Motorcyclists and accidents – do we see proportionately more motorcyclists than car drivers?
Statistics from the Victorian Transport Accident Commission demonstrate a vastly increased lethality due to motorcycle riding compared with driving a car.
In the last ten years, more than 430 motorcycle riders and pillion passengers have been killed, and close to 9,000 riders and pillions have been seriously injured on Victorian roads. This represents 14% of all road fatalities in the last ten years and 16% of all hospitalised claims.
Fatalities
Of the 243 people killed on Victoria’s roads in 2013, 41 were riders and passengers of motorcycles, representing 17% of the 2013 road toll.
Motorcycles represent less than 4% of the number of registered vehicles in Victoria, and account for around 1% of vehicle kilometres travelled*. Around 9% of Victorian licence holders hold a motorcycle licence.
Of the 41 motorcyclists and pillions killed in 2013:
The recent guideline # 19 Determination of a Recognised Psychiatric Diagnosis noted that the The Motor Accidents Authority Permanent Impairment Guidelines – Guidelines for the assessment of permanent impairment stated “The impairment must be attributable to a recognised psychiatric diagnosis in accordance with the Diagnostic Statistics Manual of Mental Disorders (4th Edition) [DSM IV], Internal Classification of Diseases (10th Edition) [ICD 10] or a substantial body of peer review research literature
1 The impairment evaluation report must specify the diagnostic criteria upon which the diagnosis is based.”
In May 2013 the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM 5) was released and in 2015 the Eleventh Edition of the International Classification of Diseases (ICD) is due to be released.
The Guideline stated that with the publication of the DSM 5 it may be unclear for Psychiatric Medical Assessors whether or not they can make a psychiatric diagnosis in accordance with DSM 5.
Preferred Approach
The DSM 5 may be considered by Psychiatric Medical Assessors as “a substantial body of peer review research literature.”(clause 7.13 MAA Guidelines) and apparently may be used together with DSM IV TR and ICD 10.
The Guidelines go on to state that any diagnosis based on DSM 5 must be clearly referenced and “must specify the diagnostic criteria upon which the diagnosis is based”,
However Psychiatric Medical Assessors were reminded that somatoform disorders, (Somatic Symptom and Related Disorders inDSM 5) are not assessed under the MAA Guidelines.
The guideline stated that the preferred interpretation is suggested to promote consistency of assessment and to assist the parties to understand the methodology behind the diagnosis of psychiatric injuries and associated impairment.
According to The Age newspaper of 27 October 2014 The Transport Accident Commission has saved $142 million after the recent amendments in the Transport Accident Amendment Act that have defined severe long-term mental illness. I have written about this previously. The new definition requires people to prove that they have had significant symptoms for at least three years after a car accident despite treatment if they are to be eligible for common-law compensation. at the time we protested vigorously stating that few people with what we regarded as severe mental illness would meet the criteria. According to the newspaper the commission has not processed any claim for severe mental injury compensation under the new criteria since it was introduced in October 2013.
A letter obtained by Fairfax Media reveals that the Transport Accident Commission lobbied the government to 2 years for the change because it believed the old threshold for mental injury compensation was not financially sustainable. The commission’s chief executive, Janet Dore, wrote to former board members last month about its progress in the final year of the six year review of its finances. She said there had been a $142 million saving to the TAC scheme-this financial year, taking its total savings to $252 million, with no “hot spots” identified by actuaries for the first time in her tenure. “The cumulative result reflects significant erosion of the metal injury threshold, which was threatening long-term financial sustainability. It required two years of work to achieve legislative change to manage this issue,” she said.
Janet Dore confirmed she had written a letter saying “the TAC has a responsibility to ensure that the scheme remained accessible and financially viable into the future….
The commission made a $499 million profit this financial year down from its $973 million profit last year. When the law was changed the Victorian State government said it was not seeking to restrict access to compensation, but to ensure that compensation claims for mental injury were made “consistently”!
The government was talking bullshit, it is obvious that this was done to save money despite the TAC making a profit last year of $500 million. Dr Nigel Strauss was quoted as saying that most seriously ill psychiatric patients would miss out on compensation under the new criteria. John Voyage, head of Maurice Blackburn’s TAC Department estimated dozens of people were no longer eligible for mental injury compensation this year.
