2.6.4 Community integration program Review, approve & transfer claims | Eligibility criteria for CIP | Organisational structure CIP | Manage a CIP claim

Workers who are eligible are managed under the Community Integration Program and are managed jointly by the TAC Transport Accident Commission and the Agent.

The program capitalises on the TAC’s expertise in delivering lifetime support services with a focus on improved community integration, whilst maintaining the strengths of Agent administration of weekly payments and premium collection.

Agent's role

The Agent identifies eligible workers and assesses eligibility for the Community Integration Program, providing a recommendation to WorkSafe.

The Agent retains responsibility for the management and administration of weekly compensation payments, common law and impairment benefits.

WorkSafe's role

WorkSafe confirms eligibility for the program and authorise the involvement of the TAC to manage the long term care service needs of eligible workers.

TAC's role

The TAC manages the Community Integration Program through their Independence Branch, using skilled support coordinators and relevant clinical resources. The TAC is responsible for the administration authorisation and payment of reasonable medical and like services in line with the legislation and WorkSafe policies.

Back to top Review, approve & transfer claims

Follow these steps to review, approve and transfer a Community Integration Program claim.

Step Agent action
Potential CIP claim identified

A CIP claim may be identified by WorkSafe or by the Agent.

WorkSafe expects Agents to identify workers who may be eligible for the CIP at the time of initial assessment. Identify workers with the following:

  • an ABI rated as severe or
  • moderately severe or a spinal injury resulting in quadriplegia or paraplegia.

This should be indicated on the initial assessment form.

Upon identification of a worker who may be eligible for the CIP, review the claim with a suitably qualified person (injury management) and contact the WorkSafe CIP Program Lead to discuss further.

The CIP Program Lead will determine if additional information is required or if the Agent can proceed with completing the ‘Community Integration Program Claim Review Summary Form’. If requested, the forms must be completed within five days of the request.

See: Community Integration Program Review Summary Form: Acquired Brain Injury | Community Integration Program Review Summary Form: Spinal

Discuss the worker’s medical status and prognosis with the treating team, hospital and family. However, at this stage, the Agent should only discuss the potential transfer of the claim to the CIP with WorkSafe.

WorkSafe reviews eligibility

WorkSafe must authorise the eligibility of a worker for the CIP (and transfer to the TAC). WorkSafe will review the Agent’s recommendation and documentation. WorkSafe may request additional information before making a decision.

If authorised WorkSafe will notify the Agent and the TAC to begin procedures for transfer.

If WorkSafe determines the worker does not meet the CIP criteria, the Agent continues to manage all aspects of the claim.

Agent transfers claim

WorkSafe will liaise with TAC and the Agent to determine a transfer date.

Within 2 days of being advised by WorkSafe Agent must contact the worker and to advise them of the proposed transfer date.

Before the transfer date:

  • send a letter to the worker, employer and current providers advising them of the transfer
  • send a copy of the worker’s file to the TAC
  • contact the CIP Team Manager to arrange a case conference.

The Agent will continue the management and administration of weekly compensation payments, Common Law and Impairment Benefits.

TAC starts claims management

From the agreed transfer date, the TAC will manage all medical and like aspects of the claim. The TAC reviews the claim information and updates their claims management system.

Within seven days of WorkSafe confirming the transfer of the claim, the TAC should arrange an initial meeting. This meeting should take place within 14 days of the TAC commencing management of the claim.

Back to top Eligibility criteria for CIP

Workers with the following injuries may be eligible for CIP referral.

Spinal injury resulting in quadriplegia or paraplegia
An ABI rated as severe or moderately severe

An acquired brain injury (ABI) is an injury sustained to the brain which is not hereditary, congenital, degenerative or induced by birth trauma. It is defined as an injury to the brain that occurs after birth and may be caused by trauma, illness or disease.

Agents are required to ascertain the severity of the ABI, using objectives outlined in the WorkSafe eligibility criteria that are relevant for assessment of severity. Organisational structure CIP

The Agent and the TAC will each nominate one central point of contact for the Community Integration Program (CIP).

The Agent will liaise with the designated TAC Team Manager for contact about:

  • organisational, administration and resourcing matters
  • overall cohort management – including claims transfer notification and management and employer claim review requirements
  • liaison with WorkSafe.
Coordination of individual claims

Day to day claims management, administration and case management for individual claims is coordinated between the allocated Case Manager and the TAC Support Coordinator.


Timely communication of accurate and reliable information between the Agent and the TAC is essential. In general, information relevant to the management of individual claims is made available as it comes to hand.

Share critical information or incidents immediately by telephone.

Back to top Manage a CIP claim

The management of a claim for a worker participating in CIP is as follows:


The Agent will continue to manage most aspects of the claim, including:

  • receiving Certificates of Capacity and paying weekly payments
  • common law
  • impairment benefits.

The TAC will manage the medical and rehabilitation aspects of the claim:

Healthcare and other service provider accounts for medical and like services are forwarded to the TAC Support Coordinator.

Next | Back to top