Our next meeting with the WorkCover Executive is on the 8th of September. At this meeting we will be presenting Workcover with our concerns on the underutilisation of Injury Management Plans.
For those who don’t know the Injury Management Plan is a plan devised with you, your doctor and your insurer to help you recover or adjust after a workplace injury. In our opinion these plans are ignored or incomplete. We are asking for a number of changes to the way in which insurers use these plans which we believe will ensure a greater chance of a quick recovery without the current headaches.
Injured Workers Support Network’s submission to WorkCover on the under utilization of Injury Management Plans in the workers compensation system. [please note the word insurer is used to cover both self-insurers and scheme agents].
The Injured Workers Support Network believes that the Injury Management Plan is a contract between the Insurer, the injured worker and their treating doctor. Within the Workers Compensation System it is the mechanism for ensuring appropriate and timely intervention to assist the injured worker in their recovery or their adaptation to an acquired disability.
It is therefore vital that the Injury Management Plans created with and for our members be of the highest quality with due care to the injured worker and their doctor. They should also be created and adapted in a timely manner.
Establishing and enforcing time frames on the creation and implementation of Injury Management Plans with insurers.
There is a significant issue with insurers withholding the creation and release of injury management plans within the workers compensation system. A significant number of our members have either a. not received an injury management Plan or b. have waited months to years before one has been issued.
The IWSN believes that the timely creation and dissemination of an injury management Plan is essential to a timely recovery from an injury. Injury management plans should be created and disseminated within 13 weeks from the date of the injury.
The underutilization of Injury Management Plans to preempt the requirement to seek approval from insurers before certain medical and related procedures take place.
The IWSN is painfully aware that the process of obtaining permissions from insurers for mundane medical procedures can be an elongated process. Though certain procedures are legislated as mundane others are not. Obtaining Ct scans to check on the process of a broken bone being one example of this, blood samples being taken is another, Regular visits to a psychiatrist for a medication review being a third. These mundane medical procedures should not be subjected to a lengthy and monotonous approval process where they can be approved and potentially scheduled into an active injury management plan
The lack of review of created Injury Management Plans.
The IWSN is not aware of any of our members receiving a revised injury management Plan once one has been agreed upon.
The injury management Plan should never be a static document, being revised when new information is obtained by the treating doctor.
The Injured Workers Support Network wants Workcover (and their likely successors) to ensure that specified time frames exist for their review consistent with legislation and the likely needs of the injured workers recovery or adaption.
The lack of consultation with injured workers and their treating doctors in the creation of an Injury Management Plan.
The IWSN is aware of too many cases where an injury management Plan has been created by an insurer without consultation with the injured workers treating doctor and the injured worker. This consultation:
- Should occur on all instances,
- Should be between the injured worker and their treating doctor without the interference of the insurer or their paid representative and
- Should be consistent with a principle of empowerment of the injured worker in their control over their recovery or adaptation.
The utilization of Injury Management Consultants.
The IWSN has recorded a large number of cases where an insurer has used an injury management consultant to argue against the considered opinion of medical specialists and treating doctors during their treatment reviews. This practice is so widespread that there appears to be an industry created to limit treatment options for injured workers. This practice contributes to the blow out in recovery times for injured workers.
The IWSN believes that greater reliance on treating specialists in particular and the injured workers treating doctor rather than injury management consultants is the only way to ensure timely and accurate information on the recovery and adaption needs of injured workers.
The Utilization of rehabilitation services within the Injury management plan.
The IWSN is significantly concerned with the referral system currently in place between insurers and rehabilitation services. The current system ignores the basic right of the injured worker to choose their rehabilitation provider.
The IWSN insists that the “preferred provider” system currently in place be abolished. That WorkCover (or its successor) enforces with insurers the right of injured workers to choose their rehabilitation provider and does so by insisting the insurers
- Identify that right to injured workers
- Provide a listing of all accredited rehabilitation providers to injured workers so that the injured worker makes the choice.
The separation of Injury Management Plans from the Work Capacity Assessment process.
The IWSN is aware that both injury management plans and reports from independent medical consultants are currently used by insurers in their work capacity assessment process. The purpose of an independent medical consultant is to review the recovery or adjustment progress of an injured worker and to provide appropriate commentary to the treating doctors regarding the recovery or adjustment process. They should not be used as a mechanism to deny benefits to an injured worker. The utilization of independent medical consultants in this way demeans the injury management plans, undercuts the position of the independent medical consultants and amounts to an abuse of power over the injured worker. This practice needs to cease.