56—Lump sum payments—economic loss
(1) Subject to this Act, if a worker, other than a seriously injured worker, suffers a work injury resulting in permanent impairment as assessed under Part 2 Division 5, the worker is entitled (in addition to any entitlement apart from this section) to compensation for loss of future earning capacity by way of a lump sum.
(2) An entitlement does not arise under this section if the worker’s degree of whole person impairment from physical injury is less than 5%.
(3) An entitlement does not arise under this section in relation to—
(a) a psychiatric injury or consequential mental harm
58—Lump sum payments—non-economic loss
(1) Subject to this Act, if a worker suffers a work injury resulting in permanent impairment as assessed under Part 2 Division 5, the worker is entitled (in addition to any entitlement apart from this section) to compensation for non-economic loss by way of a lump sum.
(2) An entitlement does not arise under this section if the worker’s degree of whole person impairment from physical injury is less than 5%.
(3) An entitlement does not arise under this section in relation to a psychiatric injury or consequential mental harm.
Stress Claims in Victoria as of June 30 2014 (adapted from The Age 21 October 2014)
The annual number of claims for mental disorders has risen by almost 470 in five years while the annual amount paid out in compensation has soared by 45 per cent to $273 million. Job-related stress is increasing in Victorian workplaces with 58 compensation claims for psychological injuries being accepted every week.
Victoria’s two biggest worker compensation categories – musculoskeletal complaints and major sprains and strains – have either fallen or remained steady in claim numbers over the same period along with most other physical injuries. For the first time, mental disorders have overtaken wounds to become the state’s third-leading workplace injury.
WorkCover data shows the average individual compensation payout for psychological injuries has ballooned from $73,000 in 2008-09 to almost $90,000 in the past financial year.
Mental health group Beyondblue attributes the rise in work-related mental stress claims to reduced stigma, heavier workloads and increasing job insecurity. But it was also being driven by a heightened recognition of the connection between the workplace and mental health, the group said, with a series of high-profile civil lawsuits ending in six and seven-figure payouts from employers found at fault.
Last month, former teacher Peter Doulis was awarded more than $1.3 million in damages for chronic depression after he was found to have been allocated an unduly heavy workload of a western suburbs school’s worst-behaved students.
“Cases like these get people thinking about their own workplace and conditions, and reflecting more objectively about situations they may be tolerating,” Beyondblue head of workplace policy Nick Arvanitis said.
With an estimated one in five workers taking time off work due to feeling mentally unwell in the past year, industry groups and health advocates have urged employers to treat the mental health of their staff as seriously as physical health and safety.
The data below gives a more comprehensive overview of those industries and workers more likely to make stress claims.
Mental Disorders in Victoria
Claims
2008/2009 2590
2013/2014 3056
Cost Estimate
2008/2009 $189.3m
2013/2014 $273.2m
All Injuries
2008/2009 28,805
2013/2014 26,508
Cost Estimate
2008/2009 $1,566.6m
2013/2014 $1,620.7m
The Institute for Safety, Compensation and Recover Research (ISCRR) has produced another newsletter. There is an interesting PhD Scholarship Opportunity focused on preventing work‐related injury and illness in Victoria with the Monash Centre For Occupational & Environmental Health part of the School of Public Health and Preventive Medicine,
Monash University, Melbourne. This is funded by the Institute for Safety, Compensation and Recover Research (ISCRR) .
The main objectives of this PhD project are to use workers’ compensation data to answer questions related to the primary prevention of work related injury and illness in Victoria; and to develop methods to integrate workers’ compensation data with other data sources (e.g. labour market survey information or emergency department data) and to examine questions concerning the use of workers’ compensation data for surveillance purposes. There is also said to be scope to conduct analyses comparing primary prevention performance across different jurisdictions.
The ISCRR, about which I have written previously, is a disappointment to me. I had expected that there might be some research looking at the neglected area (in academia) of impairment assessment. To my knowledge there have been no worthwhile studies on this enormous and vastly expensive area.
Canberra’s Tax Office letter bomber has won a battle against the government over his right to continue receiving worker’s compensation for its mishandling of a workplace love affair.
