In the confusing world of Workers Compensation, there are often multiple parties involved when it comes to a claimant’s treatment and the management of a claim. The parties involved in a claim have a very large influence on the duration and outcome of a claim and whether this be a positive, or negative influence. Looking at the statistics, we are seeing an increase in the number of claims lasting over 60 days, over the last year this number has increased by 12.7% alone, with the number of short duration claims reducing by 5.3%. There may be a multitude of factors as to why we have seen these changes in claim duration and we don’t have the exact answer for that, however, we can assist to reduce the duration of the claim by ensuring we have the right people on the treatment team. Similar to administering CPR, early identification, early access, and early intervention are critical with any workers compensation claim if we want to keep claim durations and costs low. It is important for the parties involved to communicate effectively so that everyone is on the same page with treatment plans, and for all parties to know their boundaries and limitations regarding their specific treatment modality.
So, who is essential on the team?
The worker, the Insurer, the workplace and the treating General Practitioner are all essential to establish a good working team in the early stages of a claim. If these parties can work closely together and communicate effectively, they may be the only parties involved in a claim. These parties can then work together to identify if and when other interventions may be required to assist with the treatment plan. For example, if a worker has sustained a musculoskeletal injury, a Physiotherapist may be required in the acute stages of the injury followed by treatment from an Accredited Exercise Physiologist to assist with reaching full functional capacity for the critical physical demands of the job role. It is the responsibility of all involved parties to also identify circumstances where assistance may be needed from a Vocational Rehabilitation provider. For example, in a circumstance where the claimant may need alternative duties or has work restrictions, a Vocational Rehabilitation provider would be considered essential to assist with a graduated return to work plan. Other parties that may be useful on your team (if identified as required) include Surgeons, Occupational Therapists, Psychologists’ and other allied health providers.
Many of these decisions are often actioned by the treating General Practitioner or the Insurer. If these referrals are sent directly to the treatment provider, it enables the process to be quickened with earlier access to treatment for the claimant. Concurrent treatment modalities may often be required with more complex claims where it becomes even more important to maintain communication, expectations and boundaries to ensure a positive outcome. If you would like more information on Workers Compensation Rehabilitation programmes at Absolute Balance, please don’t hesitate to contact us at firstname.lastname@example.org.
Alixe Marion (B.Sc. Exercise Physiology)
Senior Accredited Exercise Physiologist – Clinic Manager
(AES, AEP) (ESSAM)
WorkCover WA. (2018, December). www.workcover.wa.gov.au. Retrieved from WorCover WA: https://www.workcover.wa.gov.au/wp-content/uploads/2019/03/6.1-Attachment-2-Claims-Experience-Status-Report-December-2018.pdf