3.2.2 Further investigation
Unless special reasons exist, initial medical certificates are only valid for up to 14 days and ongoing Certificates of Capacity are only valid for up to 28 days.
If the Agent is not satisfied that an extension is warranted they must notify the worker before the 14 days (for a medical certificate The first medical certificate is for a maximum of 14 days and can only be issued by a registered medical practitioner.) or 28 days (for a Certificate of Capacity Ongoing certificate is issued for up to 28 days and can be issued by a: medical practitioner, osteopath, physiotherapist, chiropractor.) expires.
Backdated or post-dated certificates
A backdated certificate is where the commencement date of incapacity is before the date of the examination.
Post-dated certificates can be accepted but Agents are to assess circumstances of each claim.
| Step | Agent action |
|---|---|
| When not to make payments |
The Agent must not make weekly payments for the backdated or post-dated period if:
|
| Contact the provider |
Contact the provider by telephone for an explanation or further information. Note the explanation on the file if certificates are backdated and:
|
| Write to the worker and employer | If the explanation is still not satisfactory write to the worker and the employer to explain why weekly payments are not payable for the full certified period. |
Changed diagnosis
If there is a change in diagnosis, Agents must consider whether the new diagnosis is related to the compensable injury.
See: Diagnosis
If it is not obvious that the new diagnosis is related to the compensable injury, the Agent must refer to a suitably qualified person (injury management) or Medical Advisor and then if necessary, arrange an independent medical examination.
See: Arrange independent medical examinations
Doctor is a long distance from the worker's home
If the worker travels long distances from their home address to receive Certificates of Capacity and the reason is not straightforward, review the worker's circumstances.
Certificates from interstate providers
Agents might receive certificates from interstate providers, for example, in the Albury/Wodonga district which are not in the approved form. Interstate certificates are acceptable if they contain the required information.
See: Valid certificate of capacity
Contact provider
If a certificate from an interstate provider has insufficient information, the Agent should contact the practitioner for clarification.
If the information is still insufficient:
- provide the interstate provider with the details of where to obtain an approved form
- send the certificate back to the worker and write to both the worker and employer to advise that the:
- certificate is not in the approved form
- treating provider has been provided with the details of where to obtain an approved form and that the worker should contact the provider to have the certificate completed.
Irregularities in issuing certificates of capacity
Agents are to report certificate irregularities to:
Recovery Performance Provider Team
WorkSafe Victoria
1 Malop Street
GEELONG VIC 3220