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Both Sides of the Fence #12 22 October 2010 The WorkCover Ombudsman: Who Complains and Why?

Both Sides of the Fence #12 22 October 2010 The WorkCover Ombudsman: Who Complains and Why?. Presented by Wayne Lines WorkCover Ombudsman. The WorkCover Ombudsman: Who Complains and Why?. Who can complain? Who complains? Types of complaints Examples Why do they complain?.

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Both Sides of the Fence #12 22 October 2010 The WorkCover Ombudsman: Who Complains and Why?

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  1. Both Sides of the Fence #1222 October 2010The WorkCover Ombudsman:Who Complains and Why? Presented by Wayne Lines WorkCover Ombudsman

  2. The WorkCover Ombudsman:Who Complains and Why? • Who can complain? • Who complains? • Types of complaints • Examples • Why do they complain?

  3. Who cancomplain? • Complaints may be received from anyone affected by the operation of the South Australian workers compensation scheme • workers • employers • service providers • individuals, organizations (public and private sectors)

  4. Who complains? • 200 formal complaints lodged in the 2 year period 2008-2010 • 90% lodged by or on behalf of injured workers • 9% lodged by or on behalf of employers • 1% lodged by or on behalf of service providers

  5. Types of Complaints The WorkCover Ombudsman may receive complaints about: • “Administrative acts” under the Act • Failures to comply with Sections 58B or 58C • Other matters relating to rehabilitation and return to work

  6. Examples of Complaints • Administrative acts under the Act • Complaints by workers • Refusal of provisional weekly payments • Inappropriate referral to IME or MPSA • Delay in complying with S107B or S109 • Pressured by case manager to accept a redemption

  7. Examples of Complaints (continued) • Administrative acts under the Act • Complaints by employers • Delay in reimbursement of wages paid to injured worker • Inadequate investigation of claim by case manager • Failure by case manager to respond to request to review worker’s entitlements

  8. Examples of Complaints (continued) • S58B/C and Rehabilitation • Complaints by workers • Employer failed to ensure injured worker performed duties in accordance with RRTW Plan • Worker’s requests for retraining ignored • Worker not consulted with preparation of RRTW Plan • Employer refused to offer suitable employment

  9. Examples of Complaints (continued) • S58B/C and Rehabilitation • Complaints by employers • Inadequate investigation by WorkCoverSA as to whether reasonably practicable to offer suitable employment • Delay in arranging worker’s return to work

  10. Why do they complain? • Frustration • Cannot sort it out with the case manager. • Desperation • Time is running out. Need action quickly. • Distrust • Lost faith in the people or the system. • Comfort • Want an independent person involved. • Hope • Perhaps the Ombudsman can help?

  11. Contact Details • Office: Level 6, 91-97 Grenfell Street, Adelaide • Freecall: 1800 195 202 • Mail: GPO Box 1719, Adelaide SA 5001 • Email: owo@sa.gov.au • Web: www.wcombudsmansa.com.au • Fax: (08) 8204 2169

  12. Questions? The End

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