The Scheme is a no-fault insurance scheme that seeks to ensure that people who are catastrophically injured in a work accident or motor vehicle accident in the ACT can manage their ongoing care needs into the future.
Under this scheme, injured persons needing lifetime care as a result of a catastrophic injury have the opportunity to access a scheme targeted at providing long-term care and support.
The introduction of the Lifetime Care and Support Scheme is part of the implementation in the ACT of a nationally agreed scheme, which will transform the way the ACT community supports people with catastrophic injuries, their families and carers.
The Scheme aims to give catastrophically injured workers and their families the best opportunity to recover and participate in society as far as possible through provision of specialised early intervention medical and rehabilitation care.
Injured workers who qualify to join the LTCS Scheme will have their treatment and care coordinated through a scheme which is geared to offering specialised care and support to people with complex and serious injuries.
The LTCS Scheme provides the catastrophically injured worker a continuum of care during their whole life with their treatment and care needs met in a timely manner without the added stress of litigation or managing a financial settlement.
Private sector workers in the ACT will benefit from the certainty that if they sustain a catastrophic injury in a work accident and are accepted as a lifetime participant into the Scheme, their reasonable and necessary treatment and care needs will be guaranteed under the LTCS Scheme for life. Under the scheme, reasonable and necessary treatment and care can include where required, home or workplace modification and equipment.
The ACT Scheme covers work injuries occurring on or after 1 July 2016.
The categories of catastrophic injury that the Scheme cover include spinal cord injuries, moderate to severe brain injury, amputations, severe burns or permanent blindness. The precise injuries covered by the Scheme are set out in the Lifetime Care and Support Scheme Guidelines.
Eligibility is not assessed using the concept of whole person impairment (WPI) drawn from the American Medical Association’s (AMA) Guides of the Evaluation of Permanent Impairment.
The treatment and care needs that are covered by the Scheme are found in section 9 of the Lifetime Care and Support (Catastrophic Injuries) Act 2014 and include:
- medical treatment (including pharmaceutical treatment);
- dental treatment;
- ambulance transportation;
- respite care;
- attendant care services;
- aids and appliances;
- education and vocational training;
- home and transport modification; and
- workplace and educational facility modifications.
Yes. The LTCS Scheme covers reasonable and necessary lifetime treatment and care for catastrophic injuries. It does not provide income support such as weekly compensation payments, impairment payments, or any other benefits that you may be entitled to under the Workers Compensation Act 1951.
All of your rights, obligations, and entitlements apart from treatment and care under the LTCS Scheme remain under the Workers Compensation Act 1951.
Your application to join the LTCS Scheme is not a substitute for, and cannot be used to obtain, compensation under the Workers Compensation Act 1951 or any other avenue that may be available to you.
Your claim remains managed by your workers compensation insurers and your employer. You are still required to comply with all of the normal workers compensation procedures, except for the requirement of a Personal Injury Plan (or PIP).
This includes providing a medical certificate to support ongoing benefits, including wage entitlements.
The LTCS Scheme cannot provide you with advice or assist you with entitlement to benefits under the workers compensation legislation.
An injured worker who qualifies as a lifetime participant of the LTCS Scheme will no longer claim for treatment and care under the Workers Compensation Act 1951. If a worker is not accepted as a lifetime participant after 2 years in the LTCS Scheme, the worker’s treatment and care costs will revert to the worker’s compensation claim.
However, a worker who has been accepted in the LTCS Scheme will still be able to seek compensation under that Workers Compensation Act for economic and non-economic loss.
The extension to cover injured workers will be fully funded through a levy collected from workers compensation insurers and self-insurers.