WACHS WORKERS COMPENSATION AND INJURY MANAGEMENT …€¦ · compensation and injury management Act 1988 (as amended) and the WorkCover Injury management code of practise 2005. Whilst

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WACHS WORKERS COMPENSATION

AND INJURY MANAGEMENT SYSTEM

Prepare Prepared by: WACHS INJURY MANAGEMENT UNIT AND OSH REFERENCE GROUP

July 2007 D by:

WACHS OSH REFERENCE GROUP NETWORK August 2006

Author: Reijer Groenveld Authorised By: Ken Mills A/Director Corporate and Finance Version No: 1 Date endorsed/last reviewed: 14 July 2007

Signature _ ___________________________

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Table of Contents

Table of Contents .......................................................................................................................................................2

Introduction.................................................................................................................................................................3

Background ................................................................................................................................................................3 Workers’ Compensation .............................................................................................................................3 Injury Management .....................................................................................................................................3 Workers Compensation ..............................................................................................................................3 Risk Management.......................................................................................................................................4

The Aim of the Workers Compensation and Injury Management System.................................................................5 Workers Compensation Processing and Management ..............................................................................5 Injured Worker Rehabilitation .....................................................................................................................5 Philosophy ..................................................................................................................................................5 Objectives ...................................................................................................................................................5 WACHS Designated Responsibilities and Contacts for Workers Compensation and Injury Management5

WACHS Workers Compensation and Injury Management Procedure ......................................................................7 Workers’ Compensation Claim Procedure .................................................................................................7 Flow Chart: WACHS Claims Management Process.................................................................................10 Injury Management Procedures................................................................................................................11 Flowchart: WACHS Injury Management Process.....................................................................................13

WACHS Responsibilities for Workers Compensation and Injury Management.......................................................14 Injured Employee......................................................................................................................................14 Manager / Supervisor ...............................................................................................................................14 Regional OSH Coordinator – Regional OSH Administrative Assistant – Claims Management ...............15 WACHS Injury Management Coordinators...............................................................................................15 Medical Practitioners ................................................................................................................................16 Approved Vocational Rehabilitation Provider ...........................................................................................16 Insurer - RiskCover...................................................................................................................................16 HCN – Payroll ...........................................................................................................................................16 HCN Finance – Accounts Receivable.......................................................................................................16

Workers Compensation and Injury Management Issue Resolution.........................................................................17 Issue Resolution Policy.............................................................................................................................17 Dispute process ........................................................................................................................................17 Non Work Related Injuries........................................................................................................................18

Workers Compensation and Injury Management Outcome Evaluation ...................................................................19 Annually ....................................................................................................................................................19 Monthly / Quarterly....................................................................................................................................19 Related Policies, Procedures and Source Documents.............................................................................19 Supersedes...............................................................................................................................................19

Attachment 1: Employee Letter from Injury Management Consultant .....................................................................20

Attachment 2: OSHC Regional Letter ......................................................................................................................21

Attachment 3: RTW Program...................................................................................................................................25

Attachment 4: Questionnaire....................................................................................................................................27

Attachment 5: WACHS Injury Management Referral Form .....................................................................................29

Attachment 6: Workers Compensation Pay Advice Form........................................................................................30

Attachment 7: List of Employees Responsible for Workers Compensation and Injury Management .....................31

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Introduction WA Country Health Service (WACHS) aims to establish a single strategic approach to Occupational Safety and Health (OSH), Workers’ Compensation (WC) and Injury Management (IM) across all regions. The intention of the injury management system for WACHS is to achieve compliance with regulatory requirements, The Australian Council of Healthcare Standards (ACHS) accreditation, and beyond that to establish a best practise model for managing safety, health and workers’ compensation. WACHS is a well established and highly regarded organisation committed to the provision of health services to its communities. In addition to its commitment to provide a high level of service to its consumers, WACHS places a significant emphasis on its commitment to employees. WACHS acknowledges that effective injury management ranks along side the traditional areas of productivity and quality as an essential component in the overall efficiency of the Organisation. WACHS also acknowledges and actively promotes the philosophy of consultation and co-operation between the employer and employee, indeed it is the fostering and the development of this alliance, which will lead to WACHS to achieve best practice in Injury management. Consultation between management and employees allows decisions on managing workplace Safety and Health to be based on information gained from a holistic approach. A consequence of this co-operative approach ensures that there is a greater commitment to the decisions that are made resulting from all concerned participating and having ownership of the process. WACHS carries out all its injury management obligations within the guidelines set out under the Workers compensation and injury management Act 1988 (as amended) and the WorkCover Injury management code of practise 2005. Whilst adherence to the aforementioned Act and code of practise is a minimum standard requirement, it is the view and vision of WACHS that a best practise Injury Management System should be maintained. This will achieve a self-regulated, pro-active and innovative approach to Injury management, which will enable WACHS to strive towards leadership in injury management within the Health industry. Background Workers’ Compensation As of the 14th November 2005, an amendment to the WA Workers’ Compensation and Injury Management Act 1981 has created a requirement for employers to establish a designated injury management system for their organisation. The WorkCover WA code of practise for injury management, designed to assist employers with implementing the legislative changes, recommends that specific responsibilities be assigned for injury management within an organisation and the requirements be clearly documented in the organisation’s policies and procedures. It is therefore important for WACHS to create a systematic approach to managing workers’ compensation claims and injury management requirements within these guidelines. Injury Management Injury management is defined as the management of workers injuries in a manner that is directed at enabling injured workers to return to work. The key principles are as follows: Workers Compensation • Return to work is the most appropriate outcome within the workers compensation system in WA; • Injury management provides physical, psychological and vocational benefits to workers, minimises disruption

at the work place and contains workers compensation cost; • The employer, injured worker and treating medical practitioner are the key parties in injury management.

Consultation and communication between the key parties should occur at a regular basis; • Timely and appropriate medical treatment should be provided and sought for inured workers; • Employers should be directly involved in the management of work injuries and ensure that injury

management process is started early; and • Vocational rehabilitation is required once agreed between the key parties and it should commence as soon as

possible, be focussed on return to work outcomes and regularly monitored. • The workers compensation code of practice (injury management) 2005 under section 3 (2) prescribes that the

code applies to:

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“ Employers whose workers who suffer an injury under the Workers compensation and injury management Act 1981, unless

(a) the worker has returned to the position held by the worker immediately before the injury occurred; or (b) The worker has a total capacity to work in that position.

Risk Management The Department of Health has implemented a Risk Management policy and framework of which the principles will be adopted in the WACHS Workers compensation and Injury management plan. (http://intranet.health.wa.gov.au/RiskManagement/docs/Health%20Risk%20Management%20Framework.pdf) Purpose And Scope To achieve consistency for the WACHS workers compensation and injury management approach, it is essential that the workers compensation and Injury management system provides for:

• Effective and efficient communication; • Professional resourcing of injury management functions; • Clarity of policy, management practices and programs; and • Goals and objectives to be logically established monitored and reviewed. WACHS Workers Compensation and Injury Management System

WACHS Services Training Services

Regional OSH Coordinators

Claims Management Injury Management

Coordinators

Legisation WorkSafe WA Common Law

WorkCover WA

Injury Management Team

Injured worker Manager / supervisor

Treating medical practitioner

Service Providers External Injury

management providers Treating specialists and

medical service providers

Allied health services

WACHS Policy and Procedures

Rules and Regulations Emergency Procedures

Safety Standards Safety Policies

WACHS guidelines Contract Documents Purchasing Orders

Insurance Claims manager Claims advocate

OrganisationManagement

OSH Coordinators Suppliers

Supervisors Contractors Employees OSH Reps Committees

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The Aim of the Workers Compensation and Injury Management System Workers Compensation Processing and Management WACHS as an employer has a responsibility to ensure that eligible employees have timely access to their workers compensation entitlements. This involves ensuring that claims are appropriately lodged within the prescribed timeframes. The system will set out the responsibilities of all those within the process and outline the procedures underlying the lodgement and management of workers compensation claims for WACHS. Injured Worker Rehabilitation The aim of providing injury management is to ensure appropriate and adequate medical treatment is given, in order to enable a quick and efficient return to work outcome wherever possible. Effective injury management helps to ensure that employees understand their value to the employer and provides a boost to their self-esteem. WACHS workers compensation and injury management policy is defined below: (insert policy link)

Philosophy It is the policy of WACHS to provide injury management for all employees who have sustained an injury, illness or disability at the workplace. For the purpose of this policy, Injury Management is defined as:

“The combined and co-ordinated use of medical, psychological, social, educational and vocational measures to restore function or achieve the highest possible level of function of persons at work following injury or illness.”

Objectives To ensure timely lodgement and management of the workers compensation claims for any WACHS employee. To establish a structured “in-house” rehabilitation program/ policy for employees who have suffered a work related injury, disability or illness. To develop the expectation that is normal practice, following a work related injury, disability or illness for an employee to actively co-operate in a rehabilitation program, with the intention of a return to appropriate employment. To establish that employee referral to an injury management program should occur as early as practical following the proper identification of the nature and anticipated duration of the incapacity. To provide appropriate alternative duties, which will assist the employee’s recovering abilities whilst facilitating an early return to work. To involve immediate supervisors in the injury management program wherever possible. This is to evoke a full understanding of the injured person and any limitations the duties may impose in that person. The following table will provide a broad overview of the WACHS workers compensation and injury management system.

