A Guide to the Return to Work System in NSW

1
A Guide to the Return to Work System in NSW

• Presented by
• Mary Yaager
• OHS Workers Compensation Officer
• Unions NSW

2
WorkCover Framework
Parliament
Minister
Workers Compensation and Workplace Occupational
Health and Safety Council of NSW
WorkCover NSW
Industry Reference Groups (13)
3
Overview of Injury Management

• What is Injury Management?
• What do you think it means?
• Who is responsible for injury management?
• What about self insurers?
• Why is Injury Management so important

4
Injury Management

• Injury Management is the safe timely and durable
  return to work of an injured worker.
• It may involve
• Treatment e.g. physio
• Retraining
• Counselling
• Work conditioning
• Gradual increase of activity and work hours

5
Parts of Injury Management
6
The Program

• All NSW Employers are required to have a Return
  to Work Program under the workers compensation
  legislation.
• The program must be agreed to and signed off by
  the Industrial Union representing those
  employees.
• There are different programs for Category 1 and 2

7
Employer Responsibilities

• What is the employer required to do?
• Have systems in place
• Establish a Return-to-Work program (consistent
  with Guidelines for Employers Return-to-Work
  Programs).
• Provide Suitable Duties (Penalties apply).

8
Return-to-Work Program

• Procedures
• Identify Return-to-Work Coordinator
• Identify providers
• Develop methods for identifying suitable duties
  and developing Return-to-Work Plans
• Develop methods for resolving disputes

• Commitments
• Prevent injury
• Develop a Return-to-Work Program
• Early Commencement of rehabilitation
• Provide suitable duties
• Consult with workers
• Participate in return to work
• Do not disadvantage the worker

9
In Addition

• Obligations
• Employer
• Employee
• Insurer
• NTD
• RTW coordinator

10
Confidentiality

• Confidentiality is a critical part of the return
  to work coordinators role
• WorkCover have confidentiality guidelines
• Your role as a RTWC is to make sure you comply

11
SDAs RTW Program

• SDA has a model return to work program
• Complies with WorkCover guidelines

12
Exercise

• Does the employers return to work program
  comply?

13
The People

• The Injured Worker
• The Return to Work Coordinator
• SDA Representative
• Doctors
• Rehab Providers
• Insurance Company
• WorkCover
• Other Health Professionals

14
The Injured Worker

• Worker must return to work if medically certified
  for suitable duties (S48)
• Worker must accept all reasonable offers of
  suitable duties from employer (S48)
• Worker must follow the Return-to Work Plan (S57)

15
What are injured workers rights regarding return
to work?

• Right to choose own treating doctor (S47)
• Right to choose own accredited rehabilitation
  provider (S48)
• Right not to be terminated from employment within
  6 months of injury (IR Act)
• Right to be provided with suitable duties (S49)

16
What documents must injured worker sign?

• WorkCover Medical Certificate
• Information Consent Form
• Injury Management Plan
• Return to Work Plan
• Workers compensation claim form    

17
RTW Coordinator Role

• Is the person responsible for the employers RTW
  program
• Must liaise with the union delegate
• Contact injured workers
• Talk with treating doctors
• Organise suitable duties
• Write a Return to Work Plan
• Review the workers progress
• Keep confidential case records

18
SDA Representatives Role

• What do you think the role of the SDA
  representative should be?

19
Working with Key Players

• A) Doctors there are 6 in the scheme.
• B) Accredited Rehabilitation Providers
• C) Treatment Providers

20
1) Nominated Treating Doctor

• Nominated by worker - normally the workers GP.
• Completes WorkCover Medical Certificate (worker
  to sign consent section).
• Certifies workers fitness.
• Provides advice re suitable duties.
• Manages treatment plan for the worker.
• Communicates with insurer, employer rehab
  provider.
• Consults about arrangements for the workers
  injury management andReturn-to-Work Plan.

21
2) The Treating Specialist

• The NTD can refer the worker to a specialist
• For Example
• Orthopaedic specialist
• Neurologist
• Psychiatrist
• However, the NTD continues to complete the
  WorkCover medical certificate

22
3) Injury Management Consultant

• Medical Practitioner.
• Authorised by WorkCover.
• Assists insurer, employer and treating doctor
  where there is disagreement over suitable duties.
• Is required to attend training in mediation /
  conflict resolution.
• Is experienced in workplace based rehabilitation.

