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Medical practitioners

For: Service providers Information seekers

As a medical practitioner—working as a general practitioner or a specialist—you play a vital role in the rehabilitation and return to work of employees.

We provide information and resources to help you work with employees who have a work-related injury or illness.


Your role in an employee's rehabilitation

The main goal for a medical practitioner working with an employee who has a work-related injury or illness is to help the employee safely stay at or return to work, health and independence as soon as possible.

As a medical practitioner, you play a critical role in an employee's rehabilitation and return to work and health.

Your role is to:

  • diagnose and assess illness, injury and health conditions
  • assess work capacity and provide medical certification
  • provide treatment
  • refer employees for specialist treatment
  • provide advice on alternative duties or workplace modifications
  • review proposed return to work plans to ensure duties suit capacity
  • participate in return to work case conferences
  • provide information for clinical reviews.

Diagnosis

For a claim to be accepted, there must be a clear diagnosis from a medical practitioner.

Under the Safety, Rehabilitation and Compensation Act 1988, a legally qualified medical practitioner can be a general practitioner or a specialist, such as a surgeon, psychiatrist or a dentist.

A claims manager may contact you, as the treating medical practitioner, if they need more information about an employee’s injury or illness.

Contact is often made in writing and the claims manager will ask you to provide a written response. In some cases, a phone call may be enough to clarify an issue.

If you want to discuss any matter related to an employee’s claim, you can contact the claims manager to discuss the case.

For more information, see Assessing a claim and Claims manager role.

Assessing work capacity

When assessing capacity, it is important to focus on what the employee can do, not what they can’t do.

This information is included in the medical certificate, which is a form of medical evidence. Comcare’s preferred medical certificate is the certificate of capacity.

The medical certificate:

  • provides information on the employee’s injury or illness, diagnosis and recommended treatment
  • assesses the capacity of the employee and certifies capacity to work
  • sets expectations early about timeframes for recovery and safe stay at or return to work
  • is used by the employee’s rehabilitation case manager and employer to look for and offer suitable duties that fit the employee's functional abilities
  • update the employee’s certificate as the injury, medical condition or capacity changes.

Claims managers will generally not accept backdated medical certificates.

Return to work case conferences

You may be required to be involved in a return to work case conference.

Return to work case conferences connect professionals and others involved in an employee's illness or injury to discuss and support the employee’s rehabilitation and return to work process.

For more information, see Case conferences and Billing for a return to work case conference.

Clinical reviews

A clinical review is an internal claims management process.

Reviews are a cooperative and collaborative process between treating healthcare providers and members of Comcare's clinical panel.

As part of a review, the clinical panel assesses information on an employee’s claim file and asks healthcare providers to provide information.

For more information, see Clinical panel and clinical reviews.

Working with mental health conditions

Medical practitioners are increasingly required to diagnose, treat and assess work-related mental health conditions.

The following resources are useful guides:

Watch a video

Watch a video on how to assess capacity for patients with a psychological condition.

Assessing capacity for patients with a psychological condition is a video featuring Consultant Psychiatrist Dr Dielle Felman which provides information and recommendations for assessing work capacity for patients with a psychological condition.

Adapted for national use with the support of WorkSafe Victoria.

Transcript of Assessing Capacity for Patients with a Psychological Condition video

Support available to injured and ill employees

A range of support and payments are available to help an employee return to heath and to work.

Employees who have a compensable claim under the Safety Rehabilitation Compensation Act 1988 may be able to claim:

Billing and payments

Billing for medical treatment

After an employee makes a claim for compensation, the claims manager lets the employee know if their claim has been accepted.

The employee is then responsible for letting their medical practitioner know if they are entitled to compensation benefits.

If a claim is not accepted, any unpaid accounts will be returned to the employee to arrange for payment.

For more information, see Rates for medical and allied health treatment.

Billing for case conference participation

You can call us on 1300 366979 if the employee does not know which type of arrangement their employer is working under.

Employees of an Australian Government agency or statutory authority

Comcare uses the Australian Medical Association (AMA) rates (available to AMA members or by subscription) to pay for participation in a case conference.

Invoices for participation in a return to work case conference must include:

Invoices should be sent to Comcare by:

Employees of a self-insured licensee

Payment rates should be discussed directly with the licensee. Invoices should also be sent directly to the licensee.


Health authorities agree that work is good for mental and physical health and wellbeing.

Being away from the workplace for a significant period can cause an employee to:

  • become isolated and feel depressed
  • suffer financial and social consequences
  • find it more difficult to find employment in the long term
  • experience family disruption, loss of self-esteem and quality of life
  • have higher rates of many health conditions and an increased risk of death.

We also know that the longer an employee is off work, the less likely they are to return to work.

Evidence shows patients are three times more likely to return to work if they are given a date by their health professional.


More information

Our Emerging evidence alerts provide the latest literature research on evidence-based results on health benefits of good work, recovery at and return to work, and work health and safety issues in a free monthly publication.

Page last reviewed: 07 December 2019
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Comcare
GPO Box 9905, Canberra, ACT 2601
1300 366 979 | www.comcare.gov.au

Date printed 01 Oct 2020

https://www.comcare.gov.au/service-providers/medical-allied-health/medical-practitioners