WACHS Designated Responsibilities and Contacts for Workers Compensation and Injury Management WACHS regional OSH Coordinators shall have overall responsibility for the workers compensation portfolio and management of the claims in their region and shall refer appropriate cases to the WACHS injury management team Designated injury management coordinator will establish a Case Team approach will be used to determine the most effective course of action for any employee who has suffered a work related injury, disability or illness. Where possible the injury management process encouraged by WorkCover WA shall be utilised through out the injury management process.

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Injury management Case Team will comprise of the following persons and be dependent on current variables in force (legislation): • Medical provider; • Supervisor; • Injured Employee; and • WACHS Injury Management Coordinator The team may also include the following as required: • Union representative; • Safety representative; • Occupational Safety, Health Coordinator; and • Representative of RiskCover An Injury management Consultant from a WorkCover approved external injury management provider may also be engaged by either party to assist in the return to work process. Contractors All contractors must have an acceptable injury management program as part of their overall Safety and Health Management Plan.

Safe and early return to work for workers following injury or illness, by agreement between medical practitioner, employer and worker. Safe and early do not compromise each other. Compliance with Workers’ Compensation and Injury Management Act 1981 (the Act), and Occupational Safety and Health Regulations 1996, No 2.4 Notifications under Section 19 The following is a detailed outline of the procedures for WACHS for workers compensation and injury management:

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WACHS Workers Compensation and Injury Management Procedure Workers’ Compensation Claim Procedure (Read in conjunction with flow chart page 12) WWoorrkkeerrss ccoommppeennssaattiioonn rreeqquuiirreess iimmmmeeddiiaattee sseeqquueennttiiaall aaccttiioonn ffoolllloowwiinngg aann IInncciiddeenntt// aacccciiddeenntt bbyy tthhee ffoolllloowwiinngg ppaarrttiieess:: EEmmppllooyyeeee

1.1. Notify the manager / supervisor immediately. Notify the manager / supervisor immediately. 2.2. Seek first aid and / or medical attention if required. (The employee has the choice of medical

provider). Seek first aid and / or medical attention if required. (The employee has the choice of medicalprovider).

3.3. Obtain a completed First Medical Certificate from the treating doctor on the first visit if the employee

intends to lodge a claim to seek compensation for time lost or medical or rehabilitation costs. Obtain a completed First Medical Certificate from the treating doctor on the first visit if the employeeintends to lodge a claim to seek compensation for time lost or medical or rehabilitation costs.

NNoottee:: TThhee cceerrttiiffiiccaattee mmuusstt bbee pprroovviiddeedd bbyy aa mmeeddiiccaall pprraaccttiittiioonneerr,, mmeeddiiccaall ssppeecciiaalliisstt oorr ddeennttiisstt,, nnoott aa cchhiirroopprraaccttoorr,, pphhyyssiiootthheerraappiisstt oorr ootthheerr hheeaalltthh pprrooffeessssiioonnaall..

MMaannaaggeerrss // SSuuppeerrvviissoorrss

1.1. Provide the employee with a regional Employee Incident and Accident Form for completion and assist in completing this document. Provide the employee with a regional Employee Incident and Accident Form for completion and assistin completing this document.

2.2. If the employee intends lodging a claim, notify the regional OSH coordinator immediately to obtain the

following documentation to be completed: If the employee intends lodging a claim, notify the regional OSH coordinator immediately to obtain thefollowing documentation to be completed:•• Workers Compensation Claim Form [Form 2B] or Recurrence of Disability [Form 3A] (if the injury

appears to involve an exacerbation of a previous injury). Workers Compensation Claim Form [Form 2B] or Recurrence of Disability [Form 3A] (if the injuryappears to involve an exacerbation of a previous injury).

•• Witness form. Witness form.•• Employee declaration form. Employee declaration form.•• Explanatory information re lodgement of claim for employee and manager to follow. Explanatory information re lodgement of claim for employee and manager to follow.

OOrr oobbttaaiinn aa ccllaaiimmss ppaacckkaaggee ffrroomm tthhee iinnttrraanneett ssiittee aanndd iissssuuee ttoo eemmppllooyyeeee ((lliinnkk ttoo ccllaaiimmss ppaacckkaaggee oonn lliinnee)) IImmppoorrttaanntt TThhee eemmppllooyyeerr ((mmaannaaggeerr // ssuuppeerrvviissoorr)) hhaass oonnllyy tthhrreeee ddaayyss ttoo llooddggee aa ccllaaiimm wwiitthh tthhee iinnssuurreerr ffrroomm tthhee llooddggeemmeenntt ddaattee,, wwhhiicchh iiss ““wwhheenn aann eemmppllooyyeeee hhaass pprroovviiddeedd eeiitthheerr aa ssiiggnneedd WWoorrkkeerrss’’ CCoommppeennssaattiioonn CCllaaiimm FFoorrmm 22BB wwiitthh aa FFiirrsstt MMeeddiiccaall CCeerrttiiffiiccaattee oorr aa ssiiggnneedd RReeccuurrrreennccee ooff DDiissaabbiilliittyy FFoorrmm wwiitthh aa PPrrooggrreessss MMeeddiiccaall CCeerrttiiffiiccaattee ttoo tthheeiirr eemmppllooyyeerr.. NNoottee:: TThhee tthhrreeee ddaayyss ddooeess nnoott ccoommmmeennccee uunnttiill tthhee eemmppllooyyeerr hhaass rreecceeiivveedd tthhee llaasstt ooff tthhee ttwwoo ffoorrmmss.. TThhee ccllaaiimm ppaappeerrss sshhoouulldd nnoott bbee ddeellaayyeedd iiff tthhee rreeggiioonnaall EEmmppllooyyeeee IInncciiddeenntt aanndd AAcccciiddeenntt FFoorrmm oorr tthhee iinnvveessttiiggaattiioonn iiss ssttiillll bbeeiinngg ccoommpplleetteedd.. AA pphhoottooccooppyy ooff tthhee rreeggiioonnaall EEmmppllooyyeeee IInncciiddeenntt aanndd AAcccciiddeenntt FFoorrmm ((tthhee sseeccttiioonn ccoommpplleetteedd bbyy tthhee eemmppllooyyeeee)) sshhoouulldd bbee iinncclluuddeedd wwiitthh tthhee oorriiggiinnaall ccllaaiimm ppaappeerrss.. IIff aa rreeggiioonnaall EEmmppllooyyeeee IInncciiddeenntt aanndd AAcccciiddeenntt FFoorrmm hhaass nnoott bbeeeenn ccoommpplleetteedd tthheenn tthhee ccllaaiimm ppaappeerrss sshhoouulldd bbee ffoorrwwaarrddeedd wwiitthhoouutt ddeellaayy..

3.3. Notify the OSH representative of the incident / accident. Notify the OSH representative of the incident / accident. 4.4. Initiate an investigation of the incident / accident in consultation with the OSH representative and

Regional OSH Coordinator. Initiate an investigation of the incident / accident in consultation with the OSH representative andRegional OSH Coordinator.

SSuubbsseeqquueenntt AAccttiioonn RReeqquuiirreedd EEmmppllooyyeeee

1.1. Fully complete the Workers Compensation Claim Form [Form 2B], Recurrence Form [Form 3A] and regional Employee Incident and Accident Form providing detailed answers to each and every question even if the answer is in the negative.

Fully complete the Workers Compensation Claim Form [Form 2B], Recurrence Form [Form 3A] andregional Employee Incident and Accident Form providing detailed answers to each and everyquestion even if the answer is in the negative.

NNoottee:: CCllaaiimm aapppprroovvaallss aarree ffrreeqquueennttllyy ddeellaayyeedd dduuee ttoo aa llaacckk ooff iinnffoorrmmaattiioonn oonn tthhee ccllaaiimm ffoorrmm.. IInn

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ppaarrttiiccuullaarr,, aa ddeettaaiilleedd aaccccoouunntt ooff tthhee cciirrccuummssttaanncceess ooff tthhee aacccciiddeenntt aanndd tthhee mmeeddiiccaall hhiissttoorryy aanndd pprreevviioouuss ccllaaiimm hhiissttoorryy iiss oofftteenn rreeqquuiirreedd ffoorr ttiimmeellyy ddeetteerrmmiinnaattiioonn ooff tthhee ccllaaiimm bbyy tthhee iinnssuurreerr..

2.2. Ask witnesses to complete Witness Statement Forms [Form 5A] if the accident was witnessed and if

possible submit these forms with the other paperwork. Ask witnesses to complete Witness Statement Forms [Form 5A] if the accident was witnessed and ifpossible submit these forms with the other paperwork.

3.3. Ask person first notified to complete Witness Statement Forms [Form 5A] if no witness was present

during the Accident / incident. Ask person first notified to complete Witness Statement Forms [Form 5A] if no witness was presentduring the Accident / incident.

4.4. Submit any medical certificates to the manager / supervisor without delay. Submit any medical certificates to the manager / supervisor without delay. 5.5. Complete the Employee Declaration Form 7A. Complete the Employee Declaration Form 7A. 6.6. Submit all the above forms together to the manager / supervisor at the earliest possible time. Submit all the above forms together to the manager / supervisor at the earliest possible time.