23
4) Approved Medical Specialist

• Medical Specialist
• Resolves medical disputes.
• Assesses workers medical condition, fitness for
  employment, permanent impairmentt.
• Authorised by WorkCover.
• Appointed by the President of the Workers
  Compensation Commission.
• All permanent impairment assessments are
  conclusive and binding.

24
5) The Company Doctor

• The employer may engage in the services of a
  company doctor
• Their role may include
• Immediate assessment of injury
• Treatment of injury
• Communicating with the NTD
• Assistance with workplace OHS

25
6) Independent Medical Examiners

• Used by Insurers and the injured workers
  solicitor
• Gather information
• Help make decisions

26
Rehabilitation Providers

• SDA Preferred Rehab provider
• Australian Injury Management

27
Introduction

• Who is an accredited rehabilitation provider?
• Who is AIM?
• What do they do?
• Specialise in injury management
• Sports Medicine Model

28
Reasons to refer to a Rehab Provider

• complex or multiple injuries
• communication problems
• reports anxiety, stress and/or depression
• needs assistance to retrain into alternative
  employment
• needs equipment or workplace modifications for a
  safe return to work
• dissatisfied with the progress of his/her return
  to work

29
Working closely with the SDA

• Our number one priority is the Injured employee
  their family
• We work closely with the SDA
• Other providers may be insurer or employer
  focused often owned by insurance companies
• It is important for unions to consider this when
  selecting a rehab provider for a workplace

30
Exercise

• What are the roles of
• Injured Worker
• RTW Coordinator
• Employer
• Insurer
• Rehab Provider
• NTD

31
Return to Work Process

• An employee is injured
• They see their own treating doctor
• WorkCover medical certificate is issued
• The employee advises the insurer of their
  nominated treating doctor this is important
• Treating doctor advises the employee of their
  status
• This is when a rehab provider gets involved - AIM
• The worker is referred to a provider it is
  important that they are referred to the right
  provider

32
Why is the Medical Certificate important?

• Fitness for work is described
• Medical restrictions are listed
• Duties to avoid are listed
• Time frame for suitable duties is listed
• Consent of worker for treating doctor to obtain
  and release information is included

Http//www.unionsafe.labor.net.au
33
Example of WorkCover Medical Certificate
34
What Happens Next

• The insurance company approves the referral
• The case is given to a case manager
• They talk to the workers treating doctor find
  out what the worker can and cant do
• Before plan is developed a workplace assessment
  is conducted
• A Return to Work Plan is prepared this is
  discussed with the employer
• Must be agreed to by NTD

35
What are the Options for Suitable Duties?

• Pre-injury duties
• Different duties same work section
• Different duties different work section
• Different duties new workplace
• Training courses

36
Suitable Duties Must Comply

• As per Workers Compensation Act 1987 (s43A).
• employment in work for which the worker is
  suited, having regard to the following
• a) the nature of the workers incapacity and
  pre-injury employment
• b) the workers age, education, skills and work
  experience
• c) the workers place of residence
• d) the details given in the medical certificate
  supplied by the worker
• e) the provisions of any injury management plan
  for the worker
• f ) the length of time the worker has been
  seeking suitable employment
• g) any other relevant circumstances
• h) must not be demeaning in nature
• i) must not be token in nature.

37
Suitable Duties Must Consider

• Functional capacity.
• Productive / meaningful.
• Time limits.
• Monitoring process.
• Regular reviews.

38
The Return to Work Plan

• What is Involved?

39
Offering Suitable Duties

• Workplace assessment must take place
• Make an offer in writing in the RTW plan
• Must indicate
• Return to work goal
• Duties performed
• Duties to be avoided
• Hours of work
• Medical restrictions
• Supervisor
• Monitoring arrangements
• Review dates

40
Reviewing the Return to Work Plan

• It is important to regularly review the RTW plan
  to ensure the worker does not remain on suitable
  duties indefinitely
• Rehab Providers should conduct regular 2 week
  reviews to review and update plan

41
The Final Steps

• Employee returns to full pre injury duties
• The plan must be followed
• Monitoring

42
Exercise

• Write a RTW Plan using following case study

43
(No Transcript)
44
Dispute Resolution

• Return-to-Work Program has procedures
• WorkCover Assistance Service - Claims Assistance
  Service (CAS)
• Workers Compensation Commission (Injury
  Management Dispute Arbitrators)

45
Dispute Prevention

• Return-to-work program.
• Effective communication.
• Options for assistance
• Human resource management
• Injury Management Consultants
• Accredited Rehabilitation Providers
• Claims Assistance Service
• Workers Compensation Commission