Former public servant Colin George Dunstan sent 28 bombs in the post to colleagues and high-profile figures in 1998. One of Mr Dunstan’s bombs exploded in a mail centre and injured a postal worker. The rest were intercepted by police, but the letters had already caused mass evacuations and fear just before Christmas.
Mr Dunstan, now in his late 50s, spent nine years in prison over the notorious letter-bombing campaign, and was formally sacked from the public service in 2001. The crimes came after a turbulent romantic affair with a colleague, known as ”Ms X”, that took place over a number of years.
The former Australian Tax Office employee claimed he was left feeling suicidal and depressed after the woman sexually harassed and stalked him. He won a long-running compensation battle in 2012 when the Administrative Appeals Tribunal ruled the ATO had compounded his depression through its handling of the matter.
But, the year after Mr Dunstan’s win, federal government workplace insurer Comcare decided he should stop receiving compensation because he had become eligible for the superannuation pension at the age of 55. That pension, part of the generous Commonwealth Superannuation Scheme, was valued at about $1066 a week, or a $40,000, lump sum.
But Dunstan never formally elected to take the superannuation out, either as a lump sum or a weekly payment. The government insurer argued that Mr Dunstan, and others in his position, were ”double-dipping”, forcing the government to contribute to their super benefits while also paying them workers’ compensation.
But Comcare lost its fight in the tribunal last year, and was ordered to keep paying the former public servant compensation until he turned 65, died, or became permanently disabled. Comcare appealed in the Federal Court on Friday, arguing before the full bench that the tribunal’s decision was flawed.
It based the appeal on two grounds, alleging the tribunal had misdirected itself in interpreting the meanings of terms in relevant legislation. It argued that Mr Dunstan had the ability or right to take the superannuation pension at the age of 55, which could have meant he was taken to have received it. That could then have disqualified him from the compensation payments.
But the Federal Court ruled against Comcare without hearing submissions from Mr Dunstan’s barrister. It said no error had been made by the tribunal and dismissed the appeal.
Comcare was ordered to pay Mr Dunstan’s costs. Mr Dunstan still has two ongoing legal battles with authorities, in the ACT Supreme Court and at the Administrative Appeals Tribunal. He is arguing against his original suspension from the ATO in the Supreme Court.
There is no more to be said, I wonder how this claim can be accepted when so many others, with arguably more merit, are rejected.
Motorists could save about 15 per cent on their green slips under proposed reforms to make the Compulsory Third Party (CTP) insurance scheme fairer and more affordable. NSW Premier Barry O’Farrell and Minister for Finance and Services Greg Pearce said CTP in NSW is the least affordable in Australia and a NSW Motor Accidents Authority review had recommended an overhaul. “CTP needs to be more affordable for motorists and fairer for people injured in motor vehicle accidents,” Mr O’Farrell said.
“At the moment, motorists in NSW are paying on average $500 a year for CTP insurance – up to $260 more than other states – while injured people are waiting years to receive benefits. “The NSW Government’s proposed green slip changes could reduce the cost of the average CTP premium by about 15 per cent and ensure claimants receive benefits as soon as possible. “The current scheme has turned into a lawyers’ picnic – less than half of all premiums collected by insurers actually goes to accident victims. That’s simply not good enough. “These proposed changes will drive down costs by ensuring the system is focused on those who are injured, not ambulance chasing lawyers.” Mr Pearce said the plan is for a ‘no fault’ scheme to significantly reduce long and costly disputes and give those injured in accidents faster access to benefits. This would also bring the NSW system into line with Victoria. “The current CTP scheme is expensive because of the time it takes to settle compensation disputes often delayed by lengthy legal battles over who is at fault and who should pay,” he said.
“Generally, the majority of compensation is paid out between three and five years after an accident and often it’s the lawyers who walk away with more money than those with injuries. “A ‘no fault’ scheme would reduce costs, create a more competitive CTP insurance market, and get money to those who need it the most, rather than lawyers, insurers and investigators. “CTP in NSW is the least affordable in Australia and will only get worse unless we change it,” he said. The Lifetime Care and Support Scheme remains unchanged.
Current CTP Scheme case studies
A pedestrian was hit by a car while walking on a footpath – it took seven years to resolve the case which resulted in the claimant receiving $6,000 to cover medical expenses, while legal costs amounted to about $50,000.
