exercised at large. Further, the powers and discretions that the AAT may exercise under s 43(1) are the powers and discretions conferred by the Act on the determining authority for the purposes of reconsidering a determination under s 62 of the Act. The AAT will not be authorised on review of a reviewable decision to exercise any powers and discretions which would not have been available to the determining authority at the second tier decision-making stage, albeit that such powers and discretions might have been available to the determining authority at the first tier decision-making stage.