5.5.7 Worker choice of OR provider

The Agent must ensure that the worker has been given a choice of OR Occupational Rehabilitation provider at the time that OR services are approved.

Before providing the worker a choice of OR provider, the Agent must first establish the RTW Return to Work goal and determine the type of OR services to be approved.

Criteria when compiling an OR provider list

The Agent must compile a list of no less than three OR providers (where available) after having regard as far as possible to the following:

• the worker’s injury type
• the type of OR services required
• where the worker resides and
• the location where the OR provider will provide the OR services.

In some instances, particularly for workers residing in regional or remote areas, less than three OR providers of a particular OR service may be available.

For example The Agent approves a NES New Employer Services Vocational Report but there are only two NES providers located within a 'reasonable' distance from where the worker resides. In this case it would be enough for the Agent to list only two NES providers for the worker to choose from.

WorkSafe approved occupational rehabilitation service provider directory

OR providers are approved to deliver Original Employer Services (OES Original Employer Services). Some OR providers are approved to deliver Facilitated Discussion (FD) and/or New Employer Services (NES).

This directory is available via WorkSafe’s website and has a search engine that displays the distance to the nearest OR provider location based on the:

• type of OR service
• the worker’s postcode or suburb.

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Offer of OR provider choice

Whenever workers are offered a choice of OR provider, a written list of OR providers must be given.

After a choice of OR provider has been offered in writing, the worker’s choice can be confirmed by:

• the worker responding in writing
• the worker contacting the Agent by telephone
• the Agent contacting the worker by telephone.

The Agent must keep a record of any offer or confirmation of OR provider choice.

To ensure the worker makes an informed decision, the list of OR providers offered to the worker must contain the:

• names of the nominated OR providers
• addresses (locations) of the nominated OR providers nearest to where the service will be provided and
• contact details of the OR providers (eg phone number or website).

For example If Geelong is the location of the workplace and where the worker resides, then the Geelong address for the nominated OR providers must be listed although their head office may be in the Melbourne CBD.

OR service approved on a pending claim

See: OR services on pending claims

Choice of OR provider at time of claim acceptance

WorkSafe requires the Agent to offer a choice of OR provider at the time of claim acceptance for a time loss claim by attaching a completed ‘Worker Choice of Occupational Rehabilitation Provider’ nomination form to the claim acceptance letter (ACC1) unless the worker has already chosen their OR provider as part of provisional payments. This is intended to minimise any delays in initiating OR service delivery if the Agent approves an OR service at a later date.

The worker may respond by returning the nomination form or by calling the Agent. Alternatively, the Agent may contact the worker after providing the claim acceptance letter to confirm OR provider choice.

The Agent must keep a record of any choice of OR provider made by the worker at this time. However, the worker is not obliged to respond to an offer of OR provider at this stage. This is because the legislative requirement is for the worker to receive OR services from an OR provider chosen by the worker so unless OR services are to be received, there is no requirement for OR provider choice to be made.

Choice of OR provider when OR service is approved

At the time an OR service is approved the Agent must check whether the worker has previously chosen an OR provider.

If the worker has not yet chosen an OR provider but the OR providers listed continues to meet the legislative criteria, the Agent can contact the worker by phone to confirm choice of OR provider.

If the Agent cannot establish that the worker has previously made a choice of OR provider or has not responded to a phone call or if the OR providers previously listed no longer meets the legislative criteria, the Agent must send the worker an ORP4 letter offering a choice of OR provider again. The worker is required to respond within 14 calendar days by returning the nomination form or by calling the Agent.

If the worker does not respond within 16 calendar days (14 + two calendar days for postage), the Agent is to choose an OR provider from the list on behalf of the worker.

The Agent must keep a record of the OR provider chosen by the worker or record that the worker made no choice at this time.

Worker choice of OR provider for worker residing outside Victoria

Worker choice of OR provider also applies to OR services approved for workers residing interstate.

The Agent should contact the relevant workers compensation jurisdiction for assistance in identifying a list of OR providers who may be able to assist them.

