My workcover case manager refuses to provide me with a copy of a psychiatric independent assessment (IME). She states that it is ‘their policy not to release psychiatric IME’s as the content of the report may be too sensitive“. Yeah, right… How am I supposed to know if I agree with the contents of the IME report or whether I’d like to appeal some decisions?
I would have thought that the content of reports of the physical assessments conducted by the so called independent medical examiners may be far more upsetting and sensitive! (refer to the earmarks of medical whores’ reports)
Workers reasonably expect access to their claim file documents under the Accident Compensation Act (ACA) or Freedom of Information Act (FoI) but both the ACA and FoI Act set out a number of exemptions by which access to information may be denied.
Access to your workcover information
According to the Online Claims Manual (section 3: “Access to information)
These guidelines have been developed to help agents in the processing of requests made by workers for information in relation to their claim under the Accident Compensation Act 1985 (ACA) or the Freedom of Information Act 1982(FoI Act).
WorkSafe is subject to the FoI Act but agents are not. However, under these guidelines workers may access information in relation to their claim held by agents in accordance with the FoI Act.
A worker can choose to seek access to their own claim file information and documents under either the ACA or the FoI Act. Not all information requested is available automatically. Both Acts provide for WorkSafe or an agent to refuse access to certain documents or information. These documents or information are often called ‘exempt’ documents or information.
The rules and principles of the ACA and FoI are substantially similar but there are some differences between the two regarding processing timeframes and review rights.
Accident Compensation Act
The ACA gives workers and their authorised representatives the right to access information in relation to their own claim, other than exempt information. The ACA does not give third parties a right to access information.
Freedom of Information Act
The FoI Act gives any member of the public the right to:
- Access documents about their personal affairs and the activities of government agencies, such as WorkSafe
- Request that correct or misleading information held by an agency about them be amended.
Making a request for information
A request must clearly describe the documents a worker is requesting access. For sample letters, click here.
You may want to add to the sample letter(s) the following sentence: “If you deny any or this entire request, please cite each specific exemption you feel justifies the refusal to release the information and notify me of appeal procedures available to me under the law.”
Exemptions (see online Claims Manual for more info)
- internal working documents
- the public interest ‘test’
- law enforcement documents
- legal professional privilege
- personal affairs
- privacy laws
- serious threat to life or health
- information provided in confidence
- information requested in previous 12 months (ACA)
Whilst workcover insurance companies, in my experience, do not have a problem providing the injured worker with copies of relevant documents under the FoI Act, such as copies of independent medical examinations (physical), copies of your own specialist’s reports and letters etc, they always REFUSE to provide me with a copy of a psychiatric independent medical examination.
When digging deeper the case manager tells me that the IME psychiatry contains “sensitive” information which may be a threat to my life or health and which – in my case – has never been the case, on the contrary! The psychiatry IME reports I have received over the years have always been “in my favour” and have always been much less “painful” to read than the slander of the physical whores’ reports.
The the case manager tells me that “it is the workcover insurance policy” not (never) to release psychiatric IME reports to injured workers under the FoI Act. Now, when you have a read of the Online claim’s manual ( the section about Access of information), which by the way is written by WorkSafe as a guide for their Insurance Agents – it clearly spells out that information cannot be released IF it poses a “serious threat to life or health”, right?.
Moreover, the guide also clearly states that the Agent needs to send the requested report to your nominated treater to discuss the report and then he/she can decide whether or not to give you a copy of the report or not. Well, my case manager NEVER asks me where I’d like the report to be sent to! On one occasion she ‘mistakenly’ sent it to an old GP who I haven’t seen since 2006! (And who is NOT my GP anymore). In the end, after lots of delay and unpleasant discussions, she eventually sent the report to my psychologist, who then – of course- gave me a copy.So,basically if your case manager refuses to release you a copy of your Psychiatry IME report(s), make her/his life difficult by requesting s/he forwards you a copy of the relevant policy and the specific details and reasons of the refusal (on what medical grounds) AND ask her/him to send the report(s) to your treating GP, psychologist, other carer (of your choice) AND/OR your solicitor! GOTCHA!
