Injured workers in NSW denied medical treatment & entitlements

workcover-denies-medical-treatment

The NSW government’s current workers compensation scheme and insurance companies denying medical treatment put workers at a “double disadvantage”, says an independent review (undertaken by the WIRO). That the O’Farrell workcover NSW amendments have colossally failed is, by now, well known by all injured workers.

However it is promising to see a blunt report by the WIRO on the failed scheme, heavily biased towards insurers (and employers). We can only hope that this be the necessary catalyst for a review of the draconian and corrupt workcover NSW scheme!

Injured workers in NSW denied medical treatment & entitlements

workcover-denies-medical-treatment

Injured workers denied treatment, entitlements, WorkCover report says

Nicole Hasham – The Sydney Morning Herald
State Politics reporter
5 March 2014

Insurance companies are denying injured employees vital medical treatment and the O’Farrell government’s contentious workers compensation scheme puts workers at a “double disadvantage”, an independent watchdog says.

A report by the WorkCover Independent Review Office (WIRO) cited the case of a factory worker whose leg was crushed by machinery and partially amputated. An insurer initially denied him a prosthetic limb.

The findings have prompted criticism the system is skewed towards insurers and employers.

The office, led by Kim Garling, was set up in late 2012 to help workers dispute decisions about their entitlements under the reformed workers compensation regime.

As part of the changes, an insurer, rather than a worker’s doctor, determined their capacity to work after an injury.

But in its first annual report to Parliament, the office said WorkCover had repeatedly ignored requests that insurers be required to tell injured workers about the advice service and their appeal rights.

It said the new system created “a gap … which disadvantages workers from obtaining assistance and an explanation of their rights and entitlements”.

Under the law, both insurers and workers were restricted from getting legal advice, which supposedly ensured both parties were on an equal footing.

But the government’s intention had “failed”, the report said, and insurers were using lawyers on work capacity decisions. This “left the injured worker at a double disadvantage” and those with psychological injuries were worst affected.

The report noted insurers commonly refused to “approve treatment recommended by the worker’s doctor“. In the case of the man who sought a prosthetic, the office contacted the insurer, which eventually accepted liability and provided it.

Finance and Services Minister Andrew Constance welcomed the report and the “blunt account of WorkCover’s performance”.

He said the office was established to be a “strong watchdog … I am glad to see that the system is working”.

Mr Constance said WorkCover would address the issues raised and some had already been resolved.

But Unions NSW deputy assistant secretary Emma Maiden said the report showed the system was “skewed against” workers, and “the only people that are really benefiting from these changes are insurers and employers”.

A WorkCover spokeswoman said it was working with the office “to promote its services”, including putting fact sheets on its website.

Referrals to the office were also provided by its customer service centre and other information sent to injured workers, she said.

[Source: http://www.smh.com.au/nsw/injured-workers-denied-treatment-entitlements-workcover-report-says-20140304-343g0.html] Relevant links inserted.

 

Read the WIRO’s first Annual Report for the Period 1 October 2012- 30 June 2013 , which has now been tabled in Parliament.

Head over to the WIRO website>>

 Corruption fallout hits O’Farrell

Voters have turned on the O’Farrell government and are threatening to throw it out of office after just one term in a dramatic resetting of the political contest in NSW.

Corruption fallout hits O’Farrell

Sean Nicholls
Sydney Morning Herald State Political Editor
1 March 2014

 

corrupt-barry-o-farrelThree years after Barry O’Farrell was swept to power after an historic rejection of the long-serving Labor government, the latest Fairfax-Nielsen poll shows Labor is leading the Coalition 51 per cent to 49 per cent on a two-party preferred basis. The turnaround represents a 15 per cent swing since the March 2011 election and is the first time Labor has led the Coalition since 2008.

Labor’s primary vote, which crashed to an historic low of 25.6 per cent in 2011, has recovered to 35 per cent – an improvement of 12 points since the last Nielsen poll in March 2013.

The Coalition’s primary vote has fallen to 40 per cent from 51.2 per cent at the last election – down 12 points since last year’s poll.

If the 15 per cent swing was applied uniformly across the state it would see the Coalition lose up to 25 seats – wiping out gains it made in western Sydney, the central coast and the Hunter three years ago.

The poll of 1000 voters was conducted between February 22-26, shortly after the Independent Commission Against Corruption announced an inquiry involving former resources minister Chris Hartcher and two other government MPs, Chris Spence and Darren Webber.

It also coincides with ructions between the Liberals and Nationals over the push by Primary Industries Minister Katrina Hodgkinson to take over the seat of Goulburn from Community Services Minister Pru Goward.

