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["2021-07-02","Friday"]
["2021-07-03","Saturday"]
["2021-07-04","Sunday"]
["2021-07-05","Monday"]
["2021-07-06","Tuesday"]
["2021-07-07","Wednesday"]
["2021-07-08","Thursday"]
["2021-07-09","Friday"]
["2021-07-10","Saturday"]
["2021-07-11","Sunday"]
["2021-07-12","Monday"]
["2021-07-13","Tuesday"]
["2021-07-14","Wednesday"]
["2021-07-15","Thursday"]
["2021-07-16","Friday"]
["2021-07-17","Saturday"]
["2021-07-18","Sunday"]

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[]
[null,null,null,null,null,null,"Weekly Payment Reimbursement Request  ."]
[]
[]
[null,"Employer Name:",null,null,null,"Employer ABN:"]
[null,"ReturnToWorkSA  Registration No:",null,null,null,"Location No:"]
[]
[null,"Worker Name: ",null,null,null,"Date of Injury:"]
[null,"Claim Number:",null,null,null,"Date of First Incapacity:"]
[null,"Notional Weekly Earnings:",null,null,null,"Normal hrs worked per week:"]
[]
[null," Week Starting:",null,null,null,"No. of Weeks:"]
[null,"Agreed Pay Cycle Start Day:",null,{"$f":"IF(D12=\"\",\"\",VLOOKUP(D12,Days!A:B,2,FALSE))","v":""},null,"Entitlement Percentage:"]
[null,"* NOTE: if the reduction date falls within a week, the estimated reimbursement will show at 80%.  This may not be accurate."]
[null,"Date","Week Day","Hours Worked","Earnings from \nPaid Employment",null,{"$f":"DATE(YEAR(G9)+1,MONTH(G9),DAY(G9))","v":"1900-12-31"}]
[null,{"$f":"IF($G$12>=1,D12,\"\")","v":""},{"$f":"IF($G$12>=1,VLOOKUP(B16,Days!A:B,2,FALSE),\"\")","v":""},null,null,null,{"$f":"B16>=$G$9","v":true}]
[null,{"$f":"IF($G$12>=1,B16+1,\"\")","v":""},{"$f":"IF($G$12>=1,VLOOKUP(B17,Days!A:B,2,FALSE),\"\")","v":""},null,null,null,{"$f":"B17>=$G$9","v":true}]
[null,"",{"$f":"IF($G$12>=1,VLOOKUP(B18,Days!A:B,2,FALSE),\"\")","v":""},null,null,null,true]
[null,"",{"$f":"IF($G$12>=1,VLOOKUP(B19,Days!A:B,2,FALSE),\"\")","v":""},null,null,null,true]
[null,"",{"$f":"IF($G$12>=1,VLOOKUP(B20,Days!A:B,2,FALSE),\"\")","v":""},null,null,null,true]
[null,"",{"$f":"IF($G$12>=1,VLOOKUP(B21,Days!A:B,2,FALSE),\"\")","v":""},null,null,null,true]
[null,"",{"$f":"IF($G$12>=1,VLOOKUP(B22,Days!A:B,2,FALSE),\"\")","v":""},null,null,false,true]
[null,"Week Ending",null,{"$f":"IF($F22=TRUE,\"\",IF(SUM(D16:D22)=0,\"\",SUMIF($G$16:$G$22,TRUE,$D$16:$D$22)))","v":""},{"$f":"IF($F$22=TRUE,\"\",IF(SUM(E16:E22)=0,\"\",SUMIF($G$16:$G$22,TRUE,$E$16:$E$22)))","v":""},"Estimated Reimbursement",{"$f":"IFERROR(IF(F22=TRUE,($D$10*$G$13)/100,($D$10-E23)*$G$13/100),\"\")","v":""}]
[null,{"$f":"IF($G$12>=2,B22+1,\"\")","v":""},{"$f":"IF($G$12>=2,VLOOKUP(B24,Days!A:B,2,FALSE),\"\")","v":""},null,null,null,{"$f":"B24>=$G$9","v":true}]
