Workers’ Compensation Consultancy Program

MyWorkCover’s purpose is to resolve claims for the benefit of all parties involved. Early intervention injury management can help reduce claim costs, frequency of claims, occupational injuries, WorkCover premiums, and the number of days injured workers miss work. Injury management is critical to achieving the best possible outcomes for your injured employees and your company. This also helps to foster a supportive culture in your organisation, as well as high expectations for all employees.

Consultancy Program

Our consulting services include the following:

Policy Management

We review your policy to ensure that your business activity is classified correctly. We examine your company’s structure to see if there are any opportunities to reduce your premium. We ensure that you pay the correct premium by reviewing your remuneration, industry classification, and claims statement. We ensure that your organisation complies with WorkCover legislation in your legislative state to reduce the risk of fines. For budgeting and planning purposes, we can provide future premium projections based on claims costs.

See Policy Management Service

Claims Management

We assess and manage all workplace injuries that your company has to a resolution. We are aware that any claims decision can have an impact on premiums. Understanding your claims is an important aspect of claims management. Effective claims management and the right strategy will result in claims being resolved and settled sooner, reducing future liabilities and the risk of affecting your premiums.

See Claims Management Service

Case Conferences & Conciliation

To ensure a positive outcome for your company and its employees, we will attend claims meetings and conciliation for all adverse decisions made. We communicate with your insurer, review statistical case estimates, and, if necessary, consult with third-party service providers. We can help you find an Occupational Rehabilitation (OR) provider who understands and works with your company, saving you time, and money, and lowering your future liabilities.

Return to Work

We can provide advice on the “return to work” provision and identify and eliminate any barriers to your workers from returning to work. We focus on effective injury management so your business can have a decrease in costs and claims, whilst creating a supportive workplace culture. We can assist in putting in a Return-to-Work Plan if required.

Stakeholder

We collaborate with all parties to maintain positive relationships and achieve positive outcomes. Throughout each claim, we provide guidance and support to your organisation and its stakeholders.

What sets myWorkCover apart from others?

Claims management aims to maximise both injured workers’ rehabilitation and return to work (RTW) as well as our clients’ financial sustainability. We have a solid strategy in place to address the barriers to long-term RTW that any injured worker may face. Each injured worker’s short, medium, and/or long-term RTW goals must be determined.

• Understanding the relationship between RTW goals, methods, and our actions, including timeframes, is crucial to removing barriers and achieving a successful RTW rate.

• Receiving and assessing claims, deciding liability and eligibility for compensation as part of the employer’s responsibilities, and selecting, arranging, and reviewing services for injured workers to ensure an early, safe, and sustainable return to work are all difficult tasks.

• We examined and analysed the injured worker’s injury, capabilities, and expectations, as well as potential psychosocial risks and barriers to the injured worker’s rehabilitation and successful RTW.

• Claims management requires evaluating a worker’s right to compensation on a regular basis and taking necessary action, such as discussing termination benefits with the insurer for workers who violate the law.

The strategy aims to:

• improve and maximise better outcomes for our clients the efficiency of case management to resolve each claim for our clients

• increase in workers’ RTW rate

• minimise the cost of claims to reduce the impact on premiums

• the length of each claim to reduce the impact on premiums.

In the claim’s life cycle, the preceding approach also aids in the early detection of growing impediments to recovery and RTW. In response to emergent challenges and/or changes in the injured worker’s status, we update or adapt our strategies and actions:

• we monitor and review the worker’s progress
• consult with relevant stakeholders
• seek expert advice when necessary, such as an OR, THP, IME and the insurer
• update our strategies in response to changes:
  • worker’s injury circumstances and mindset
  • decision making – Injured workers’ RTW, recovery, and premiums can all be affected by poor decisions. Poor decision-making, on the other hand, can be avoided by implementing high-quality claims assessment and management procedures and practices on a regular basis.

There will always be times when the insurer makes an unfavourable decision, such as suspending, reducing, or terminating worker’s compensation benefits, which will almost always result in a conciliation through the Workplace Injury Commission (previously known as the Accident Compensation Conciliation Service (ACCS)). If a worker chooses to refer an adverse decision to conciliation, we will attend the conciliation and review the decision, taking into account any new information and attempting to achieve the best possible outcome.

myWorkCover utilises the WorkSafe Claims Manual in managing our client’s claims. To optimise an injured worker’s early, safe, and sustainable RTW and community activities, good case management practice necessitates the active, cost-effective management of each claim. We work to the standards set by the Victorian Auditor-General’s Office. This is what sets myWorkCover Solutions apart from the competition.

This service will cover:

• Policy Quotation & New Placement if needed
• Policy restructuring
• Policy Management
• WorkCover Industry Classification (WIC) review for accuracy
• Penalty review
• Workplace activity review
• Add new workplace
• Grouping & Succession review
• Wage Audit review
• WorkSafe Self-Assessment Audit for compliance
• WorkSafe Premium Audit for compliance
• Claim Consulting and Management, including collaboration with rehab providers and injured workers. We work with your insurer and case managers to ensure the best possible claim outcome. As a central communication point, all communications will be directed to myWorkCover. We will handle all of the paperwork. More on our claims management service can be found here myWorkCover Claims Service

Written by Yon Ta, updated 16 November 2022

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Disclaimer:

The information in this post is strictly for informational and educational purposes only and should not be construed as legal advice. It is not intended to express specific opinions about specific cases. Before acting on any of the issues discussed in this post, seek additional advice. The information provided should not be relied on for any purpose other than to assist you in understanding how Workers’ Compensation insurance works. It is for illustrative purposes only and My WorkCover Solutions Pty Ltd does not accept liability for any loss or damage suffered by any person resulting in any way from the use of or reliance on, the information provided. The information in this article is believed to be correct as of the date of publication. However, changes in the applicable laws may have an impact on the accuracy of the material. This article contains general information that is not tailored to any specific person’s situation. This publication may contain information that relates to the regulation of Workers’ Compensation insurance in your State or Territory. To ensure you comply with your legal obligations, we would recommend you refer to the appropriate legislation as currently in force in the State or Territory you conduct your business. You can find up-to-date legislation by visiting each state’s WorkCover Authority website, alternatively contact myWorkCover for updated information.