Q: How do I manage when an Injured Worker attends treatment?
A: the worker is working reduced hours, they should attend when they are not performing suitable employment. If they are at full pre-injury hours, it is something you should negotiate.
You can get more information this post How Do You Manage Injured Workers Attending Appointments Or Treatment?
Q: Does the person who looks after Return to Work in my company need to be trained?
A: Under workers compensation law, category one employers (i.e. employers whose basic tariff premium exceeds $50 000 annually as well as self-insurers, and employers who are insured by a specialised insurer and employ more than 20 workers) must have a return to work coordinator who has done the 2-day NSW WorkCover Accredited course.
Q: What sort of person should I select as the Return to Work Co-ordinator and what do they need to do?
A: The skills and responsibilities of a Return to Work Coordinator include:
developing and implementing a return to work program, educating the workforce, keeping injury and return to work statistics and developing policies and strategies
providing information to injured workers on benefits and the return to work process,
determining an injured workers needs by a discussion with the worker, their nominated treating doctor and other treating practitioners
identifying suitable duties and developing and implementing a return to work plan
working with the insurer to develop an injury management plan
being the main point of contact for the injured worker
coordinating and monitoring the worker's progress in treatment, rehabilitation services and return to work plans
excellent written and verbal communications skills, including negotiation and listening skills
decision-making skills and organisational and time management skills.
Active OHS conducts the WorkCover Accredited Return to Work Coordinator training
Q: Can I take my injured workers to a company preferred medical advisor, and can they become the Nominated Treating Doctor?
A: Absolutely on both counts. While the injured worker has the express right to choose their own Nominated Treating Doctor in Active OHS' experience, many companies have engaged with local doctors skilled in workplace health. These companies' Return to Work Program incorporates a process where injured workers attend the preferred medical advisor and given the service and targeted treatment, provided the injured worker is happy to appoint the preferred medical advisor as their Nominated Treating Doctor. This approach proves to be a win-win due to best practice medicine and a focus on Stay at Work.
You can read more about working with a Preferred Medical Advisor on our blog.
Q: I have a worker who is injured and still off work, so when should a Workplace Rehabilitation Provider be involved?
A: Most injured workers get back to work without any intervention; however, the 20% of claims that do not, tend to account for 80% of workers' comp costs. Consequently, it is important to know WHEN to refer & that tends to be on a case-by-case basis. Some guiding principles are:
Active OHS as your Preferred Provider
The worker still certified unfit after 4 weeks
Reported symptoms seem extreme for the injury
Injury is complex
History of poor performance
Conflict with the supervisor
Culture of people staying off work due to injury
You can read more about 'Why don't employers refer earlier for workplace rehabilitation?' on our blog.
Q: Can I choose my own Workplace Rehabilitation Provider or do I need to use one from my Agent's Panel?
A: One of the Obligations of the Employer under the NSW WorkCover legislation is to select and nominate approved workplace rehabilitation provider, and their details should be included in your Return to Work Program. See Guidelines for workplace return to work programs on Pages 4 and 22 respectively. There is nothing in the Guidelines that says you have to use the Agent's Panel, but instead, they state that "consideration should
be given to the fields of expertise that a particular workplace may require".
Q: Can I refer directly to my Nominated Preferred Workplace Rehabilitation Provider?
A: Many of the employers that Active OHS work with refer directly to us as is their right as an Employer. Best practice Return to Work Programs are when the employer takes control of the process and does not divulge responsibility to a 3rd party such as an Agent. The landmark Michigan study on work disability found senior management involvement was a common element in organisations that had low levels of work absence. Agents of course have a very important role in the process of Return to Work but it is the employer’s money that is on line. Additionally referrals made by employers tend to be more timely meaning services to get someone back to work can commence as soon as possible.
Q: What are the common workers’ compensation premium drivers?
A: Wages are the greatest cost of any claim that means the more time off work the more this will impact on your claims and experience and so premium. For this reason it is important to adopt a Stay at Work approach to any ache or pain or injury. The next biggest cost are medical expense that means having a Preferred Medical Advisor who practices evidence-based medicine is important. Likewise the biopsychosocial approach is critical to address all factors that might be impacting on the injured worker’s recovery.
Q: Why does it seem like the insurance company accepts any claim regardless
of the circumstances like there were no witnesses?
The workers compensation scheme in NSW is no-fault so the benefit of the doubt is always with the injured worker. If they have a WorkCover Certificate of Capacity signed by a Doctor who considers the injury or illness is work-related then they can submit a claim. There is the option for an insurance company to ‘reasonably excuse’ a claim but for this to proceed to denial there needs to be good evidence to support not accepting the claim.
Q: What happens when some is injured when working from home?
A: Working from home needs to be treated just like the person is in the office. The person conducting the business needs to ensure their health, safety and welfare that means ensure the space is free from hazards. Importantly there needs to be an assessment of the home office done by a suitably qualified person along with agreed and documented procedures around work from home arrangements to ensure there is agreement around hours of work, recess breaks and the responsibilities of the employer and the worker.
Q: Do you need the employee’s permission to contact the treating Doctor?
A: The relationship between the injured worker and their Doctor is confidential so permission is required. This can be best managed by including a Consent Form in the Rehab Co-ordinator’s kit. The injured worker would sign at the time they lodge their claim so as to obtain information relating to the claim on a ‘need to know’ basis.
The injured worker can refuse to give permission however that would probably impact the acceptance of liability as the insurance officer for example needs this info.