[null,{"$f":"IF($G$12>=2,B24+1,\"\")","v":""},{"$f":"IF($G$12>=2,VLOOKUP(B25,Days!A:B,2,FALSE),\"\")","v":""},null,null,null,{"$f":"B25>=$G$9","v":true}]
[null,"",{"$f":"IF($G$12>=2,VLOOKUP(B26,Days!A:B,2,FALSE),\"\")","v":""},null,null,null,true]
[null,"",{"$f":"IF($G$12>=2,VLOOKUP(B27,Days!A:B,2,FALSE),\"\")","v":""},null,null,null,true]
[null,"",{"$f":"IF($G$12>=2,VLOOKUP(B28,Days!A:B,2,FALSE),\"\")","v":""},null,null,null,true]
[null,"",{"$f":"IF($G$12>=2,VLOOKUP(B29,Days!A:B,2,FALSE),\"\")","v":""},null,null,null,true]
[null,"",{"$f":"IF($G$12>=2,VLOOKUP(B30,Days!A:B,2,FALSE),\"\")","v":""},null,null,false,true]
[null,"Week Ending",null,{"$f":"IF($F30=TRUE,\"\",IF(SUM(D24:D30)=0,\"\",SUMIF($G$24:$G$30,TRUE,$D$24:$D$30)))","v":""},{"$f":"IF(F30=TRUE,\"\",IF(SUM(E24:E30)=0,\"\",SUMIF($G$24:$G$30,TRUE,$E$24:$E$30)))","v":""},"Estimated Reimbursement",{"$f":"IFERROR(IF(F30=TRUE,($D$10*$G$13)/100,($D$10-E31)*$G$13/100),\"\")","v":""}]
[null,{"$f":"IF($G$12>=3,B30+1,\"\")","v":""},{"$f":"IF($G$12>=3,VLOOKUP(B32,Days!A:B,2,FALSE),\"\")","v":""},null,null,null,{"$f":"B32>=$G$9","v":true}]
[null,{"$f":"IF($G$12>=3,B32+1,\"\")","v":""},{"$f":"IF($G$12>=3,VLOOKUP(B33,Days!A:B,2,FALSE),\"\")","v":""},null,null,null,{"$f":"B33>=$G$9","v":true}]
[null,"",{"$f":"IF($G$12>=3,VLOOKUP(B34,Days!A:B,2,FALSE),\"\")","v":""},null,null,null,true]
[null,"",{"$f":"IF($G$12>=3,VLOOKUP(B35,Days!A:B,2,FALSE),\"\")","v":""},null,null,null,true]
[null,"",{"$f":"IF($G$12>=3,VLOOKUP(B36,Days!A:B,2,FALSE),\"\")","v":""},null,null,null,true]
[null,"",{"$f":"IF($G$12>=3,VLOOKUP(B37,Days!A:B,2,FALSE),\"\")","v":""},null,null,null,true]
[null,"",{"$f":"IF($G$12>=3,VLOOKUP(B38,Days!A:B,2,FALSE),\"\")","v":""},null,null,false,true]
[null,"Week Ending",null,{"$f":"IF($F38=TRUE,\"\",IF(SUM(D32:D38)=0,\"\",SUMIF($G$32:$G$38,TRUE,$D$32:$D$38)))","v":""},{"$f":"IF(F38=TRUE,\"\",IF(SUM(E32:E38)=0,\"\",SUMIF($G$32:$G$38,TRUE,$E$32:$E$38)))","v":""},"Estimated Reimbursement",{"$f":"IFERROR(IF(F38=TRUE,($D$10*$G$13)/100,($D$10-E39)*$G$13/100),\"\")","v":""}]
[null,{"$f":"IF($G$12>=4,B38+1,\"\")","v":""},{"$f":"IF($G$12>=4,VLOOKUP(B40,Days!A:B,2,FALSE),\"\")","v":""},null,null,null,{"$f":"B40>=$G$9","v":true}]
[null,{"$f":"IF($G$12>=4,B40+1,\"\")","v":""},{"$f":"IF($G$12>=4,VLOOKUP(B41,Days!A:B,2,FALSE),\"\")","v":""},null,null,null,{"$f":"B41>=$G$9","v":true}]
[null,"",{"$f":"IF($G$12>=4,VLOOKUP(B42,Days!A:B,2,FALSE),\"\")","v":""},null,null,null,true]
[null,"",{"$f":"IF($G$12>=4,VLOOKUP(B43,Days!A:B,2,FALSE),\"\")","v":""},null,null,null,true]
[null,"",{"$f":"IF($G$12>=4,VLOOKUP(B44,Days!A:B,2,FALSE),\"\")","v":""},null,null,null,true]
[null,"",{"$f":"IF($G$12>=4,VLOOKUP(B45,Days!A:B,2,FALSE),\"\")","v":""},null,null,null,true]
