Administrative and scheme delivery changes

Recovery and Return to Work Program

The Recovery and Return to Work program commenced in March 2020 and uses analytics to identify cohorts of injured workers most at risk of protracted return to work. Nine specific workstreams, including multi-disciplinary case management approaches, are applied to bring the injured worker, employers, treaters and case manager together to apply a person-centred case management technique. Other workstreams include deployment of return to work inspectors and early identification of secondary mental injury via analytics.

In the two year period since March 2020, the Recovery and Return to Work program has so far conducted 9,900 injured worker interventions and returned 3,000 of these most at risk workers to work. The program includes:

● additional support via mobile case manager visits for workers exceeding expected recovery and return to work dates

● ‘Multidisciplinary’ recovery and return to work conferencing, where the worker, employer and all medical providers are brought together, coordinated by a case manager or at times a independent member of WorkSafe’s clinical panel; to create a clear agreed recovery strategy.

● the use of analytics tools to identify early signs of a secondary mental injury among injured workers and then providing these workers with suitable treatment

● bringing injured workers and colleagues together in facilitated discussions to resolve issues where interpersonal conflict has prevented a return to work

● considering alternative employment opportunities with new employers for injured workers that hadn’t returned to work but had the capacity to do so, including providing retraining and job-seeking support to injured workers who could not return to their pre-injury role or pre-injury employer

● providing specific additional support to injured workers whose employers had difficulty identifying opportunities for them as a result of COVID-19

● supporting injured workers who had not worked for two to four years with programs to help build confidence, further their recovery and, where possible, identify return to work opportunities.

● Return to work inspector interventions for employers struggling to achieve return to work outcomes.

Workers Compensation Independent Review Service

The Workers’ Compensation Independent Review Service (WCIRS), established on 30 April 2020, is an independent and impartial review function that operates within the Independent Review Division at Worksafe Victoria. The WCIRS provides injured workers with the opportunity to ask for a free and impartial review of certain disputed 'reviewable decisions' under the compensation law that haven't been resolved during the conciliation process. The WCIRS reviews all decisions in line with a Sustainability of Decision-Making Framework (SDMF) which was developed for the function. The framework requires agents to demonstrate that their decisions are fair, reasonable, based on the best available evidence and are reasonably likely to be upheld by a court. WorkSafe is monitoring decisions reviewed by the WCIRS to identify trends that will inform the development of agent training, policies and decision-making practices.

New Employment Service Outcomes

New Employment Services (NES) is support for injured workers who cannot make a return to work with their pre-injury employer and require assistance securing new work. WISE (WorkSafe Incentive Scheme for Employers) is a component of NES which further improves injured worker outcomes. New employers who offer work to an injured worker can access up to $26,000 in incentives towards wages that support sustained employment. More workers than ever before (last 10 years) have returned to work with the support of NES.

In financial year 20/21 there was a 33% increase in the number of workers who found work through NES, with 60% of workers who returned to work earning 100% of their pre-injury average weekly earnings and 39.57% earned a minimum 50%. For June/July 21, one provider reported securing work for 54 injured workers in roles including engineering, management, sales, accounting, legal, retail, education, trades and manufacturing roles.

Facilitation Discussion Service

Facilitated Discussion is a form of alternative dispute resolution for injured workers where workplace relationship issues or interpersonal conflict presents as a barrier. Specifically, this program offers a mediation process for workplace disputes, with discussions led by specific Occupational Rehabilitation providers. It is a voluntary process that offers a safe and supportive environment for workers to identify and discuss the barriers to returning to work. This work stream has seen return to work outcomes increase from 14% in 2020/21 to over 25% from 99 interventions since 1 July 2021.

