We’re ba-ack and so are workcover case managers, legislators and judges

diary-of-aworkcover-victim-we-are-back2014

It’s now 2015, we’re back, I’m back. Case Managers are back. Legislators are back. Judges are back. Workers are back, and Business is back. And Boy, was 2014 a tumultuous year for a couple of workcover schemes…

2014 was certainly a turbulent year for a few Australian state’s workcover schemes.

Heck, 2014 was also tumultuous for me!

We’re ba-ack and so are workcover case managers, legislators and judges

In the WorkCover world we have seen some notable changes and potentially pending changes in at least five Australian states.

Workcover Victoria

Victoria’s new WorkCover Act (WIRC) became effective on 1 July 2014 and basically consolidated previous workers compensation Acts. They also changed their name from WorkSafe Victoria to the Victorian WorkCover Authority (VWA) – their old name. See all our WorkCover Victoria related articles for more information.

Also, it has come to our attention that the VWA has or is cutting ‘some’ red tape on approvals process(es) for —mainly— MRI scans, gym and pool rehabilitation, some elective surgery, a range of equipment, and home help for Victorian injured workers. Allegedly injured workers won’t/don’t have to wait as long for some types of medical procedures as a result of changes made. While none of the changes are significant, they should help relieve some of the frustrations encountered by injured workers who —more often than not— have to wait for weeks or even months to have their medical treatment approved by the VWA (and insurer), which would greatly enhance our injured chances of recovery (mentally and/or physically). Again, only time will tell if the ‘approval process’ has really improved!

The main changes include:

  • MRI – scans can now be approved by a doctor without a VWA agent’s approval.
  • Gym and Swim – allied health professionals such as physios, chiropractors and osteopaths are now able to authorise courses of treatment.
  • Elective surgery – it appears that “straightforward” types of surgery may be approved more promptly; although what “straightforward” and “promptly” mean has yet to be clarified.
  • Household help – some help with household chores may be approved without the need for their independent experts to prepare a report and make recommendations
  • Special or customised mattresses – may be approved at an agent.
  • And there has been a relaxation of requirements around inpatient rehabilitation.

Workcover QLD

Queensland: Of important note is that the injury threshold was introduced and some other important changes were made. (The Workers’ Compensation and Rehabilitation and Other Legislation Amendment Act 2013 (Qld)). See all our WorkCover QLD related articles for more info and refer to WorkCover QLD for the detailed changes.

Workcover WA

Western Australia : In October 2014, the WA Government has approved the drafting of a bill to repeal and replace the Workers’ Compensation and Injury Management Act 1981. They’re basically proposing to repeal the WA workers compensation laws and replace them with a more ‘user-friendly’ Act that includes a new ‘worker’ definition to help employers easier determine whether or not a worker is covered by the  workcover scheme. A discussion paper was released, referring to the  proposal to enhance “readability and consistency” in the legislation. For more info, visit WorkCover WA’s website – Legislative Review.

Workcover SA

South Australia: The dreaded and harsh legislation to reform the SA workers’ compensation has passed the South Australian Parliament on 30 Oct 2014, and will come into effect in July 2015. The new legislation is called the new “harder!” ‘Return to Work Bill’!

The Government’s reforms are aimed at delivering better outcomes for injured workers and their employers, within a financially sustainable scheme.

The first stage of reform was completed during 2013. It consisted of a new WorkCover Charter, a new WorkCover Performance Statement and amendments to the WorkCover Corporation Act 1994 to increase Board accountability.

After a long period of discussion with key parties, including employer and employee representatives, the details of a new scheme have been finalised.

On 6 August 2014, the Minister for Industrial Relations, Hon. John Rau, introduced into Parliament the Return to Work Bill 2014 and the South Australian Employment Tribunal Bill 2014 to replace South Australia’s current WorkCover legislation.

The Minister’s second reading speech and the explanation of clauses for each bill provide information about the intent of this proposed legislation.

The new bills aim to enact a new Return to Work scheme starting on 1 July 2015, that is fair, effective and sustainable.  ReturnToWorkSA will be responsible for administering the new Scheme.

The new legislation has an absolute focus on return to work for those injured workers able to do so, with emphasis on early intervention and obligations on ReturnToWorkSA and its agents, employers and workers to achieve those return to work outcomes.

A new policy statement is available to support the Return to Work Bill 2014.

Workcover NSW

New South Wales:  On 3 September 2014 the NSW Government introduced a number of “enhancements” to workers compensation benefits. These changes were introduced by the Workers Compensation Amendment (Existing Claims) Regulation 2014 and apply to workers who sustained a workplace injury and who had made a claim for compensation for before 1 October 2012.  These changes do not apply to workers who made a claim after that date.

Key reforms

The changes allow:

  • for the insurer to meet the cost of any secondary surgery
  • that workers may receive weekly payments while a work capacity decision is being reviewed
  • workers with whole person impairment of 21% to 30% to have access to medical and related expenses up until retiring age
  • workers to continue to receive certain medical and related expenses until retiring age
  • entitlement to weekly payments for up to one year after retiring age.