[null,"",{"$f":"IF($G$12>=4,VLOOKUP(B46,Days!A:B,2,FALSE),\"\")","v":""},null,null,false,true]
[null,"Week Ending",null,{"$f":"IF($F46=TRUE,\"\",IF(SUM(D40:D46)=0,\"\",SUMIF($G$40:$G$46,TRUE,$D$40:$D$46)))","v":""},{"$f":"IF(F46=TRUE,\"\",IF(SUM(E40:E46)=0,\"\",SUMIF($G$40:$G$46,TRUE,$E$40:$E$46)))","v":""},"Estimated Reimbursement",{"$f":"IFERROR(IF(F46=TRUE,($D$10*$G$13)/100,($D$10-E47)*$G$13/100),\"\")","v":""}]
[null,{"$f":"IF($G$12>=5,B46+1,\"\")","v":""},{"$f":"IF($G$12>=5,VLOOKUP(B48,Days!A:B,2,FALSE),\"\")","v":""},null,null,null,{"$f":"B48>=$G$9","v":true}]
[null,{"$f":"IF($G$12>=5,B48+1,\"\")","v":""},{"$f":"IF($G$12>=5,VLOOKUP(B49,Days!A:B,2,FALSE),\"\")","v":""},null,null,null,{"$f":"B49>=$G$9","v":true}]
[null,"",{"$f":"IF($G$12>=5,VLOOKUP(B50,Days!A:B,2,FALSE),\"\")","v":""},null,null,null,true]
[null,"",{"$f":"IF($G$12>=5,VLOOKUP(B51,Days!A:B,2,FALSE),\"\")","v":""},null,null,null,true]
[null,"",{"$f":"IF($G$12>=5,VLOOKUP(B52,Days!A:B,2,FALSE),\"\")","v":""},null,null,null,true]
[null,"",{"$f":"IF($G$12>=5,VLOOKUP(B53,Days!A:B,2,FALSE),\"\")","v":""},null,null,null,true]
[null,"",{"$f":"IF($G$12>=5,VLOOKUP(B54,Days!A:B,2,FALSE),\"\")","v":""},null,null,false,true]
[null,"Week Ending",null,{"$f":"IF($F54=TRUE,\"\",IF(SUM(D48:D54)=0,\"\",SUMIF($G$48:$G$54,TRUE,$D$48:$D$54)))","v":""},{"$f":"IF(F54=TRUE,\"\",IF(SUM(E48:E54)=0,\"\",SUMIF($G$48:$G$54,TRUE,$E$48:$E$54)))","v":""},"Estimated Reimbursement",{"$f":"IFERROR(IF(F54=TRUE,($D$10*$G$13)/100,($D$10-E55)*$G$13/100),\"\")","v":""}]

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["claim",{"$f":"Calculator!D9","v":0}]

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[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Weekly Payment Reimbursement Request  ."]
[null,"Name of employer (as per registration)",null,null,null,null,null,{"$f":"IF(Calculator!D5=\"\",\"\",Calculator!D5)","v":""}]
[null,"Employer ABN",null,null,null,null,null,{"$f":"IF(Calculator!G5=0,\"\",Calculator!G5)","v":""}]
[null,"ReturnToWorkSA registration no",null,null,null,null,null,{"$f":"IF(Calculator!D6=0,\"\",Calculator!D6)","v":""},null,null,null,null,"Location no",null,{"$f":"IF(Calculator!G6=0,\"\",Calculator!G6)","v":""}]
[]
[null,"Worker’s Name",null,null,null,null,null,"Claim Number",null,null,"Date of Injury",null,null,"NWE*"]
[null,{"$f":"IF(Calculator!D8=\"\",\"\",Calculator!D8)","v":""},null,null,null,null,null,{"$f":"IF(Calculator!D9=\"\",\"\",Calculator!D9)","v":""},null,null,{"$f":"IF(Calculator!G8=\"\",\"\",Calculator!G8)","v":""},null,null,{"$f":"IF(Calculator!D10=\"\",\"\",Calculator!D10)","v":""}]
[null,"*Notional weekly earnings: The worker’s average weekly earnings or where adjusted, the adjusted average weekly earnings."]
