Reminder: obligations when making decisions under the Seafarers Act

Timeframes for determining claims

It is the employer’s responsibility to determine whether they should accept the claim. Although this task is often undertaken by a claims manager, the responsibility of ensuring that claims are determined and managed in line with the Seafarers Act remains with the employer. The Seafarers Act requires an employer to make a determination within:

• twelve days of receiving the claim, where a claim is made for compensation for incapacity for work, the loss or damage of property, or the cost of medical treatment received (s73 of the Seafarers Act);
• thirty days of receiving the claim, where a claim is made for compensation for permanent impairment (s73A of the Seafarers Act); or
• sixty days of receiving the claim, where a claim is made for compensation in relation to the death of an employee (s72 of the Seafarers Act).

Extensions of time to determine claims

The employer can request an extension of the time limit from the Seacare Authority if they require additional time to make a decision (s72(1)(b), s73(2)(c) and s73A(1)(b) of the Seafarers Act). This request must be made before the expiry of the original deadline. If this request is denied by the Seacare Authority, the employer may seek a review of the decision by the Administrative Appeals Tribunal (AAT) (s74 of the Seafarers Act).

The employer can take further time to make a decision where they provide the employee with written notice that further information or a document is required to make a determination (s72(2), s73(2)(b) and s73A(2) of the Seafarers Act). Examples of further information include medical certificates and witness statements. This request must be made before the end of the original timeframe. When a request for further information is made, the time period in which the claim must be determined is paused until the further information or document is provided.

It is best practice for an employer to notify the claimant when the timeframe for determining their claim has been extended.

What happens if an employer doesn’t make a determination within the timeframe?

Where no determination regarding a claim is made within the timeframes set out by the Seafarers Act, the claim is deemed to be disallowed, i.e. it is considered to be rejected.

If this occurs, the employer should still provide written notice to the claimant advising them that the claim has been rejected, advising the reason for this and what they can do if they are unhappy with the determination.

Obligations to supply the Seacare Authority with information

Employers are to notify Seacare of their determination by completing the employer’s Determination of a claim for Workers’ Compensation. Employers should send a copy of that form attached with a copy of the employee’s Claim for Workers’ Compensation form (s106 of the Seafarers Act).

Requests for reconsideration – arranging for Comcare to assist

Where an employer receives a request for reconsideration from an employee, they have 60 days to make a decision on the reconsideration request from the date it was received (s79 of the Seafarers Act). An employer may request an extension of this deadline from the Seacare Authority.

The employer is required to arrange with Comcare for a Comcare officer to assist in reconsidering the determination.

Noting that an employer has 60 days to complete the reconsideration including arranging for a Comcare officer’s assistance, employers are reminded to ensure the reconsideration is provided to the Comcare officer at least 10 business days prior to the due date of the reconsideration decision.

More information

More information on the claim determination process can be found in the Seacare Best Practice Guide – Claim Management.