Pollster John Stirton said while it was not possible to put a poll movement down to one thing, the major point of difference for the Coalition has been that the previous Labor government was tainted by corruption scandals.

”This is the first poll taken since Chris Hartcher resigned from cabinet in December and the announcement of the ICAC inquiry into those matters,” he said. ”The Coalition has lost that point of difference because of the ICAC inquiry.”

Mr Stirton said 2010 to 2013 was an ”extraordinary period” where only the ”absolute diehards” were voting Labor.

”What this poll is saying is that period has now ended and we’re back to a two-party system where the parties will have to compete to win the next election,” he said.

”While the Coalition would still clearly be favourites to win, the idea that the 2015 election is a certainty for the Coalition is now gone.” Election of a Coalition federal government ”may be a factor” affecting the popularity of the O’Farrell government.

The poll has bad news for Mr O’Farrell, revealing an 8-point slide in his personal approval rating since the Nielsen poll in March last year. His approval rating has fallen from 54 per cent to 46 per cent while his disapproval rating is up 5 points to 40 per cent for a net approval rating of 6 per cent.

Opposition Leader John Robertson’s approval rating has increased by 2 points to 34 per cent compared with last year’s poll. His disapproval rating is down 7 points to 36 per cent, for a net approval rating of minus 2 per cent.

Mr O’Farrell leads Mr Robertson as preferred premier by 50 per cent to 30 per cent. This is a 12-point deterioration for Mr O’Farrell and an improvement of 5 points for Mr Robertson.

The Greens’ primary vote is up by 2 percentage points, independents down 1 point and others steady.

Source – incl Video: http://www.smh.com.au/nsw/corruption-fallout-hits-ofarrell-20140228-33r7p.html

 



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18 Responses to “Injured workers in NSW denied medical treatment & entitlements”

  1. Regarding the first article: The Workover system / Insurer are out to make and save money not to provide real help and support to injured workers. It’s always the same! And until policy changes it will remain that way ” The injured on one side and the system on the other” its disappointing industry best practice didn’t include helping people.

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  2. It should be obvious to every injured and future injured worker in NSW that the system we now have is one of the worst in the world. There will be no change to this system unless there is a public outcry, a change of government and an ICAC investigation of the payouts received by various people like Greg Pearce and Barry O Farrell for implementing this dog’s breakfast WC system. Please do not let this report go without comment, write to the SMH and let them know how bad it is, do not sit at home and get depressed about it. Complain long and hard, make sure the people who did this to you get punished for it. Sadly every petition, every request for injured worker’s stories has only had a few replies, this is our issue, fight them anyway you can, because if you don’t, we will be stuck with this for years. At least main stream media is now publishing some things which is a pleasant surprise.

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  3. I tried to find the report on WIRO website – the link from the covering letter won’t work:
    http://wiro.nsw.gov.au/media/31452/2014___FEBRUARY_5___WIRO_WIRE___PERFORMANCE_RESULTS.pdf

    and the report is not yet listed in the ‘Result’s page:
    http://wiro.nsw.gov.au/about/publishing/results/

    Anyone know if there a link somewhere else?

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  4. This report is on the WIRO’s website, main page, right!

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    workcovervictim3 March 6, 2014 at 12:28 pm
    • Thanks WCV3. I had originally gone into WIRO – FAQS – PUBLISHING – REPORTS where prevous reports had been stored without looking the main web page, and had missed your link above.
      My mistake for glossing over too quick.

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  5. The WorkCover Independent Review Office report paints a damning picture of the ongoing problems within the NSW Workers Compensation system. The adversarial practices of insurers in particular are a cause for substantial ongoing concern for many injured workers, and often hinder their recovery. Read the report here.

    Source: David Shoebridge Greens Member of the NSW Parliament –

    WIRO annual report: damning conclusions about WorkCover

    Kim Garling, the head of WIRO expresses strong disappointment in the support provided by WorkCover to ensure that insurers advise injured workers that they have a right to seek assistance from WIRO.

    Despite this information not being provided, WIRO received 4,005 calls in the 9 months to 30 June 2013.

    Given a quarter of those contacting WIRO did so following a recommendation from their lawyer, the 2012 changes which remove workers rights to legal representation are likely to mean that many more injured people will not be able to have their complaints considered by WIRO. This is of particular concern as it relates to the ability to have work capacity decisions reviewed.

    WIRO assists injured workers with complaints they have about their treatment by insurers. Relevant issues considered include:
    • denial of liability
    • communication of problems with insurers
    • general delays by insurers in decision making
    • errors in calculations or delays in receiving weekly payments
    • referrals to independent medical specialists and approving medical treatment.

