Opinion
Dealing with WorkCover for work injuries: Closing the gap between injury and returning to work
18th Jul 2024
A recent report has revealed that while most states and territories agree on the value of early intervention for workplace injuries, the way it’s handled varies across the country, leading to a disjointed system.
Monash University has published its final report on Early intervention in the workers’ compensation process which evaluates how effective early intervention is for reducing recovery times and improving return to work (RTW).
The findings will feed into ongoing work under Safe Work Australia’s National Return to Work Strategy 2020-2030.
The ten-year national campaign aims to minimise the impact of work-related injury and illness, so that workers can return to work as quickly and safely as possible.
‘Early intervention’ programs involve employers taking proactive steps to address an injury or illness suffered by one of their workers as soon as an incident takes place.
The idea is that early action – such as offering the right kind of treatment and support as soon as possible or allowing time off or adapting work duties – can minimise the overall impact on the injured worker. This approach can also save costs for both the employer and insurer who will ultimately be on the hook for compensation.
Broadly speaking, early intervention should prevent the issue from escalating into a bigger problem down the road.
It is our experience, however, that the insurer’s procedures to optimise results for workers through the coordination of durable return to work systems, treatment, rehabilitation, retraining and claims management are troublesome.
The report identifies specific strategies to curtail recovery durations and facilitate improved return to work outcomes for workers who have endured injuries at their workplace. In reality however, healthcare providers are often presented with a program that has been prepared by the insurer and signed off by a healthcare provider without an individualised program crafted to suit the specific needs of the injured worker.
We go into further detail about our observations and concerns below.
The findings
National workplace safety agency Safe Work Australia commissioned Monash University to examine how early intervention programs work across Australia and assess which processes get the best results.
The 95-page report is the result of extensive consultation with 20 leading researchers and academics in workers’ compensation, as well as officials and representatives who make up Safe Work’s Strategic Issues Group on Workers’ Compensation.
The main finding of the report was that while individuals understand the value of early intervention and how it can help injured workers in their recovery, allowing them to return to work earlier, there was no agreed definition of what ‘early intervention’ entails.
- Preventing injuries before they happen.
- Treatments employees seek on their own without the knowledge of their employers or insurers.
- Changes in someone’s condition who’s already been in the system for over three months.
It was agreed that early intervention must:
- Happen within three months of a claim being filed.
- Involve an assessment followed by actions like treatment or support.
And it was agreed that early intervention could:
-
Happen before a claim is filed (however, there were concerns that employers might misuse such a step as an opportunity to prevent claims).
Respondents also reported several challenges to ensuring early intervention takes place. They said that early intervention could be stalled by the employer’s lack of awareness about the process involved, particularly in small and medium-sized businesses.
Healthcare providers may also hinder efforts, or the injured person may struggle to access essential healthcare services. Another chief contributor to early intervention failing was miscommunication between all the parties involved in the claim, according to the report.
The researchers made several recommendations. They said that combining the different types of support available in a coordinated plan should help people recover and return to work faster. That plan would then need to be regularly evaluated.
The researchers urged for more open and transparent information-sharing across Australia for early intervention, which should help the various states and territories learn from each other and improve their own programs.
Another recommendation was better communication with workers, listening to their needs and their concerns in early intervention, ensuring that they are always well-informed about their rights.
More dialogue is also needed with the support healthcare workers who play a crucial role in helping people get back to work after an injury, according to the report.
There should be more engagement with healthcare providers so they know what is needed from them to improve outcomes for workers. Employers and claims officers should also be better educated on consideration of the worker’s needs, such as recommendations for necessary treatment, rehabilitation, capacity, and reasonable recovery times in the early intervention programs to ensure the worker will not suffer as a result.
There are risks in early interventions, and the report said more work is needed to better understand these, and to put strategies in place to mitigate them. One of the risks presented is around concerns with confidentiality, with workers feeling they can be prevented from making a claim.
It also appears the gradual return to work program is generated as a one-size-fits-all and is not prepared with careful consideration of the worker’s restrictions and limitations before requiring them to return to their role in a short period of time. This results in further injuries and delayed returns to the workforce, as the worker is later required to source alternative employment once their claim is finalised with the insurer.
Communication breakdown: Why the WorkCover system needs reform
What we often find with our client’s experience throughout this process is that they are just another number in WorkCover’s system, and how the claim is handled depends on the individual claim officers assigned to their claim.
There appears to be an urgency to finalise their claim without careful engagement of the worker’s necessary treatment and rehabilitation needs, wellbeing support and understanding that a worker’s recovery is individualised.
Recently, we had a client requiring minor surgery because of his workplace incident, and shortly after his short course of rehabilitation, he was cleared to return to work when he clearly could not physically do so, causing unnecessary harm to the client’s wellbeing.
It is our experience that all too often, interacting with the Queensland WorkCover system results in significantly more unnecessary stress for the injured worker. This affects their recovery and their overall emotional wellbeing, which is critical when an injured worker is recovering from a work-related injury.
Some clients have reported feeling like the claims process lacked transparency and clear communication. Too often, they are left feeling like a criminal rather than an individual who is simply seeking to get their life back on track after experiencing a workplace incident that makes them eligible and deserving of compensation. All too often, they are treated poorly by claims officers, who question them about pre-existing conditions and whether the injury occurred at work.
Additionally, there have been instances where clients feel pressured to return to work before they are fully recovered, or WorkCover has made things difficult by refusing treatment or referrals and carrying out questionable ‘independent’ examinations by WorkCover panel doctors.
There is an opportunity to improve the system and ensure a more supportive environment for injured workers. Certainly, there needs to be better communication from claims officers and a more collaborative approach to treatment plans and return-to-work timelines.
Queensland WorkCover should take a critical look at these issues and implement changes that will create a more supportive and transparent process for injured workers.
The ALA thanks Yasmine Chalvatzis for this contribution.
Yasmine Chalvatzis is a Compensation Lawyer at Attwood Marshall Lawyers, based on the Gold Coast. She specialises in workers’ compensation claims, public liability claims and motor vehicle accident claims and is committed to achieving the best possible result for those whose lives have been upended by tragedy.
This is an edited version of an article first published by Attwood Marshall Lawyers.
The views and opinions expressed in this article are the author’s and do not necessarily represent the views and opinions of the Australian Lawyers Alliance (ALA).
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