MMaannaaggeerrss // SSuuppeerrvviissoorrss OOnn rreecceeiipptt ooff tthhee WWoorrkkeerrss CCoommppeennssaattiioonn CCllaaiimm FFoorrmm 22BB aanndd FFiirrsstt MMeeddiiccaall CCeerrttiiffiiccaattee ((llooddggeemmeenntt DDaattee)) ffrroomm tthhee eemmppllooyyeeee,, iimmmmeeddiiaatteellyy uunnddeerrttaakkee tthhee ffoolllloowwiinngg::

1.1. Check the Workers Compensation Claim Form 2B to ensure the employee has answered each and every question and completed the signature section which allows consent by the employer for contacting the medical practitioner regarding the claim.

Check the Workers Compensation Claim Form 2B to ensure the employee has answered each andevery question and completed the signature section which allows consent by the employer forcontacting the medical practitioner regarding the claim.

2.2. Tear off the section of the attachment to the Workers Compensation Claim Form 2B, “Information to

be provided to the Injured Worker” and provide that section to the employee. The Regional OSH Coordinator will complete the section “Details to be provided to the Medical Practitioner”.

Tear off the section of the attachment to the Workers Compensation Claim Form 2B, “Information tobe provided to the Injured Worker” and provide that section to the employee. The Regional OSHCoordinator will complete the section “Details to be provided to the Medical Practitioner”.

3.3. Check that the appropriate Workers Compensation First Medical Certificate has been provided with

the Workers Compensation Claim Form 2B by the employee (this means a first certificate from the treating doctor).

Check that the appropriate Workers Compensation First Medical Certificate has been provided withthe Workers Compensation Claim Form 2B by the employee (this means a first certificate from thetreating doctor).

4.4. If a Recurrence of Disability Form 3A is being submit ed ensure a Workers Compensation Progress

medical certificate is provided from the treating doctor. If a Recurrence of Disability Form 3A is being submittted ensure a Workers Compensation Progressmedical certificate is provided from the treating doctor.

5.5. Ensure that if time off work is indicated on the medical certificate an Application for Leave Form is

submitted and workers compensation is indicated on the form. Ensure that if time off work is indicated on the medical certificate an Application for Leave Form issubmitted and workers compensation is indicated on the form.

6.6. Follow up any Witness Statement Forms 5A required. Follow up any Witness Statement Forms 5A required.

7.7. Deliver the completed forms to the Regional OSH Coordinator or designated OSH administrative

assistant immediately. Deliver the completed forms to the Regional OSH Coordinator or designated OSH administrativeassistant immediately.

8.8. Continue to submit any progress medical certificates and / or medical bills to the Regional OSH

Coordinator or designated OSH administrative assistant without delay. The Regional OSH Coordinator will need to be informed of any time off, changes in medical status or work capacity in relation to the injury so appropriate injury management practices can be instigated.

Continue to submit any progress medical certificates and / or medical bills to the Regional OSHCoordinator or designated OSH administrative assistant without delay. The Regional OSHCoordinator will need to be informed of any time off, changes in medical status or work capacity inrelation to the injury so appropriate injury management practices can be instigated.

RReeggiioonnaall OOSSHH CCoooorrddiinnaattoorr ((iinn lliiaaiissoonn wwiitthh OOSSHH aaddmmiinniissttrraattiivvee aassssiissttaanntt)) On receipt of the claims information and forms from the supervisor the OSH coordinator will undertake the following:

1. Check the claims information to ensure the forms are completed correctly. 2. Forward the information to riskcover once all forms are completed correctly either on line or in hard

copy by fax.

3. Instigate an injury management referral form (Attachment 5) to the injury management coordinator when the following is indicated at any stage during the claim irrespective of the claim being accepted, pended or declined.

4. The employee’s treating medical practitioner advises the employer in writing that a return to work

program should be established for the employee.

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5. The employee’s treating medical practitioner sings a medical certificate indicating the employee has a partial capacity to return to work, or a totally unfit certificate.

6. The employee’s medical practitioner signs a medical certificate indicating that the worker has a full

capacity to return to work but the employee is not able to return to the position held prior to the injury occurred (e.g. Stress claim)

7. Continues to monitor the claim for any change in status indicated by the medical certificates

provided.

8. Liaises with riskcover about information required and maintains claims file.

9. Deals with queries in relation to the claimants workers compensation entitlements

10. Liaises with HCN and provides appropriate claims details and leave status in a timely fashion to HCN ensure appropriate wages and reimbursements are being provided to RiskCover

RReettuurrnn ttoo wwoorrkk pprroocceessss MMaannaaggeerr // SSuuppeerrvviissoorr ((hhttttpp::////iinnttrraanneett..hheeaalltthh..wwaa..ggoovv..aauu//oosshh//ppddffss//WWoorrkkCCoovveerr__iinnffoo__ffoorr__eemmppllooyyeerrss..ppddff)) RReessppoonnssiibbiilliittiieess aarree::

1.1. Not to allow an employee to resume work unless they have provided a doctor’s certificate or medical report clearing them to recommence unrestricted duties. Not to allow an employee to resume work unless they have provided a doctor’s certificate or medicalreport clearing them to recommence unrestricted duties.

2.2. If there are any restrictions on the employee’s work capacity noted on the medical certificate or

medical report e.g. “no lifting”, or reduced hours are indicated, the employee must not be allowed to resume work under any circumstances. The Regional OSH Coordinator will need to be advised immediately and a WACHS Injury Management Coordinator will be appointed to manage and co-ordinate provision of appropriate duties in liaison with the manager / supervisor and treating doctor.

If there are any restrictions on the employee’s work capacity noted on the medical certificate ormedical report e.g. “no lifting”, or reduced hours are indicated, the employee must not be allowed toresume work under any circumstances. The Regional OSH Coordinator will need to be advisedimmediately and a WACHS Injury Management Coordinator will be appointed to manage and co-ordinate provision of appropriate duties in liaison with the manager / supervisor and treating doctor.

EEmmppllooyyeeee ((http://intranet.health.wa.gov.au/osh/pdfs/WorkCover_info_for_employees.pdfhttp://intranet.health.wa.gov.au/osh/pdfs/WorkCover_info_for_employees.pdf )) RReessppoonnssiibbiilliittiieess aarree::

1.1. To attend treating medical practitioners and provide regular medical certificates to advise the employer of changes in medical status and ability to undertake his / her duties. To attend treating medical practitioners and provide regular medical certificates to advise theemployer of changes in medical status and ability to undertake his / her duties.

2.2. To submit a completed fortnightly Payroll advice form (attachment 6.) if partial hours are worked on a

gradual return to work program to advice employer of variation in hours. To submit a completed fortnightly Payroll advice form (attachment 6.) if partial hours are worked on agradual return to work program to advice employer of variation in hours.

3.3. To cooperate with injury management programs and guidelines set out to ensure safety at work and

to avoid exacerbation of the injury. To cooperate with injury management programs and guidelines set out to ensure safety at work andto avoid exacerbation of the injury.

4.4. To report any changes in medical status or symptoms immediately to either his / her supervisor,

manager, injury management provider, COSH or seek review from the treating medical practitioner. To report any changes in medical status or symptoms immediately to either his / her supervisor,manager, injury management provider, COSH or seek review from the treating medical practitioner.

http://intranet.health.wa.gov.au/osh/pdfs/WorkCover_info_for_employees.pdf

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Flow Chart: WACHS Claims Management Process

Injury Management

Injured worker

Manager/ supervisor

RiskCover

HCN

Regional OSH Unit

LEGEND Employee sustains Injury – Disability -Illness

Accident / Incident Report

Attend Medical Practitioner. Obtain First Medical Certificate

Complete employee section of Form 2B and give to employer/ manager/ supervisor with First Medical Certificate

Complete Form 1B and forward to HR (OSH Administration Officer / OSH Coordinator) with 2B and First Medical - within 24 hours of receipt of employee documents

Complete wages calculations and email to regional OSH unit within 24

hours of receipt of request .

WACHS Injury Management Process

Email HCN to complete pay calculations as per 1B requirement and return to OSH Admin Position within 24 hours

of receipt of documents. (To Be Determined with HCN) Review data and submit Form 1B, 2B and First Medical

Certificate on-line / by mail to RiskCover Refer all lost time or appropriate claims to IMC.

Within 17 days of the date of the claim, make decision on liability and advise worker and employer in writing if liability for the claim is accepted, disputed or pended.