You can also request your case manager to send the report to your solicitor!
This is just plain ridiculous anyway, given that those reports DO NOT pose a threat to my life or health! And by the way, how come, an uneducated, non-medically trained case manager can make this decision for you?
The other thing that pisses me off royally is that the workcover insurance company keeps on sending all my (very personal) IME reports (whether physical or psychiatric) to my PREVIOUS employer, hey I was sacked about 2 years ago! Why is it necessary for those very personal documents to go to your previous employer????
Serious threat to life or health (as per the online claims manual)
|Special requirements must be satisfied before a decision is made to refuse access to documents containing health information about a person on the basis that disclosure would pose a serious threat to the life of health of that or any other person.In some cases the agent can refuse to give a worker access to the worker’s health information. Health information is defined very broadly and includes any personal information in the provision of health services, as follows:· physical· mental· psychological· genetic information and· it must identify an individual or· it must be reasonable easy to identify an individual through the information.|
|When access should be denied||The agent must not give a worker access to health information they hold about them if:· they believe on reasonable grounds that giving access would pose a serious threat to this or her life of health or life of any other personor· the health information has been provided in confidence by a person other than the individual or a health service provider (eg a relative, friend, employer) with a request that the information not be communicated to the individual.If in doubt whether this exemption applies, the agent should check with the author of the document and/or refer the documents to a Medical Advisor.|
|Review by the Health Services Commissioner||If an agent decides to apply this exemption it must give reasons for refusing access and advise the worker of his or her right to seek a review of the decision by the Health Services Commissioner.|
|Reasonable grounds||The agent needs to consider if they have reasonable grounds to believe that release of the document sought would pose a serious threat to the life or health of the person seeking access to it, for example:· is the person suicidal?· is the person psychotic?· is the person severely depressed?· does the person have any other mental condition? There must be a real and distinct belief based on proper evidence and reasoning that the release of the health information would pose a serious threat to the worker. If there is no evidence of past or present mental or psychiatric condition then it will be unlikely that a serious threat exists.There is no obligation on the agent to make inquiries about the individual’s mental or physical health or to ensure that they are not suffering from a particular condition. Such an inquiry would be likely to be unnecessarily intrusive.|
|Procedure||When this exemption applies then the procedure set out in the Health Records Act 2001 is to be followed:If the agent’s preliminary assessment finds releasing one or more documents containing health information may pose a serious threat to the life or health of the worker, the health information should be referred to the Medical Advisor. To assist the Medical Advisor to make the final decision on whether releasing the health information is likely to represent a serious threat, the agent must attach a red tag/flag to each document or parts of documents which may be exempt under this exemption and must yellow highlight the documents or parts of documents which are exempt on other grounds.· If the Medical Advisor decides there is a serious threat, the agent must write to the worker asking them to nominate a health practitioner who has agreed to act as a nominated health practitioner and who understands the functions of that role under the HEALTH RECORDS ACT 2001 , with whom the Medical Advisor will discuss the information. At this stage any other non-exempt documents are to be released to the worker with the decision letter.· After the Medical Advisor and the worker’s nominated health practitioner have discussed the health information, the agent must then send this information only to the agreed nominated health practitioner.· The worker’s agreed nominated health practitioner must then decide what, if any, information will be released to the worker and in what form.|
|Worker’s nomination of health practitioner||The nominated health practitioner must be qualified to understand and explain the health information to the worker, eg health information relating to a psychological condition should not be sent to a physiotherapist.|
|What if a Medical Advisor is not available?||Medical Advisors are available at all agents to receive a referral of relevant documents for decision under this provision.In circumstances where a Medical Advisor is not available the agent may contact the Clinical Panel on 03 9641 1070 to make appropriate arrangements.|
You may also be interested in “rights of patients” (and relevant laws”) which you can find in the Victorian legal handbook online.
Related post: Obtaining copies of your workcover documents under the Freedom of Information Act
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