5.5.1 OR services | 5.5.2 Cost of OR services | 5.5.3 Agent prior approval of OR services | 5.5.4 Not OR services | 5.5.5 OR services on pending or rejected claims | 5.5.6 Other OR services approved by WorkSafe | 5.5.7 Worker choice of OR provider | 5.5.8 DES-DMS (formerly DEEWR)
Who approves OR services
The Agent approves OR services for a worker except where an employer has provided OR services in discharge of their employer excess for medical and like services under the legislation.
OR services require prior approval from the Agent before the service is provided.
The OR service will be approved for the worker as a result of their work-related An injury/disease is work related if it arose out of or in the course of employment and the scope of employment. injury, be reasonable and necessary in the circumstances and the costs of those services must be reasonable.
Who can request OR services
Prior Agent approval applies regardless of who requests the OR service for the worker. A request for an OR service may be made by the worker or the worker’s representative or their THP Treating Health Practitioner or the injury employer. New employers may even request an OR service if the worker has returned to work with a new employer.
The Agent must inform the worker in writing why an OR service has not been approved and include the reasons for that decision and appeal rights.
Approved OR providers
An OR provider is an independent expert who is expected to revise and amend their activities in response to changes in the worker’s RTW circumstances.
The types of OR provider activities may include to actively engaging with and updating the worker, the worker’s THP, the injury or new employer and the Agent to create a common understanding about the return to work process or any actual or perceived barriers to return to work and the expected time it will take for a return to work to be achieved.
Only OR providers approved by WorkSafe may deliver OR services. OR providers are individually approved to deliver Original Employer Services (OES Original Employer Services), and/or New Employer Services (NES New Employer Services), and/or mental injury services (including Facilitated Discussion and Support Pathway Contact services).
Worker choice of OR provider
Workers are entitled to receive an OR service from an approved OR provider of their choice.
OR services on pending claims
The Agent may pay the reasonable costs of an OR service before a worker’s entitlement to compensation being determined. OR services should cease 14 calendar days after liability is rejected or the worker’s entitlement to medical and like services has ended.
The legislation allows a worker to be represented, assisted and supported in the RTW process. A worker representative cannot include a legal practitioner Legal practitioner means an Australian legal practitioner within the meaning of the Legal Profession Act 2004. A worker may request their representative be involved in meetings with or arranged by the Agent or the OR provider or the worker’s THP. Reports or information prepared by the OR provider for a worker should be provided to the worker representative.
A worker may verbally advise the Agent and the OR provider that a person is acting as their worker representative. On being made aware of a worker representative, the Agent and the OR provider should liaise with them when scheduling any meetings with the worker so the representative can be present.
Worker privacy considerations
The Agent and the OR provider must only communicate information that is relevant to the provision of OR services ensuring a worker’s privacy is maintained. Similarly information collected about other parties in the workplace or outside the workplace must be afforded the same considerations and protections.
Use of information consent forms
OR providers should inform workers that they will deliver the OR service consistent with the Privacy & Data Protection Act 2014 and Health Records Act 2001. If any worker has concerns about OR providers collecting or disclosing personal information in the process of delivering the OR service, these concerns should be referred to the relevant WorkSafe Agent.