[null,"Details of worker earning and hours of paid employment"]
[null,{"$f":"Calculator!B13","v":"Agreed Pay Cycle Start Day:"},null,null,null,null,null,{"$f":"IF(Calculator!D13=0,\"\",Calculator!D13)","v":""}]
[null,"Pay Week Starting",null,null,"Pay Week Ending",null,null,"Nil Earnings",null,null,"Earnings from Paid Employment",null,null,"Hours Worked"]
[null,{"$f":"IF(Calculator!B16=0,\"\",Calculator!B16)","v":""},null,null,{"$f":"Calculator!B22","v":""},null,null,{"$f":"IF(Calculator!$F$22=TRUE,\"X\",\"\")","v":""},null,null,{"$f":"IF(Calculator!$E23=\"0\",\"\",Calculator!$E23)","v":""},null,null,{"$f":"IF(Calculator!$D23=\"0\",\"\",Calculator!$D23)","v":""}]
[null,{"$f":"IF(Calculator!B24=0,\"\",Calculator!B24)","v":""},null,null,{"$f":"Calculator!B30","v":""},null,null,{"$f":"IF(Calculator!F30=TRUE,\"X\",\"\")","v":""},null,null,{"$f":"IF(Calculator!$E31=\"0\",\"\",Calculator!$E31)","v":""},null,null,{"$f":"Calculator!$D31","v":""}]
[null,{"$f":"Calculator!B32","v":""},null,null,{"$f":"Calculator!B38","v":""},null,null,{"$f":"IF(Calculator!F38=TRUE,\"X\",\"\")","v":""},null,null,{"$f":"IF(Calculator!$E39=0,\"\",Calculator!$E39)","v":""},null,null,{"$f":"Calculator!$D39","v":""}]
[null,{"$f":"Calculator!B40","v":""},null,null,{"$f":"Calculator!B46","v":""},null,null,{"$f":"IF(Calculator!F46=TRUE,\"X\",\"\")","v":""},null,null,{"$f":"IF(Calculator!$E47=0,\"\",Calculator!$E47)","v":""},null,null,{"$f":"Calculator!$D47","v":""}]
[null,{"$f":"Calculator!B48","v":""},null,null,{"$f":"Calculator!B54","v":""},null,null,{"$f":"IF(Calculator!F54=TRUE,\"X\",\"\")","v":""},null,null,{"$f":"IF(Calculator!E55=0,\"\",Calculator!E55)","v":""},null,null,{"$f":"Calculator!$D55","v":""}]
[]
[null,"1.     This form is intended to assist employers seeking reimbursement for weekly income support payments made to a worker."]
[null,"2.     Use one form per worker. Please contact your Claims Officer if you need help completing this form. "]
[null,"3.     Additional copies of this form are available on Gallagher Bassett’s website (www.gallagherbassett.com.au) or by contacting "]
[null,"us on 8177 8450"]
[null,"4.     This form must be submitted within three months from the date you paid the worker the payment you are seeking to be "]
[null,"reimbursed."]
[null,"5.     Evidence of payment / pay records must be attached."]
[null,"6.     ReturnToWorkSA will only reimburse income maintenance payments that the worker was legally entitled to receive. It is"]
[null,"the employer’s responsibility to ensure (by obtaining a written authorisation from ReturnToWorkSA or Gallagher Bassett)"]
[null,"that the worker was entitled to receive a particular payment of income maintenance."]
[null,"7.     Tick the ‘Nil earnings’ box if the worker did not perform any work during the week."]
