5.8.1 Original employer services
Original Employer Services (OES Original Employer Services) are OR Occupational Rehabilitation services approved by WorkSafe specifically for the worker’s return to work with their injury employer, for both physical and mental injury claims.
Specific types of OR Services that may act as a pathway for workers to return to their injury employer with a primary mental injury claim include:
- Support Pathway Contact services (SPC), and
- Facilitated Discussion services (FD).
See: Facilitated Discussion | WorkSafe Victoria Occupational Rehabilitation Fee Schedule
Worker choice of OR provider
Workers must be offered a choice of OR provider.
Agents must ensure that only OR providers approved for OES or NES New Employer Services respectively are included in the OR provider choice. Note that Agents must also refer to the list of OR Providers with consultants that have been approved to deliver Support Pathway Contact and/or Facilitated Discussion services.
See: Worker choice of OR provider
Process
Agents are responsible for actively monitoring OES service delivery and ensuring coordination with the claim case management strategy. This requires Agents to:
- use Novus
- add the Occupational Rehabilitation process to Novus
- complete all Novus requirements including the sub-process Worker Choice of OR Provider
- add an explanatory comment for any cancellation of these Novus processes.
- review OES for RTW Return to Work progression,
- check services are effective, of high quality, timely, and
- check that the funding requested and invoiced is reasonable, necessary and consistent with the WorkSafe Victoria Occupational Rehabilitation Fee Schedule.
Agent review of OES RTW progression
Agents must review OES return to work progression at the end of the first three months of aggregate servicing under RC715 and monthly thereafter (excluding any periods of suspension or RTW sustainability).
RTW progression for the purposes of the Agent review is evidenced by sustained:
- change to certified work capacity, and
- RTW commencement, or
- increase in working hours.
For each Agent review, the worker’s RTW status at the beginning and end of the funding approval period is compared. The first funding approval period is for three months with monthly subsequent approval periods, except during the 13 week sustainability period.
Where there has been RTW progression
Where there has been RTW progression, the Agent may approve an additional month of OES servicing, which will be subject to monthly Agent reviews of RTW progression thereafter.
Where there has been no RTW progression
Where there has been no RTW progress or unsustained progress, then the Agent will arrange a case conference with the OR provider, conducted by telephone, secure video-conference or in person (this should be Agent arranged).
The Agent determines the likelihood of RTW progression with another month of OES servicing, based on evidence such as:
- a signed RTW Arrangements for RTW commencement
- new medical evidence (such as an IME Independent Medical Examiner / Independent Medical Examination) supporting RTW commencement or increase in hours.
OES should be suspended or cease if RTW progression is unlikely in the next month (OES can be reconsidered at a later date).
Agent– OR provider case conferences must be recorded on Novus, explaining the rationale for the decision to continue, suspend or cease OES.