We recently received the following question from an injured worker: “why is it so hard to get help from doctors when you are on work cover?” Many doctors are just fed up with the extremely time consuming ,“ridiculous” amount of paperwork required by WorkCover, for which they are most often not paid, and with the constant harassment, interference and pressure from case managers.
Why is it so hard to get help from doctors when you are on work cover?
Unfortunately more and more doctors (GPs and specialists alike) are shying away from treating patients who are in the workcover system.
Many doctors (including my own) state that they are just fed up with the extremely time consuming and “overwhelming”, “ridiculous” amount of paperwork required by WorkCover, for which they are most often not paid.
In addition, GPs and specialists are extremely frustrated with the bureaucracy, red-tape and drawn-out processes they encounter when dealing with WorkCover. Injured workers’ treating doctors are also not remunerated properly (read: Paid) for consultations (fixed fee), for phone calls or for filling out lengthy forms and find the processes extremely convoluted.
GPs and specialists have indicated several reasons leading to the decision not to treat workcover victims, these include:
- Constant interference and pressure on the treating doctor by the workcover insurer (case manager)
In other words: injured workers’ treating doctors lose their capacity to practice medicine without interference from the workcover insurance company.
As we highlighted in our article ” Workcover case manager: It is time to put care back in the hands of the doctors“, The injured worker’s own doctor must be able to manage care and be able to override caseworker cost containments! But nowadays, the primary injured worker’s GP or specialist is not in charge anymore of the patient.
For example: an orthopeadic surgeon stated that if he sees an injured worker patient with a rotator cuff injury, he is not allowed to send the injured worker for physio (or very limited) and surgery is denied. A pain specialist’s prescription for nerve pain medication (ie. Garbapentin, Lyrica etc) is denied by the medically uneducated case manager who believes this to be ab ‘epilepsy’ pill.
Case managers will delay, deny and refuse proper care that is being requested by the treating doctor/surgeon, thus tying that doctor/surgeon’s hands, so s/he is unable to treat his/her patient the way s/he knows best.
- Injured workers’ doctors face increased harassment from insurers and rehab providers
- Injured workers’ GPs (and specialists) who treat injured workers have to invests above average time commitment on forms or (telephone) meetings with case managers
Our treating doctors have to put up with an ever increasing/overwhelming need for ongoing paperwork and report writing, endless forms, endless requests to have basic parts of treatment accepted (i.e medication, surgery), and many of these duties are not paid for.
- There is significant bureaucracy and red tape and the burden of commitment needs to be reduced so that particularly GPs and others can engage with WorkCover patients without compromising other parts of their service delivery.
Some doctors that treat injured workers can spend up to three hours out of a 10-hour working day on paperwork for WorkCover, as well as attending three-to-four hour long meetings per week with case managers or rehabbers (either via telephone or in person).The case managers tend to want copious amounts of reports which eats into the time the doctor and treating medical teams have got to do their real work. WorkCover can really take too much time for a whole medical practice making it impossible for small GP clinics with already long waiting lists to treat injured workers.
- The red tape and potential court hearings involved with WorkCover are also deterrents
Some GPs and specialists have refused to deal with WorkCover because they are fed-up with endless red tape and poor processes associated with treating victims of road accidents and workplace injury.
As far as GPs or other specialists go, to attend court to be an expert witness … adds a whole level of complexity that doesn’t match the day-to-day working of a GP.
- There is also the false belief that there is tendency for a workcover patient to exaggerate their injuries, that they may not comply with things like ‘rehabilitation’; and that there is anecdotal evidence that for example, injured workers don’t recover well after surgery
Unfortunately these are the main reasons why it is so hard to get help or even find a doctor who is willing to treat you, the injured worker.
Saying that, we do of course acknowledge and THANK those few(er) medical and allied practitioners who still treat injured workers, who genuinely care for their workcover patients, even though they are paid lowly by a faceless, convoluted, adversarial and extremely bureaucratic party.