Furthermore, this policy outlines the process in which a worker is able to make a claim for workers compensation.

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1 WS013 REHABILITATION AND RETURN TO WORK POLICY VICTORIA Purpose EI is committed to the rehabilitation of workers who are injured at work. This policy is designed to comply with EI obligation to make important return to work information available to workers. Particularly, this policy will outline a) The obligations of EI under part VIIB of the Act and how the employer is meeting the obligations; b) The rights and obligations of workers under par VIIB of the Act and how workers can obtain further information about their rights and obligations; c) The name and contact details of the Work safe Scheme agent selected by EI; d) The name and contact details of the Return to Work Coordinator, and; e) The procedure for resolving return to work issues in the workplace. Furthermore, this policy outlines the process in which a worker is able to make a claim for workers compensation. Scope This policy applies to all workers of EI who are engaged to work on a client worksite and is to be used when a worker believes they have genuinely sustained a workplace injury. For the purpose of this policy, a worker is a person who is covered under an existing workers compensation policy of EI. A workplace injury is a medical condition or injury, which has resulted from an incident related to work. Work related incidents could be a one off event, or a series of events, which occur over a period of time and are directly related to the workers employment. This policy may also apply to workers who believe they have aggravated a pre-existing condition or injury as a result of a work related incident. This policy is not to be used in circumstances where a worker has sustained an injury or aggravated a pre -existing condition in an incident unrelated to the workplace. Any such condition, injury or aggravation will be managed directly between the worker, the relevant Human Resource Business Partner and worksite manager/supervisor in line with the workers legislative entitlement to personal/carers leave. If a worker is unsure as to whether a condition/injury or an aggravation of a pre -existing condition / injury is attributable to a workplace incident, they are able to seek a medical opinion for clarification and/or commence to lodge a workers compensation claim in line with this policy. Should it be determined that the condition, injury or aggravation is not attributable to work, management of the workers return to work will refer back to the relevant Human Resource Business Partner and be managed under the employees legislative entitlement to personal/carers leave. References EI will comply with the relevant jurisdictional work safe legislation and regulations, the Fair Work Act and other relevant legislation and industry standards. EI acknowledges this policy was prepared with reference to Codes of Practice and guides prepared by relevant state safe work authorities. To the extent this policy describes benefits and entitlements; these are discretionary in nature and are not intended to Issue Date: 01/12/2014 Reference: WS013 Rehabilitation and Return to Work Policy VIC Page 1 of 8

2 be contractual or binding on EI. If the policy specifies an entitlement granted under federal or state legislation, then this entitlement arises from this legislation and not EI and as such may change from time to time following relevant legislative amendments. This procedure does not form part of a workers contract of employment, however failure to comply with the procedure may lead to disciplinary action up to and including the termination of employment and/or other legal action. This policy may be amended from time to time at the discretion of EI. Return to Work Coordinators EI s Return to Work Coordinator s (RTWC s) hold the day to day responsibility in the implementation of EI s injury management system and play a pivotal role in the successful return to work of injured employees. EI has appointed the following people to this role who can all be reached on the VIC office mainline. NAME: Anna Makin Phone: RTWC s will work with the injured employee, worksite supervisors and/or managers, treating medical practitioner medical experts, vocational rehabilitation providers and insurers to coordinate and monitor rehabilitation in the workplace. Work safe Scheme Agent EI has engaged CGU to act as our Workers Compensation Insurer (Scheme Agent). To lodge a claim for workers compensation, workers are advised to follow the defined procedure below. However for all other enquiries EI s scheme agent is able to be contacted using the following details. WEBSITE: PHONE: POSTAL ADDRESS: GPO Box 2090S, Melbourne VIC Incident / Injury Reporting An incident is any event at work, which did, or had the potential to, cause injury. Employees are required to report incidents to their worksite supervisor/manager within 24hours of the incident occurring. Your worksite supervisor/manager is responsible for then notifying EI of an incident taking place. You are also able to inform EI directly of an incident occurring through the use of EI s Accident/Incident Report F orm. Completed report forms can be faxed or ed to EI on; FAX: (02) For urgent notifications, workers and/or worksite managers should call EI on the mainline and speak Issue Date: 01/12/2014 Reference: WS013 Rehabilitation and Return to Work Policy VIC Page 2 of 8

