Column 1
What does ADL stand for?
Activities of Daily Living
How many days do we have to investigate a (Recurrence) RRR?
21 days
What does RRR mean?
Re-activation
Recurrence
Re-open
How long can ADL support be approved for on a claim?
Under the workers compensation scheme we can approve up to 12 weeks or 72 hours (6hours per week for 12 weeks) of Domestic Assistance. If you are to approve MORE than this then the IW will have to obtain a WPI of at least 15%.
Name three types of investigations and explain what this involves?
Factual Investigation
Desktop Surveillance
Independent Medical Examination
IPC/IMC
What are the seven (7) reasonable excuse reasons?
• Insufficient Medical Information
• Unable to contact worker
• Injury person is unlikely to be a worker
• The worker refuses access to information
• The injury is not work related
• There is no requirement for weekly payments
• The injury was notified after two months
How many days does an insurer have to approve medical treatment?
21 days
How much can an IW claim for travel per km?
58 cents per km
Name two (2) forms of psychological treatment
EMDR - Eye Movement Desensitization and Reprocessing
CBT - Cognitive Behaviour Therapy
TMS - Transcranial Magnetic Stimulatio
DBT - Dialectical Behavior Therapy
What does MSP stand for and what is their role?
Medical Support Panel.
MSP provides independent clinical guidance and expert advice to support informed decision‑making in complex or prolonged injury management cases.
When does S38 for weekly benefits apply?
Worker has some capacity for work however suitable duties are NOT available (not working)
Under the delegation framework who needs to sign off on desktop surveillance?
A Senior Manager is required to sign off
Can an IW claim for meals when attending an IME? If so, how much?
Yes.
Name two (2) types of Early Intervention
Active Recovery Clinic (ARC)
RECON
Encompass
Mediation
Independent Psychological Assessment (IPA)
How many days do we have to review an Application for Review (AFR)
14 days (2 weeks)
When does section 11a apply?
Section 11A: If a psychological injury is/was wholly or predominantly caused by reasonable action taken or proposed to be taken by or on behalf of the employer with respect to transfer, demotion, promotion, performance appraisal, discipline, retrenchment or dismissal of workers or provision of employment benefits to workers.
What does each colour represent in the My Portfolio Category?
Green - Low Touch, on track
Orange - High Touch claims
Red - Declined/ Litigated Claims
Blue - Medical Retirement/Segment Transfer
What does GST & ITC stand for?
Good Services Tax (GST) & Input Tax Credit (ITC)
When is EM engaged ticked?
EM Engaged box is checked where EML have arranged the service and there is appropriate documentation supporting that we have requested it
When can a claim go to RIS?
Medical Retirement
Resignation
Termination
Redundancy
What section of the WCA 1987 does domestic assistance fall under?
Section 60AA
What is the process for non-compliance for IMEs (Section 119)
Initial Check: Confirm if the Worker missed their IME appointment and ask for any legitimate reasons for non-attendance.
Reschedule IME: The IME appointment should be rescheduled promptly, allowing at least 10 business days’ notice unless the worker agrees to a shorter timeframe.
Issue Warning: Send a Suspension Warning Notice (W602), specifying the new IME appointment details and any other obligations.
Follow-Up on Second Missed Appointment: If the Worker misses the second IME appointment, ask again for a reason. If no valid reason is given, proceed to draft a Warning to suspend - TMF Exempt W 484 for Technical Specialist or Team Leader review.
Suspend Payments: Payments are discontinued from the date of non-attendance until the Worker attends the required IME appointment.
Name 3 items in a S126 that cannot be released
Surveillance
Legal Advice
Legally priviledged documents e.g legal correspondence
Factual Investigations - If we have not relied on it in a S74/78 notice
Gain assistance for High Risk Protocol (HRP)
- Raise Blue Card (WFO) or message via teams (WFH)
- Notify IWs name/CN with team
- Verify and repeat nature of threat
- Provide customer with next steps (e.g contacting treatment team or notifying emergency services)
- End call with a committment to follow up
- Contact appropriate services & report incident on Alert
What is the maximum amount payable for damage that can be offered to an IW for damaged clothing?
The maximum amount payable for damage to clothing is $600