In a recent interview in Adelaide’s The Advertiser, WorkCover SA CEO Mr Greg McCarthy reveals the recent changes to how claims are managed in South Australia’s workers’ compensation system.
The centre piece of Mr McCarthy’s new claims handling strategy is the deployment of highly trained “rapid response teams” skilled in techniques that sound as if they have come straight out of the CIA Terrorist Interrogation Manual.
WorkCover SA deploys new SWAT teams
In a recent article in Adelaide’s The Advertiser, WorkCover SA chief executive Greg McCarthy outlines the new method of claims handling being rolled out at WorkCover SA.
WorkCover SA new claims handling procedure reads distinctly like it’s come straight out of the CIA Terrorist Interrogation Manual.
“Rapid response teams” or SWAT teams will be deployed to the injured worker’s workplace within 72 hours of notification of a claim. The SWAT teams will “start the conversation about resuming work” immediately (“the capture” and “the interrogation”).
“And no matter what…they don’t leave until they’ve got an agreement”, says Mr McCarthy. Sound more like “take no prisons”!
This is to ensure that any injured worker that should escape the heavily armed cordon is quickly re-captured “being someone who is able to pick up the kids and do things like that,” Mr McCarthy says.
“Nothing like that has been done before in any jurisdiction in Australia” Mr McCarthy proudly announces. Thank god for that we say!
Mr McCarthy goes on to say that having face-to-face conversations (“the interrogations”) with injured workers (“the terrorists”) also was helping weed out fraudulent claims. “We are easy game for attempted fraud” he said.
It’s “going to require shock treatment,” Mr McCarthy said. What next? Waterboarding, sleep deprivation and the implementation of various other CIA torture techniques?
WorkCover SA also plans to infiltrate known terror cells (GP clinics) known to be operating in South Australia providing support and cover to terrorists (injured workers).
Back to work focus for compo scheme
The Advertiser January 03, 2014
Business Editor Christopher Russell
GET there early and lock in a plan is one of the new paradigms for WorkCover SA as it moves to rein in costs and deliver better services.
“Early intervention is critical to the success of any workers’ compensation scheme,” WorkCover chief executive Greg McCarthy said.
While an obvious strategy, it’s something that has been talked about for decades but not implemented.
With a new management team in place under Mr McCarthy, the statutory authority is taking practical steps to get people back to work as quickly as possible.
“We’ve enabled our agents to engage occupational therapists and physiotherapists with workplace experience to be deployed to a workplace within 72 hours of notification of a claim,” he said.
This rapid-response team for non-psychological injuries takes a “triage” approach – deciding whether the claim is likely to be easily resolved or not and what path of action should be pursued.
“Nothing like that has been done before in any jurisdiction in Australia,” he said.
The first rapid-response teams began work in November and have already seen more than 100 cases.
Nearly 90 per cent of the 49,600 employers insured through WorkCover are small businesses. On average, they make a claim every 14 years – so most business owners and managers have no experience of using the system.
The rapid-response team guide employers and workers through procedure, start the conversation about resuming work, help fill in paperwork and give a preliminary audit of the site to prevent future accidents.
“We want to take the fear out of it,” Mr McCarthy said.
The change was fundamental – in the past it was extremely rare for WorkCover to visit a workplace.
Rob Cordiner, general manager of insurance, said the team considered what barriers might stall a return to work.
“And no matter what, they look at the options and they don’t leave until they’ve got an agreement about what’s going to happen next.
“For the first four weeks they will be the contact point.
“It’s all about support and accountability.”
If the worker had not returned to work within a month, the case was referred to a rehabilitation agent.
Mr Cordiner said the attitude of returning to work had to be set from the start. Clearly, this would be good for WorkCover.
“For workers, it’s also a good result because they don’t get caught into suddenly being someone who is able to pick up the kids and do things like that,” he said.
“That may be nice but it’s not for a worker’s comp scheme to pay for that.”
Having face-to-face conversations with injured workers also was helping weed out fraudulent claims.”
We are easy game (for attempted fraud),” he said.
“It’s easy if you can just put in a form and no one ever sees you; if you don’t have to sit there with the boss and talk about what happened.
“So this is creating a firm, fair and tight boundary.”
Mr McCarthy said employers paying premiums deserved a scheme with integrity.
“We’re not a charity,” he said.
“We want to ensure the people who are entitled to help get the best service they can – but the people who aren’t entitled don’t.”
Helping workers return to duty was better for their health and dignity.
“The best outcome is for us to help you get better and get on with our life rather than turning you into an invalid,” he said.
The rapid-response program will be extended to regional towns in the first half of this year.