    The report identifies the suspension of weekly benefits as a serious concern – particularly as this often happens because of claimed non-compliance by the worker with the management of their claim. It is considered likely that the number of workers affected by this will increase as a result of the 2012 changes which “which automatically suspends workers weekly benefits for non-attendance at assessments arranged by insurers in relation to work capacity assessments.”

    This report confirms what many have long suggested – that the workers compensation system in NSW is broken. Psychologically injured workers continue to face the trauma of the workers compensation system, in addition to their existing injury. This is not helping people recover or return to work, but is more short sighted cuts and poor management by the O’Farrell

    Source: http://davidshoebridge.org.au/2014/03/06/wiro-annual-report-damning-conclusions-about-workcover/

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    workcovervictim3 March 6, 2014 at 7:07 pm
  6. Hey guys,can someone please explain the stupid questions you get asked when you attend a ime for example what the hell does my divorce of 26 yrs ago have to do with my injury and what school I went to and wether I rent or own where I live.I walked out feeling pissed off and brain dead.So can someone please why.

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  7. Hey tony,

    Here is my perspective on your questions:

    Your divorce – they could use that by reporting that you are an angry man and that was probably the reason your marriage failed. By walking out of the IME assessment, they can weave the two together e.g. your “anger” with WorkCover is the main area of concern. They might write that this needs further investigation (i.e. more IME appointments).

    Renting or Own Own Home – The only reason is to ascertain your financial vulnerability. If you are under financial pressure, that is a marker that “you are only after a payout for the money” or they will work on ways to squeeze you harder to apply more pressure so that you will want to walk away.

    Your School – I don’t really know. But ANY information that they can get, they will use against you. If they cannot weave a story that backs up rejecting or denying your claim, certain IMEs will simply lie.

    So tony, when with a “corrupt” IME, it doesn’t matter what you say, it doesn’t matter what evidence there is regarding your injury, they will write whatever they like.

    I had an IME psychiatrist, throw me out after 2 minutes, because I advised him I wanted to audio record the assessment. This clown still wrote his report by referring to other reports and disagreeing with other “experts” saying there was nothing wrong with me. Even if you are not present – they will still write the report (IMEs love their dirty money)

    It’s all a sick little game for them, playing with us as though we were puppets. We are “assets” to the WorkCover system – we can used time and time again to make money for everyone else – then there is nothing left for our treatment.

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  8. Thank you FU CGU that’s what I thought they will stoop so low everything is $$$$$$$$ TO ME THEY ALL ARE INSURANCE HOOKERS.I didn’t expect him to be nice or to get a good report.I really don’t know how these pricks have not been threatened or bashed or even bumped off, I tell you one day they will push someone to far and it only takes one person,but I do believe in KARMA.

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  9. Tony

    If you do not think a question is relevant – ask the IME to explain why they are asking the question – you are still being cooperative and have a right to know. Explain that you are finding the questions distressing and will be unable to continue unless understand the reason for the question. A genuine IME will cooperate. If they do not and the session ends – you are still “compliant”. You could bring a recording device and state that you would like to record the session because you have problems with your memory. If the IME ends the session – you are still compliant. If they are OK with it – need to get them to state that on the recording. If you attend & cooperate, you cannot be seen as non-compliant. You could also advise the CM that they need to choose an IME who does not have an issue with a recording, since you have memory problems. This will weed out the fraudulent IMEs, since few of those would agree to that. Injured workers cannot choose the IME, but that does not mean they are completely powerless. Check that the IME has not had any adverse action taken against them – this can be a basis for an objection. As long as you are willing to attend, and cooperating, you have fulfilled your WorkSafe obligations.

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    Power to the People March 8, 2014 at 1:19 pm
    • Power to the people,you really sound like you know what you are talking about.I feel so much more wiser after reading your replies sounds like you have inside knowledge anyway thank you.

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  10. Thank you Power to the people.It seems to me that no matter what you say or do they will find fault because they are looking for anything to blame the injury on ,a blind man could see my injury and the accident is on cctv.I like the way you spoke in your reply I think you know what you are talking about and I will do it from now on.

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  11. Tony, no doubt that it is a corrupt system and many IME’s “independence” is questionable. You are right about “no matter what you say”, since there has been more than one incident of IMEs completely fabricating responses, and 10 minute examinations. There are however, also ethical IMEs in the system. To make sure they are not outnumbered by the unethical, fraudulent ones, it’s up to every injured worker to be very vocal and lodge complaints (outside of workers comp) about their bad experiences so they do not remain in the system and completely free to continue to cause further damage.

