1. You want to check the status of your policy and levy payments. How could you find out if your policy was current? Provide at least five examples.
How would you ensure or be able to prove the policy is maintained? (50–75 words)
A claim is received from Sharon Turner, a 56-year-old woman with a 30-year history as a cashier. The paperwork provided to you is inclusive of a Notice of Disability and a Claim for Compensation, and Sharon states she has hurt her back at work but does not know how. There has also been some disciplinary action taken against Sharon in the last two weeks and the employer wants the claim investigated. The form was signed by the worker seven days ago.
1. What relevant policies, procedures and/or legislation dictate how this claim should be managed? (40–60 words)
2. What should the agent do when processing this claim? (250–300 words)
Sharon Turner’s claim was received and the agency requested additional information to clarify the nature, extent, and cause of the disability. After receiving a medical report request, the treating doctor, Helen Jarvis, writes to say she treated the worker in the past for an old injury sustained in a car accident and confirms the injury is not work-related. In addition, the investigation report provides evidence the worker has lodged a claim in response to her recent disciplinary action and confirms the worker has told other employees she is not injured at all.
1. What could the agent do and why? (50–75 words)
2. The claimant is disputing the decision made. Detail the five stage of the dispute resolution process, those responsible for each stage of the dispute process and relevant time frames. (75–100 words)
1. Give three examples of how an agent could identify the nature of an illness or injury.
2. Use the following information to prepare a brief report including analysis and recommendations. Assume all of the employers are in the same industry and have similar staff numbers. (100–150 words)
|Employer||Cuts||Breaks||Muscle strain||Not identified|
1. It has been determined that a worker who broke their leg at work will not be able to return to work straight away and that they need rehabilitation assistance. How would you estimate or project a period of absence? (100–150 words)
2. List and describe five barriers to recovery. (100–150 words)
3. In the event rehabilitation is required, what must the employer do to cover a period of absences? (50–75 words)
1. A worker has fallen from a ladder and broken their hip. They will need treatment from a doctor and rehabilitation. You want to ensure that consultation occurs between the rehabilitation provider, treating doctor, relevant manager, and employee. Provide at least three examples.
2. What are some examples of initiatives that result in inevitable consultation? Give at least four examples.
1. You have received a medical report which states a worker is able to return to work for six hours a day after a period of total incapacity. What would you do? (50–100 words)
2. You need to redesign a job or identify alternative duties for an injured worker who is returning to work. What tools can be used to help consider job redesign or alternative duties? Provide at least five examples.
3. Explain the intention of rehabilitation programs. Who are they established for? When should they be established? (Students should develop a presentation and discuss this topic in class)
4. What factors should be considered when establishing a return to work program or plan? (Students should develop a presentation and discuss this topic in class)
5. Describe the relevant legislation that affects rehabilitation and returns to work programs. (100–200 words)
(Students should develop a presentation and discuss this topic in class.)
6. Outline the role of workers compensation state authorities in relation to claims, registration, and levies. (100–200 words)
(Students should develop a presentation and discuss this topic in class.)
1. You have been asked to give a presentation about the return to work programs. What are some factors that make a return to work program successful that you would discuss? (50–100 words)
2. List 12 examples of pieces of information that need to be included in a return to work program.
List the steps an agent could take when establishing a rehabilitation program with the employee.
For each of the possible risks noted describe in one sentence solutions that would mitigate risks.
1. The claim could be rejected and the rehabilitation costs may not be recoverable.
2. Pre-injury duties may not be available.
3. Industrial issues may be present.
4. The worker may be re-injured.
5. The worker may have more than one claim.
How can an agent ensure the earliest possible commencement of a rehabilitation program? (50–75 words)
List at least five ways an agent can encourage regular feedback and communication between the worker, employer, and rehabilitation provider.
List five ways in which the agent can encourage communication, feedback, and support between the rehabilitation provider and the worker.
What are four examples of how an agent might identify a breach in mutuality? Give at least three examples.
You are a case manager for a registered employer and a breach of mutuality has occurred. What would you tell the insurer? (100–150 words)
Identify three blocks to meeting the objectives of a return to work plan or program. How could you modify the plan or program to ensure effectiveness when blocks occur? (100–150 words)
- Administration assistant, Georgia Kelly is 59 years old and has lodged a notice of disability and a claim for compensation for a left wrist injury. She states she does not remember a specific incident that caused the injury and assumes it might be caused by overuse.
Her employer lodges an employer report form and argues the worker’s duties do not include repetitive movement and requests further investigation because the worker has lodged previous sick leave applications for a non-work-related injury.
Attached to the worker’s claim form is a prescribed medical certificate certifying the worker fit for alternative duties with a restriction placed on lifting with the left arm. The doctor also recommends the worker not undertake duties including typing and the employer does not know if there are any alternative duties available.
- Write a description of what you would do and justify your actions as the case manager responsible for managing this claim. Include in your answer reference to any legal, organizational and/or procedural requirements you would need to consider. Include in your answer view as to whether the claim should be accepted, rejected or initially undetermined.
- How would you decide whether the worker should have a return to work plan?
Your answers should be detailed with ideas and suggestions properly supported and/or justified.
- Using the previous scenario as an example, draft a return to work program, taking into account the treating practitioner’s recommendations. Assume alternative duties are available. Students should use the Return to Work Arrangementstemplate to complete this activity. (Students can use the sample completed Return to Work Arrangements for reference)
Describe how you will conduct a risk analysis of the return to work program and explain how you will monitor and evaluate the return to work program.
1. How suitable to the workplace are Return to Work arrangement template?
2. What might you change in the template or do differently?
3. What do you see as the main benefit of using such a template for Return to Work arrangement?
4. What recommendation you will give your colleagues to complete this type of activity in the workplace?
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