PSPG | Work Health and Safety

The Australian Government Department of Defence

Incident Capture

Form AC563: Defence WHS Incident Report, is the notification and reporting form for all WHS incidents in Defence. This form must be completed even if a DISCON signal (FATALCAS and NOTICAS) has been raised. The form is only to be used by all ADO employees (ADF, Civilian and Reservists) as well as ADF Cadets, contractors and visitors who do not have access to the WHS Incident Self Service (ISS). ISS is the notification and reporting preferred method of submission for all WHS incidents in Defence for all personnel with access to the Defence Restricted Network (DRN).

These links below will direct you to the information on this page for each specific area.

1. Purpose - This describes why AC563 information is collected, and the legislative basis for data collection.

2. Collection Authority & Privacy - This section explains WHS adherence to collection authority and privacy principles.

3. Requesting a copy of a submitted AC563 - How to access AC563 information that has been previously submitted.

4. WHS Incident Definition - Definition and Incident types with examples.

5. Guidance For Completing The Form - Who should complete the form, multiple injuries or exposures, type of information to be included and distribution.

6. Sending the form to WHS Comcare and ARPANSA - Defence Reporting requirements, who needs to be told, timeframes for reporting and contacts.

7. Claiming Compensation - ADF and APS - Information Regarding Compensation.

8. Other Forms & Documents - Details on other Health & Safety related forms.

9. Frequently Asked Questions - Provides further information.

Non-DRN Defence WHS Incident Reporting

1. Purpose

This information is collected in accordance with legislative requirements to notify Comcare and the Australian Radiation Protection and Nuclear Safety Agency of certain WHS incidents and to maintain a record of WHS incidents in Defence. It may be used to trigger an investigation by the relevant Defence group or service. As well, it may be used to provide Work Health Safety (WHS) Branch with information for Defence Reporting. This form is not a claim for compensation. However, WHS Incident data is given to the Department of Veterans Affairs to support compensation or rehabilitation claims.

2. Collection Authority & Privacy

Information on this form is collected under the authority of the Defence Act 1903 (the Act), Work Health and Safety Act 2011 , the Australian Radiation Protection and Nuclear Safety Act 1998 (ARPANS Act). The information on this form is protected according to privacy principles in the Privacy Act 1998.

3. Requesting a copy of a submitted AC563

Access to a copy of your Defence WHS Incident Report can be sought by making a request via e-mail. A copy of the report can be e-mailed, posted or faxed to you usually within 5 working days.

1. Requesting a Copy of a Defence WHS Incident and Fatality Report

Send an e-mail to ac563@defence.gov.au. Include the following details:

2. Your Personal & Incident Details

Surname, Given Name, Date of Birth, PMKeys Number, Service Number, Date of Incident, Brief description of illness or injury and Incident location.

3. Your Contact Details

E-mail address, Fax Number, Postal Details if required

4. WHS Incident Definition

A WHS incident is any accident or event that is caused in the course of Defence work, which involves:

work illnesses;
uncontrolled fire and explosions;
disabling injuries;
serious equipment plant or property damage;
dangerous occurrences which could have, but did not injure any person;
exposures to hazardous substances or circumstances;
minor injuries;
any other serious incident that could put employees or plant at risk.

This includes WHS incidents for all Defence employees, Cadets, and third parties (which includes contractors and the general public). Defence contractors have dual reporting requirements both to the Commonwealth and to the State WHS Authority.

