Medical Assessment of Work Capacity. The Independent Medical Examination

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3 Medical Assessment of Work Capacity The Independent Medical Examination

4 Work Safe Week 2013 For the respect of others please ensure your mobile phone is switched off or on silent. In the event of an emergency a Convention Centre team member will direct us to the nearest Evacuation Assembly Area which is under the freeway next to the South Wharf car park, or the grassed area in front of Melbourne Exhibition Centre. Please remain seated until directed to leave. Please note recording of this session is not permitted. Presentations for most seminars will be available on our website after the conclusion of Work Safe Week Later this afternoon you ll receive an inviting you to complete our evaluation. We ask you to complete this and help us to improve Work Safe Week. As a thank you, you ll go into the draw to win a $100 Coles Group and Myer gift card.

5 Medical Assessment of Work Capacity The Independent Medical Examination Dr Kevin Sleigh

6 The Independent Medical Examination (IME) 3 Key Points What are Independent Medical Examinations (IMEs)? How are they used in WorkSafe? What is the IME experience?

7 What are Independent Medical Examinations? Healthcare professionals are approved by WorkSafe to conduct IMEs Findings can be used in decisions relating to WorkSafe claims IMEs play a critical role in ensuring that Victoria s workers compensation scheme provides the right treatments and benefits to injured workers

8 What is an Independent Medical Examination for WorkSafe? Defined under Victorian Workers Compensation legislation The Authority or a self-insurer may require a worker who has made a claim for compensation to submit at reasonable intervals to an examination by an independent medical examiner provided and paid for by the Authority or self-insurer.

9 Who may perform an IME In this legislation independent medical examiner means: a medical practitioner; or a registered dentist; or a registered physiotherapist; or a registered chiropractor or a registered osteopath; or a registered psychologist who is approved by the Authority for the purposes of the section

10 Approved by the Authority and application process An Independent Medical Examiner is appointed under the legislation Must be approved by the Authority Any suitably qualified practitioner may apply to be an IME Selection criteria are published on the WorkSafe website From time to time WorkSafe undertakes active recruiting campaigns Casual applications Areas of special need

11 Selection Criteria for IME appointment Mandatory criteria Current registration with no conditions, limitations Current member of a specialist college for a minimum of 5 years A minimum of 5 years full time (or equivalent) work experience as a practitioner in his or her chosen discipline A minimum of 8 hours practice each week in the area of practice in which the IME provides specialist opinion Professional indemnity Public liability insurance Strong verbal and written skills and the ability to communicate with a wide range of professionals

12 Selection Criteria for IME appointment Highly desirable criteria Experience treating people in a compensation scheme context (including workrelated injuries and illnesses, and transport accident injuries) Relevant post graduate qualifications Commitment to advanced clinical practice demonstrated by the devotion of professional time to: > the instruction of students; or > active participation in formal special interest groups or networks; or > clinical research.

13 Appointment process WorkSafe receives written application Checks for completeness and assesses against selection criteria Appraisal of two or more submitted reports from applicant Reference checks Agreement signed and returned to WorkSafe Recommendation to Delegate of the Minister for appointment Name added to list of IMEs with Specialty and areas of special interest Agents and Self Insurers advised of addition

14 Current IMEs appointed Total Number 310 Common Specialties

15 IME Report Quality Assurance Program (QAP) Introduced in current form in 2009 All IME reports subject to review An IME is selected for review 5 reports selected randomly by WorkSafe and de-identified Sent to two peer reviewers working independently of each other Marked against published marking guide and free form comments IME Manager and Senior Medical Adviser review marks and comments and assign a category for IME i.e. Cat 1, 2A, 2B or 3 2B and 3 require improvements to reports and review in 3 months again data/assets/pdf_file/0004/8275/qap_process_final_04_nov_09.pdf

16 Organising an IME Organised by claims manager Arising from a claims case conference Recommendation from a WorkSafe Clinical Panel Medical Adviser Recommendation from an Occupational Rehabilitation provider Recommendation from an Employer Recommendation from a Panel Solicitor

17 Organising an IME reasons To answer a medical question (usually many questions) to assist with claims management : Initial liability question Work relatedness of the claimed condition Treatment questions Reasonableness and relatedness Work Capacity Questions Does the worker have a work capacity for Pre injury duties and hours Pre injury duties on reduced hours Alternative or modified duties on pre injury or reduced hours What restrictions may apply to employment

18 Organising an IME reasons In response to a request from a treater or treater action, e.g: Request for surgery or procedure Delayed RTW Regression in RTW Review of ongoing allied health services

19 The IME Experience For the: Worker RTW Co coordinator (employer) IME Treating doctor Agent WSV

20 The IME Experience Worker s responsibilities rights, and experience Must submit to the examination under the legislation Can be subject in special circumstances to review under hardship or medical provisions Generally seen as a negative experience by the worker

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22 The IME Experience- RTW Co-ordinator Act imposes a duty to consult with injured worker (CM notifies employer of intended IME) Can assist with job description etc for IME Make sure CM has most recent medical certificates for IME May receive edited parts of the report to assist in RTW

23 The IME Experience - Treating Doctor Can be seen as negative intrusion for most part by treaters Not involved Not notified No input May receive copy of report

24 The IME Experience - Agent Important claims management process Standard questions (15 max) Receives report and must review May discuss with IMA and or TECH manager or MA May send copy of report to treater May send excerpts to employer May use report as basis for terminating or reducing benefits

25 The IME Experience The IME IMEs undertake work for a variety of reasons Enjoyable work Balances the work of practice Financial HOWEVER No therapeutic relationship between IME and Client (not a patient ) Must overcome negative feelings of client to establish rapport at outset Must over explain everything being done during examination (no surprises) Area of medical practice which has highest incidence of complaints

26 The IME Experience WorkSafe Mandated under legislation Integral part of claims management Provides objective specialist medical opinion Activities and Management IME issues QAP Program Complaints process

27 The RTW IME Worksite Visit program Initiative of WorkSafe Victoria focussing on improving worker RTW outcomes Undertaken by Occupational Physicians or GPs with Occupational Medical training The IME performs a standard in rooms assessment and forms opinion regarding RTW Organises with employer to perform a worksite visit Conducts WSV with RTW Coordinator, injured worker (if available) and others By personally examining the injured worker and the worksite, facilitates RTW by negotiating specific tasks within specified restrictions and graded hours. WorkSafe Agents follow up any actions arising from IME and worksite visit

28 Outcomes from RTW IME Worksite Visit Program 1400 injured workers go through program each year 70% RTW

29 IMEs - Dispute resolution IME opinion vs. Treating GP opinion Adverse decision Avenues for dispute Internal review by agent (or WorkSafe review) Conciliation Medical Panels

30 Getting further information The Agent Claims Manager WorkSafe Victoria Website Independent Medical Examiners data/assets/pdf_file/0020/10946/ws V617-Information-for-injured-workers-Independent-medicalexaminations.pdf The IME team at WorkSafe

31 Any Questions

32 Work Safe Week 2013 Don t forget the evaluation form that you will receive via . We ask you to complete this and help us to improve Work Safe Week. As a thank you, you ll go into the draw to win a $100 Coles Group and Myer gift card.

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