Fax progress medicals as soon as received to regional OSH Admin, regional fax no. Forward further documents including witness statements, recurrence of disability forms, original progress medicals, claims for expenses etc to

regional OSH/ IM admin

RiskCover claims meetings with OSHC and IMC

2 / 3 Monthly

Complete wages reimbursement fortnightly and send to RiskCover

Refer all lost time or appropriate claims to IMC

WACHS Injury Management Process

Forward further documents/ medical certificates to RiskCover. Maintain separate files for all regional claims with copies of all documents. When claim finalised store file adjacent to personal file. Monitor, coordinate and facilitate

claim progress and forward lost time information and medical certificates to HCN

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Injury Management Procedures (Read in conjunction with flow chart page 15) Injury management coordinators WWAACCHHSS wwiillll eennggaaggee WWAACCHHSS IInnjjuurryy mmaannaaggeemmeenntt ccoooorrddiinnaattoorrss aanndd wwhheerree rreeqquuiirreedd eexxtteerrnnaall rreehhaabbiilliittaattiioonn pprroovviiddeerrss ttoo aassssiisstt iinn tthhee pprroocceessss ooff ffaacciilliittaattiinngg eemmppllooyyeeeess wwhhoo aarree iinnjjuurreedd aatt wwoorrkk ttoo rreettuurrnn ttoo ggaaiinnffuull eemmppllooyymmeenntt.. TThhee RReeggiioonnaall OOSSHH CCoooorrddiinnaattoorrss iinn lliiaaiissoonn wwiitthh tthhee iinnjjuurreedd eemmppllooyyeeee,, RRiisskkCCoovveerr ((tthhee iinnssuurreerr)) aanndd tthhee ttrreeaattiinngg mmeeddiiccaall pprraaccttiittiioonneerr mmaayy iinniittiiaattee aa rreeffeerrrraall ttoo aann iinntteerrnnaall WWAACCHHSS IInnjjuurryy mmaannaaggeemmeenntt CCoooorrddiinnaattoorr.. AAnn aappppooiinntteedd WWAACCHHSS IInnjjuurryy mmaannaaggeemmeenntt CCoooorrddiinnaattoorr wwiillll lliiaaiissee wwiitthh aallll iinnvvoollvveedd ppaarrttiieess ttoo eessttaabblliisshh aanndd mmoonniittoorr tthhee ffoolllloowwiinngg sstteeppss::

11 An injury management program will be implemented as soon as practicable in consultation with the treating doctor, supervisory staff and the injured employee to match capabilities with available duties. An injury management program will be implemented as soon as practicable in consultation with thetreating doctor, supervisory staff and the injured employee to match capabilities with available duties.

22 Generally an employee’s workers’ compensation claim must be approved before an injury

management program can be undertaken. The approval of the claim provides funding for injury management. At times a decision can be made to proceed with an injury management program without having the approval of the claim established where it is in the interest of the employee to recommence a return to work program. This will not imply that any liability for the claim be accepted and is on without admission of liability / without prejudice basis. This should be documented in the return to work program, until the claim has been determined.

Generally an employee’s workers’ compensation claim must be approved before an injurymanagement program can be undertaken. The approval of the claim provides funding for injurymanagement. At times a decision can be made to proceed with an injury management programwithout having the approval of the claim established where it is in the interest of the employee torecommence a return to work program. This will not imply that any liability for the claim be acceptedand is on without admission of liability / without prejudice basis. This should be documented in thereturn to work program, until the claim has been determined.

33 No program will commence without specific approval from the doctor, employer and employee, or

without appropriate supervision. No program will commence without specific approval from the doctor, employer and employee, orwithout appropriate supervision.

44 Regular liaison will take place with the injured worker, the treating medical practitioner, injury

management coordinator, the insurer, supervisor or manager, and any other party, such as external rehabilitation provider who may assist with achieving the goals of the program. All progress reports will be documented and provided to all parties.

Regular liaison will take place with the injured worker, the treating medical practitioner, injurymanagement coordinator, the insurer, supervisor or manager, and any other party, such as externalrehabilitation provider who may assist with achieving the goals of the program. All progress reportswill be documented and provided to all parties.

55 WACHS will maintain a flexible approach to the provision of suitable duties wherever it is safe and

operationally viable to do so. Support for this approach will be expected from the employee, co-workers, and the supervisor or manager. WACHS management will facilitate injury management by modifying tasks and duties, work environments and working hours to accommodate the injured employee’s medical guidelines.

WACHS will maintain a flexible approach to the provision of suitable duties wherever it is safe andoperationally viable to do so. Support for this approach will be expected from the employee, co-workers, and the supervisor or manager. WACHS management will facilitate injury management bymodifying tasks and duties, work environments and working hours to accommodate the injuredemployee’s medical guidelines.

66 The injured employee, whilst on an injury management program, has an obligation to report anyThe injured employee, whilst on an injury management program, has an obligation to report any

problems with duties at all times to the manager / supervisor immediately. Concerns raised by the employee should be addressed immediately by the supervisor or manager in liaison with the COSH or injury management provider.

problems with duties at all times to the manager / supervisor immediately. Concerns raised by theemployee should be addressed immediately by the supervisor or manager in liaison with the COSHor injury management provider.

77 If there is any uncertainty with regard to the suitability of a particular task, the doctor will be contacted

by the accredited rehabilitation provider or, if not available, the COSH, for advice on suitability before the employee proceeds with that task.

If there is any uncertainty with regard to the suitability of a particular task, the doctor will be contactedby the accredited rehabilitation provider or, if not available, the COSH, for advice on suitability beforethe employee proceeds with that task.

88 A time frame for monitoring progress will be established by the WACHS injury management

coordinator in line with medical reviews and duty upgrades. A time frame for monitoring progress will be established by the WACHS injury managementcoordinator in line with medical reviews and duty upgrades.

99 Employees on an injury management program will be encouraged to take responsibility for outcomes

through participation in the formulation of long and short-term goals in the return to work process. Employees on an injury management program will be encouraged to take responsibility for outcomesthrough participation in the formulation of long and short-term goals in the return to work process.

1010 Referral to a medical specialist may be recommended in consultation with the doctor or RiskCover. Referral to a medical specialist may be recommended in consultation with the doctor or RiskCover.

1111 The WACHS Injury Management Coordinator will continue to be involved with individuals referred to

external rehabilitation providers by liaising with the parties to monitor the external provider’s management of the case and the available resources under the claim

The WACHS Injury Management Coordinator will continue to be involved with individuals referred toexternal rehabilitation providers by liaising with the parties to monitor the external provider’smanagement of the case and the available resources under the claim

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1212 Finalising an Injury Management Program Finalising an Injury Management Program

IInnjjuurryy mmaannaaggeemmeenntt pprrooggrraammss aarree ccoommpplleetteedd wwhheenn::

•• The employee makes a successful return to the pre-injury position having been monitored in their original position on full duties for a minimum of four weeks, or as appropriate to the claim. (Eg. stress claims 3 months)

The employee makes a successful return to the pre-injury position having been monitored in theiroriginal position on full duties for a minimum of four weeks, or as appropriate to the claim. (Eg.stress claims 3 months)

•• The employee is appointed to another suitable vacancy within the organisation or with a different

organisation and is able to undertake all of the duties required. The employee is appointed to another suitable vacancy within the organisation or with a differentorganisation and is able to undertake all of the duties required.

•• When medical evidence supports further injury management efforts will not be successful. When medical evidence supports further injury management efforts will not be successful.

•• When the injury management program is due to conclude, a Progress or Final Medical Certificate

indicating fitness for pre-disability duties is required from the treating medical practitioner before resuming normal duties.

When the injury management program is due to conclude, a Progress or Final Medical Certificateindicating fitness for pre-disability duties is required from the treating medical practitioner beforeresuming normal duties.

13.13. The Injury management coordinator following finalisation of the injury management will provide a closure

file note and advise on the Injury management outcome of the case to the regional OSH coordinator. The Injury management coordinator following finalisation of the injury management will provide a closurefile note and advise on the Injury management outcome of the case to the regional OSH coordinator.

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Flowchart: WACHS Injury Management Process

Injured Worker Legend

Regional OSH

WACHS Injury

Arrange return to work or maintain at work program including consultation with service

manager/employee/medical practitioner and other parties

Return to work Return to work

Monitor and adjust return to work program until fit or progress medical certificate indicates further medical restriction change e.g. fit with restrictions or totally unfit

Medical practitioner

Report incident

Return to work program

Agreed and approved

First or final medical totally fit

Regional OSHC or OSH admin to refer to designated WACHS Injury

Management Coordinator

First or progress medicals – fit for pre-

disability duties OSHC and supervisor to

monitor

Claim finalised

OSHC to finalise claim with RiskCover

Injury management completed and

employee fit for pre-disability duties or

permanent alternative duties. Or

return to work no longer feasible

First or progress medicals indicating: Fit with restrictions, or lost time.

Injury- Disability- Illness

Claim finalised

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WACHS Responsibilities for Workers Compensation and Injury Management Injured Employee • Attend to First Aid if required. • Complete and submit to employer a regional Incident Report. • Visit medical practitioner of own choice, and obtain First Medical Certificate. • Complete employee section of the Workers Compensation Claim Form 2B. • Provide Form 2B and First Medical to the service manager as soon as possible. • Be actively involved in decisions and planning related to return to work, including consideration of agreement

to prepared return to work programs. • Attend medical reviews where requested by the employer or RiskCover which will not be more frequently than

every 14 days and within reasonable hours. • Attend treating medical practitioner appointments as required, and to maintain chronological continuity of

medical certificates. • Provide manager / supervisor with medical certificates and other documentation as soon as possible. • Cooperate with employer to arrange return to work programs including attending injury management case

meetings as required. • Return to work when declared fit with restrictions when the return to work program has been agreed by

medical practitioner, employer and employee. • Subsequent return to work program when declared fit with restrictions implemented only when agreement by

medical practitioner, employer and employee in place. Until then the worker will continue within the framework of the previous program, unless the restrictions from the later medical certificate are more restrictive than the previous certificate.