Once an interstate OR provider is identified and agrees to deliver OR services, the Agent must advise WorkSafe's Accounts Solutions branch on (03) 8663 5098 to enable approval of the OR provider and registration on ACCtion. Without approval by WorkSafe and registration on ACCtion, the OR provider cannot be paid.

Agents must also advise the OR provider of the type of service to be provided and the appropriate fees that are payable.

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Employer has offered OR provider choice

If the Agent approves an OR service but an employer has previously offered OR choice to a worker, then the Agent must be satisfied that the OR provider meets the requirements of the legislation.

The Agent must also update the claim file and/or Novus to document that the employer has met these requirements. This may include a copy of employer correspondence to the worker offering a list of OR providers.

If the Agent is unable to confirm that an appropriate choice of OR provider has been offered by the employer, the Agent must offer the worker a choice of OR provider in writing to ensure the legislative criteria is met.

Further worker choice of OR provider after OR services commenced

Once the worker has chosen an OR provider, the same OR provider should provide OR services approved by the Agent. The exception to this is where the OR provider is not WorkSafe approved to deliver a particular OR service.

The Agent nominates three OR providers (where available) that can provide the approved OR service to the worker so the worker has a further choice of OR provider taking into account the legislative criteria.

Offer worker choice of provider

Follow these steps to offer the worker a choice of OR provider.

Step	Agent action
Offer OR providers at claim acceptance	On making a decision to accept liability on a claim registered or converted to standard time loss, the Agent must nominate a list of not less than three OR providers (where available) taking into consideration the legislative criteria. Request worker to nominate OR provider. A copy of the claim acceptance letter and populated nomination form must be retained on the claim file or in a ‘completed’ status on Novus. Note: There is no requirement that an acceptance letter contain a list of OR providers if, at the date the acceptance letter is generated and sent, a full return to work has been coded on ACCtion (ECE02) or a clearance certificate has been recorded on ACCtion (ECD01). The worker chooses an OR provider by returning the completed nomination form or by contacting the Agent by telephone. At the time of claim acceptance, the worker is not obliged to return the form but the Agent must retain a copy of the nomination form if it is returned by the worker.
Offer of OR provider at time service approved	The decision to approve an OR service is confirmed by the Agent adding the Occupational Rehabilitation process on Novus. The Agent checks the claim file for any evidence that OR provider choice was previously offered such as: a completed ‘Worker Choice of Occupational Rehabilitation Provider’ nomination form has been returned by the worker any record of worker contact confirming choice. The Agent also checks that any list of OR providers previously given (usually at the time of claim acceptance) remains relevant taking into account: the criteria in the legislation the type of OR service approved (eg OES or NES) when the previous list of OR providers was offered (eg is it current?) any change in circumstances (eg to the worker’s injury type or where the worker resides). AC s99AB WIRC s230 The Agent completes the OR Service Details eform and answers the question, ‘Has an Occupational Rehabilitation (OR) Provider been chosen?’ The Agent answers the question as follows: Yes If the list of OR providers previously nominated is still appropriate and there is evidence that the worker has selected an OR provider. No If the list of OR providers previously nominated is inappropriate at this time or there is no evidence that the worker has selected an OR provider. The Agent adds a comment about why any prior OR provider choice is now inappropriate, for example, ‘The previously selected OR provider is not approved to deliver NES’.
Confirm worker choice of OR provider	The worker has 14 calendar days from the date of the ORP4 standard letter to complete and return the ‘Worker Choice of Occupational Rehabilitation Provider – Services Approved’ nomination form. Alternatively, the worker’s choice of OR provider can be confirmed by the worker contacting the Agent by telephone (or vice versa). The Agent retains a file copy of any nomination form returned by the worker. If the worker’s choice of OR provider is confirmed by telephone the Agent makes a record of this conversation. If the worker has not responded to a list of OR providers within 16 calendar days (two days allowed for postage), then the Agent records whether the worker has chosen an OR provider and if not, chooses an OR provider from the list on the worker’s behalf.
Commence OR service

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