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Follow the links below to find material targeted to the unit's elements, performance criteria, required skills and knowledge

Elements and Performance Criteria

1. Assess claim
   • Assess available information to establish if it is sufficient for a determination to be made.
   • Identify additional information required, if any, to make the determination.
   • Obtain additional information.
   • Re-assess information to determine if it is sufficient or if further investigation is required.
   • Make a decision to defer where information is insufficient, and consider interim payments where applicable.
2. Make a determination
   • Confirm the claimant’s eligibility and the reported condition as compensable under the legislation.
   • Assess details of the claim to ensure they qualify for payment.
   • Accept or reject the claim based on all available evidence.
   • Calculate notional weekly earnings where required.
   • Advise the claimant and other relevant parties in writing of the decision, and ensure advice contains all information required by the legislation.
   • Complete case records ensuring they contain comprehensive details of the claim and justification for the decision.
3. Assess claim
   • Assess available information to establish if it is sufficient for a determination to be made.
   • Identify additional information required, if any, to make the determination.
   • Obtain additional information.
   • Re-assess information to determine if it is sufficient or if further investigation is required.
   • Make a decision to defer where information is insufficient, and consider interim payments where applicable.
4. Make a determination
   • Confirm the claimant’s eligibility and the reported condition as compensable under the legislation.
   • Assess details of the claim to ensure they qualify for payment.
   • Accept or reject the claim based on all available evidence.
   • Calculate notional weekly earnings where required.
   • Advise the claimant and other relevant parties in writing of the decision, and ensure advice contains all information required by the legislation.
   • Complete case records ensuring they contain comprehensive details of the claim and justification for the decision.

Performance Evidence

Evidence required to demonstrate competence must satisfy all of the requirements of the elements and performance criteria. If not otherwise specified the candidate must demonstrate evidence of performance of the following on at least one occasion.

applying legislation, regulations and policies relating to determination of compensation claims

assessing the sufficiency of information and the requirement for further investigation

analysing information and making judgments

calculating interim payments

reading and applying complex information

using communication with a diverse range of people including employers, unions, workplace supervisors, medical advisers, legal advisers, insurer/self-insurer

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Knowledge Evidence

Evidence required to demonstrate competence must satisfy all of the requirements of the elements and performance criteria. If not otherwise specified the depth of knowledge demonstrated must be appropriate to the job context of the candidate.

public sector legislation, including work health and safety, and environment

regulations, policies, procedures and guidelines relating to determination of claims

privacy legislation

freedom of information legislation

procedures to ensure confidentiality and security of information

eligibility and compensable conditions under the legislation

expenses that may be claimed

non-economic loss

medical terminology

documentary requirements of a claim

organisational standards for claim determinations

range of payment options under the legislation

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