• Complete Reimbursement of Travelling Expenses Form when required and provide to the service manager. • Option to attend an Injured Worker’s Information Session at WorkCover. Appointment by telephoning 1 300

794 744. Travel expenses are not refundable. • Injured Worker’s Information Session information may be accessed by telephoning WorkCover 1 300 794

744. • Option to be provided with the services of an Approved vocational rehabilitation provider. • Rights and responsibilities in accordance with the Act concerning dispute resolution. Information provided in

WorkCover brochures attached to letter from employer following lodgement of claim or by telephoning WorkCover 1300 794 744.

• Obtain final medical certificate as required Manager / Supervisor • Ensure regional Incident Report is completed and processed. • Notify regional OSH Coordinator / OSH administrative assistant within 24 hours of incident occurring. • Advise the regional OSH coordinator if the worker needs assistance to complete the Form 2B and provide the

Form 2B and First Medical to the employee, • Complete first page of Form 1B and employer section of Form 2B and forward together with the First Medical

Certificate to regional OSH coordinator within 24 hours of receipt of the papers. • Fax progress medical certificates as soon as received to regional OSH coordinator. • Forward all subsequent documents including Form 5A Witness Statement forms, other documents including

original medical certificates, to OSH coordinator as above. • Represent the employer when return to work programs is being discussed and approved. • Facilitate once the initial return to work has been agreed by medical practitioner, employer and employee. • Cooperates with adjustments to subsequent return to work programs when agreed by medical practitioner,

employer and employee. • Ensure the injured worker is supervised during any return to work program and that they comply with the

conditions of the return to work program. • If the worker has been relocated to a different work area to carry out return to work duties, ensure appropriate

occupational safety and health training is conducted. • Organise the work place to ensure the duties excluded in the return to work program are allocated to others

safely and equitably. • Maintain Rostar system details in relation to return to work status for injured worker to reflect workers

compensation and return to work hours and changes.

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• Discretionary referral of non-work related injuries of employees to regional OSH coordinator. Regional OSH Coordinator – Regional OSH Administrative Assistant – Claims Management • Check and complete Page 1 of Form 1B and Form 2B and lodge with RiskCover on line, together with First

Medical Certificate to RiskCover within 24 hours of receipt of the documents from health service unit to ensure lodgement within 3 working days to the insurer of worker submitting First Medical Certificate and Form 2B. (The legislation only requires the First Medical and the Form 2B to be lodged within three days of receipt from the employer, however the claim cannot be considered by RiskCover until the Form 1B is received.) . Should the claim subsequently be declined the wages paid for supernumerary attendance in the work place on a return to work program will be employer funded i.e. not from the worker’s leave entitlements.

• Request HCN to provide wages calculation on Page 2 of the Form 1B, through submission of HCN wages calculation form and provide the date of first weekly payment received through Regulation 19P / Form 36 report to RiskCover within 24 hours of claim receipt.

• Assist the injured worker to complete the Form 2B and provide First Medical Certificate if required. • Forward other forms, documents and medical certificates to RiskCover as soon as possible after receipt. • Write to injured worker to introduce them to claim and injury management. Enclose the WorkCover brochure

Workers’ Compensation and Injury Management Important Information for Workers. (Proforma letter attachment one)

• Write to injured worker’s practitioner to introduce them to claim and injury management. Enclose the WorkCover brochure Workers’ Compensation and Injury Management Important Information for Workers. Advise the WorkCover web site address. www.workcover.wa.gov.au which provides a schedule of fees and a comprehensive document Workers’ Compensation and Injury Management in WA - Guidance Notes for Medical Practitioner. (Proforma letter attachment one)

• Refers claimants that are either totally unfit, partially unfit, have restrictions identified, or have psychological/ stress related issues identified on their medical certificates to WACHS Injury management Coordinator within 24 hours of receipt of the claim. (See attached WACHS Injury Management referral form attachment 5)

• Monitor, coordinate and facilitate claim progress through to Final Medical Certificate and/or finalisation of the claim.

• Report to Regional Executive on claims Annual performance indicator as required. • Establish and maintain workers compensation claims file separate to the personal file. Forward file as per

regional requirements when claim finalised. File to be kept secure and confidential. • Advise HCN, and manager/ supervisor, by email, when claim approved and request amendment to pay

records as appropriate through the fortnightly HCN workers compensation spreadsheet. \ • Conduct regular claims meetings with designated Injury management coordinator at a minimum once a

month • Convene claim conference with RiskCover as required, and minimum at least every three months. • Monitors claimants and medical certification who are initially either totally fit or fit without restrictions and

refers to injury management coordinator if certification changes to unfit, have work restrictions identified, or have additional psychological/ stress related issues associated with the claim.

• Distribute evaluation form to employee when claim finalised. • Report to Commissioner of WorkSafe in accordance with Occupational Safety and Health Regulations 1996

No 2.4. • Advise the worker that leave credits will be utilised for time off work until a decision on liability for the claim is

received from RiskCover. If the claim is approved these credits will be reinstated. • Maintaining regional database on workers compensation / claims list and files as required. (Link to regional contacts appendix 7) WACHS Injury Management Coordinators • Will manage the return to work processes for those employees that are either off work or have restrictions in

relation to their duties as identified on the medical certificate, or otherwise referred by the regional OSH coordinators.

• Commence injury management immediately without waiting for claim approval. • Consult with the injured worker, treating practitioner, and the line manager to facilitate return to work and to

ensure the return to work occurs once agreed by medical practitioner, employer and employee. • Will organise or undertake Initial work site assessment and report on ergonomics, modifications and

equipment as required. • Prepare initial and ongoing written return to work programs in the format provided in this document within the

http://www.workcover.wa.gov.au/

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framework of the most recent medical certificate. • In liaison with the Regional OSH coordinator organises and monitors external injury management providers • In consultation with the injured worker, the service manager or line manager, the treating medical

practitioner/s and others authorised by the employee, facilitate and coordinate the most effective (safe for the injured worker and others working with them) and efficient (early) return to work for an injured or ill worker, in accordance with this procedure.

• Accesses and monitors external injury management services as required. • Convene case conferences as required. • Provide awareness training for managers. • Provide advice, support and encouragement to the injured worker. • Report via email to supervisor / manager / OSH Coordinator / admin assistant/ RiskCover after each contact

with the injured worker, or others concerning the injured worker. • Forward copies of return to work programs to employee, supervisor / manager / OSH Coordinator / admin

assistant and RiskCover, including those from external providers (Link to Injury management coordinators appendix 7)

Medical Practitioners • Provide specific diagnosis and initiate appropriate treatment. • Provide detailed and legible first, progress and final medical certificates. • Communicate with the employer and the worker to assist the safe and early return to work. • Be actively involved in decisions related to return to work including consideration of agreement to return to

work programs prepared within clinical parameters determined by the treating medical practitioner. • Determine return to work goal in consultation with worker and employer. • Participate, if required, in the referral process for Approved vocational rehabilitation. • Submit invoices to the employer for expenses for fees in accordance with the WorkCover schedule see

www.workcover.wa.gov.au. Approved Vocational Rehabilitation Provider • Direct liaison with OSH Coordinator, Injury management coordinator with regards to injury management

service and progress. • Provide services and reporting as required by employee, employer and or general practitioner in accordance

with WorkCover requirements. • Provide specific services such as occupational therapy services as agreed between provider and region. • Provide a copy of return to work programs to RiskCover.

Insurer - RiskCover • Decide liability for the claim within 14 days of receiving the claim from the employer i.e. within 17 days of

receipt by employer, and notify the employer and injured worker of the decision in writing and provide a reason if declined or pended.

• In consultation with the employer, arrange for an injured worker to attend a medical review if required. • In consultation with the employer or worker to have a dispute resolved. • Notify injured worker at least 21 days notice of intent to cease, reduce or suspend weekly payments • Notify the worker when 75% of medical expense entitlement is exhausted. • Form 36 (930) (from 14 November 2005) to employer and employee • Provide Injury Management data to WorkCover (e.g. RTW programs) HCN – Payroll • Following receipt of the 13 week calculation form from the regional OSH coordinator/ assistant, complete

wages calculation as per requirement of Page 2 of Form 1B and email it to OSH coordinator/ assistant within 24 hours of receiving the request.

• Processes fortnightly reports as per spreadsheet provided by regional OSH coordinator/ assistant to HCN Accounts Receivable for recouping wages.

• Provide regular spreadsheet identifying verification process for wages reimbursement to regional OSH Unit HCN Finance – Accounts Receivable • In consultation with Payroll, invoice RiskCover fortnightly to recoup wages.


