Application
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.
It 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 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.
No licensing, legislative or certification requirements apply to this unit at the time of publication.
Elements and Performance Criteria
ELEMENT | PERFORMANCE CRITERIA |
Elements describe the essential outcomes. | Performance criteria describe the performance needed to demonstrate achievement of the element. |
1 Assist with managing claims | 1.1 Process workers’ compensation claims according to organisational policies and procedures, and all relevant legal and workers’ compensation insurance requirements 1.2 Notify rehabilitation provider according to organisational policies and procedures, and all relevant legal and workers’ compensation insurance requirements 1.3 Advise claimants as to whether their claim has been accepted 1.4 Assist with the analysis of claims to identify the nature of the illness or injury and prepare reports according to organisational policies and relevant legal and insurance requirements 1.5 Estimate projected period of absence from work and, where rehabilitation assistance is required, help to ensure arrangements are made in the work team to deal with absence |
2 Assist with planning for and implementing a successful rehabilitation or return-to-work program | 2.1 Facilitate consultation between rehabilitation provider and treating doctor and other health professionals, as required 2.2 Facilitate consultation between rehabilitation provider, relevant managers and affected worker 2.3 Document existing skills, experience and capabilities of affected worker to assist with return-to-work planning 2.4 Assist with job redesign, reduced hours and alternative duties according to advice from health and rehabilitation professionals 2.5 Assist with design of a rehabilitation or return-to-work program to achieve a successful return to work 2.6 Consult with relevant managers about the return-to-work program 2.7 Determine retraining that may be required when it is not possible for the worker to return to previous duties 2.8 Assist with establishing a rehabilitation or return-to-work program in consultation with worker 2.9 Start program as soon as possible |
3 Assist with monitoring and evaluating a rehabilitation or return-to-work program | 3.1 Facilitate regular feedback and communication between provider, supervising manager and worker 3.2 Facilitate regular contact and support between provider and worker 3.3 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 3.4 Assist with modifying return-to-work programs where appropriate 3.5 Assist with evaluating each rehabilitation or return-to-work program and implementing recommendations for system improvement where appropriate |
Foundation Skills
This section describes language, literacy, numeracy and employment skills incorporated in the performance criteria that are required for competent performance.
Skill | Performance Criteria | Description |
Reading | 1.1, 1.4 | Interprets and analyses complex legal and organisational texts relating to workers’ compensation, rehabilitation and return-to-work |
Writing | 1.2, 1.3, 1.4, 2.3 | Produces information, reports and records using structure, language and layout appropriate to audience and organisational requirements |
Oral communication | 2.1, 2.2, 2.6, 2.8, 3.1, 3.2 | Seeks or provides information about claims using language and features suitable for audience and context |
Numeracy | 1.5 | Performs calculations necessary to provide estimates related to timeframes |
Navigate the world of work | 1.1, 1.2, 1.4, 3.3 | Takes responsibility for adherence to legal and regulatory responsibilities and organisational policies and procedures in relation to role and responsibilities Keeps up to date on changes to legislation or regulations and organisational policies and procedures |
Interact with others | 1.5, 2.1, 2.2, 2.4, 2.5, 2.6, 2.8, 3.1, 3.2 | Understands what to communicate, with whom and how in context of role and responsibilities Cooperates with others as part of processes, and contributes to specific activities requiring joint responsibility and accountability Collaborates and negotiates with others to achieve joint/agreeable outcomes in sensitive situations |
Get the work done | 1.4, 1.5, 2.4, 2.7, 2.8, 2.9, 3.4, 3.5 | Plans tasks with logically sequenced steps, reflecting awareness of time and resource constraints and needs of others Uses formal decision-making processes, setting or clarifying goals, gathering information and identifying and evaluating choices against a set of criteria Monitors progress of tasks in order to provide timely information to claimants and modify plans as necessary Evaluates outcomes with a view to implementing improvements |
Sectors
Regulation, Licensing and Risk – Work Health and Safety