More information is available in the below fact sheets:

 

So yep, I’m back, and we’re back because the more things change, the more they stay the same 🙂  there’s lots to write about, lots to discuss and debate and perhaps lots to reflect upon. However, saying that, we do sometimes wonder if we’ll have anything to write about. I mean, honestly, what can be so interesting about workcover? Same sh*t, different year!

In my personal, injured life I have (and still am) struggling with quite a nasty and painfully debilitating infection of my dominant total reverse shoulder prosthetic, for which I have been in and out of hospital – as recently as over the Xmas period (!) The major part of my 2014 (and current) breakfasts, lunches and dinners consist mainly of antibiotics (yuck!). Obviously feeling physically unwell (fevers etc), being in pain and in hospital have all contributed to decreased ‘activity’ on the blog. Thank you, Captain Harryrort for keeping us afloat! And please remind me I ask Santa next year for one of those mobile sticks (portable modem to connect to the internet when in hospital!).

Welcome to 2015!

 

[Dictated and transcribed by WCV3 on behalf of WCV]



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10 Responses to “We’re ba-ack and so are workcover case managers, legislators and judges”

  1. Dear WCV,
    Great to hear from you – hope you are on the mend! Those anti-biotics can really wear you down!

    I have another issue that I’m wondering if others have faced. Has anyone else had the experience of being FALSELY blamed for causing their injury? This has only come to light recently.

    It has been made in writing and was sent to the IME, who commented upon it. I used FOI to access the accusations made, but the persons making them have had their names deleted. (3 “witness” accounts, which are not entirely consistent).

    There was no opportunity given for me to achieve Natural Justice (although my employer said there would be such an opportunity at the time of the incident that caused my injury) – to face my accusers in a fair environment, and the rumour mill has worked overtime re. this accusation.

    I am concerned that I may have difficulty finding emplyment not only because of my Workcover Claim, but also this false accusation. Any ideas as to what I should do? I have asked The Law Institute for referral to an Employment Lawyer, but feel I need to know who actually made the accusations. I thought of paying for access to the information through the VWA, so that I will have the actual names.

    Any suggestions?

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    • do you mean these people are accusing of deliberately staging the incident so to intentionally injury yourself?

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  2. Welcome back

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  3. In answer to “bullied”, I am not exactly sure. I think they are or might be claiming that I tried to hurt someone else, but hurt myself in the process. I am not even sure about this interpretation. Nevertheless, I am concerned that my employer verbally told me that he believed my version of events, yet after the Workcover Claim occurred they appear to have changed their minds. The IME decided to comment on my version of events based upon the “evidence” of the 3 witnesses. So it has become a written record that I am very concerned about. I know that the person that claimed I had hurt her, had actually deliberately tried to hurt me – hence my injury, but I assume her friends have decided to support her version of events, as I still have no idea who the 3 “witnesses” (whose evidence was inconsistent) were. I am trying to be careful what I write here so I do not give too many clues as to my identity for any insurer’s rep, etc. that might be reading this. I was not given the opportunity to face my accuser following the incident, as had been promised by the employer. It looks as if the employer has since decided that I was at fault.

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    • If I were you I would write a statutory declaration (which is considered court evidence), stating what happened. I would provide this to your solicitor and ask them to provide the insurer a copy. It is your perception of what happened that is considered and how that has affected your health that impacts on your claim.

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      Bashed and bullied January 13, 2015 at 1:23 pm
  4. Hi,
    I need shoulder surgery and my case manager says it is under review with a medical advisor its been nearly 3mths now. Is there any time frame they have to respond by or can anyone tell me how long it normally takes to get approval ?

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  5. Hi,
    I need shoulder surgery and my case manager says its under review with a medical advisor its nearly been 3mths now!! Is there a time frame that I should get a reply by or whats the normal time for approval ?
    Rgds
    C-rod

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    • @C-rod: see http://aworkcovervictimsdiary.com/2014/02/long-will-take-workcover-approve-surgery/

      If in VIC, I would urge you to 1) contact the manager of your case manager and make a formal complaint if no reasonable reason for the delay is given; AND ask for a letter of denial of surgery as it is your intention to lodge a conciliation 2) contact the workcover authority, they can be very effective in speeding things up. If of no help, lodge a formal complaint.

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      • @C-Rod, I contacted my lawyer about the lack of notification… He then managed it all, as I just get too frustrated with it all…
        My referring Dr also contacted regarding the need/urgency…. They initially said no but at 11th hour (before conciliation) they changed their mind… The main problem I have found is that the CM are too young and not experienced… They don’t have medical training and usually interpret legal jargon incorrectly… Always worthwhile pushing for an answer. Mine wanted me to attend IME for clarification, my referral was semi urgent and my initial appointment was given 5 months post request, I requested an earlier appointment, citing my inability to continue working with the pain, and an earlier appointment was given, but they still took their time issuing the verdict…

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  6. Thanks,

    I will get onto this tomorrow..
    rgds
    C-rod

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