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Workers Compensation and Injury Management Issue Resolution

Issue Resolution Policy WWAACCHHSS aaiimm ttoo rreessoollvvee aallll wwoorrkkeerrss ccoommppeennssaattiioonn aanndd iinnjjuurryy mmaannaaggeemmeenntt iissssuueess qquuiicckkllyy aanndd eeffffeeccttiivveellyy ttoo tthhee ssaattiissffaaccttiioonn ooff mmaannaaggeemmeenntt aanndd eemmppllooyyeeeess,, aanndd hhaavvee ddeevveellooppeedd tthhee ffoolllloowwiinngg iissssuuee rreessoolluuttiioonn pprroocceedduurree.. TThhee pprroocceedduurree iiss ccoonnssiisstteenntt wwiitthh PPaarrtt IIIIIIAA ooff tthhee WWoorrkkeerrss ccoommppeennssaattiioonn aanndd IInnjjuurryy mmaannaaggeemmeenntt AAcctt 11998811 ((aammeennddeedd)).. Dispute process IIff aa ssiittuuaattiioonn aarriisseess wwhheerree aann eemmppllooyyeeee ccoonnssiiddeerr tthheeyy hhaavvee rreeaassoonnaabbllee ggrroouunnddss ffoorr bbeelliieevviinngg tthhaatt tthheerree iiss aa ddiissppuutteedd mmaatttteerr oonn tthheeiirr ccllaaiimm ffoorr wwoorrkkeerrss ccoommppeennssaattiioonn bbeettwweeeenn tthheemmsseellvveess aanndd tthhee eemmppllooyyeerr,, iinnssuurreerr oorr ootthheerr ppaarrttyy rreeggaarrddiinngg tthhee ffoolllloowwiinngg::

•• Dispute on liability for entitlements under the Workers Compensation and Injury Management act Dispute on liability for entitlements under the Workers Compensation and Injury Management act1.1. Employees can notify their regional OSH coordinator about the issue in dispute and the OSH

coordinator may provide advise on the process of resolving the dispute or negotiate with the other party to resolve the dispute

Employees can notify their regional OSH coordinator about the issue in dispute and the OSHcoordinator may provide advise on the process of resolving the dispute or negotiate with theother party to resolve the dispute

2.2. Where the above is not practicable the employee has the right to access the WorkCover WA dispute resolution directorate on the matter by contacting: Where the above is not practicable the employee has the right to access the WorkCover WAdispute resolution directorate on the matter by contacting:

WWoorrkkCCoovveerr WWAA DDiissppuuttee rreessoolluuttiioonn DDiirreeccttoorraattee BBeeddbbrrooookk PPllaaccee SShheennttoonn PPaarrkk WWAA 66000055 PPhhoonnee 9933888855555555 FFaaxx 9933888855669900

A matter involving a dispute on the provision of injury management services. A matter involving a dispute on the provision of injury management services.1.1. Employees can notify their designated Injury management co rdinator about the issue in dispute

and the Injury management coordinator may provide advise on the process of resolving the dispute or negotiate with the other party to resolve the dispute.

Employees can notify their designated Injury management cooordinator about the issue in disputeand the Injury management coordinator may provide advise on the process of resolving thedispute or negotiate with the other party to resolve the dispute.

2.2. Employe s can notify their regional OSH coordinator about any issue in dispute and the OSH coordinator may provide advise on the process of resolving the dispute or negotiate with the other party to resolve the dispute.

Employeees can notify their regional OSH coordinator about any issue in dispute and the OSHcoordinator may provide advise on the process of resolving the dispute or negotiate with theother party to resolve the dispute.

3.3. Where the above is not practicable the employee has the right to access the WorkCover WA Injury Management Review Unit for issues related to Where the above is not practicable the employee has the right to access the WorkCover WAInjury Management Review Unit for issues related to•• Return to work programs Return to work programs•• Referral for vocational rehabilitation Referral for vocational rehabilitation•• Participation in vocational rehabilitation Participation in vocational rehabilitation

The Injury management review Unit at WorkCover WA can be accessed through the WorkCover WA info Line on 1300 794 744 The Injury management review Unit at WorkCover WA can be accessed through theWorkCover WA info Line on 1300 794 744

4.4. Where the above is not practicable or appropriate the employee has the right to access the

WorkCover WA Dispute Resolution Directorate on the matter by contacting: Where the above is not practicable or appropriate the employee has the right to access theWorkCover WA Dispute Resolution Directorate on the matter by contacting:

WWoorrkkCCoovveerr WWAA DDiissppuuttee rreessoolluuttiioonn DDiirreeccttoorraattee BBeeddbbrrooookk PPllaaccee SShheennttoonn PPaarrkk WWAA 66000055 PPhhoonnee 9933888855555555 FFaaxx 9933888855669900

http://www.workcover.wa.gov.au/DisputeResolution/AboutTheDRD.htmhttp://www.workcover.wa.gov.au/DisputeResolution/AboutTheDRD.htm NNoottee:: AAddvviiccee ffrroomm tthhee rreeggiioonnaall OOSSHH ccoooorrddiinnaattoorr sshhoouulldd bbee oobbttaaiinneedd wwhheerree ppoossssiibbllee,, bbeeffoorree eexxtteerrnnaall oorrggaanniissaattiioonnss oorr ccoonnssuullttaannttss aarree iinnvvoollvveedd iinn tthhee rreessoolluuttiioonn ooff aann iissssuuee..

http://www.workcover.wa.gov.au/DisputeResolution/AboutTheDRD.htm

18

Non Work Related Injuries WACHS has a further commitment to ensure their duty of care under the Occupational Safety and Health Act is complied with in relation to providing a safe workplace for employees or potential employees that may have a reduced capacity for work. This may occur in the following situations where assistance through injury management may be required: Non work related injury / fitness for work issues AA WWAACCHHSS eemmppllooyyeeee mmaayy ssuuffffeerr aa ppeerrssoonnaall iillllnneessss oorr aann iinnjjuurryy tthhaatt iiss nnoott wwoorrkk rreellaatteedd,, bbuutt wwhhiicchh iiss sseevveerree eennoouugghh ttoo ccaauussee eexxtteennddeedd aabbsseennccee ffrroomm wwoorrkk oorr iimmppaaccttss oonn tthhee ppeerrssoonn’’ss ccaappaacciittyy ttoo ppeerrffoorrmm nnoorrmmaall dduuttiieess.. UUnnddeerr tthheessee cciirrccuummssttaanncceess tthheerree mmaayy bbee aann iinnccrreeaasseedd rriisskk ooff iinnjjuurryy wwhheenn tthhee eemmppllooyyeeee ffiirrsstt rreettuurrnnss ttoo wwoorrkk.. IInn oorrddeerr ttoo mmaannaaggee tthhaatt rriisskk aanndd ttoo pprrootteecctt aallll eemmppllooyyeeeess,, tthhee eemmppllooyyeeee’’ss wwoorrkk ccaappaacciittyy mmaayy nneeeedd ttoo bbee aasssseesssseedd,, aanndd mmeeddiiccaall aaddvviiccee oobbttaaiinneedd ttoo eessttaabblliisshh iiff aannyy aalltteerrnnaattiivvee aarrrraannggeemmeennttss sshhoouulldd bbee mmaaddee ffoorr tthhee eemmppllooyyeeee,, ssuucchh aass wwoorrkkiinngg rreedduucceedd hhoouurrss oorr pprroovviiddiinngg aalltteerrnnaattiivvee dduuttiieess.. AAnnyy eemmppllooyyeeee wwhhoo eeiitthheerr hhaass bbeeeenn ooffff wwoorrkk ffoorr tthhrreeee mmoonntthhss oorr mmoorree oorr wwhheerree tthheeiirr mmaannaaggeerr // ssuuppeerrvviissoorr ppeerrcceeiivveess aa rriisskk ooff iinnjjuurryy mmaayy rreeqquuiirree aann aasssseessssmmeenntt ooff tthheeiirr ccaappaacciittyy ttoo wwoorrkk..

WWAACCHHSS mmaannaaggeemmeenntt mmaayy rreeqquueesstt aa mmeeddiiccaall eexxaammiinnaattiioonn bbee ccoonndduucctteedd ttoo eessttaabblliisshh tthhee wwoorrkk ccaappaacciittyy ooff ssuucchh eemmppllooyyeeeess aanndd ddeevveelloopp gguuiiddeelliinneess ttoo aassssiisstt iinn tthheeiirr rreettuurrnn ttoo tthheeiirr pprree--ddiissaabbiilliittyy dduuttiieess.. DDuurriinngg tthhee ppeerriioodd ooff aasssseessssmmeenntt tthhee eemmppllooyyeeee mmaayy bbee rreeqquuiirreedd ttoo uunnddeerrttaakkee ssuuiittaabbllee aalltteerrnnaattiivvee dduuttiieess oorr rreemmaaiinn ooffff wwoorrkk oonn ssiicckk lleeaavvee oorr aalltteerrnnaattiivvee ppaayy aarrrraannggeemmeennttss.. WACHS employees that present with a reduced capacity for work might require input from the WACHS injury management unit to determine their safety whilst undertaking their designated duties. This could apply to the following situations employees may encounter:

• Alcohol and drug use; • Long term chronic health conditions; • Non-work related injury.

If in a situation as above the employee is at risk of further injury or exacerbating their injury or condition or adversely affecting the safety and health of any other person in the workplace it may be appropriate for an injury management program to be put in place. This may include implementation of the following injury management interventions:

• Medical assessment to be organised; • Working guidelines or a return to work program to be implemented • The employee be monitored at work; • Provision of alternative duties for a determined period.

