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Workers’ Compensation and Injury Management

Long Duration Claims and Delays in Return to Work

31 October 2013

Chris WhiteA/Chief Executive Officer, WorkCover WA

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Outline

Introduction

Overview of WA workers’ compensation scheme

Employer’s obligations

Imperatives for return to work

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About Workers’ Compensation in WA

• Legislation: Workers Compensation and Injury Management Act 1981

• No-Fault system• Privately underwritten

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Key objectives of the WA workers’ compensation scheme

Equitable and accessible workers’ compensation system for all stakeholders

Reduce social and economic burden of having a work related injury or disease

Return injured workers to suitable and sustainable employment as soon as is practicable

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Differentiated regulation

Communications & Education

AdvisoryServices

CustomerAssistance

Unit

Standards& Monitoring

(service providers)

ComplianceServices(employers)

Information Advice Assistance Monitoring Enforcement

Advice & Assistance

Unit

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Communications and Education

• Targeted education programs - e.g. insurance brokers

• education• code of practice

• Information sessions– Legislative obligations– Rights and responsibilities of key parties– Injury management– Return to work– Contractors and sub-contractors– Conciliation and Arbitration Services– WorkCover WA’s role and responsibilities

• Presentations available on request

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Advice and Assistance

Advisory Services

• Trained, friendly staff

• Private rooms for private conversations

• Phone 1300 794 744

• Email postmaster@workcover.wa.gov.au

Customer Assistance

• Guidance to parties relating to claim issues

• Can help resolve issues between parties if all agreeable

• Assist parties to complete legislative requirements for Conciliation

and Arbitration Services (CAS) applications

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Approved service providers

Approval and monitoring of:

Insurers (5 year approval) 8

Self-Insurers (annual review of approval) 27

Workplace Rehabilitation Providers (3 year approval) 31

Approved Medical Specialists (indefinite) 212

Registered Agents (annual registration) 207

Audiometric Officers (annual review of approval) 547

Audiologists (subject to Audiological Society Australia membership) 92

ENT Specialists (indefinite) 5

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Legal obligations for employers

Workers’ compensation insurance policyMust cover ALL workers (including contractors & sub-contractors)

Claim Form & Medical Certificate to insurer within 5 daysIf submitted through an insurance broker, the broker must forward immediately

Make payments to injured worker

Implement an injury management systemNot complicated - templates are available on the WorkCover WA website

Prepare and implement a return to work programEmployers may discharge this obligation to their insurer

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Injury management & return to work

• Defined as: ‘the management of workers’ injuries in a manner that is directed at enabling injured workers to return to work’

• It is a legal requirement for employers to: – have an injury management system that describes the steps to be

followed if a workplace injury occurs– implement a ‘return to work’ program if the treating doctor advises that

the injured worker has a capacity to work

• Code of Practice (Injury Management) 2005 and Guidance Notes for the Code of Practice (Injury Management) 2005

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Why is injury management required?

• Workplace injuries have direct and indirect costs to workers and business:

– direct financial costs– reduced productivity– personal costs to worker

• Minimise impact of injuries with effective injury management

• Facilitates recovery and injured worker’s return to work

• Prepare for an injury before it occurs

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Reasons for not returning to work

Reasons for not

returning to work

Not recovered from work

related injury

Psychological reasons

Left employment voluntarily (e.g.

study)Retrenched/ dismissed

Source: Australian Institute for Social Research “The role of the workplace in return to work” (WorkCover SA) March 2010

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Helping people return to work – using evidence for better outcomes

Key recommendations:

• Use of evidence based medicine and evidence based policy making to form the basis of return to work approaches

• Health outcomes of workers to be routinely collected/reported

• Training for medical practitioners

• Develop systems support for improved practitioner-workplace communication

Source: http://www.racp.edu.au – AFOEM publications

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“For most people their work is a key factor in their self worth, family esteem and identity. So if they become sick and are not helped quickly enough, they can all too easily find themselves on a downward spiral into long term sickness and a life on benefits.”

Dame Carol Black

Professor of Rheumatology at the UCL Medical School;Former Director for Health and Work;

Former President of the Royal College of the Physicians

Return to Work is the “Healthiest Outcome”