Workers' Compensation and Workplace Rehabilitation in Queensland

Content on this page:

The Workers' Compensation Scheme
Q-COMP, the Workers' Compensation Regulatory Authority
Workers' Compensation Insurers
Workplace Rehabilitation
The Employer's Rehabilitation and Return to Work Coordinator
Suitable Duties Program - Guidelines for Completion
Roles in Rehabilitation

The Workers' Compensation Scheme

Queensland's workers' compensation scheme operates under the Workers' Compensation and Rehabilitation Act 2003 (the Act). There is a strong emphasis on the benefits of workplace rehabilitation and an early return to work.

The scheme is an insurance-based scheme funded from employer's premiums, not out of Government's consolidated revenue. Statutory benefits to injured workers are paid on a no fault basis (as opposed to claiming for damages at common law, where negligence must be proved).

Both workers and employers have certain obligations under the Act. Injured workers must participate in rehabilitation as soon as it is practical and medically advisable. Employers must insure their workers and must provide an opportunity for workers to participate in workplace rehabilitation.

Treatment and workplace rehabilitation are based on a medical model that requires medical certification and the treating medical practitioner's approval for all treatment and rehabilitation services.

In the majority of cases injured workers may only need medical treatment and/or a small number of physiotherapy or other allied health provider interventions. Indicating clear restrictions for return to work capacity (on the medical certificate), and if necessary, contact between the treating medical practitioner and workplace supervisor, is often all that is required to facilitate the return to work of an injured worker.

Many small employers are unlikely to have a nominated rehabilitation and return to work coordinator (RRTW coordinator) and therefore discussion should occur between the treating medical practitioner and the insurer if rehabilitation is required.

For large and self-insured employers the usual contact person is likely to be either the RRTW coordinator or the nominated external provider.

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Q-COMP, the Workers' Compensation Regulatory Authority

Q-COMP, the Workers' Compensation Regulatory Authority, has a compliance, advisory, and educative role.

Q-COMP's functions under the Act are to:

• monitor insurer performance and compliance;
• decide self-insurance applications;
• review insurers' decisions;
• manage appeals;
• support and oversee efficient administration of medical assessment tribunals;
• accredit workplaces and monitor employer and insurer rehabilitation compliance;
• provide rehabilitation advisory services;
• maintain a scheme-wide database;
• promote education about the scheme; and
• collect fees and administer grants.

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Workers' Compensation Insurers

WorkCover Queensland

WorkCover Queensland is the largest workers' compensation insurer in Queensland and handles approximately 85% of all claims. In Queensland, every employer, unless licensed as a self-insurer, must have a workers' compensation policy with WorkCover Queensland.

Self-insurers

Employers may be licensed by Q-COMP to become self-insurers if they meet set criteria and follow specific procedures. The 26 self-insurance licences in Queensland encompass over 274 employers and their employees.

List of Insurers

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Workplace Rehabilitation

What is workplace rehabilitation?

Workplace rehabilitation is a managed process delivering:

• early intervention;
• assessment of rehabilitation needs;
• appropriate, adequate and timely services; and
• maintenance of an injured worker at work or returning the injured worker to suitable employment.

In a workers' compensation system, the focus is on:

• maximising physical and mental functioning following injury;
• returning the worker to suitable work at the earliest possible time; and
• reducing the human and economic cost of workplace injury for all parties.

The treating medical practitioner

For most workers' compensation claims in Queensland, the treating medical practitioner managing the injured worker's medical treatment will be a general practitioner (GP). The treating medical practitioner may choose to refer the injured worker to medical specialists or allied health professionals for treatment or a second opinion. In some cases, for example where the injury is serious, the treating medical practitioner may be a specialist.

Your role in workplace rehabilitation

There are a number of fundamental things you can do to assist an injured worker with their rehabilitation:

• Explain the injury to the worker, including the recovery process and timeframes for return to work.
• Use the workers' compensation medical certificate to provide advice on their work capacity.
• Refer the injured worker to a specialist in the early stages to confirm your diagnosis and/or assist with treatment options. Insurers encourage early involvement of specialists.
• Regularly communicate with other parties involved - insurer, employer, allied health providers.
• Refer the injured worker to rehabilitation providers as appropriate, for example:
  • physiotherapist;
  • psychologist; and
  • occupational therapist for functional capacity evaluations and worksite assessments - these are especially valuable if you are unfamiliar with the workplace or the demands of the worker's job.
• Complete any work capacity checklists that you receive from workplaces with more complex tasks. This is an opportunity for you to indicate which tasks you believe are suitable for the worker from those available at the workplace.