Managers and supervisors of the affected employee will be responsible for managing this process and any injury management requirements need to be referred to the Regional Occupational Health and Safety Coordinator. The OSH Coordinator / Human Resources Manager will discuss with the manager/ supervisor appropriate referral to a designated injury management coordinator. The Injury Management Coordinator will then facilitate for the medical assessment to be set up, workers consent to be obtained ( attachment 8), and write to the medical practitioner to request information. The injury management coordinator will then provide the information received from the medical practitioner to the manager, and if required sets up in conjunction with manager and worker an injury management program or working guidelines. OSH Coordinators and Injury Management Consultants act in an advisory capacity only. It remains the responsibility of the manager to supervise the worker during the program and whilst on working guidelines. Pre-employment screening

WACHS management may identify the requirement for a medical assessment of a potential employee on application for a job due to a pre-existing medical condition or injury that may impact on that employee’s ability to undertake the duties required. This person can be referred through to the Regional OSH coordinator by management for assessment. The OSH coordinator in liaison with the injury management coordinator will organise the appropriate referral and assessment and or worksite assessment or duty description. The Injury management coordinator will provide a specific service in relation to the provision of medical

19

information and medical recommendation. Once the injury management coordinator in liaison with the regional OSH coordinator has provided advise to the manager, It remains the responsibility of management to implement the process of recruitment and appropriate provision of duties, or other Human Resource actions required. Workers Compensation and Injury Management Outcome Evaluation Outcome indicators to be reported to regional executive and corporate governance committee quarterly and annually prior to 30 June of the following financial year. Annually • Injury Index • Lost Time injury frequency rate • Return to work percentage of lost time claims • Delay in referral to injury management • Workers compensation contributions per region • Client satisfaction survey. Monthly / Quarterly • Number of open and closed claims per region • Average workers compensation claims cost per region. • No of lost time claims per region • Average lost time per region • No of claims with external injury management WACHS to seek outcome indicators from other industry and health services and use the data for evaluation and comparison. Related Policies, Procedures and Source Documents

• WorkCover: Guidelines for injury management in the workplace Injury Management in WA –

http://www.workcover.wa.gov.au/NR/rdonlyres/25272652-90B4-4B37-ACB0-122FD82B87DD/0/Guidelines.pdf

• WorkCover: Workers compensation Code of Practise (injury management) 2005

http://www.workcover.wa.gov.au/NR/rdonlyres/9A530AA8-2235-45A7-82B5-8B01F31966A9/0/CodeofPracticeapprovedversionforweb.pdf

• WorkCover: Guidance note s for the Code of practice (injury management) 2005

http://www.workcover.wa.gov.au/NR/rdonlyres/D9C9C47C-47D8-41F5-9022-2C28E3BDD07A/0/26532IM_Guide41.pdf

• Western Australian Code of Ethics, Public Sector Standards Commission • Health risk management Policy and framework 2005

http://intranet.health.wa.gov.au/Riskmanagement/docs/Health%20Risk%20Management%20Framework.pdf

Supersedes Various WACHS regional workers compensation and injury management policy and procedures documents This document to be reviewed initially in one year and subsequently no sooner than three months from one-year review approval, by request, and not later than three years after initial approval.







http://intranet.health.wa.gov.au/Riskmanagement/docs/Health%20Risk%20Management%20Framework.pdf

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Attachment 1: Employee Letter from Injury Management Consultant

Combine letter to employee with cc to GP and OSHC / RiskCover <date> <name> <home address> Dear <first name> We have been made aware you had a workplace injury and have been referred to the WACHS injury management program. The WACHS injury management program’s focus is a safe and early return to work. Our policy is to assist our workers to return to or remain at work while recovering from injury, or encourage early return to a graduated return to work program (alternative or restricted duties and or hours), or full employment, as soon as possible. Our procedure includes the requirement for a return to work program coordinated by a designated injury management coordinator following a workplace injury As soon as your doctor declares you fit for pre-disability duties you may return to your normal job. If your doctor declares you fit with restrictions you will be consulted about a return to work program by a WACHS Injury management coordinator. The focus of a return to work program is your safe and early return to work. When declared fit with restrictions, you must not return to work until your return to work yourself, your medical practitioner and your employer agree to program. During this period you are expected to be available for contact and appointments concerning your workers’ compensation claim and return to work. Subsequent progress medical certificates may mean a new return to work program is required. As per consent on the 2B claim form I will be contacting yourself and your GP to discuss a return to work program and other assistance we can provide. The WACHS Injury management coordinator will work with you, your medical practitioner and manager or supervisor towards your safe and early RTW and I have sent a copy of this letter to your medical practitioner, and manager for their information Commencement of a return to work program does not mean liability for the claim is accepted. A claim can remain pended, but WACHS will work with you to undertake injury management irrespective of your claims status. Please do not hesitate to contact me if you have any queries, comments or concerns. If I am not available, please leave a message and I will return your call as soon as possible. For further information re WC contact WorkCover website www.workcover.wa.gov.au phone 1 300 794 744. or RiskCover on 992643400 I look forward to supporting you so that you may safely return to work as soon as possible. Yours sincerely Injury Management Coordinator


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Attachment 2: OSHC Regional Letter

Your Ref : Our Ref : Enquiries to :

Phone No. :

Department of Health Government of Western Australia WA Country Health Service Regional Office

“IN CONFIDENCE”

Mr Joe Bloggs Dear Mr Bloggs, WORKERS COMPENSATION CLAIM FORWARDED TO RISKCOVER

FILE No- We advise confirmation of receipt of your completed Workers’ Compensation claim papers describing your alleged injury suffered on 14 -04 -2006. We have since forwarded these documents to our insurer, RiskCover, for their consideration. Whilst awaiting Risk Cover’s decision on liability, the Health Service shall continue to pay your salary/ wages (leave forms required) strictly on a without prejudice or admission of liability basis according to the Workers Compensation and Rehabilitation Act 1981 (as amended). Please refer to, complete and return the attached authority form for processing. Should there be a dispute regarding liability or should your claim be denied, we will discuss with you what other leave entitlements you may have. It is also a requirement under section 59 of the Workers Compensation and Rehabilitation Act 1981 (as amended) that you disclose any information as to other remunerated work. Therefore please respond to the following particulars within seven days of receipt this notice and return so that your entitlements may be processed. Please specify any additional organisations where you have undertaken remunerated work since and one month before the submission of your Workers Compensation claim; 1. The date of commencement of the work;

2. The title, classification and a brief description of the work;

3. The remunerated entitlement for the work (base pay rate);

4. The name and address of the organisation for whom the work was performed.

If this does not concern you then please still reply to this by a statement advising that you receive no other remunerated work (please also refer to the attached authority). I wish to draw your attention to the WACHS Injury Management program which focus’ on a safe and early return to work. Please find attached a copy of the injury management model advocated by WorkCover and adopted by WACHS for your perusal. Our policy is to assist our employees to return to or remain at work while recovering from injury, or encourage early return to a graduated return to work program (alternative or restricted duties and or hours), or full employment as soon as possible. This includes our requirement for a return to work program coordinated by a WACHS Injury Management Coordinator. Accordingly, ---------------, our Injury Management Coordinator will be in contact with you to commence your injury management process.

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The Injury Management Coordinator will work with you, your medical practitioner, manager and supervisor to progress your safe and early return to work. As soon as your medical practitioner declares you fit for pre-disability duties, you may return to your normal job. If you doctor declares you fit with restrictions, your WACHS Injury Management Coordinator will consult you about a return to work program. The focus of a return to work program is your safe and early return to work. When declared fit with restrictions, you must not return to work until you, your medical practitioner and your employer agree to the program. During this period you are expected to be available for contact and appointments concerning your workers’ compensation claim and return to work. Subsequent progress medical certificates may mean a new return to work program is required. The commencement of a return to work program does not mean that liability for the claim is accepted. Your injury management process with WACHS will continue irrespective of the status of your claim. Please liaise with myself or ----------on issues not related to Injury Management pertaining to your above Workers Compensation claim such as the status of your claim and invoices. I take this opportunity to bring to your attention the availability of the outsourced professional confidential counselling services. The main features of these services are completely confidential, voluntary, and professional and experience counsellors, free of charge and available for all employees of the Health Service. The confidential counselling service providers can be contacted on the following numbers; EAP provider details I thank you for your co-operation on this matter and wishing you a speedy recovery. Further information regarding Workers Compensation, can be found from WorkCover website www.workcover.wa.gov.au phone 1300 794 744 or RiskCover 9264 3400. Should you wish to discuss this matter further, please do not hesitate to contact me on 9956 2499. Yours sincerely, Regional OSH Coordinator <date> Attached: Application by employee to utilise leave credits in anticipation of claim acceptance,

Overview of the Injury Management Process and Workers’ Compensation fact sheet. CC: Manager

Supervisor Medical Practitioner Injury Management Coordinator

Application by Employee to Utilise Leave Credits in Anticipation of Claim Acceptance and Overpayment Deduction Authority

I………………………………………………………………………………….wish to use sick leave/ annual leave/ other leave entitlements for an injury/ illness on 14 / 04 /06 pending advice from RiskCover of acceptance of my claim for workers compensation.

I am aware by requesting sick leave/annual leave/long service leave; my workers’ compensation claim is in no way prejudiced.

It is understood that the above leave taken will be re-credited to my existing leave balances if the claim is accepted.

I am also aware that under the current worker’s compensation legislation I will be entitled to:

Workers Whose Earnings are Prescribed by an Industrial Award • For the first thirteen weeks my weekly payments will consist of the rate of weekly earnings

payable under the relevant industrial award, plus any over award or service payment paid on a


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regular basis including overtime, bonuses or allowances up to a maximum of $1609.90 per week (overtime and bonuses averaged over 13 weeks prior to the date of injury/illness).