Alfred Occupational Respiratory Clinic

In addition, WorkSafe partnered with the Alfred Hospital for 2 years commencing in 2021 to assist with the newly opened Alfred Occupational Respiratory Clinic (AORC). The AORC facilitates the non-medical referral process for silicosis health assessments. This is Victoria’s first and only Occupational Lung Disease Clinic and will support workers in the stonemason industry with the health screening process, claims management, recovery and the social and work participation of these injured workers. The AORC accepted its first referral on 17 July 2021. More information regarding the criteria for the AORC is available on the WorkSafe Victoria website.

CGU Transition from the Victorian WorkCover Scheme

CGU Workers Compensation (CGU) informed WorkSafe in December 2020 that they were transitioning out of their role as an Authorised agent in the Victorian workers compensation scheme. More than 500 long-term injured workers were managed directly by WorkSafe, following the exit of CGU from the Victorian WorkCover scheme and a further 12,000 active cases at the time were transitioned to WorkSafe’s other four agents. WorkSafe focused on minimising any disruption for injured workers and employers, and ensured injured workers continued to receive the support, treatment and care they needed.

Independent Review of the management of complex workers compensation claims

Following the release of the independent review into the management of complex claims in Victoria’s Workers Compensation scheme, entitled “A review of WorkSafe Victoria’s management of complex workers’ compensation claims”, WorkSafe Victoria will transition approximately 1,500 further long term injured worker claims into WorkSafe’s direct management, by 31 December 2022.

Policy Developments

Victoria’s response to the COVID-19 outbreak

During the COVID-19 outbreak in Victoria, WorkSafe undertook a range of activities to ensure the impacts of COVID-19 on injured workers, and their recovery, was minimised wherever possible, including:

● reviewing the implications of Stage 4 restrictions and changes to restriction levels, particularly business shutdowns

● working closely with, and providing guidance to Agents, employers, injured workers, service providers and Independent Medical Examiners (IMEs)

● continuing essential IMEs via telehealth, unless exceptional circumstances require a physical examination monitoring

● establishing a Recovery Support Service, which recognises that a number of injured workers are impacted by COVID-19 and may be prevented from returning to or remaining at work and/or accessing services such as allied health treatments or support from an occupational rehabilitation provider. This service aims to keep the injured worker, employer and treating health practitioner engaged, connected and supported

● implementing new occupational rehabilitation services for injured workers to support connection to the workplace. This service promotes wellbeing and vocational readiness for injured workers who are unable to receive the service in the traditional sense

● introducing item codes to enable a wide range of services to be delivered by telehealth. The new item codes allow workers to continue to access essential health services within their home and reduce the risk of exposure to COVID-19 for vulnerable people in the community

● facilitating a process where Agents are providing employers who report a COVID-19 outbreak in their workplaces with information on how their impacted employees can access workers compensation entitlements to encourage speedy claims lodgement.

Mental Health Strategy

WorkSafe Victoria’s first Mental Health Strategy 2021 – 2024 (the strategy), is a significant milestone in our commitment to prevent workplace mental injuries and to better protect workers with a mental injury. The strategy is underpinned by the principles of protecting workers and supporting the needs of employers, it outlines objectives, focus areas and priority groups to engage with over the next three years. WorkSafe has identified five strategic focus areas that set the direction for achieving the strategy’s objectives. Each focus area has medium to long-term actions that WorkSafe will undertake to address the underlying causes of poor mental health across all workplaces. The focus areas are:

● Compliance and enforcement

● Fostering organisational change

● Awareness, education and training

● Building the evidence base

● Supporting Innovation

Legislative Amendments

Arbitration

The Workplace Injury Rehabilitation and Compensation Amendment (Arbitration) Act 2021 (the Arbitration Act) received Royal Assent on 11 May 2021. The Arbitration Act amended the Workplace Injury Rehabilitation and Compensation Act 2013 (WIRC Act) and Accident Compensation Act 1985 (AC Act). The Arbitration Act amends the WIRC Act to:

● allow the Accident Compensation Conciliation Service (ACCS) to hear and make binding determinations on disputes not resolved by conciliation.

● give workers the choice to have their matter arbitrated by the ACCS, instead of going to court, who must commence a hearing within 30 days of the dispute being referred.

