WorkCover Patients

The worker’s role is to focus on their recovery. They should aim to stay at work in some capacity, or return to work as soon as possible. They must notify their employer of their injury or illness as soon as possible after it has occurred. They are also required to maintain a current WorkCover certificate and provide a copy to their employer and/or insurer.

The worker has the right to choose their treating allied health practitioner. The chosen practitioner must meet the requirements and conditions outlined in this guide in order to deliver any treatment services to the worker.

Workers must actively participate in their recovery at work planning, attend appointments arranged by the insurer case manager, and make reasonable efforts to participate in recovery and return to work strategies.

The employer is required by law to provide suitable work (where possible) that matches the worker’s capacity and supports their recovery. This work should be as close as possible to the worker’s normal duties in order to maximise their recovery and minimise disruption to their usual routine at work and at home. If the worker is employed by a large employer, there may be a return to work coordinator, whose role is to assist the worker with their recovery/return to work.

The greater the employer’s ability to accommodate their worker while they recover, the less likely it is that they will need time away from the workplace as a result of their injury.

You may find it helpful to contact the employer to discuss the worker’s needs. The employer can assist by:

• providing information about the workplace, the worker’s usual job and available short term suitable work options
• discussing any risks or barriers that may have an impact on the worker’s recovery
• developing a recover at work plan to ensure the worker’s recovery progresses as expected and that they receive adequate support in the workplace.

The employer’s insurer appoints a case manager who coordinates all aspects of the worker’s compensation claim. They are the primary contact for the worker and support team. It is their responsibility to establish positive working relationships with all key parties.

After receiving notification of a work-related injury, the case manager makes early contact with the worker, employer and support team in order to determine the assistance required.

The case manager helps the employer meet their legal obligations. They also arrange assessments or services for the worker, authorise payment for ‘reasonably necessary’ medical expenses, and determine the worker’s entitlement to compensation payments.

You are encouraged to discuss the worker’s capacity with both the doctor and the case manager. To facilitate case management, you should respond to telephone calls from the case manager within five working days.

The doctor will assess, diagnose, and treat the worker like any other patient. They will also assess their capacity for work and support their recovery. Selected by the worker, the doctor is usually their general practitioner.

The doctor has a key role in the worker’s recovery and rehabilitation. They:

• provide the worker with a completed capacity certificate
• act as the primary communicator for treatment and the injury management plan
• are authorised by the worker to provide relevant information to the employer, insurer and other parties involved in the management of the injury.

The workplace rehabilitation provider will deliver specialised services to help workers recover at/return to work.

As the allied health practitioner, your primary objective is to support the worker to optimise their recovery and return to work. This is generally achieved through evidence‑based clinical intervention and management.

The worker will look to you for information about their condition and recovery. Your role may involve:

• setting expectations from the first consultation regarding their recovery at/return to work, active participation in recovery, planning and treatment
• conducting a detailed worker assessment and (where applicable) providing information to inform and/or confirm diagnosis and treatment strategies. Where a diagnosis is not clear, you should provide a provisional diagnosis and explain your reason(s) for this
• obtaining information from the insurer and/or employer to assist with goal setting and tailoring of treatment interventions
• providing information to the support team regarding the worker’s progress and capacity for work
• educating all parties about the health benefits of good work
• improving the worker’s independence and participation in their home and community if recovery at work is not possible

Other health practitioners may be involved in the management of the worker’s injury/condition and may help you facilitate the worker’s recovery by:

• conducting a detailed assessment of the worker and providing information to inform and/or confirm diagnosis and the treatment strategy
• providing treatment to improve the worker’s capacity for work
• providing recommendations about the worker’s progress and their capacity for work.

These may include:

• independent medical examiners
• specialist physiotherapists / independent examiners