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Comcare and employers use medical certificates to determine an employee's capacity for work and the nature of their injury. A medical certificate is a legal document that needs to be completed accurately, based on the facts given to the medical practitioner. Comprehensive medical certificates lead to more timely determinations of new claims and consequently, a quicker and more effective return to work.
A medical certificate provides important information to all parties and guides determinations about:
- accepting a workers compensation claim
- the type and amount of benefits an employee will be paid
- the development of a rehabilitation program by the employer if required
- approving reasonably necessary medical treatment
- incapacity entitlements.
Why are comprehensive medical certificates important?
Comcare often receives new claims that do not have a medical certificate or a medical certificate with insufficient information. This can slow the determination of the new claim which delays support and compensation for the employee. We know that the earlier employees receive support, the more likely they will return to work, health and independence. A comprehensive medical certificate ensures an employee receives their entitlements and treatment is not delayed.
Comcare has collaborated with other insurers in the ACT to develop a medical certificate that focuses on capacity rather than incapacity.
What information should a medical certificate include?
To ensure that determinations are made in the timeliest way, medical certificates need to include:
- employee's details
- precise diagnosis or description of the condition and symptoms
- cause of the condition
- date of injury
- date the employee first sought treatment for the condition
- details of any pre-existing or contributing factors
- recommended treatment
- fitness for work
- the legally qualified medical practitioner's signature and date.
If the medical certificate attached does not state the diagnosis or description of the condition and does not state the cause of the condition, Comcare will not be able to assess the claim until this is received and will advise employees to obtain this information.
Please note the cause of the condition is not required for psychological injury claims as further medical evidence will be sought.
Modified duties refer to any changes or restrictions that should be applied to an employee's pre-injury activities to allow them to return to work.
If the employee is unable to return to their pre-injury duties but is capable of performing some work tasks, the medical certificate should reflect these capabilities. This will allow the employer to offer the employees suitable duties and support the health benefits of work.
These capabilities can be incorporated into the employees return to work plan and will support them to stay at or return to work safely.
Communication is at the heart of a successful return to work
Employers must consult with employees and their treating healthcare providers to support return to work. All parties bring something to the table: medical expertise and opinion and an understanding of an injured worker's duties. If needed, employers may contact a medical practitioner in their bid to achieve successful return to work outcomes.
If a medical practitioner has not heard from a patient's employer, as the employee's treating healthcare provider, they can call an employer to find out more about the employee's employment and suitable employment options that may be available.
The Rehabilitation Case Manager at the employee's employer is the best person to talk to.