South Australian Numbered Regulations South Australian Numbered RegulationsSchedule 1—Requirements for applications for statutory compensation
Part 1—Information to be included in application
A claimant must include in an application for statutory compensation the
following information:
(a) the
name, address and date of birth of the claimant;
(b) the
name, address and date of birth of the victim of the offence (if not the
claimant);
(c) the
date, time and place of the offence;
(d) the
nature of the offence and the details surrounding the occurrence of the
offence;
(e) when
and where the offence was reported to the police or, if not reported, the
reason for not reporting the offence;
(f)
details of the nature and extent of the injury;
(g) if
the victim of the offence is dead—
(i)
the relationship of the claimant to the victim; and
(ii)
the date of death; and
(iii)
the date of the funeral.
Note—
Failure to report an offence to the police within a reasonable time after its
commission may result in a claimant being refused statutory compensation
unless the claimant can establish good reason for the failure—see
section 20(7) of the Act.
A claimant must include in an application for statutory compensation the
following information about the offender:
(a) the
name and address of the offender (if known);
(b) if
the offender was charged with any offence—
(i)
details of the charges laid; and
(ii)
details of the court in which the charges were laid; and
(iii)
the date of the trial (if any);
(c) the
outcome of the prosecution of any offence, including, if the offender was
convicted of an offence—
(i)
details of the conviction recorded; and
(ii)
details of the court in which the conviction was
recorded; and
(iii)
the date of the conviction; and
(iv)
details of any appeal lodged against the conviction by
the offender;
(d)
whether the claimant gave evidence for the prosecution at the trial of the
offender and, if not, the reasons why the claimant did not give evidence;
Note—
Failure of or refusal by the victim to give evidence in the prosecution of an
offender may result in a claimant being refused statutory compensation unless
the claimant can establish good reason for the failure or refusal—see
section 20(7) of the Act.
(e) if
the claimant seeks an exemption from the requirement to serve the application
on the offender on the ground that the whereabouts of the offender are unknown
and cannot be readily ascertained (see section 18(4)(c) of the
Act)—details of attempts by the claimant to locate the offender.
3—Information about action taken to ascertain defendant's assets
A claimant must include in an application (other than a limited application)
for statutory compensation details, and results, of any searches carried out
by the claimant in order to ascertain the assets (if any) of the defendant.
4—Information about statutory compensation being claimed
(1) A claimant must
include in an application for statutory compensation that is limited to
compensation for funeral expenses an itemised list of funeral expenses.
Note—
Section 17(4) of the Act sets out who is eligible to claim statutory
compensation for funeral expenses.
(2) A claimant must
include in an application for statutory compensation the following information
about the compensation being claimed:
(a)
particulars of any special damages being claimed, including—
(i)
an itemised list of expenses in relation to any treatment
and the name of the person or institution to whom the expense was paid or is
payable;
(ii)
as to each item, details of any refund or entitlement to
refund of treatment costs from Medicare, an insurer or any other source;
(iii)
an itemised list of funeral expenses;
(b)
particulars of any loss of earnings as follows:
(i)
if past loss of earnings is being claimed, details of the
period off work or any period of reduced work and the amount that would have
been earned had the claimant worked during that period (showing how this is
calculated);
(ii)
if an ongoing loss of earnings or a loss of earning
capacity is being claimed, details of—
(A) the occupation or business of the
claimant at the time of the injury and during the 12 months prior to the
injury;
(B) the gross income received from the
occupation or business during the 12 month period ending on 30 June last prior
to the injury;
(C) any disability (including mental
disability) from which the claimant is suffering or has suffered in
consequence of the injury and which is preventing or has prevented (wholly or
in part) the claimant from carrying on his or her occupation or business;
(D) the periods since the injury during
which the claimant has been unable (wholly or in part) to perform his or her
usual occupation or business, together with the periods during which the
incapacity has been total and the periods during which it has been partial;
(E) where there has been partial
incapacity, the nature and extent of the partial incapacity;
(F) the periods since the injury during
which the claimant has been employed or otherwise engaged in an occupation or
business and, in respect of each such occupation or business—
• the nature of
the occupation or business;
• the address at
which it was conducted or performed;
• the name of
the employer;
• the gross
income received by the claimant.
