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RTW Assessment and Medical Management Phase

Within 24 hours of receipt of referral, both the Operations Manager and the Senior Consultant would make contact with all of the parties, including the insurance Case Manager, the Employer Supervisor / RTW Coordinator and the injured worker to discuss the purpose of referral and intervention, to establish the history of the claim and current status and to arrange a suitable date and time to conduct an initial / workplace assessment with the employer and injured worker.

Once confirmed, an email would be sent to all parties within 2-3 hours re-confirming the time, date and purpose of the assessment. This assessment would be conducted within 2-4 days of the referral. Upon arriving at the workplace, the Consultant would meet with the employer independently to discuss their concerns around the mechanism of injury and to obtain further information about the employee and their past performance, to discuss their obligations to provide suitable duties and to finally review the injured clients’ workers compensation history.

At the assessment, an injury history and initial interview would be conducted, specifically addressing the mechanism of injury, current symptomology, treatment, date of next surgical and GP review, other vocations being undertaken, reasons why she believes she is totally unfit current RTW capacity and proposed RTW capacity. At this time, a consent form would be signed and a confirmation that liaison would occur between Injury Treatment and the treating GP and surgeon would occur. Additionally, a review of the workplace and duties is performed, taking into consideration the physical demands of the pre injury role; key duties / responsibilities; environmental, psychological and psychosocial view of the workplace, combined with a specific break down of tasks and function and whether the injured worker is able to perform the role at this time. At the time of assessment, Injury Treatment would also acquire signed information consent whilst providing the injured worker relevant Work Cover NSW pamphlets including ‘Your rights and responsibilities as an injured worker’.

During this, ergonomic advice would be supplied regarding set up, functional education and exercise prescription. When assessing the suitable duties, the Consultant would specifically focus on the clients injury and likely restrictions (given they are unfit) and establish a tentative agreement with the client and employer regarding timeframe for the commencement of suitable duties. This meeting would involve the worker, employer and the Consultant (and union representative if needed). Following the meeting, the Consultant would discuss teh case with the insurer to confirm the outcome of the meeting and the proposed actions to move the case forwards. This would also be reinforced in an email.

During this assessment phase, the Consultant would immediately address potential ‘barriers’ from both the injured client and the employer’s perspective. In this case the reluctance of the employer to accommodate suitable duties would need to be explored and addressed as follows:

  • Awareness of Workcover Legislation and the roles and responsibilities of employers.
  • Addressing the concerns of the employer about the injured worker’s activities outside work, clarifying that under the legislation it is a ‘no fault’ scheme. Should the employer have clear evidence that the injury is not work related then the Senior Consultant needs to pose these concerns to the treating health professionals and establish the nature and cause of the injury and its relationship to the work environment.
  • Explaining the benefits in achieving a durable return to work outcome and the impact on the employers insurance premium should a return to work not be achieved.
  • Exploring any other potential injured worker performance issues that may be impacting on successful return to work that will need to be addressed to achieve a durable RTW outcome.

During the initial /workplace assessment the Senior Consultant would assist the employer to identify and assess suitable duties that can accommodate the injured workers medical restrictions but will also be meaningful for the employer. The Consultant would then develop a proposed (given worker is unfit) graduated RTW Plan (suitable duties) within 24-36 hours of the workplace assessment, as discussed and agreed upon during the initial meeting by all parties. This plan would be distributed to all parties within 36 hours of the assessment in the desired format. Prior to this occurring, communication with the Nominated Treating Doctor (NTD) would occur to obtain agreement to the plan. This would be attempted in person with the injured client and GP with the intention of establishing a return to work date and clarification regarding hours and restrictions.

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