BSBWHS407A - Assist with claims management, rehabilitation and return-to-work programs Competency Mapping Template
Unit of Competency Mapping – Information for Teachers/Assessors – Information for Learners
BSBWHS407A Mapping and Delivery Guide Assist with claims management, rehabilitation and return-to-work programs
Version 1.0 Issue Date: May 2024
Qualification
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Unit of Competency
BSBWHS407A - Assist with claims management, rehabilitation and return-to-work programs
Description
This unit describes the performance outcomes, skills and knowledge required to assist with the management of workers’ compensation claims, rehabilitation and return-to-work programs.
Employability Skills
This unit contains employability skills.
Learning Outcomes and Application
This unit applies to individuals who assist with claims management, rehabilitation and return-to-work programs.Note that the unit does not in any way address the process of treating the worker for their injury or illness as this is the task of health and rehabilitation professionals. Instead the unit focuses on assisting with managing claims and ensuring that the organisation supports the worker through return-to-work programs.NOTE: The terms Occupational Health and Safety (OHS) and Work Health and Safety (WHS) are equivalent and generally either can be used in the workplace. In jurisdictions where the National Model WHS Legislation has not been implemented RTOs are advised to contextualise the unit of competency by referring to the existing State/Territory OHS legislative requirements.
Duration and Setting
X weeks, nominally xx hours, delivered in a classroom/online/blended learning setting.
Prerequisites/co-requisites
Not applicable.
Competency Field
Development and validation strategy and guide for assessors and learners
Student Learning Resources
Handouts Activities
Slides PPT
Assessment 1
Assessment 2
Assessment 3
Assessment 4
Elements of Competency
Performance Criteria
Element: Assist with managing claims
Process workers’ compensation claims according to organisational policies and procedures, and all relevant legal and workers’ compensation insurance requirements
Notify rehabilitation provider according to organisational policies and procedures, and all relevant legal and workers’ compensation insurance requirements
Advise claimants as to whether their claim has been accepted
Assist with the analysis of claims to identify the nature of the illness/injury and prepare reports according to organisational policies, and relevant legal and insurance requirements
Estimate projected period of absence from work and where rehabilitation assistance is required, help ensure arrangements are made in the work team to deal with absence
Element: Assist with planning for and implementing a successful rehabilitation or return-to-work program
Facilitate consultation between rehabilitation provider and treating doctor, and other health professionals as required
Facilitate consultation between rehabilitation provider, relevant managers and injured worker
Document existing skills, experience and capabilities of injured worker to assist with return-to-work planning
Assist with job redesign, reduced hours and alternative duties according to advice from health and rehabilitation professionals
Assist with design of a rehabilitation or return-to-work program to achieve a successful return to work
Consult with relevant managers about the return-to-work program
Determine retraining that may be required when it is not possible for the worker to return to pre-injury duties
Assist with establishing a rehabilitation or return-to-work program in consultation with injured worker
Commence program as soon as possible
Element: Assist with monitoring and evaluating a rehabilitation or return-to-work program
Facilitate regular feedback and communication between provider, supervising manager and injured worker
Facilitate regular contact and support between provider and injured worker
Assist with identifying breaches of the return-to-work program, notifying breaches and taking prompt remedial action according to organisational policies, procedures, and relevant legal and insurance requirements
Assist with modifying return-to-work programs where appropriate
Assist with evaluating each rehabilitation or return-to-work program and implementing recommendations for system improvement where appropriate
Evidence Required
List the assessment methods to be used and the context and resources required for assessment. Copy and paste the relevant sections from the evidence guide below and then re-write these in plain English.
The evidence guide provides advice on assessment and must be read in conjunction with the performance criteria, required skills and knowledge, range statement and the Assessment Guidelines for the Training Package.
Overview of assessment
Critical aspects for assessment and evidence required to demonstrate competency in this unit
Evidence of the following is essential:
understanding of the organisation’s rehabilitation and return-to-work programs
sound communication skills
knowledge of relevant legislation.
Context of and specific resources for assessment
Assessment must ensure access to:
appropriate documentation and resources normally used in the workplace.
Method of assessment
A range of assessment methods should be used to assess practical skills and knowledge. The following examples are appropriate for this unit:
analysis of responses to case studies and scenarios
assessment of written reports
direct questioning combined with review of portfolios of evidence and third-party workplace reports of on-the-job performance by the candidate
observation of performance in role plays
oral or written questioning to assess knowledge of workers’ compensation tribunal procedures
review of assessment undertaken of a proposed return-to-work program
evaluation of contact and support organised between provider and injured worker.
Guidance information for assessment
Holistic assessment with other units relevant to the industry sector, workplace and job role is recommended.
Submission Requirements
List each assessment task's title, type (eg project, observation/demonstration, essay, assignment, checklist) and due date here
Assessment task 1: [title] Due date:
(add new lines for each of the assessment tasks)
Assessment Tasks
Copy and paste from the following data to produce each assessment task. Write these in plain English and spell out how, when and where the task is to be carried out, under what conditions, and what resources are needed. Include guidelines about how well the candidate has to perform a task for it to be judged satisfactory.
