Getting medical help while negotiating the hazards of Work Cover can be more than frustrating indeed… as highlighted in this shameful story, published in WA Today.
Greg Ross – caught up in Work Cover quagmireGreg Ross 28 August 2013
For the last 45 years, I’ve thankfully never had the need to be involved in workers’ compensation; however a recent, relatively minor accident at work finds me dealing with the West Australian Work Cover system.
System? That’s an interesting term. Let me introduce you to the markedly un-level playing fields of Work Cover quicksand.
There was a lot of unspoken pressure.
The background is relatively simple – I work at a mine site and while pushing up a bull bar on a roadtrain, I “‘pulled”/damaged what at first appeared to be an arm muscle.
As required, I reported the incident to the supervisor, who immediately stood me down from active work (on full pay) and sent me to the camp medical officer.
He ascertained there were no broken bones, gave me some pain killers and some cream to put on the sore arm.
It seemed to do the trick and I returned to work a couple of hours later.
While sleeping at night the arm became more painful, but I put it down to the normal healing process.
However later that week when I finished my shift and drove home, the 450km journey became more and more difficult, to the point where holding on to the steering wheel with my right arm was very painful.
Two days later, having swallowed copious Ibuprofen and after a week of interrupted sleep, I saw my doctor.
That was the first mistake.
While the system (God help us) might say you can choose your doctor, the reality is your employer and their insurer won’t like it … at all!
The doctor put me off work for an initial five days, telling me it was now a worker’s compensation claim and the surgery would deal with procedures. They gave me a First Medical Certificate, then sent me for an x-ray and an ultra-sound, which showed that although the pain was in my upper right arm, the actual damage was to the bursa shoulder muscle.
The doctor then put me off work for two weeks, gave me a Progress Medical Certificate and suggested a steroid jab may help speed the healing process. I readily agreed and arrangements were made for the injection.
I had emailed both the medical certificates to my employer. On receipt of the Progress Certificate, a supervisor rang me to reproach me for not dealing directly with the company.
“You’re only supposed to see our doctors,” he said. “You’ll have to go and see them, somebody will ring you in the next couple of hours.”
Someone indeed did, asking if I had any objections to seeing the company doctors. I had none and he told me they would be able to administer the steroid injection and take over the whole process.
He asked me for the ultra sound provider’s contact details, to cancel the steroid injection appointment for me etc.
So the next morning I duly turned up at the company-preferred medical centre.
There I was presented with a form to fill in, requesting all the usual details, however on the reverse side, I was required to sign that I would accept all financial responsibility if the company and/or its insurers rejected the claim.
I queried this, saying I was here at the company’s request and had already signed a similar form with my own doctor and other providers.
But there was no choice: sign the form or no consultation. No worries, I didn’t need another doctor, my own has been looking after my health very well for the last 14 years. So I gracefully left.
My mobile went, it was “Marty” the company rep.
“Where are you?” he asked.
I explained the position.
He replied that it was a standard form and that if I didn’t sign it, he couldn’t help me. I replied that was fine, I had expert medical help.
Later that afternoon, I found out the steroid injection appointment had not been cancelled – I’d have been up for a missed appointment!
A week or so went by, with me faxing a further Medical Progress report to work. No response.
Then a chap contacted me to say he’d been on holidays and would I mind re-attending the company medical centre with him to see a company doctor.
I replied that I had no objection, but would not sign anything to accept financial responsibility.
“No,no, you won’t have to. You’re there at our request and cost, don’t worry.”
But sure enough, when I got there, I was expected to sign!
Caught in a conundrum of not wanting to be seen as difficult, or refusing to see company doctors, I eventually signed on the basis that I wrote on the form that I was there at the company’s insistence and they had told me they were paying. There was a lot of unspoken pressure.
Their doctor told me she thought the damage repair was coming along very well, but she didn’t approve of the medication my doctor had provided.
I replied that so far, all the advice and care I’d received must have been good, as she’d admitted herself that things were coming along nicely.
She wasn’t interested in the x-rays I had – I assumed she had the two ultra-sounds. She advised that I immediately see the company physio and, as my doctor had said it might prove to be a good option, I readily agreed.
In fact, the physio proved to be the one beneficial thing from the company-requested medical visits.
He quickly established the damage and found the twisted muscles in my arm and upper back that were reacting to the bursa muscle damage, giving me exercises that also proved very beneficial.
I then sat with the company representative who explained to me that I would receive no pay/salary initially, until the claim was accepted by the company insurers, however I could access accrued holiday and sick pay to “see me through”.
This was my first real inkling that all was not straight in the Land of Work Cover.
As I write this, it’s been almost eight weeks since the injury and seven weeks since I first visited my doctor – and I’m owed more than $6500 net wages.
The insurance company wrote to Work Cover and myself on August 6 (three weeks ago!) stating that they needed more time to make a decision about liability.
As of August 26, there is still not even a case number and my employer’s representative told me this morning, he had 45 other people to look after and, as I was already back at work, I was understandably not a priority for him.
He also told me that he had people who had not been paid for several months.
It gets better.
The company’s doctor saw me this morning and asked me how it was going. I explained that I’d had to use the one piece of machinery I couldn’t easily use and had exacerbated the injury and that, for some strange reason, using a computer mouse was currently painful.
She scoffed and said: “Your arm is resting while you’re using a mouse, so how could you have a problem? And you say you can do your job without any problems. So I’m going to discharge you as fit for work. You can always reopen the case if you want. Have a nice day.”
Now I’m not a malingerer, in fact it’s me who’s pushed to go back to work. I don’t want to let people down.
But there’s a few things that seem a little suss here, not the least of which is that the company doctor does not have the right to discharge me. Whether they like it or not, my doctor is the person in control of the situation.
Secondly, two months have passed and still there’s not even a claim number, which makes one wonder if the injury (on a minesite) has even been reported to the relevant authorities.
I wonder if the company doctor has even seen the ultra sounds, and quite what influences have affected her decisions. I’ll be fascinated to hear what my doctor has to say.
It’s not the end of the earth for me, even if it takes two years for this claim to got through (and that time period is looking increasingly realistic). However my real concern is for young people with families, mortgages and car repayments. How on earth are they supposed to survive?
Greg Ross is a fly-in, fly-out worker who unsuccessfully stood as an indepedent candidate for Kalamunda in the State election.
Kindly shared by Co_author “Trinny” – Source: http://www.watoday.com.au/comment/greg-ross-caught-up-in-work-cover-quagmire-20130827-2sn2c.html