Workers’ Compensation - Claims Management Policy and Procedure
Scope of Policy
The scope of this policy relates only to employees of The South Australian Synod of the Uniting Church in Australia on behalf of the Church (“Synod of SA”) and therefore does not apply to:
- Employees of Uniting Church SA congregations.
- Those in specified Ministries not covered by Workers Compensation Legislation
- Volunteers for any Synod of SA activities
For those excluded from this policy separate and specific claims management procedures apply.
As an expression of Synod of SA’s commitment to its employees, a Rehabilitation and Return to Work Coordinator (RRTWC) has been allocated the duty of overseeing rehabilitation services and return to work plans/programs occurring within Synod of SA. Synod of SA has appointed Karen Granger (HRM Adviser) as its RRTWC.
The roles and responsibilities of those involved in various aspects of the claims management process are outlined in Appendix 1 of this policy
Policy Statement
Synod of SA is committed to providing a safe and healthy workplace free of accidents and injury for all employees, volunteers and visitors to any Synod of SA site.
In the event of a claim Synod of SA will use workers’ compensation claims management procedures that will ensure each employee receives the most prompt and equitable determination of all workers’ compensation claims. This will be achieved through procedures developed by Synod of SA in liaison with the Claims Agent.
These claims management procedures have the objective of supporting injured employees until they have been successfully returned to work.
Information related to workers’ compensation claims will be kept strictly confidential. Access to these files will be restricted to the staff directly involved in the administration of these claims, that is, the HRM Adviser or those who have written authority from the injured employee.
Procedure
In administering an employee’s claim for workers’ compensation, Synod of SA:
- has appointed a RRTWC;
- has established a budget to effectively resource claims management;
- will return the injured employee to work as soon as reasonably practicable and safe to do so, within their identified physical capacity. This may be either to the position held prior to the injury, or another suitable position;
- where necessary, and after consultation with the employee (and representative if requested), their manager/supervisor, treating practitioner, and Rehabilitation Provider etc., will endeavour to provide suitable alternative duties that reflect the capacity of the employee to undertake employment; and
- will ensure that discriminatory practices do not occur upon the return to work of the employee.
The RRTWC will:
- report any serious workplace accident, injury or incident (death, injury with acute symptoms, treatment in hospital as an in-patient, or dangerous occurrence) to SafeWork SA as soon as practicable;
- ensure that the injured employee is contacted as soon as possible after the incident (no later than twenty-four (24) hours) to explain the claims management process and offer support in assisting the injured employee to return to work;
- ensure the expedient lodgement of any claim, including the WorkCover medical certificate and any other relevant documents to the Claims Agent preferably within forty-eight (48) hours, but no later than five (5) days;
- where applicable, investigate the validity of any claim, together with the Claims Agent;
- maintain a log of all accidents and incidents for reporting purposes;
- complete all investigations and accident and incident reporting required; and where applicable, advise the OHS&W Site Group Member
- liaise with treating medical practitioner and Rehabilitation Provider (both physical and vocational), once appropriate approval has been obtained from the injured employee;
- ensure that the policies and procedures of Synod of SA comply with the relevant legislation and WorkCover Corporation standards;
- proactively manage and monitor claims to promote timely and safe rehabilitation; and
- ensure that regular communication is maintained with the injured employee, the Rehabilitation Provider (where appropriate) and the Claims Agent.
Roles and Responsibilities
Case Manager
A Case Manager is employed by the Claims Agent or self-insured employer to manage matters relating to rehabilitation and workers’ compensation. It is the Case Manager’s responsibility to determine claims and work with the injured employee, the employer, medical practitioners and Rehabilitation Provider to coordinate the return to work process.
Claims Administrator
A Claims Administrator is an officer of an organisation who is responsible for the in-house administration of their employer’s workers’ compensation claims. It is the Claims Administrator’s function to liaise with the Claims Agent on behalf of the employer. The HRM Adviser is currently performing this role. Synod of SA’s Workers’ Compensation - Claims Management Policy deals with the administration of claims.
Claims Agent
A Claims Agent is an agent of the WorkCover Corporation. The function of the Claims Agent is to undertake the management of workers’ compensation claims on behalf of the WorkCover Corporation. The current Claims Agent is Employers Mutual.
Occupational Health Safety and Welfare Site Consultative Group
This is not a committee. It is a group of employees that have volunteered to take on an OHS&W role in addition to their regular duties. They are trained in basic OHS&W principles and conduct OHS&W consultation process with all employees on a regular basis. They make recommendations to the Responsible Officer for corrective action on incidents and hazards reported.
Rehabilitation and Return to Work Coordinator
The RRTWC will liaise with all parties to facilitate the timely return to work performing safe, sustainable employment. A broad description of the role of the Rehabilitation and Return to Work Coordinator can be accessed on the Human Resources Intranet page.
Rehabilitation Provider
The Rehabilitation Provider coordinates the rehabilitation and return to work plan/program of injured employees and will liaise with all parties to facilitate the timely return to work performing safe, sustainable employment. The Rehabilitation Provider is responsible for the writing of the return to work plan/program for the injured employee.
Executive Officer, Resources Board