Comcare's new approach to managing claims for compensation
On 7 February 2011 we implemented a new approach to managing claims for compensation and a new service delivery model. The service delivery model has been co-designed with input from injured workers, employers, industry experts, unions, our employees and service providers. These changes will strengthen the services provided to injured workers, employers and providers and improve injury management practices, return to work outcomes and our decision making.
This approach reflects the value we place on returning injured workers to work as early as possible and will support our work with you to achieve that. We have been particularly influenced by the insights from the research undertaken by Dame Carol Black and Sir Mansel Aylward in the United Kingdom on the social and financial impacts of worklessness on people and the significant health benefits of good work.
Under the new service delivery model, ongoing claims will be managed by a Claims Services Officer based in the Canberra or Melbourne Service Delivery teams. Each Service Delivery team is comprised of a number of smaller specialised and segmented teams. Customised service offers have been developed for each segment.
- Stay at work – those claims where injured workers are expected to have less than four weeks off work or are back at work and still require some regular ongoing support or treatment.
- Return to work – those claims where injured workers are expected to have more than four weeks off work and there are barriers to an early return to work.
- Return to independence – those claims where the injured worker has a serious injury requiring long term care, has poor prospects of returning to work or is no longer employed and requires ongoing long term support.
Features of the new service delivery model:
- Renewed focus on ensuring every injured worker has returned to health and appropriate return to work or return to independence goals and introducing ways to better track progress against these goals.
- Early expectation setting with injured workers on typical return to health and return to work timeframes according to injury type.
- More regular claims reviews and case conferences supported by legal, clinical and allied health experts to progress return to health and return to work goals - injured workers, employers, treaters and/or providers may be involved in case conferencing.
- Improved communication - more phone contact with injured workers and employers, simpler letters.
- Implementation of clinical panel to review treatment plans and provide expert clinical advice to improve decision making by claims managers.
- Capability building to enhance the knowledge and skills of claims services officers.
Download the Recovery and Support Group structure [ppt].