Mr McCarthy joined WorkCover in December 2012. He has a wealth of experience stretching back to the 1970s. This includes being director of the NSW local government workers’ insurer StateCover Mutual, chairman of WorkCover NSW and owner/chief executive of Workplace Injury Management Services.
He worked widely as a consultant, including over about 10 years with WorkCover SA.
Another change he has introduced is to take deeper analysis of the data.
“Insurance companies have lots of data,” he said.
“That data can tell you where the problems are in your business and where you need to put your attention.”
He has set up an actuarial and analytics department to identify problems.
This gives management targets to address performance and write contracts with agents to deliver specific outcomes.
General manager scheme improvement and regulation Michael Francis heads up the new data unit.
He cites as an example of an identified problem the provision of non-prescription items bought through pharmacies. Mostly small purchases, these items are costing a total of $8.5 million a year.
While something like crutches would be justified others items such as anti-dandruff shampoos or cosmetic creams might be “highly questionable” in terms of their relationship to a compensable injury.
Loose controls had allowed a culture of “milking the system” to develop in some quarters, he said.
Data also will be used to identify medical practices with high numbers of claims so WorkCover can talk to GPs about why this is happening.
WORKCOVER chief executive Greg McCarthy understands why Industrial Relations Minister John Rau calls the scheme “buggered” and in need of a complete restructure.
That was essentially the reason, Mr McCarthy became chief executive a year ago.
“I saw this as opportunity to work with a scheme that was in desperate need of reform and improvement,” he said.
His top priority was to get the place running efficiently as an insurance business under its charter.
In addition, he was advising the Government on potential reforms.
“The minister is saying the scheme is buggered because the Government wants something that’s competitive with other jurisdictions,” he said.
“That will take reform.
“But that’s a separate issue and they, ultimately, are the ones who will make those decisions, not us.”
In August, Mr Rau announced a two-phase reform program beginning with reducing the board size and demanding a stronger commercial focus.
A discussion paper on the second, deeper, phase was due in December but it is now promised “within weeks”.
A survey by accountants Pitcher Partners found SA was the costliest state for workers’ compensation insurance.
An SA firm with a payroll of $1.1 million would owe $31,160 and a firm on $5.7 million would owe $155,788.
These were more than double amounts due by businesses of the same size in Victoria.
However, Mr McCarthy said it was unfair to make a simple comparison.
“It’s very differently structured to schemes in other states,” he said.
“It is more expensive – but that’s because the benefits are more generous.”
The average WorkCover premium is 2.75 per cent of payroll. It was scheme was designed at a rate of 3 per cent but is paying out at a rate of 3.34 per cent.
Mr McCarthy said it will take three to five years to rein in the costs and change the culture to get to running at the rate it was charging.
“But if you want a scheme that charges half, that’s going to require shock treatment,” he said[Source: http://www.adelaidenow.com.au/business/back-to-work-focus-for-compo-scheme/story-fni6uma6-1226794488975]
Editorial: Scheme in need of deep reform
The Advertiser January 03, 2014
A SCHEME which is the most expensive in the nation, has the highest number and longest-lasting disputes and carries an enormous liability is something which is crying out for reform.
That scheme is WorkCover SA. Employers have consistently been concerned about paying high premiums but workers have not always been convinced it really looks after them.
Over the years, the scheme has accumulated an unfunded liability that stood at $1.366 billion at the end of 2012-13. While that liability – and the way WorkCover SA operates – is complex and obscure to most ordinary South Australians, it is a scheme which affects us all as workers, employers and taxpayers.
It does, therefore, demand attention.
WorkCover SA chief executive Greg McCarthy and a new management team have taken a more business-like approach to running the scheme.
They have used a bit of common sense by establishing rapid-response squads which actually go to workplaces and talk to employers and workers rather than simply sending out forms.
They are taking a rigorous approach to data to pinpoint and address problems such as rising claims for psychological injury.
Running a more efficient business is clearly the first step on a long road and the management should be applauded for their initiatives.
However, WorkCover’s problems run deeper, than thatas acknowledged by Industrial Relations Minister John Rau.
Labelling the scheme as “buggered”, he urged a revamp. that starting from the beginning. He missed a December target to propose reforms but now promises a discussion paper within weeks.
The Opposition has frequently pointed out the problems of WorkCover, especially growth in the unfunded liability. However, it has not offered any clear alternative to improve things.
As SA now enters the serious phase of the election campaign, both parties have a duty to describe a path that will fix the books while also being in the interest of employers and workers.[Source: http://www.adelaidenow.com.au/news/opinion/editorial-scheme-in-need-of-deep-reform/story-fni6unxq-1226794482653]
[Article and commentary by co-author Madame Zena]
Revised May 2014