A person was hit by a car and the costs of legal, investigation and medical expenses was $190,000 – the victim received less than $30,000 for injuries suffered and the claim took eight years to resolve.
A motorist involved in a car accident was found to be at fault. He sustained a broken collar bone and had to take several months off his job as a labourer to recover. He was not able to claim for all his lost income as a result of the accident and subsequently found himself in severe financial distress.
A motorcycle rider was involved in an accident due to the road conditions – the rider was seriously injured but unable to claim compensation as no other vehicle was involved. Legal costs were $30,000.
The Age – 30 March 2013 SRC Act Review
Federal public servants seeking workers’ compensation payouts face the biggest crackdown in decades. – ComCare Review (link to the Review)
A federal government review of the $1.2 billion Comcare insurance scheme has urged sweeping reform to curb dubious claims for psychological injuries, payouts for dodgy therapies, doctor shopping and outright fraud.
The review has made more than 147 recommendations to re-write the legislation on Commonwealth public sector compensation claims, with the aim of getting injured workers back to work and ending their “passive” reliance on compensation.
The taxpayer-funded insurer lost more than half a billion dollars in the 2011-12 financial year as the number of claims for psychological injuries in the public sector – many based on accusations of bullying and harassment – increased.
According to the review’s two reports – by Melbourne barrister Peter Hanks, QC, and former Defence Department head Allan Hawke – some long-running claims under the Comcare scheme have exceeded $2 million.
The review, ordered in 2012 by Workplace Relations Minister Bill Shorten, cited a case of taxpayers paying nearly $30,000 for massage therapy that had “no curative effect” and another of a Brisbane-based bureaucrat flown to a Buddhist meditation retreat in Alice Springs to treat his anxiety disorder.
In other cases that have made recent headlines – not mentioned in the review – a Commonwealth public servant was compensated, after a court appeal, for injuries sustained during a “vigorous” sex session in a motel room on a work trip.
And an underperforming Canberra public servant was compensated after she claimed one-on-one counselling sessions constituted bullying.
The reports do not call for cuts to benefits for injured workers but urge a shift from a payout-oriented insurance scheme to one that emphasises rehabilitation and a return to work.
The report says claims for psychological injuries in the public service have increased by 30 per cent in the past three years and is four times higher in the federal public service than for other employers.
Mr Hanks says compensation for these claims should not be paid for more than three months without a diagnosis by a properly qualified medical practitioner.
He also wants to see an end to payouts for mental stress caused by imaginary factors.
“It is an unfair burden on employers to make them liable to pay compensation for a psychological injury that is caused by an employee’s fantasising rather than by any aspect of employment,” he wrote.
Among the key recommendations is a no-fault, provisional liability that would cover injured workers for a three-month rehabilitation period and a shift in jurisdictions for workplace dispute resolution from the Administrative Appeals Tribunal to Fair Work Australia.
Mr Hanks wrote that Comcare’s legislative framework was supposed to be beneficial to workers but the insurer had a duty to spend taxpayers’ money wisely.
He also urged greater vigilance on doctors who signed off on compensation payouts and “that health practitioners are held accountable for their conduct, and that they do not exploit what is, in effect, a publicly funded scheme by overcharging, overservicing or providing services that do not meet basic professional standards”.
Mr Shorten said he would now consult ”stakeholders” on the reports by Dr Hawke and Mr Hanks.
“It is vital that the Comcare scheme is focused on early and effective intervention to promote recovery of injured workers,” he said.
“It is also critical that employers and Comcare are pro-active in supporting injured workers from the point of injury, during rehabilitation and when they return to work.”
The Victorian Branch of the Australian Medical Association has been contracted to provide AMA4 training for the government. Nigel Strauss and myself have been the trainers of the GEPIC. We have just been informed that “due to the overwhelming number of psychiatrists that have completed the GEPIC module in recent years, the Government Authorities have decided not to include Psychiatry modules as part of this year’s AMA4 Guides Training program. At this stage the program schedule beyond 2013 has not been confirmed.”
I hear there are similar problems getting training in the PIRS in NSW. At this satage, if you have not been accredited you have to wait until 2014.