Required skills
communication skills and discretion to discuss compensation, treatment, rehabilitation and return-to-work matters sensitively with a range of people
consultation and negotiation skills to address issues around compensation, treatment, rehabilitation and return-to-work matters sensitively with a range of people
organisational and administrative skills to see that all claims are properly managed and that claimant is clear about what is happening and what to expect
planning skills to customise rehabilitation or return-to-work programs to suit injured workers.
Required knowledge
external parties involved in return to work
processes and procedures for accessing relevant workers’ compensation legislation, principles and procedures
processes and procedures for preparing a workplace for return to work
importance of return to work to the injured worker, fellow workers and the employer
organisation’s responsibilities for rehabilitation or return-to-work programs
rehabilitation concepts and return-to-work procedures
return-to-work planning and return-to-work arrangements
rights and obligations of all parties under the relevant workers’ compensation scheme and relevant legislation
sources of assistance to help with rehabilitation and return-to-work programs
variety of methods, techniques and tools to support the injured worker.
The range statement relates to the unit of competency as a whole. It allows for different work environments and situations that may affect performance. Bold italicised wording, if used in the performance criteria, is detailed below. Essential operating conditions that may be present with training and assessment (depending on the work situation, needs of the candidate, accessibility of the item, and local industry and regional contexts) may also be included.
Rehabilitation provider may include:
allied health professional, such as occupational therapist and physiotherapist
job placement or training consultant
medical practitioner
mental health professional
rehabilitation case manager
return-to-work manager.
Relevant managers may include:
business owners
line managers
persons conducting businesses or undertakings (PCBUs) or their officers
project managers
senior managers
supervisors
team leaders.
Alternative duties may include:
alternative position
limited range of duties drawn from the injured worker’s regular job
normal duties supported by providing workplace aids, equipment and other measures
combination of the above.
Evaluation may include:
determining the extent to which the program meets its objective in relation to:
attainment and durability of the worker's return to work
timeframes
success rates
costs
requirements of the injured worker, fellow workers, supervisors and managers
specified organisational objectives, targets and policies
legislative duties and requirements.
Copy and paste from the following performance criteria to create an observation checklist for each task. When you have finished writing your assessment tool every one of these must have been addressed, preferably several times in a variety of contexts. To ensure this occurs download the assessment matrix for the unit; enter each assessment task as a column header and place check marks against each performance criteria that task addresses.
Observation Checklist
Tasks to be observed according to workplace/college/TAFE policy and procedures, relevant legislation and Codes of Practice
Yes
No
Comments/feedback
Process workers’ compensation claims according to organisational policies and procedures, and all relevant legal and workers’ compensation insurance requirements
Notify rehabilitation provider according to organisational policies and procedures, and all relevant legal and workers’ compensation insurance requirements
Advise claimants as to whether their claim has been accepted
Assist with the analysis of claims to identify the nature of the illness/injury and prepare reports according to organisational policies, and relevant legal and insurance requirements
Estimate projected period of absence from work and where rehabilitation assistance is required, help ensure arrangements are made in the work team to deal with absence
Facilitate consultation between rehabilitation provider and treating doctor, and other health professionals as required
Facilitate consultation between rehabilitation provider, relevant managers and injured worker
Document existing skills, experience and capabilities of injured worker to assist with return-to-work planning
Assist with job redesign, reduced hours and alternative duties according to advice from health and rehabilitation professionals
Assist with design of a rehabilitation or return-to-work program to achieve a successful return to work
Consult with relevant managers about the return-to-work program
Determine retraining that may be required when it is not possible for the worker to return to pre-injury duties
Assist with establishing a rehabilitation or return-to-work program in consultation with injured worker
Commence program as soon as possible
Facilitate regular feedback and communication between provider, supervising manager and injured worker
Facilitate regular contact and support between provider and injured worker
Assist with identifying breaches of the return-to-work program, notifying breaches and taking prompt remedial action according to organisational policies, procedures, and relevant legal and insurance requirements
Assist with modifying return-to-work programs where appropriate
Assist with evaluating each rehabilitation or return-to-work program and implementing recommendations for system improvement where appropriate
Forms
Assessment Cover Sheet
BSBWHS407A - Assist with claims management, rehabilitation and return-to-work programs
Assessment task 1: [title]
Student name:
Student ID:
I declare that the assessment tasks submitted for this unit are my own work.
Student signature:
Result: Competent Not yet competent
Feedback to student
Assessor name:
Signature:
Date:
Assessment Record Sheet
BSBWHS407A - Assist with claims management, rehabilitation and return-to-work programs
Student name:
Student ID:
Assessment task 1: [title] Result: Competent Not yet competent
(add lines for each task)
Feedback to student:
Overall assessment result: Competent Not yet competent