This unit is appropriate for injury management advisers and case managers of long-term or high risk claims in the claims handling area of the personal injury management sector.

ELEMENT

PERFORMANCE CRITERIA

1. Provide rehabilitation advice and return to work and health strategies

1.1. Information on available rehabilitation services is provided to relevant parties

1.2. Advice provided highlights the benefits of early intervention and the parameters of the personal injury management system

1.3. Legislative rights and responsibilities of relevant parties are reinforced

2. Establish rehabilitation need and potential for return to work and health

2.1. Nature and status of claim is determined and high risk claims are referred for appropriate rehabilitation as early as practicable

2.2. Rehabilitation needs and potential for return to work and health are assessed with reference to all available documentation and information as soon as possible after injury and communicated to relevant parties and the injured person

2.3. Objectives goals and parameters for rehabilitation and return to work and health are developed in consultation with key stakeholders

3. Assess rehabilitation and return to work and health plan

3.1. Rehabilitation plans are assessed to ensure and facilitate an early, safe and durable return to work and health outcome

3.2. Cooperative participation between injured person, relevant parties and medical providers is promoted in developing the occupational rehabilitation program and return to work and health plan

3.3. A program of graduated and suitable work duties is outlined in the plan

3.4. Plans provide details and lists of specific return to work and health goals, objectives for the injured person to achieve, services to be provided, and estimates of the cost and duration of the services

4. Arrange rehabilitation services

4.1. Rehabilitation services and relevant assistance are arranged to meet client needs

4.2. Access to reasonable rehabilitation treatment is facilitated in order to restore injured persons as much as possible to their pre-injury capacity

4.3. Assistance is given to the injured person to return to meaningful employment with pre-injury or new employer

4.4. Payments for services are arranged according to reasonable costs and in accordance with schedule of fees

5. Monitor client's progress

5.1. The effectiveness of rehabilitation services is monitored and reviewed to reflect changing client needs

5.2. Regular communication is maintained with relevant parties

5.3. The direction and progress of the case towards the person's return to work and health is progressively arranged, actively monitored, and regular reviews by professional specialists and rehabilitation providers are managed

Required skills

well-developed communication skills to:

determine and confirm information, using questioning and active listening as required

liaise with others, share information, listen and understand

use language and concepts appropriate to cultural differences

well-developed interpersonal skills

numeracy and IT skills to:

perform calculations related to achieving required outcomes

use computer applications (word processing, spreadsheet, database, specific purpose computer systems) to assist in achieving required outcomes

access and update records electronically

use internet information

literacy skills to:

read and interpret documentation from a variety of sources and record and consolidate relevant related information

interpret policy and application research

analyse and interpret relevant information

effective interpersonal skills

organisation skills, including the ability to plan and sequence work

well-developed judgement and decision making skills

well-developed mediation and negotiation skills

proactive case management skills

risk assessment skills

Required knowledge

common law, legal systems and procedures, relevant Personal Injury Acts

organisation policy, procedures, underwriting guidelines and authorities

injury management models

rehabilitation processes

relevant information technology and communications systems and organisation software

risk prevention methods and application

sector and organisation policy wording

sector compliance requirements

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 ability to:

interpret and comply with industry, organisation obligations and objectives

negotiate effectively on behalf of the organisation and build client relationships

assess rehabilitation need and potential for return to work and health

assess and document return to work and health strategies and implement a detailed plan for rehabilitation and return to work and health for high risk or long-term case

monitor and effectively report on progress of client, maintaining privacy and confidentiality while performing case management functions.

Context of and specific resources for assessment

Assessment must ensure:

competency is demonstrated in the context of the work environment and conditions specified in the range statement either in a relevant workplace or a closely simulated work environment

access to and the use of a range of common office equipment, technology, software and consumables

access to organisation records

access to organisation policies and procedures.

Method of assessment

A range of assessment methods should be used to assess practical skills and knowledge. The following examples, in combination, are appropriate for this unit:

evaluating an integrated activity, which combines the elements of competency for the unit, or a cluster of related units of competency

observing processes and procedures in workplaces

verbal or written questioning on underpinning knowledge and skills

evaluating samples of work

accessing and validating third party reports.

Guidance information for assessment

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 services may include:

any service as provided for under each State or Territory's legislation.

Relevant parties may include:

employer and industry associations

injured person's family

insurance brokers

legal services providers

medical and like providers

rehabilitation providers

risk management consultants

team members in the worker's workplace

the community

the employer

the insurer

the worker

unions and union representatives.

Advice may include:

organisation policy and general procedures

confidentiality assurance

counselling provisions

definitions of 'worker', 'deemed worker' and 'employment' under relevant acts

fraudulent practices

medical and like certification requirements

methods of payment for worker and for services

promotion of appropriate medical intervention

rights, obligations and processes for return to work and health and rehabilitation

selection of medical and like services

taxation and government benefits implications

types of claims, benefit entitlements and rehabilitation procedures to the injured person and relevant parties.

Legislative rights and responsibilities are covered in:

Personal Injury Acts and regulations.

Nature and status of claims may include and involve:

claims for weekly payments, medical and like expenses only, death, permanent disability and pain and suffering, pecuniary loss, vehicle accidents, journey, third party

workers in situations such as after employment ceases, after retirement, worker residing overseas, imprisonment.

Documents may include reports from:

medical and like providers

medical panels

rehabilitation providers

the employer.

Assistance may be provided in:

arrangements for rehabilitation service rates and insurers obligations on return to work and health

completing relevant forms

ensuring that, when appropriate, injured people are referred to an accredited rehabilitation provider

establishing a general rehabilitation, return to work and health program

estimating and arranging a return to work and health in consultation with the treating doctor or the rehabilitation provider

methods of monitoring return to work and health

termination, cessation or alteration of payments on return to work and health.

Unit sector

Personal injury management

This unit contains employability skills.