Suitable duties

An integral component of workplace rehabilitation is access to suitable duties for the injured worker to improve their tolerances and functioning in a realistic environment. They are duties for which the worker is suited according to their medical condition, their age, education, skills and work experience.

Development of a suitable duties program is the responsibility of the employer and must be consistent with restrictions noted on the medical certificate. You may be asked to provide more information (if clarification is required) and approve the program.

Suitable duties must be meaningful and productive. Injured workers may be provided with suitable duties for partial hours/days or even full-time hours. If duties are available at another location, the impact of travel and the reasonableness of the time required to travel must be assessed.

The RRTW coordinator has detailed knowledge of the workplace and can assist you to assess the appropriateness of the suitable duties. In fact, the return to work or suitable duties program is often designed by the RRTW coordinator at the workplace, in collaboration with the treating medical practitioner. In some cases, the RRTW coordinator may also consult with a physiotherapist or an occupational therapist, a rehabilitation provider, or the insurer's case manager.

In conclusion

The scheme in Queensland operates under a medical model. As the treating medical practitioner, you are in an important position to motivate and influence injured workers and employers during the rehabilitation and return to work process.

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The Employer's Rehabilitation and Return to Work Coordinator

The employer's rehabilitation and return to work coordinator (RRTW coordinator) is responsible for assisting in the return to work of injured workers and coordinating return to work activities at the workplace.

RRTW coordinators have detailed knowledge of the workplace and can help you to establish the duties most suitable for the injured worker.

Core functions of the RRTW coordinators are:

1. initiate early communication with the injured worker to clarify the nature and severity of the injury;
2. compile and complete initial notification information (employer's report) for lodgement with the insurer;
3. consult with relevant parties eg. injured worker, supervisor and treating practitioners to develop the suitable duties program:
4. advise the injured worker of their rights and responsibilities in the rehabilitation and return to work process;
5. indicate as early as possible when there is a need for intervention by the insurer;
6. monitor and review the coordination of the suitable duties program in the workplace;
7. liaise with the insurer's case manager regarding the worker's progress; and
8. maintain both verbal and written confidentiality for each injured worker undertaking rehabilitation.

As a medical practitioner, when communicating with RRTW coordinators and employers it is helpful to keep the following hints and tips in mind.

• The medical certificate can be used as a major source of communication between yourself and the workplace.
• You can help to facilitate effective workplace rehabilitation by ensuring that the medical certificate provides clear guidelines for a worker's capacity for work and restrictions for suitable duties.
• The RRTW coordinator or employer is required by legislation to obtain documented consent from the injured worker to contact any treating practitioners including doctors.
• You may find it useful to contact the RRTW coordinator to assist in determining suitable duties.
• RRTW coordinators may not hold allied health or other tertiary qualifications and therefore may have a limited understanding of medical terminology and the functional impacts of injury.
• Sometimes RRTW coordinators may have difficulty identifying suitable duties when the worker has multiple injuries or the injury is of a psychological/psychiatric nature. In these cases you may wish to refer the injured worker for an assessment by a rehabilitation provider such as an occupational therapist, physiotherapist or psychologist.
• Organisational factors may impact on the RRTW coordinator role, ie. workplace culture, size of organisation and the availability of suitable duties.
• You may, with prior approval from the insurer, elect to convene a case conference or visit the worksite to develop workplace rehabilitation options for workers with more serious injuries/illnesses.
• You may elect to use telephone, fax or emails to communicate with the RRTW coordinator or employer. The Medical Table of Costs (available under Useful Information on this CD) outlines billing protocols for contact with the employer.

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Suitable Duties Program - Guidelines for Completion

Suitable duties programs aid the recovery and return to work of people with work-related injuries or disease in Queensland. This guide has been developed for medical practitioners, rehabilitation professionals, rehabilitation and return to work coordinators and other parties in the rehabilitation process who develop suitable duties programs.

Injured Worker Details

• Please include as much detail as possible.

