5.5.4 Not OR services
WorkSafe will only pay approved OR Occupational Rehabilitation services provided direct to the worker. OR providers may not seek payment for a worker’s non-attendance or cancellation of an appointment.
A Household Help (OT Occupational therapy is a client-centred health profession concerned with promoting health and well being through occupation. The primary goal of occupational therapy is to enable people to participate in the activities of everyday life. Occupational therapists achieve this outcome by working with people and communities to enhance their ability to engage in the occupations they want to, need to or are expected to do or by modifying the occupation or the environment to better support their occupational engagement .) assessment is not an approved OR service.
See: Household help
Employer obligations for RTW
The legislation obliges an employer, for the duration of the employment obligation period, to plan the worker’s return to work and provide suitable or pre-injury employment (1) In this Part — pre-injury employment means the employment of a worker in a position which is the same as or equivalent to the position in which the worker was employed before receiving the injury consistent with the worker’s capacity for work.
Planning a return to work includes obtaining information about the worker’s work capacity, assessing and proposing suitable employment, consulting with the worker and their THP Treating Health Practitioner and providing the worker with clear, accurate and current details of the RTW Return to Work arrangements. This must occur as often as is necessary considering the worker’s capacity for work.
OR services provided as part of an employer’s excess
An employer may pay for Agent approved OR services and claim the payment as part of their employer excess if liability for the worker’s claim is accepted.
Employers using information from an OR provider report to meet their RTW obligations
An employer may use information obtained from an OR provider report (such as OES Original Employer Services Work Report Annex B which identifies duties and tasks that the worker could perform) to assist them to meet their RTW obligations for planning a return to work and providing the worker with suitable or pre-injury employment consistent with their capacity for work.
Using an OR provider report for this purpose does not remove or change the employer’s obligations.
RTW planning and providing suitable or pre-injury employment
WorkSafe has templates to assist employers plan a worker’s return to work and to assess and propose suitable employment.
While it’s not mandatory that an employer use a form to document RTW planning and arrangements, most employers find it is very helpful to do so.
Alternatively, an employer may use their own method of documenting their planning activity, suitable duties If during the period in which an employer has an obligation to provide employment to an injured worker, the worker has a demonstrated current work capacity, the employer is required to provide the worker suitable employment (suitable duties). Refer to definition of suitable employment also. and RTW arrangements but they will need to ensure the information contained adequately fulfils their RTW obligations to provide the worker with clear, accurate and current details of the worker’s RTW arrangements.
In-house employer assistance
Some employers provide ‘in-house’ assistance to workers before or after a claim is made. Although the employer may sometimes refer to this assistance as ‘RTW services’, this should not be confused with WorkSafe approved OR services for workers under the legislation.
In-house assistance services are an employer responsibility and costs cannot be paid as a claim or OR service cost, even though in some cases the employer may have engaged an organisation that is also a WorkSafe approved OR provider to provide these services.
An organisation who is a WorkSafe approved OR provider is not precluded from supporting an employer meet their RTW obligations for a worker but they cannot also provide OR services under the legislation to the same worker.
Outsourced RTW coordinator role
Activities associated with the functions of a RTW coordinator are an employer responsibility and any costs associated with this role cannot be paid as a claim or OR service cost even though in some cases the employer may have engaged an organisation that is also a WorkSafe approved OR provider to provide these services.
An organisation who is a WorkSafe approved OR provider is not precluded from supporting an employer to meet their RTW coordinator obligations under the legislation but where they act for the employer in that role the organisation cannot provide OR services for workers of that employer under the legislation.
OR providers engaged by an employer must avoid conflict of interest
An organisation providing services such as ‘in-house’ or RTW coordinator assistance to the employer that is also an approved WorkSafe OR provider must avoid any situation which may constitute a ‘conflict of interest’.
WorkSafe’s agreement with an OR provider requires a provider’s declaration of any real or perceived conflict of interest.
It would be considered to be a conflict of interest, for example, if the OR provider assisted or acted as an employer’s RTW coordinator to meet the employer’s RTW obligations then sought to provide OR services to the same worker under the legislation.
If the Agent or the OR provider has a query about conflict of interest, they can contact WorkSafe via occupational_rehab@worksafe.vic.gov.au.