Poor administration and red tape are to blame for blowouts in the NSW workers’ compensation scheme, the Australian Medical Association (AMA) has told a state parliamentary inquiry. AMA NSW vice president told the inquiry that benefits to the genuinely injured and disabled wouldn’t have to be cut if administration could be streamlined. We couldn’t agree more!
Workcover NSW blowouts caused by red tape says AMA
Red tape causing WorkCover blowouts: AMA
Poor administration and red tape are to blame for blowouts in the NSW workers’ compensation scheme, the Australian Medical Association (AMA) has told a state parliamentary inquiry.
AMA NSW vice president Dr Michael Gliksman, who is also a medical assessor in the scheme, told the inquiry that benefits to the genuinely injured and disabled wouldn’t have to be cut if administration could be streamlined.
He said non-medical professionals were currently assessing whether injuries are work-related.
If doctors were doing this, approximately a third of claims would not “get to first base”, he said.
“Eliminating that alone would make a very substantial difference to the cost,” Dr Gliksman told the hearing in Sydney.
AMA NSW chief Fiona Davies said insurers’ repeated and unnecessary requests for additional reporting and documentation from doctors were causing delays in workers returning to the job, and increasing medical costs.
“We think there are a range of activities being undertaken by scheme agents that are unnecessary and that are not benefiting the patient and adding a significant cost to the scheme,” Ms Davies said.
“Treatment delayed means a delayed returning to work, and it also means a potentially worse injury,” he said.
The NSW state government wants to overhaul the state’s WorkCover scheme, saying premiums will skyrocket if a $4.1 billion deficit isn’t reined in.
Unions fear the reform will lead to injured workers having benefits slashed, with a discussion paper being examined by the parliamentary inquiry recommending capping the duration of weekly payments.
The paper also suggests a step-down from 100 per cent payments before the current 26 weeks, and the scrapping of journey claims between home to work.
Also giving evidence to the inquiry, Slater & Gordon NSW General Manager Hayden Stephens said WorkCover’s financial problems were “related to the cost of the delivery of benefits, not the cost of the benefits themselves”.
He urged the government to tackle the management of the scheme, before tinkering with premiums and benefits.
“Before doing anything about premiums or benefits look at the management of the scheme, the red tape,” Mr Stephens said.
Let us hope that Barry takes this on-board!
[Article source: http://news.ninemsn.com.au/article.aspx?id=8474337]
Shortlink: http://aworkcovervictimsdiary.com/?p=8910
That pretty much sums it up
‘Bunny” posted this very insightful comment on the topic on our [public] forum, which I believe is worth sharing with everybody:
“I just read this article about what the AMA thinks is wrong with NSW Workers Compensation. I have to agree with their position that endless paperwork from insurance companies causes delays in treatment and return to work. Let’s face it, doctors should be the ones who make assessments on workplace injuries, not case managers. Opinions of doctors should only be based upon the scientific medical evidence and case managers need to be reminded (perhaps with fines) that they are not trained doctors, so many think their unqualified opinions on medical injuries are valid”
Bunny, the evidence from all over the word points to the fact that doctor’s certificates for Insurance claims are subject to claimant advocacy. They do not represent clinical necessity but the claimant’s wishes. The majority of workers compensation and also Life Insurance claims are Psychosocial in nature and not predominantly biological injuries or illnesses, though these are usually an element of the claim. Doctors are not the best people to determine these claims, and whilst they have a role to play, that role is best confined to their clinical opinion of the Bio component of the Biopsychosocial model of disease.