[null,"8.     Only include amounts paid for work performed in your employment by the worker which includes personal leave. Do not "]
[null,"include any allowances or benefits relating to annual leave or other leave type."]
[null,"9.     Weekly payment reimbursement requests and pay slips can be emailed to wprr@gb.rtwsa.com for reimbursement."]
[]
[null,"I declare that weekly payments of income support have been paid to the worker in accordance with the Return to Work Act 2014"]
[null,null,null,null,null,null,null,null,null,null,null,"Date:"]
[null,"Signature of authorised officer of employer"]
[]
[null,"AGENT OFFICE USE ONLY"]
[null,"I confirm that the details of this form match my knowledge of the worker’s expected earnings from employer"]
[null,"Signed / authorised",null,null,null,null,null,null,null,null,null,null,"Date"]
[null,"Name of authorising officer"]

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[]
[null,"WPRR Calculator Instructions  ."]
[]
[null,"COMPLETING CALCULATOR"]
[]
[]
[null,"NOTE: Macros must be enabled for this calculator to work.\n"]
[null,"Shaded Cells: You only need to enter information into the grey shaded cells.\n"]
[null,"Employer Name / Employer ABN / Location Number / WorkCover Registration Number: Must be per registration details with ReturnToWorkSA."]
[null,"Worker Name / Claim Number / Date of Injury: Can all be located on the latest claim determination letter(s).\n"]
[null,"Date of First Incapacity: This date is the first day where the injured worker was medically certified with an incapacity for work. This is most commonly the date income maintenance was first paid on the claim and should be noted on the initial claim determination letter.\n"]
[null,"Notional Weekly Earnings (NWE): Enter the NWE for the determination period that covers the \"Week Starting\".\n"]
[null,"Normal Hours Worked Per Week: This is the base hours the injured worker is employed for. This is usually 38 or 40 hours per week for a full time employee.\n"]
[null,"Week Starting:  This is the first date in the pay cycle you are claiming for.  This date cannot be prior to 1/07/2015. \n"]
[null,"No of Weeks: You can enter up to 5 weeks at a time into the calculator.  The more weeks that are selected, the further the pre-filled dates will be displayed.\n"]
[null,"Agreed Pay Cycle Start Date: This is the pay cycle that you have entered into an agreement with Gallagher Bassett to pay the worker.  This may be, for example, from Thursday to Wednesday, or Monday to Sunday.  You must enter the start day here.\n"]
[]
[null,"Date / Weekday: These will prefill, based on the date you have entered in \"week starting\".  This can be any date; however the first \"week day\" must match the day you have entered in the \"Agreed Pay Cycle Start Date\".\n"]
[null,"Hours Worked:  If the worker has completed any hours of work, this must be entered into each applicable day.  The hours must include their base hours, overtime and any personal leave. Do not include annual leave (etc.) hours in this field.\n"]
[null,"Earning from Paid Employment:  An amount must be entered (excluding zero) for every day in the period that a the worker has received earning for hours completed. Any amounts entered that are in periods the worker was not entitled to income support will be disregarded.\n"]
[null,"Nil Earnings from Employment for Week: If the worker has not worked for the week, you can tick this box and it will complete the reimbursement information on the WPRR form.  If you have entered earnings and also tick this box, the \"nil earning\" will be displayed.\n"]
[null,"NOTES"]
[null,"\nIf the First Date of Incapacity occurs in the first week that is being submitted for a reimbursement request, the Estimated Reimbursement amount for this week may not be accurate and should be noted as an estimate only.\n"]
[null,"If an anniversary of the First Date of Incapacity falls within the period that a reimbursement request is being submitted for, the Estimated Reimbursement amount for the week that includes this anniversary may not be accurate and should be noted as an estimate only.\n"]
[null,"SUBMITTING WPRR"]
[]
[null,"If you wish to submit the WPRR via email, you can simply click on the \"Email to GB\" button at the top of the WPRR tab.  This will attach the workbook to an email, addressed to the Gallagher Bassett WPRR inbox.  Please remember to attach any payslips to this email as evidence, prior to sending it."]

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["Monday"]
["Tuesday"]
["Wednesday"]
["Thursday"]
["Friday"]
["Saturday"]
["Sunday"]