As these changes will most likely impact on your role as Return to Work Coordinator we have invited Penny Nicholson, a Project Manager at WorkCover to address these issues at our February MADRIG session. (No charge)

Date: Friday, February 2nd, 2007
Time: Session 1: 9am – 10.30am.
Session 2: 11.00am – 12.30pm
Venue: Quality Occupational Health Training Rooms
Unit 4 / 2-6 Gladstone Street, Merrylands
RSVP: Email chris.kawamura@qoh.com.au by January 29th, 2007 to secure a place

Some of the changes:

On 1 November 2006, several changes were made to the NSW workers compensation legislation. In summary these were:
• All spinal injuries sustained on or after 1 January 2006 that result in permanent impairment will receive an additional 5% lump sum in dollar terms.
• Agent to provide all evidence for a decision
• Expanded expedited assessment process (up to $7500 for medical expenses and up to 12 weeks in final determinations for weekly payment claims)
• Clarification of mandatory pre-conditions for lodgment of applications to the Workers Compensation Commission
• Permanent impairments disputes to be resolved by an Approved Medical Specialist at first instance
• Limits on amount of independent medical expert reports
• Changes to power of Registrar, Approved Medical Specialist and Medical Appeal Panel.

We consider the most significant changes to be in the claims dispute resolution process.
WorkCover have advised that the changes are to prevent and improve the claims dispute resolution process. In summary these changes are in relation to:
a) Disputes about benefits and services and
b) Disputes about level of permanent impairment.

1) Disputes about benefits and services
The new arrangements will make for a very transparent process and are essentially aimed at agents resolving disputes amicably with the injured worker, rather than referring the decision to the Workers Compensation Commission.
To ensure injured workers understand decisions being made about their benefits, the new changes require agents to provide a copy of all information relied upon to make their decision to the injured worker. This is to ensure injured workers know why their physiotherapy sessions were reduced, weekly benefits were stopped or request for domestic assistance denied etc. It’s important to note that injured workers could be receiving copies of report from treating doctors and allied health professionals, injury management consultant’s, independent medical examiners and rehabilitation providers.

If the injured worker is unhappy about the decision, they can request the agent perform an internal review of decision. Each agent will have a quota for the number of internal reviews that can occur before the dispute is referred to the workers Compensation Commission.

Injured workers and employers can seek advice from the WorkCover Claims Assistance Service regarding the claims dispute process if they are not happy with the information provided by the agent.

2) Disputes about level of permanent impairment
If the dispute is about the level of permanent impairment, an approved medical specialist will review all medical evidence, assess the worker, and make a final determination on the level of permanent impairment for a lump sum compensation payment.

Additionally, if a party wishes to rely on a report in the Workers Compensation Commission it must be provided to the other party.

Only one independent medical expert report per specialty will be permitted, and the report must be from a specialist of the type who has treated the worker.