Incident Type Definitions

Incident type	Definition
Fatality	Death
Serious Injury or Illness	Section 36 of the WHS Act sets out that a serious injury or illness of a person is an injury or illness requiring the person to have: immediate treatment as an in-patient in a hospital immediate treatment for the amputation of any part of his or her body a serious head injury a serious eye injury a serious burn; the separation of his or her skin from an underlying tissue (such as de-gloving or scalping) a spinal injury the loss of a bodily function serious lacerations medical treatment within 48 hours of exposure to a substance the following prescribed illnesses: any medically diagnosed infectious disease that is reliably attributable to carrying out work, including work with micro-organisms, that involves providing care or treatment to a person, that involves contact with human blood or body substances, or that involves handling or contact with animals, animal hides, skins, wool or hair, animal carcasses or animal waste products medically diagnosed Q fever, anthrax, leptospirosis, brucellosis, Hendra virus, avian influenza or psittacosis. In the case of a serious injury or illness it does not matter whether a person actually received treatment, just that the injury or illness could reasonably be considered to warrant such treatment. The regulations may include or exclude other injuries or illnesses as ‘serious injuries or illnesses’ for the purposes of section 36 of the WHS Act, however the Regulations are currently silent on this.
Dangerous Incident	Section 37 of the WHS Act sets out that a dangerous incident is an incident in relation to a workplace that exposes a worker or any other person to a serious risk to a person’s health or safety emanating from an immediate or imminent exposure to: an uncontrolled escape, spillage or leakage of a substance an uncontrolled implosion, explosion or fire an uncontrolled escape of gas or steam an uncontrolled escape of a pressurised substance electric shock the fall or release from a height of any plant, substance or thing—this includes falls into open trenches or pits the collapse, overturning, failure or malfunction of, or damage to, any plant that is required to be authorised for use in accordance with the regulations the collapse or partial collapse of a structure the collapse or failure of an excavation or of any shoring supporting an excavation the inrush of water, mud or gas in workings, in an underground excavation or tunnel the interruption of the main system of ventilation in an underground excavation or tunnel The Regulations may include or exclude other events as being ‘dangerous incidents’ for the purposes of section 37 of the WHS Act; however the Regulations are currently silent on this.
Exposure	An event where an employee comes into contact with a substance or circumstance which does not lead to an immediate injury or illness.
Minor injury	An employee is injured and is: Unable to work for between 1 and 4 days; or Sees a doctor, nurse, or first aid attendant, but is not given emergency medical treatment; or Attends a medical centre, but is not given emergency medical treatment

5. Guidance For Completing The Form

Supervisor responsibility - It is thesor at the time of the incident that is responsible to complete and submit this form.
supervi
Multiple Injuries - Where more than one person is injured, a separate form must be completed for each person.

Multiple People Exposed - Where exposure incident involves more than one person, attach a list of all personnel involved showing their surname, given names, PMKeyS and service or AGS numbers of each person.

Information to include on the WHS Incident Report:

DO:

Use Defence WHS Incident Self Service system where possible.
Complete form online ensuring all mandatory fields are valid and form is submitted electronically to ac563@defence.gov.au
Provide as much information as possible describing the incident clearly.
Choose only one submission method i.e. electronic submission, fax, email, or postal mail.

DO NOT:

Use acronyms
Fax AC563 Instructions Page to WHS Branch
Send reports of minor injury to COMCARE
Submit the AC563 via multiple means.

6. Sending the form to WHS, Comcare and ARPANSA

This section provides guidance on Defence internal reporting requirements as well as reporting to the Commonwealth regulators, Comcare and ARPANSA. Specific instructions for deployment, ADF sport and radiation incidents are found below.
Deployment, ADF sport and Radiation

The following reporting procedure applies to WHS incidents that occur on deployment, during organised ADF sporting activity (DI(G)14-2) or incidents that involve radiation exposure.

Who needs to be told

Condition	Deployment	And the Incident Type Is	Notify
If you are	being paid a deployment allowance	All incidents	WHS
If you are	not being a paid deployment allowance	radiation exposure	WHS, Comcare and ARPANSA
If you are	not being paid a deployment allowance	not related to radiation exposure	WHS and Comcare

Timeframes for reporting

Timeframes for notifying and sending this form are mandated by legislation. The table below shows the reporting procedure. Timeframes for notifying and sending this form are mandated by legislation. The table below shows the reporting procedure. For further clarification of definitions see Incident Definitions above.

