Elements and Performance Criteria
- Monitor injury management cases
- Progress of the injured worker is monitored against the goals and objectives of the return to work plan and/or the case management plan.
- Compliance with the return to work plan is monitored in terms of agreed requirements.
- Compliance with treatment protocols is monitored and action is taken on non-compliance.
- Case management meetings are conducted to identify issues and barriers to successful return to work and facilitate resolution.
- Changes to the return to work plan are authorised and recorded in accordance with legislation, policy and procedures.
- Review injury management cases
- Capacity review of injured worker is undertaken as required by legislation in accordance with organisational procedures.
- Capacity for return to work is assessed and return to work/case management plans are updated to reflect current status.
- Treatment and medication review is undertaken as required by legislation and case management plan, and return to work plan is adjusted as required in light of medical information.
- Currency of prescribed medical certificate is reviewed and a current certificate is obtained where necessary.
- Currency and content of rehabilitation and return to work plan are reviewed and adjusted to address changes in circumstances.
- Case file is reviewed and case conferences are conducted at regular intervals as required by organisational procedures in order to progress claim to best possible outcome.
- Review injury management claim details
- Entitlements are reviewed in the light of disability and changes to personal circumstances.
- Economic review is conducted in accordance with legislation to ensure entitlements are adjusted in line with economic changes for similar workers.
- Claim estimates, duration and costs are reviewed and action is taken to address issues in accordance with legislation, policy and procedures.
- For continuing incapacity, cases are reviewed for permanent disability entitlements in accordance with legislation, policy and procedures.
- Redemption opportunities are assessed for suitable cases and recommendations are made for progressing these in accordance with organisational priorities.
- Improvements to policies, procedures and processes relating to case management are identified from reviews and recommendations are made in accordance with organisational policy and procedures.