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    Power to the People March 8, 2014 at 6:18 pm
  12. Power to the people,you are right this certain shrink has a bad rep for bad reports.When I walked into his office the first thing that struck me was the carpet,yes I know that sounds funny but if you see it it is a OHS issue its all buckled up and well if someone trips.I know when I sit there they are no better than me and it can happen to them too,also they need the injuried workers to make the big dollars,so they need us more than what I need them.And I know there will never be a royal commission into workcover cause no one is game enough.To many people in high positions make money from us,and a lot of them would probably be put behind bars or at least in court.Yes there are good imes I have struck 1 out of my 12 his report is never sent because he was in favour of me,so I take it with me everytime I go to one.

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  13. I think the NSW Workers’ compensation scheme is worthy of a class action to pressure a review.

    With my injury I am now having to pursue the legal route.

    My insurer is TMF Aliianz and whilst I had a fabulous case manager for the latter half of my claim I can say little good beyond this. My fall and ensuing injuries occurred on 5th February 2013. I must have had 5 case managers in the process not one of whom, at any stage during the 12 months of my claim, disclosed the changes to the NSW Compensation Law which came in to place in October 2012. The initial generic handout I received, upon acceptance of liability by the insurer, only had a footnote which referred to WC Act 1987 and Workplace Injury management & WC Act 1998!

    My most current case manager after consultation with his Team Leader (Darren), purportedly due to lack of knowledge of the new legislation and its ramifications, only informed me of Section 59 legislation once the 12 month period was over and liability declined. WHAT EVER HAPPENED TO ‘DUTY OF DISCLOSURE’?

    I am fighting to have surgery done to one knee that was requested on December 12th (2 months prior to the end of the 12 month cut off). It may prove harder to win with the surgery for the other knee as, although the specialist doctor said this would be required in his report of the same period, it was not requested as surgery as both knees could not be done together.

    I was sent to an IME a week after my time line had finished (proof I guess that my case manager and his team leader were not au fait with the new legislation). The examining doctor, Dr Richard Powell of Sydney (other posts have referred to him as a ‘gun for hire’ but my request to see another specialist for an orthopedic assessment was denied)I saw him on the 14th of February. To date , over a month later, his report has still not been completed and he is on leave. DO NOT SEE HIM!!!!! My suspicion is that this is because the outcome of his report has been predetermined int he insurers favour.

    I was sent to the IME despite my treating doctor and the orthopedic surgeon agreeing on the need for surgery to my left knee.

    Also, although my areas of injury included 3 separate areas related to an orthopedic specialists area of expertise, Dr Powell was only asked to report on the left although I had been assured verbally by my case manager that he would assess all three areas. Why? I can only think because it drags the entire case out and lo and behold one is over the 12 month period.

    I am appalled that this is the way things are in NSW. I work with students with learning difficulties and disabilities and there is a huge emphasis on access to education on an ‘equal basis for all’. We need equity and fairness for injured workers.

    I will be tenacious in fighting for a fair outcome. I have already contacted WorkCover Independent Review Office, the Federation and plan to contact the Ombudsman, Allianz, my local member and Four Corners.

    PLEASE RESPOND TO THIS EMAIL AND IF YOU GIVE YOUR CONSENT I PLAN TO PRINT OUT ALL RESPONSES AND SHOW THE NUMBERS OF THOSE OF US WHO ARE GENUINE CLAIMANTS WHO FEEL WE HAVE BEEN SHAFTED BY THE CURRENT LEGISLATION AND OUR INSURERS. This legislation has passed in June 2012- it has gone on long enough and I plan to do my utmost to make its review my cause. United we stand, isolated we suffer.

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  14. Send your story to David Shoebridge the NSW Greens senator he has been collecting injured workers stories to present to Andrew Constance the Finance Minister in charge of Workcover. Your distress is totally justified and the fight is not over. The merry go around of case managers is deliberate. I myself have had at least ten since my injury. Each case manager is given a huge amount of injured workers to deal with, many of them leave and some of them are just plain out incompetent or psychopathic. You are not alone, this is standard behaviour. The whole aim is to destroy Workers Comp as we know it and make workers responsible for their own workplace injuries, hence why you are now seeing so many ads for income protection and accessing your super for payments if you are sickinjured at work. I just read that the Abbott government’s plan for the Green Army (young unemployed people who will work for half minimum wage cleaning up creeks etc) will have no workers comp for the workers, but there will be workers comp for their supervisors, if that does not set off alarm bells then I don’t know what would. So we are in for a big fight at all levels.

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