• From the fourteenth week onwards for any time lost in relation to my claim, my weekly payments

will consist of the rate of weekly earnings payable under the relevant industrial award, plus any over award or service payment paid on a regular basis, but excluding overtime, bonuses and allowances up to a maximum of $1609.90. Information as to other remunerated work Pursuant to Section 59, I do / do not (delete which ever is appropriate) receive other remunerated work as detailed below and proof (payslips) attached. 1.……………………………………………………………………………………………… 2………………………………………….…………………………………………………… 3………………………………………….…………………………………………………… 4………………………………………………………………………………………………. Overpayment deduction Authority. Whilst awaiting the decision regarding my claim, I understand that I may be overpaid and that in the event of any overpayments, payroll may, in line with the conditions outlined in the Enterprise Bargaining Agreement/ Workplace Agreement deduct such overpayments made to me.

___________________________ ________________________ Signature Date

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OVERVIEW OF THE INJURY MANAGEMENT PROCESS

Return to Work Strategy

Same Employer

Claims process implemented

Same Job New Job No Training Required Training Required

Maintenance in or return to work No return to work Return to work

Placement Activities

New Employer

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Attachment 3: RTW Program

WA COUNTRY HEALTH SERVICE, (letterhead) RETURN TO WORK PROGRAM CLIENT: POSITION TITLE: AVERAGE HOURS PER WEEK: REGION: SITE: LINE MANAGER: IM COORDINATOR: Actions required prior to return to work Action By Whom By when Return to Work Goal

Same organisation/same job (select this option unless otherwise directed by medical practitioner)

Same organisation/modified job Same organisation/new job New organisation/same job New organisation/modified job Other

Current Medical Restrictions Return to Work Program Duties Special Requirements

• Breaks • Work postures • Equipment • Assessments

Supernumerary Status (delete one option) The restrictions and capabilities of the injured worker are such that the person will be supernumerary during the duration of this return to work program.

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The restrictions and capabilities of the injured worker are such that the person will not be supernumerary during the duration of this return to work program. Schedule Not to include unsupervised work or work attracting penalty rates. Week ending (ddmmyy) M T W Th F Total

Conditions

• This program is developed in consultation with Dr ----------. • ---------Progress will be reviewed on a fortnightly basis by the Injury Management Coordinator. This

will be done in consultation with all relevant parties. • ----- should perform only the tasks and hours designated in the program. Should any symptoms

occur, immediately stop task and report this to: o Supervisor o Medical Practitioner o Injury Management Coordinator

• The supervisor should not alter any aspects of the return to work program with the express

consent of the injured employee and their treating general practitioner and in liaison with the injury management coordinator.

• Any changes to the return to work program should be presented in writing in an amended return to work program.

---- Should advise the Injury Management Co-ordinator of all work absences if they occur during the program. Also, you must inform your supervisor prior to work if unable to attend, and obtain a medical certificate from your Medical Practitioner for each day absent.

----- is to comply with normal work practices and safety requirements of the workplace. Should any queries arise during the program the supervisor / employee should contact the Injury

Management Coordinator on 97570425 or 0419195821. If any leave is required during the RTW program application must also be forwarded to and

approved by the IMC This program is subject to change only after consultation between all parties. This return to work program has been formulated in conjunction with injured employee, line manager and treating medical practitioner AGREEMENT TO THIS RETURN TO WORK PROGRAM ………………………….. Medical practitioner’s signature ………………………….. Date Manager and employee to sign on commencement of the program ………………………….. Employee’s signature ………………………….. Date ………………………….. Supervisor’s signature …………………………..Date

DRAFT , not for circulation

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Attachment 4: Questionnaire

WA COUNTRY HEALTH SERVICE, WORKERS COMPENSATION AND INJURY MANAGEMENT QUESTIONNAIRE

As an employee with a recently finalised workers’ compensation claim you have a unique perspective on both the strengths and the weaknesses of the service provided. I invite you to complete the following questionnaire and return it in the self-addressed reply paid envelope enclosed. Your feedback will be valuable in assisting us to improve the way we provide services to people who incur an injury or illness at work. Please circle the number which best answers the question. Further comments including suggestions for improvement welcome. If RTW all questions If no RTW please complete Q 1 – 5 Name ………………………….……. (optional) 1. Were you aware of your entitlements and responsibilities? 1 2 3 4 5 6 Bad Poor Fair Good V Good Excellent 2. Are you aware of the procedure to follow for an early and safe return to work? 1 2 3 4 5 6 Bad Poor Fair Good V Good Excellent 3. During your return to work program how well were you supervised by your line manager or

supervisor? 1 2 3 4 5 6 Bad Poor Fair Good V Good Excellent 4. During your return to work program how well were you supported by the Injury management

Consultant? 1 2 3 4 5 6 Bad Poor Fair Good V Good Excellent 5. During your return to work program how well were you supported by your line manager

or supervisor? 1 2 3 4 5 6 Bad Poor Fair Good V Good Excellent


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6. During your return to work program how well were you supported by your fellow

workers? 1 2 3 4 5 6 Bad Poor Fair Good V Good Excellent 7. Were you happy with the frequency of contact with the Injury management Consultant? 1 2 3 4 5 6 Bad Poor Fair Good V Good Excellent 6. Was return to work program commenced in a timely manner? 1 2 3 4 5 6 Bad Poor Fair Good V Good Excellent 7. How appropriate were the work duties that were organised for you? 1 2 3 4 5 6 Bad Poor Fair Good V Good Excellent 8. How do you feel your claim was administered with respect to wages and payment of accounts? 1 2 3 4 5 6 Bad Poor Fair Good V Good Excellent


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Attachment 5: WACHS Injury Management Referral Form

Region Referring: Date: Mobile:

Employee details

Name:

Address:

Phone numbers Home: Work: Mobile:

Health Care Unit: Work location:

Job Title: Duties:

Claim No: DOI:

Type and Description of Injury:

Dr name: Phone:

Supervisor Contact Details Name:

Title: Phone:

Line manager Contact Details Name:

Title: Phone:

Current Status on medical certificate (Fitness to Work Restrictions):

Relevant History ( previous claims):

1.

2.

3.

Action Commenced / Planned:


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Attachment 6: Workers Compensation Pay Advice Form Full Name: _____________________ Pay Period Ending: ____________________

Time Date Work Area Start Finish

Total Hours Worked

Hrs Worked: 1. Rostered hours worked 2. Workers compensation absence 1. 2.

Authorised By Manager

Comments (Any alterations to the official return to work program hours e.g. unable to work full RTW for shift due to sick leave or attending treatment)

WC Clerk

Totals Employee to forward completed workers Notes: Compensation Advice To OSH Administrative assistant 1. Sick days must be indicated as “sick days – not W/C”. --------- by fax --------By Monday 9:30am after end of 2. Annual leave must be indicated as annual leave and requires prior authorisation each Pay Period. by Injury Management Coordinator.

3 A DoH Leave form needs to be completed for any leave other than workers compensation Supervisor must: Confirm hours worked and sign authorisation. 4 Return to Work Programs cannot exceed contracted hours (less ADO accrual). 5. Employees on Return to Work Programs are only to work office hours as Employee must: Notify line manager for the day if they cannot attend Normal penalties are not paid whilst on Workers Compensation. and explain why . 6. Overtime is not permitted. Complete this form daily and seek authorisation from line manager 7. Returns to work programs are only to be conducted between Monday and Friday dayshift Explain any discrepancy between RTW Hours Planned & only to be worked. Total Hours Worked under “Comments”. _________________________________ Signature of employee


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Attachment 7: List of Employees Responsible for Workers Compensation and Injury Management WACHS WORKERS COMPENSATION RESPONSIBILITIES WACHS Region OSH Coordinator Contact phone Mobile Phone E-mail Kimberley Glen Bowers 91941607 0418931449 [email protected] Pilbara Christine Goddard 99410542 04388835542 [email protected] Midwest - Gascoyne Mark Gardiner 99562499 04189940954 [email protected] Wheatbelt Tom Carpenter 98810406 0427 443 920 [email protected] Goldfields Zoran Simic 9080 5790 0408947339 [email protected] Great southern Stuart Ion 9892 2349 [email protected] SouthWest Jeff McQuade 9754 4444 0438967485 [email protected] Head Office Reijer Groenveld 92238554 0408605842 [email protected] WACHS INJURY MANAGEMENT UNIT RESPONSIBILITIES WACHS Region Injury management

Coordinator Contact phone Mobile Phone E-mail

Head Office Reijer Groenveld (Unit Manager)

92238554 0408605842 [email protected]

Wheatbelt Narelle Skepper 92238500 0427775682 [email protected] Kimberley Pilbara and Midwest - Gascoyne

Harry Treloyn 9941 0541 0418 954 381 [email protected]

Goldfields and SouthWest

Jack Hough 9757 0425 0419 195 821 [email protected]

Great Southern Matt Wells 98922216 0427990069 [email protected]


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Attachment 8: employee consent form

Department of WA Country Health ServiceGovernment of Western Australia

AUTHORITY TO OBTAIN AND RELEASE INFORMATION I,………………………………………., authorize the Injury Management Coordinator of WA Country Health Service ……………………………….. to obtain and release information relevant to my injury management program. Signed: …………………………… Dated: ……/……/……..