(1) A claimant must
include in an application (other than a limited application) for statutory
compensation a formulated claim showing the amount of compensation for which
the claimant proposes the claim be settled.
(2) The formulated
claim must set out separately—
(a) the
number of points claimed for non-financial loss (see section 20(3)(a)(ii) of
the Act); and
(b) the
amount claimed for—
(i)
any closed period of past loss of earnings; and
(ii)
any loss of earning capacity; and
(iii)
special damages.
(3) The formulated
claim must include a statement of all amounts received, or likely to be
received, by or on behalf of the claimant from the offender, an insurer or any
other source, and details of any steps taken to obtain payment or compensation
from the offender or any other person, body corporate or government department
or agency in respect of the injury.
Part 2—Documents required to accompany application
6—Police records, statements etc
An application for statutory compensation must be accompanied by a copy of any
record, statement or evidence relating to the offence provided to the claimant
by the police.
7—Hospital reports and reports from general medical practitioner or
dentist
The claimant's application (other than a limited application) for statutory
compensation must be accompanied by either (or both) of the following:
(a) if
the victim was treated for the injury in a hospital—the hospital report
(up to 20 pages) relating to the victim;
(b) a
report from a general medical practitioner or dentist summarising—
(i)
the history taken from the victim; and
(ii)
the nature and extent of the injury; and
(iii)
the history of the treatment of the injury; and
(iv)
whether there is a need for any future treatment and, if
so, the nature of the future treatment; and
(v)
the prognosis; and
(vi)
the nature and extent of any permanent disability
resulting from the injury.
Note—
See also clause 4(2) of Schedule 2.
(1) If an application
for statutory compensation includes a claim for a permanent disability in the
nature of scarring, deformity or disfigurement resulting from an injury caused
by an offence, the application must be accompanied by—
(a) any
relevant photographs, which must be dated, of the victim taken before the
victim was injured; and
(b)
photographs of the injury taken at or about the time of the making of the
application.
(2) A photograph taken
for the purposes of subclause (1)(b) must, on the reverse of the
photograph, be signed and dated by a legal practitioner or justice certifying
that—
(a) he
or she has seen, and is satisfied as to the identity of, the victim; and
(b) the
photograph is a true photograph of the victim.
9—Statement of loss of earnings etc
(1) If an application
for statutory compensation includes a claim for past loss of earnings—
(a) by
the claimant as an employee—the application must be accompanied
by—
(i)
a letter from the employer or employer's insurer; or
(ii)
some other written evidence,
confirming the period during which the claimant lost earnings and the amount
lost during the period;
(b) by
the claimant as a self-employed person—the application must be
accompanied by written evidence confirming the period during which the
claimant lost earnings and the amount lost during the period.
(2) If an application
for statutory compensation includes a claim for loss of earnings as a result
of the claimant being unable, as a consequence of the injury, to enter into,
or carry out, a contract with a particular person, the application must be
accompanied by—
(a) a
letter from the person confirming the availability of work for the claimant
during the relevant period and the value of that work; or
(b) some
other written evidence supporting the claim.
(3) If an application
for statutory compensation includes a claim for loss of earning capacity by
the claimant, the application must be accompanied by a copy of the claimant's
income tax return—
(a) for
each of the 5 financial years immediately preceding the commission of the
offence resulting in the injury; and
(b) for
the financial year during which the offence resulting in the injury was
committed; and
(c) for
each of the financial years occurring since the financial year referred to in
paragraph (b).
Note—
Copies of tax returns may be obtained from the Australian Taxation Office.
10—Documents relating to amounts received by claimant from other sources
An application for statutory compensation must be accompanied by copies of any
documents relating to any amounts received, or likely to be received, by or on
behalf of the claimant from the offender, an insurer or any other source, and
details of any steps taken to obtain payment or compensation from the offender
or any other person, body corporate or government department or agency in
respect of the injury.