Return to work assessment service

1. Return to work assessment services29 May 2014Leanne HoManager, Allied Health and Return to Work Services

2. Return to work assessment service PURPOSE: To provide you of Return to work assessment services “in practice” from 1 July 2014 1. Background 2. Expectations of service 3. In context WorkCoverSA

3. WorkCoverSA

4. NES FFW PIE RtC RTW Assmt Physio / OT / Psych 1 July 2014 Return to work services fee schedule Workplace rehabilitation provider services PIE JPS Mediation RtC WorkCoverSA

5. Medical expert rehabilitation services WorkCoverSA

6. Pre-injury employer service GRTW JA Worker RTW provider Worker WSA Employer Employer RC WorkCoverSA

7. RRTWP JA INA WSA RRTWP CC WorkCoverSA

8. What we expect of Return to work services…. • Focus on service • Reduced delays • Reduced disruption • Accountability in delivering the right service • Purposeful service • Reduce medicalization Worker Employer WorkCoverSA

9. Case manager’s tool kit

11. Return to work assessment services within the case manager’s tool kit • Targeted and specific scenarios • Where return to work services are not involved • Where return to work services are not able to provide the required information WorkCoverSA

12. Return to work assessment services

13. Who are return to work consultants? $170.20 per hour $138.50 per hour 2 years FT clinical experience OR 1 year FT as a class B consultant supervised by a Class A consultant 2 years FT membership and experience

14. NEW NEW CHANGE *Additional travel for regional areas applicable where criteria met WorkCoverSA

15. Agent case conference support service

16. Service overview Agent case conference support service • Service to assist the case manager in their Agent case conferencing (Agent claims review) • Agent case conferencing ≠ Traditional case conference • Each service may have different requirements (information required, method of obtaining)

17. Return to work assessment Agent case conference support service

18. Referral scenarios Agent case conference support service Insufficient information to conduct Agent Claim Review SERVICE: Gather info from involved parties, in support of Agent claim review Presence at a case conference SERVICE: Facilitate a case conference, with agenda guided by CM (at Agent, or treating practitioner’s rooms) Expertise to review file is required SERVICE: Provide specialist review on return to work management WorkCoverSA

19. What is expected Agent case conference support service (14/4/14) • Who delivers this service? • 14th April – 30th June: currently appointed workplace rehabilitation provider ($135.30 hourly rate) • 1st July onwards: • Class A ($170.20 hourly rate) • Class B ($138.50 hourly rate) • RTW Consultants of appointed Return to work services provider • What is included? • Up to 4 hours of service, including travel if required • Provision of a brief summary report • Communication with parties as requested by case manager WorkCoverSA

20. WorkCoverSA

21. Return to work goal verification service and report

22. Return to work assessment Return to work goal verification service and report

23. Referral scenarios Return to work goal verification service and report Long term sustainability of worker returning to pre-injury employer is unclear Dispute in return to work goal direction between parties Second opinion is required to review the durable suitable employment options available prior to changing return to work goal WorkCoverSA

24. What is expected Return to work goal verification service and report • Equivalent to Level 1 Intervention Pre-injury employer service • Assess the physical and / or psychological demands of duties at the workplace and recommend for appropriate workplace modifications where required to accommodate a worker’s medically certificated work capacity • PLUS explore and exhaust any suitable employment options with the pre-injury employer WorkCoverSA

25. Return to work assessment Return to work goal verification service and report • Who delivers this service? • Class A RTW Consultant • What is included? • Level 1 Intervention pre-injury employer service such as: • Review of history and return to work progress • Attendance at workplace to review suitable employment options • Explore and exhaust all suitable employment options with pre-injury employer • Recommendations for workplace modifications or equipment where necessary • Up to 9 hours of service, including travel • Provision of a Return to work goal verification report including recommendation for the RTW Goal (PIE or NES) WorkCoverSA

26. WorkCoverSA

27. Worksite assessment and report

28. Return to work assessment Worksite assessment and report WorkCoverSA

29. Referral scenarios Worksite assessment and report Treating doctor expresses concerns about certifying worker’s return to work Worker’s employer requires advice regarding suitable employment in the workplace to facilitate return to work New employment is identified and workplace design, modification advice is required for safe and durable return to work WorkCoverSA

30. Return to work assessment Worksite assessment and report • Who delivers this service? • Class A RTW Consultant – Occupational Therapist, Physiotherapist, Psychologist • What is included? • Attendance at the worksite with worker, and employer • Establishing worker’s capacity to undertake duties and individual tasks • Identification of suitable duties • Recommending workplace modifications where necessary to accommodate worker’s return to work • Up to 6 hours of service, including travel • A worksite assessment report WorkCoverSA

31. WorkCoverSA

32. Functional capacity evaluation and report

33. Return to work assessment Functional capacity evaluation and report WorkCoverSA

34. Referral scenarios Functional capacity evaluation and report Treating doctor requires clarification of the worker’s functional ability to appropriately certify Treating health practitioners are not able to provide sufficient assessment of worker’s full functional abilities Complex claims WorkCoverSA

35. Return to work assessment Functional capacity evaluation and report • Who delivers this service? • Class A RTW Consultant (Physio / OT) • What is included? • Review of medical information provided by the requestor • Identification of potential return to work goals and options for which the FCE is required • Assessment of worker’s functional abilities to perform the physical demands of the proposed job(s) and determine whether the worker has the capacity to undertake these demands WorkCoverSA

36. WorkCoverSA

37. Suitable employment assessment

38. Return to work assessment Suitable employment assessment WorkCoverSA

39. Referral scenarios Suitable employment assessment Where return to work services is not involved e.g. worker is independently job seeking Legal requirement for claims purposes Due to worker’s circumstances, a more robust assessment, functional and practical is required to prepare the worker for JPS WorkCoverSA

41. Vocational assessment

42. Return to work assessment Vocational assessment WorkCoverSA

43. Referral scenarios Vocational assessment Where suitable employment option identified requires re-training where there is no evidence to demonstrate worker’s ability to meet demands More robust psychological assessments are required to assess the suitability of a suitable employment goal WorkCoverSA