Employers must be insured with ReturnToWorkSA (RTWSA) under the Return to Work Act 2014 (RTW Act) to cover income support, medical treatment and rehabilitation services for their injured workers.
Many employers do not realise that while RTWSA’s claims agents make day‑to‑day decisions, those decisions have direct and lasting consequences for how a business operates, affecting legal obligations, financial exposure, staffing, and day‑to‑day operations.
Employers should not sit on the sidelines when they have genuine concerns about the legitimacy or impact of an employee’s claim. It is critical for employers to be informed, engaged, and proactive during the claims and dispute process.
We discuss why SA Employment Tribunal (SAET) disputes deserve your attention and explain why making your voice heard can make a measurable difference to your business.
Disputes in the SAET
RTWSA manages claims made against all registered employers in South Australia via its claims agents, Gallagher Bassett (GB) and Employers Mutual Limited (EML).
Most disputes in the SAET occur when a worker or employer challenges a decision made by GB or EML. For example:
- A worker may lodge an Application for Review in the SAET if their claim is rejected, or their rate of Average Weekly Earnings (AWE) is set too low, or a request for certain medical treatment is denied; and
- An employer may commence proceedings in the SAET if an employee’s claim is accepted but the employer believes the claim is not genuine, or if they consider the employee’s AWE rate is too high.
Resolution of SAET disputes
Most disputes in the SAET are resolved by agreement. However, if an employer is not a party to the SAET dispute, the worker and RTWSA can reach agreement without the employer’s consent.
This means that a worker with a rejected claim could, for example, convince the claims agent to accept their claim without the employer's knowledge or approval, leaving the employer to manage the injured employee’s return to work.
To be involved in a dispute, an employer must file a Form 42 - Notice to be Heard in the SAET. The employer is then joined to the dispute as the Other Party which enables it to receive relevant documents and attend conferences in the SAET. Most importantly, this means that the worker and claims agent cannot reach agreement to resolve the SAET dispute without the employer’s consent.
If an employer decides not to be involved, any decisions made may have significant ramifications for the premiums payable to RTWSA, explained below.
RTWSA premiums
Employers’ premiums payable to RTWSA are calculated on:
- the annual remuneration paid to employees (including wages, superannuation, allowances and bonuses) by the employer;
- the premium rate applicable to the employer’s industry; and
- income support (i.e. weekly payments) paid to the employers’ employees in the previous year for injuries sustained within the previous three years.
Employers can reduce their RTWSA premiums by minimising the income support paid to employees with work injury claims. To that end, employers should:
- ensure that injured employees return to work as soon as possible; and
- become involved with in disputes in the SAET to ensure employees do not receive more income support than they are entitled.
A worker with an accepted claim has various rights, as explained below.
Suitable employment obligations
The “pre-injury employer” is subject to various obligations under the RTW Act.
The most significant is the obligation to provide suitable employment to injured workers. This obligation can be burdensome, as employers must accommodate a worker’s limited capacity, which may include restrictions on hours and duties worked, unless it is not reasonably practicable to do so.
It is common for disputes over the acceptance or rejection of a claim to resolve on the basis that:
- the employer agrees to the claim being accepted in some manner, entitling the employee to certain benefits (e.g. a defined period of income support payments or medical expenses); and
- the worker agrees to resign their employment and give up the entitlement to the provision of suitable employment.
Resolving disputed workers compensation claims in such terms allows employers to draw a line in the sand and manage their liability to an injured employee.
Legal costs
Registered employers in SAET disputes are entitled to claim a contribution to their legal costs from the claims agent.
However, unreasonable, frivolous or vexatious conduct can result in no costs being payable, or a party being required to pay another party’s legal costs.
What can you do?
If your employee is disputing (or preparing to dispute) a rejected workers’ compensation claim in the SAET, becoming involved by filing a Notice to be Heard ensures that orders are not made without your knowledge or consent, helps you reduce the risk of unnecessary increases to your RTWSA premiums, and paves the way for a practical outcome.
Likewise, if an employer has genuine concerns about an employee’s accepted claim, seeking early legal advice and considering an Application for Review can be an important step in challenging the compensating authority’s decision and protecting your business interests.
Employers have very little to lose – and a great deal to gain – by taking an active role in the process.