Allied health practitioners have an important role in the workers compensation system. You are engaged to provide specialised expertise to identify a worker’s strengths and barriers to work, and to develop evidence based strategies to treat their injury and maximise their recovery.
The information that follows will help you understand what to do and what to expect when delivering services for a worker’s compensation claim. It outlines your obligations under workers compensation legislation, and provides practical advice to help get the best possible outcome for the worker.
It will also explains the roles of the other people in the worker’s support team, including the employer, doctor, insurer, approved workplace rehabilitation providers, and any other allied health practitioners involved.
Most injured workers take little or no time off work. For those that do, the vast majority (more than 80 per cent) return to and recover at work within the first 13 weeks.
Advice and direction in this document is based on a strong body of research and evidence about the health benefits of good work. It explains how returning to and where possible, recovering at work after an injury, can promote healing and facilitate recovery.
The Western Australian WorkCover system operates under the several state Acts (i.e. Workers' Compensation and Injury Management Act (1981) , and associated Regulations. It provides no-fault protection to workers and their employers following a work related injury or illness.
Workers compensation insurance is typically provided by approved insurers, however individual employers who meet the criteria to manage the workers’ compensation of their own employees are known as ‘exempt’ or ‘self-insurers’.
Regardless of which type of insurer is involved, they all have an obligation to support workers and employers during the recovery process and manage the claim to ensure entitlements are received.
The Workers' Compensation and Injury Management Act 1981 identifies specific responsibilities for insurers, employers, medical and treatment practitioners to encourage a safe, timely and sustainable recovery at/return to work.
Injury management is an integrated process involving multiple components within a biopsychosocial framework.
Success depends on the integration of sound clinical, workplace and insurance claims management, as well as agreement about the worker’s goals and progress. So, it’s important you understand the role of others in the support team.
The team includes the employer, insurer case manager, doctor, a workplace rehabilitation provider (if required) and you. Each member has an important role to play in the worker’s recovery and these are outlined below.
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:
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:
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:
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:
These may include:
Each member of the support team has an important role to play in the worker’s recovery.
Clear communication and collaboration with others in the support team is essential to:
Issues may arise during the life of the claim that you might wish to discuss with members of the support team. Some examples include, but are not limited to:
Goldfields Physio's model of treatment for WorkCover patients recognises the importance of implementing effective treatment to facilitate the worker remaining in work (where appropriate), facilitating a return to work/normal work duties and hours and return to health outcomes.
The framework of our model is based off the Clinical Framework for the Delivery of Health Services. This works through a set of guiding principles intended to support our team in the management of work-related injuries. These principles are:
It is important that you maintain appropriate levels of communication with all stakeholders involved in a WorkCover claim.
It is also important NOT TO place work restrictions, infer or state liability in relation to any work related, possible work related or internally managed work-related claim with the worker/client. If you have concerns regarding work conditions (i.e. duties, hours, etc) please engage in conversation with the OHN, safety advisor, employer and/or doctor. When making recommendations, ensure that this is supported by the client's presentation and objective measures.
If you are unsure of how to proceed please liaise with the physiotherapy manager or clinic director.