The Arbitration Act delivered on the Victorian Government’s commitment to improve the dispute resolution process in line with a recommendation from the Victorian Ombudsman 2019 report “WorkSafe 2: Follow-up investigation into the management of complex workers’ compensation claims”.

The Arbitration Act will come into operation on a day to be proclaimed, or by 1 January 2023 the latest.

Provisional Payments

The Workplace Injury Rehabilitation and Compensation Amendment (Provisional Payments) Act 2021 (Provisional Payments Act) came into effect on 1 July 2021. The Provisional Payments Act amends the WIRC Act and Accident Compensation Act 1985 (AC Act) to provide for a provisional payments scheme for workplace mental injuries.

Under the scheme, Victorian workers who seek compensation for a mental health injury under WorkCover will receive payments to cover reasonable medical expenses while they await the outcome of their claim. Provisional payments are payable up to the date of claim acceptance or, in any other case, 13 weeks after the day the worker is determined to be entitled to provisional payments.

The new legislation also requires employers to provide early notification of mental injury claims to their Agent (within 3 business days of receiving the claim). Agents will then need to determine whether a claim is eligible to receive provisional payments within 2 business days. Self-insurers will have 5 business days to determine a provisional payments claim. Where employers do not meet these early notification requirements penalties will be applied.

COVID-19 related amendments

Parts 8 and 9 of the Justice Legislation Amendment (Supporting Victims and Other Matters) Act 2020 amended the WIRC Act and AC Act, respectively, to amend the definition of ‘relevant period’ for the purposes of calculating the pre-injury average weekly earnings (PIAWE) of a worker. The amendment excluded any period between 1 March 2020 and 31 December 2020 where a worker’s earnings were reduced for a COVID-19 reason from the calculation of PIAWE.

The COVID-19 Omnibus (Emergency Measures) Act 2020 and the COVID-19 Omnibus (Emergency Measures) Amendment Act 2020 (COVID-19 Omnibus Acts) were passed in October 2020 and made temporary changes to the WIRC Act and AC Act. The amendments extended the notice period given to an injured worker for second entitlement determinations made during the relevant period from 13 weeks to 39 weeks.

Under the WIRC Act, a worker with an accepted WorkCover claim may be entitled to weekly payments for up to 130 weeks if they are unfit for their pre-injury duties. Weekly payments only continue beyond 130 weeks (the second entitlement period) if a worker is assessed as having no current work capacity and is likely to continue to have no current work capacity indefinitely (second entitlement determination).

Prior to the COVID-19 Omnibus Acts amendments, the WIRC Act specified that a worker's entitlement to weekly payments must not be terminated on the ground that the second entitlement period has expired, unless and until the Victorian WorkCover Authority or the self-insurer has made a second entitlement determination and has given at least 13 weeks’ notice of the decision to terminate weekly payments.

The increased notice period provided for by the COVID-19 Omnibus Acts was intended to provide the worker with an opportunity to make arrangements, both financial and work, in preparation for the termination of weekly payments.

Firefighters presumptive rights

The Firefighters' Presumptive Rights Compensation and Fire Services Legislation Amendment (Reform) Act 2019 came into effect in July 2019. It allows career and volunteer firefighters to access presumptive compensation for specified cancers contracted while serving as a firefighter. The compensation applies to career and volunteer firefighters who:

● have served in active firefighting roles for a specified number of years, depending on the cancer type

● have been diagnosed since 1 June 2016 with one of 12 specified cancer types Summary of Workers’ Compensation Scheme Developments Australia and New Zealand 1st Edition 13

● are diagnosed during their service or within 10 years after the conclusion of their service

● have a listed cancer because of an exceptional exposure event in a firefighting capacity.

In 2021, the Forests Amendment (Forest Firefighters Presumptive Rights Compensation) Act 2021 expanded the rebuttable presumption to forest firefighters provided certain eligibility criteria are met.