WHS incident reporting timeframes
		All incidents report to WHS Branch (Notification timeframes)		Specific Incidents report to COMCARE	Radiation incidents report to ARPANSA
		Initial Report	Follow on Actions	Notification to Comcare is required immediately after becoming aware that a notifiable incident arising from the business or undertaking has occurred. Notification in the first instance should be by phone – 1300 366 979. Seek advice from Comcare regarding site preservation and submission of written notification of the incident.	Reporting to ARPANSA is to be, in the first instance, within 24 hours of the incident
Fatality	Notifiable Death – The work-related death of any person including a contractor, member of the public or employee.	Within 24 hours	Within 28 days		The reporting to ARPANSA of radiation incidents it to be completed if the source of the radiation, which caused or had potential to cause an exposure, is currently licensed to Defence by ARPANSA under the ARPANS Act. Types of equipment that are Licensed Apparatus includes (but are not limited to) Class 3B and 4 Lasers, radioactive material and X-ray equipment. Further details are available on the JLC DRSA website.
Serious Injury or Illness	An injury to or disease in a person caused in the course of work which the person needed emergency treatment by a registered medical practitioner, treatment in a hospital as a casualty, with or without being admitted to hospital	Within 24 hours	Within 28 days
Dangerous Incident	An incident where no person is injured, but could have been injured, resulting in Serious Personal Injury, Incapacity, or Death. Commonly called a ‘near miss’.	Within 24 hours	Within 28 days
Exposure	Potential exposure to substance/ material including workplace hazards that did not result in a fatality, serious illness, minor injury, or dangerous incident.	Within 24 hours	Within 28 days
Minor Injury	Any minor injury that did not result in a Fatality, SPI, or Dangerous Incident.	Within 28 days	Within 28 days

Group or service distribution

The distribution procedures for groups and services are different across Defence. While specific group and service distribution should be sought, it is recommended that a copy of the WHS Incident Report be placed:

Employee File
Supervisor
Unit Safety Coordinator
Regional WHS Coordinators
Command Safety Officer
Group Safety Coordinators

Contact details

WHS Contact Details	COMCARE Contact Details	ARPANSA Contact details
Incident Capture ISS Helpdesk - 1800 220 820 ac563@defence.gov.au Incident Reporting WHSCAR@defence.gov.au	Business Hours Hotline 1300 366 979	24 Hour Phone Emergency Officer 03 9432 5384 BH phone Director, Regulatory Branch 02 9541 8329
	www.comcare.gov.au	www.arpansa.gov.au
Fax: 1800 563 563	Fax: 1300 305 916	Fax: (All states) 02 9541 8348
Postal address: WHS ICR 33-35 Brindabella Circuit Department of Defence PO Box 7927 CANBERRA BC ACT 2610	Comcare has a National (local call costs) contact telephone number for all enquires and notification of fatalities and fax number for reporting of incidents.

7. Claiming Compensation - ADF and APS

ADF members who require information in relation to their compensation entitlements under the Military Rehabilitation and Compensation Act 2004 (MRCA) are advised to visit the Department of Veterans' Affairs website: http://www.dva.gov.au/benefitsAndServices/Pages/MRCAbenefits.aspx.

APS employees who require information in relation to compensation entitlements under the Safety, Rehabilitation and Compensation Act 1988 (SRCA) for a work related injury or illness can visit the Comcare website: http://www.comcare.gov.au/claims/injured_employees.

APS employees who would like to contact a Defence rehabilitation case manager can do so through the Defence Service Centre (Cooma) on 1800 000 677 or via email dsc@defence.gov.au .

8. Other Forms & Documents

In addition to the AC563, completion of other Defence forms or reports may be required. Check your unit or group standard operating procedures.

AD088 - Comcover Notification Form
RODUM - Report of Defective Unsatisfactory Material
ASOR - Air Safety Occurrence Report
OA79 - Hazard Report
OHSIR - Work Health and Safety Incident Report
ADFP202 - Administrative Inquiries Manual

9. Frequently Asked Questions

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