Elements and Performance Criteria
- Analyse claims
- 1.1 Ensure that the organisation has and maintains a current Workers' Compensation insurance policy (or equivalent) as required by the applicable legislation
- Process claims in accordance with organisational policies and legal and insurance requirements
- Dispute claims where insurer or organisational requirements are not met
- Notify rehabilitation provider in accordance with organisational procedures
- Advise claimants as to whether their claim has been accepted
- Analyse claims to identify the nature of the illness/injury and prepare report/s
- Identify projected period of absence and where rehabilitation assistance is required and ensure arrangements are made in the work team to deal with absence
- Establish rehabilitation/return to work program
- Ensure consultation occurs between rehabilitation provider and treating doctor
- Ensure consultation occurs between rehabilitation provider, relevant managers and employee
- Consider job redesign, reduced hours and alternative duties in the light of medical advice
- Design a rehabilitation/return to work program to achieve a successful return to work
- Obtain approval for return to work program by relevant managers
- Establish rehabilitation program with employee
- Undertake risk analysis in relation to proposed program and mitigate risk where appropriate
- Commence program as close to the time of the accident/illness as possible
- Monitor/evaluate rehabilitation/ return to work program
- Encourage regular feedback/communication between provider, supervising manager and employee
- Organise regular contact and support between provider and employee
- Identify breaches of the return to work program and take remedial action promptly
- Refer return to work program to workers compensation authorities where breaches occur
- Modify return to work program where appropriate if it is not delivering the required outcomes
- Evaluate each rehabilitation/return to work program at its conclusion and implement recommendations for system improvement where appropriate