Program Details

• Goal - long term - insert the long term goal for the suitable duties program. Examples include: return to normal duties; to maximise physical functional recovery.
• Objective of this program - insert the methods by which the overall long term goal will be achieved. Examples include: increase endurance/tasks/hours.
• Duration of this program - it is important that all parties are clear on the term of the suitable duties program. Insert the dates the program is to start on and the day it will end.
• Fit for suitable duties - an injured worker must have a medical certificate issued by their treating medical practitioner to indicate they are fit to participate in suitable duties or restricted return to work. Insert the dates the medical practitioner has provided on Part A of the medical certificate.
• Job description - insert a brief description of the injured worker's role while participating in suitable duties.

Task Details

• Week - insert the date that the suitable duties program will commence and the start date for each subsequent week of the program. Insert the hours that the injured worker is to work per day. The hours of work may change in line with the injured worker's rate of recovery. Insert the days per week that the injured worker is to work whilst participating in suitable duties. This information should be obtained from the current medical certificate, medical practitioner, or allied health provider.
• Duties - provide a description of each of the tasks that the injured worker will perform.
• Restrictions - provide details of any restrictions that the injured worker is to observe whilst completing the program, including any medical restrictions detailed on the current medical certificate.
• Treatment occurring during this program - provide the details of the allied health or medical treatment that the injured worker will receive during the program (eg. physiotherapy treatment twice per week).
• Training required yes/no - it is important to consider whether the injured worker has been trained to complete the tasks selected for the suitable duties program. On the job training by a colleague may be helpful where tasks or duties that are different to the worker's normal duties have been selected, or the duties are to be performed in a different section of the company. Training in any necessary health and safety considerations relevant to the suitable duties should also be considered. Insert the details of the person who will provide the training and the date the training is to occur.
• Program to be reviewed - insert the date for review and the person who is responsible for the review (eg. occupational rehabilitation provider, rehabilitation and return to work coordinator, medical practitioner).
• Signatures - the suitable duties program is a responsibility shared between the key parties involved in the rehabilitation process. Each of these parties (treating medical practitioner, supervisor, worker and rehabilitation and return to work coordinator) should sign the suitable duties program.

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Roles in Rehabilitation

Injured workers

Injured workers are responsible under the legislation (section 232) to participate in rehabilitation as soon as practicable after an injury and for the period for which the worker is entitled to compensation.

Medical practitioners

Medical practitioners provide medical assessment and ongoing management of a worker's injury. They also provide essential medical guidance regarding an injured worker's capabilities for insurers, employers and other professionals working towards the rehabilitation and return to work of injured workers.

Medical practitioners can be involved in the rehabilitation of injured workers or they can nominate other rehabilitation professionals to assist the injured worker's return to work.

Employers

Employers are responsible under the Act (section 228) to report injuries and provide appropriate rehabilitation for injured workers. Large employers and those in high risk industries must appoint a Rehabilitation and Return to Work Coordinator (RRTWC) and establish rehabilitation policies and procedures.

Insurer case managers

Insurer case managers are employed by WorkCover or self-insurers. They are responsible for approval, payment, coordination and monitoring of all aspects of workers' compensation and rehabilitation for which the insurer is liable following a workplace injury.

Rehabilitation and Return to Work Coordinators (RRTWC)

Rehabilitation and Return to Work Coordinators work for employers and must be accredited by Q-COMP. They are responsible for managing the injured worker's return to work by coordinating suitable duties at the workplace.

Rehabilitation professionals

Rehabilitation professionals are registered health professionals or providers otherwise approved by an insurer. Rehabilitation professionals provide active support to workers and employers to design and implement rehabilitation and return to work plans. Some examples of rehabilitation professionals are occupational physicians, occupational therapists and physiotherapists.

They may be engaged to assist the employer, and or the employer's workplace Rehabilitation and Return to Work Coordinator, to manage more complex or serious injuries or in situations where there is a lack of suitable duties at the workplace.

The appropriate rehabilitation professional may:

• provide various strategies to increase strength and endurance
• conduct a functional capacity evaluation of the worker
• provide advice on the selection of suitable duties
• conduct a workplace assessment including job and task analysis
• supervise suitable duties programs
• provide vocational assessment and vocational rehabilitation services for those injured workers who are unable to return to their pre-injury job.

Legislation

The Workers' Compensation and Rehabilitation Act 2003 (the Act) and the accompanying Workers' Compensation and Rehabilitation Regulation 2003 set out the requirements and obligations of parties for the rehabilitation and return to work of injured workers in Queensland.

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