Ability at work 
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Appendix B – Model form of words for data collection
Collecting Diversity Data
Attached to this letter is a form that we have developed to help us to capture information about the personal background of all of our staff.
I am personally committed to ensuring that the workforce of [our agency] represents the diversity of the community it serves, and that our employees are supported to achieve their maximum potential. Completing the form is voluntary. Nevertheless, I want to encourage employees to record this information and return it to the [human resources area]. Recording this information will help us to develop and monitor our strategies to ensure that we are attracting the best people to work in [this agency] from across the full diversity of the Australian community.
It can also help us support you in your employment. If you identify as having a disability and require any adjustments to be made or specific equipment to be provided, please contact [relevant employee] as soon as possible to discuss your situation.
How we keep your personal information
We will hold your information on a secure basis, with access only available to authorised staff on a need to know basis, and subject to the provisions of the Privacy Act 1988. Records must be kept for the periods set out in the Workplace Relations Regulations and the National Australian Archives Administrative Functions Disposal Authority.
To whom do we disclose information
Information in your personnel records may be disclosed as appropriate to Comsuper, Comcare, the Australian Taxation Office, the Australian Industrial Relations Commission, the [agency’s] protective security vetting service provider or the Australian Government Solicitor’s Office. In addition, if you move to another APS agency, your personnel records will be transferred to the gaining agency.
Amending your information
I will ask you again for this information from time to time during your career with us. I want to make sure that this information is as complete and up to date as it can be.
If you want more details of what other personnel records we hold about you, or wish to seek access to your records, or to request an amendment to your records to ensure that they are accurate, complete and up to date, please contact [details].
[Agency Head signature block]
1. Are you of Aboriginal or Torres Strait Islander origin?
Yes
No
Choose not to give this information
2. What country were you born in?
Australia (go to Question 4)
Other (please specify)
Choose not to give this information
3. If you were born outside of Australia, what year did you arrive in Australia?
Choose not to give this information
4. What was your first language spoken?
English only (go to Question 6)
English and another language
Language other than English
Choose not to give this information
5. What was your (main) first non–English language spoken?
____________________________
Choose not to give this information
6. What was your mother's first language?
English
English and another language
Language other than English
Language unknown
Choose not to give this information
7. What was your father's first language?
English
English and another language
Language other than English
Language unknown
Choose not to give this information
8. Do you have a disability (see below)?
Yes
No
Choose not to give this information
If yes, please state:
Physical or sensory disability
Intellectual disability
Mental illness or psychiatric disability
Learning disability
Are any adjustments to the nature of your work or workstation required to assist you in your duties?
Yes
No
If so, please contact [contact officer]
Some questions you may have…
Why do you want to know about my background and whether I have a disability?
We’re committed to merit in the workplace. We want the most talented available people working with us. If we’re not recruiting from the diversity of the Australian community then we may not be tapping the best available pool of talent.
We need to know whether our policies to attract, recruit and retain people with that talent are working effectively. The data you give us helps us to evaluate those policies and make any changes we need to make.
We’re also committed to ensuring that all of our employees have the right tools and the right environment to allow them to make the best contribution they can to our work. If you have a disability, for example, we’d like to know that so that we can make sure that we’ve got the right arrangements in place to support you in your work.
How will this information be stored?
All information is held on a secure basis, with access only available to authorised staff on a need to know basis
Who will get this information?
Your personal information is released to a strictly limited number of people and organisations:
- it will be used in an anonymous way to help us monitor and evaluate the effectiveness of our workplace diversity plan and other relevant employment policies
- the information will be passed to our Diversity Co–ordinator who may contact you to discuss any reasonable adjustments that we can make to assist you in undertaking your work effectively
- we report regularly to the Australian Public Service Commission on the composition of our workforce. That information is used anonymously in publications like the Commission’s State of the Service Report published each year.
Will this information be passed on to my manager or co–workers?
The information you give us is protected by the provisions of the Privacy Act 1988. In almost all cases this means that, unless you agree to it being disclosed to your manager or co–workers, it won’t be.
What do you include as a ‘disability’
For data collection purposes, all APS agencies use the Australian Bureau of Statistics Disability, Ageing and Carers: Summary of Findings 2003 definition, according to which
…a person has disability if they report they have a limitation, restriction or impairment, which has lasted, or is likely to last, for at least 6 months and restricts everyday activities. This includes:
- loss of sight (not corrected by glasses or contact lenses)
- loss of hearing where communication is restricted, or an aid to assist with, substitute for, hearing is used;
- speech difficulties;
- shortness of breath or breathing difficulties causing restriction;
- chronic or recurrent pain or discomfort causing restriction;
- blackouts, fits, or loss of consciousness;
- difficulty learning or understanding
- incomplete use of arms or fingers;
- difficulty gripping or holding things;
- incomplete use of feet or legs;
- nervous or emotional condition causing restriction;
- restriction in physical activities or doing physical work;
- disfigurement or deformity;
- mental illness or condition requiring help or supervision;
- long–term effects of head injury, stroke or other brain damage causing restriction;
- receiving treatment or medication for any other long–term conditions or ailments and still restricted;
- any other long-term conditions resulting in restriction.
