NES commencement is taken to be from the date of first appointment with the worker, rather than from date of referral.
Where a worker fails to attend the scheduled appointment, the OR provider should inform the Agent immediately of the non-attendance and provide a copy of all written correspondence to reschedule the appointment.
The New Employer Services available, dependent on the worker’s current work capacity Under the legislation, unless inconsistent with the context or subject-matter — current work capacity, in relation to a worker, means a present inability arising from an injury such that the worker is not able to return to his or her pre-injury employment but is able to return to work in suitable employment, declared training program are:
- Capacity Support Service (CSS)
- Job Seeking Service (JSS)
- Ongoing Job Seeking Reviews (JSR)
- Transferable Skills Analysis (TSA)
When the Agent approves any New Employer Services they will:
- add the Novus Occupational Rehabilitation process. Complete the requirements of Worker Choice of OR provider using the supporting Novus tasks and eform/s.
See: Worker choice of OR provider
- once the OR provider has been selected, send standard letter ORP6 Commencement Letter 'New Employer Services - Worker' to the worker, their THP Treating Health Practitioner and injury employer
- fax/email a completed OR Approval form to the OR provider chosen by the worker, highlighting the specific service and enclosing a copy of relevant medical information related to the worker’s CWC Current Work Capacity, including any work restrictions.
Workers may be referred to this service if they have a capacity for employment based on current IME Independent Medical Examiner / Independent Medical Examination opinion but are certified with no capacity for employment.
CSS is a six week service with the purpose of engaging treaters to support the worker in being able to return to work. The OR provider structures the CSS to customise it to the individual needs of the worker.
A CSS report by way of a Transferable Skills Analysis (TSA) is the output of this service.
GP RTW Return to Work Case Conferences are a feature of the service and do not require Agent approval. OR providers should advise Agents when this service will be undertaken to avoid duplication. It is important to note that a CSS referral is not appropriate and should not proceed when surgery is imminent or a surgical opinion is being sought.
Referring to JSS without CSS:
CSS must be completed before JSS where a worker is certified with no capacity for employment. JSS can only be referred to without completing CSS where:
- the worker has an certified capacity for employment, or
- the worker has an IME capacity and the GP has confirmed that the worker is likely to have a capacity for employment in the near future.
After referring for CSS:
- the OR provider can invoice RC814 for the commencement of the service
- the OR provider can forward RC277 (max of two hours) to arrange, attend and complete an action plan for a GP RTW Case Conference
- the Agent must ensure that a CSS report is received no later than 10 days from completion of the six week CSS period
- the OR provider can invoice RC815 at completion of the service
- the OR provider can also invoice commencement of Job Seeking Service (JSS) RC811 when criteria for automatically commencing JSS are met
- CSS report, invoice for RC815 and invoice for RC811 can be submitted at same time for ease.
Outcomes of CSS
- Where worker has not returned to work and has certified capacity for employment:
The OR provider can commence JSS automatically without prior Agent approval.
- Where the worker has not returned to work and does not have a certified capacity for employment:
By the end of week five of CSS, if the worker remains unfit but an IME has indicated CWC or potential CWC, the OR provider must discuss commencement of JSS with the Agent and GP to ensure JSS is appropriate.
- Where return to work has been achieved:
If a return to work is achieved during CSS, the OR provider will submit a RC889 Placement Report and a RC810 Workplace Report (if required) with an invoice. The Agent will:
review the reports to determine if the reports are complete and pay for the reports
- create and complete Novus Task ‘NES Placement Report’ and ‘NES Workplace Assessment Report’
- send letter NES6 ‘NES RTW Achieved’ to the worker and their THP within one working day
- pay incentive when sustainability period met and invoice for incentive received. Incentives payable for sustained capacity changes as well as RTW.
Note: Where the certifying practitioner towards the end of CSS indicates a change in capacity will be reflected in the next certificate, however this certificate is not received until after JSS commences, the sustainability period will be backdated to commence from the commencement of JSS. This will avoid confusion as to when the incentive will be payable.
If a worker obtains a CWC during CSS and secures a job during CSS the capacity change incentive can be sent at the same time as the placement report acknowledging that the full 12 weeks of JSS is unlikely to be completed.