3 with any HR representative, who will note the necessary information and advise the appropriate people. What will EI do upon receipt of an Injury Report? Upon receipt of an incident report, one of EI s RTWC s will make contact with the injured employee. The RTWC will consult with the employee to determine the underlying causes of the incident. This information will then be used in order to allow EI to consult with the client supervisors/managers in order to implement control measures, which aim to prevent a similar incident causing injury again. The RTWC will also assist an employee lodge a claim for workers compensation should the employee incur any medical costs and/or lost time due to the incident. How to lodge a claim for Workers Compensation If you believe you have sustained an injury due to a work related incident, you are entitled to lodge a claim for workers compensation. As soon as possible after sustaining the injury see a doctor of your choice and request they complete a Certificate of Capacity. You must then complete a Workers Compensation Claim Form. If you are having difficulty completing the form, in the first instance you should contact one of EI s workplace rehabilitation coordinators. If you are still having difficulty you are also able to contact the Work Safe Advisory service on (03) , or You should then send the Certificate of Capacity and the completed Workers Compensation Claim form to one o f EI s workplace rehabilitation coordinators. EI will lodge these forms with our workers compensation insurer within 10 days of receiving the documentation. Within 28 days of EI lodging the claim, our workers compensation insurer will make contact with yo u and notify you in writing if the claim as been: 1. Accepted; Upon acceptance of a claim, EI will commence making weekly compensation payments if you are incapacitated for work. Further information on payments can be found later in this policy. 2. Denied; In some instances your claim for compensation may not be accepted by EIs workers compensation insurer. The reasons for this decision will be communicated to the injured working in writing by EI's workers compensation insurer. If you are unhappy with the decision, you have a right to appeal. Further information on appeals can be found in the disputes section of this policy. 3. Require Further Information. In some instances, EI s workers compensation insurer may not be able to immediately determine liability w ith the information provided by the injured worker and EI. In such instances EIs workers compensation insurer may appoint a Circumstance Investigator to collect further information on their behalf in order to allow them to make a decision. EI s Workers Compensation Insurer may also send an injured worker to be independently assessed by a medical professional. EI will cooperate in full with circumstance investigators and independent medical professionals as part of the determination process and it is expected injured workers do the same. Disputes Issue Date: 01/12/2014 Reference: WS013 Rehabilitation and Return to Work Policy VIC Page 3 of 8

4 If an injured worker is unhappy with a decision made by EI s Workers Compensation Insurer, it is advised that they seek further information from EI's workers compensation insurer or EI. They are also able to co ntact the WorkSafe Advisory Service (contact details below) for free information and advice. Should the injured worker wish to have the claim formally reviewed they must first ask EI's workers compensation insurer to conduct a review. An internal review will be conducted by a senior member of staff from EI's workers compensation insurer who was not involved in the initial liability decision. If the injured worker is still not happy with the decision, they are able to refer the matter to the Accident Compensation Conciliation Service (ACCS). While the matter is being heard by the ACCS an injured worker is able to contact Workcover Assist for information and advice on the dispute process. Contact details for Workcover Assist and the ACCS are below. WorkSafe Advisory Service Phone: (03) or Accident Compensation Conciliation Service Phone: or WorkCover Assist Phone: (03) Rehabilitation 1. Medical Certificates of Capacity An injured workers treating doctor must provide a Certificate of Capacity in order for a claim for workers compensation to be lodged. Certificates of Capacity are an important part of managing an injured employees return to work as they set the workers capacity for work, required medical treatment and review progress on a regular basis. The first certificate of capacity issued after an injury is valid for a maximum period of14 days with subsequent certificates valid for up to 28 days. To be considered valid, certificates of capacity must also be signed by the injured worker and their treating doctor. Certificates of Capacity must be provided by a treating doctor until an injured worker has fully recovered from their work related injury. 2. Payments For employees who have had a claim for workers compensation accepted, they will be entitled to payment for lost time and reasonable medical expenses. EI will start making paying workers compensation during the first pay run Issue Date: 01/12/2014 Reference: WS013 Rehabilitation and Return to Work Policy VIC Page 4 of 8

5 after liability has been accepted. Weekly entitlements for compensation are paid in accordance with applicable industri al instruments and are based on the injured workers average weekly wage for the 52 week period prior to them having sustained the injury (known as PIAWE). An employee s entire service will be used to calculate average weekly wages if they have been employed for a period less than 12 months. An employee s weekly entitlement for compensation will be paid to an employee in line with their usual pay cycle. EI will only process payment for weekly entitlements if: The claim has been accepted in full by our Workers Compensation Insurer, and; A valid and current certificate of capacity has been presented. Should the employee be totally incapacitated for work, EI is responsible to pay for the first 10 days of lost time (based off a workers usual roster) after the injury has occurred. Thereafter, an employee who is totally incapacitated is entitled to the following; 0 13 Weeks following the injury: 95 % of the injured workers PIAWE to a maximum of twice the Victorian average weekly earnings; Weeks following the injury: 80% of the injured workers PIAWE to a maximum rate of twice the Victorian average weekly earnings. After 130 Weeks: As advised by EI Workers Compensation Insurer. If an injured employee has some form of capacity to work, and are working on modified or restrictive duties they will be entitled to; 0 13 Weeks following the injury: 95% PIAWE less the amount an employee has earned as wages while working on modified/ restrictive duties (known as CWE) to a maximum rate of twice the Victorian aver age weekly earnings; Weeks following the injury: 95% PIAWE less 80% CWE to a maximum rate of twice the Victorian average weekly earnings; After 130 Weeks: As advised by EI Workers Compensation Insurer. Reasonable medical expenses are also able to be claimed if a claim for workers compensation has been accepted. Such expenses can include expenses incurred through GP, physio, medicine and other treatment providers. EI s workers compensation insurer will only pay amounts up to the approved cost of t reatment outlined by Worksafe Victoria. A detailed list of approved costs can be found on the Work Safe Victoria website. If an injured worker seeks treatment which is greater than the approved cost, they may need to pay the difference as a gap. Some services that an injured worker may need are required to be pre-approved by EI s workers compensation insurer. 3. Return to Work Programs; A return to work program (RTWP) will be developed by one of EI RTWCs when: A treating doctor indicates to EI in writing, that an RTWP is required, or; When EI receives a certificate of capacity stating an injured employee has regained some capacity for work. Issue Date: 01/12/2014 Reference: WS013 Rehabilitation and Return to Work Policy VIC Page 5 of 8

6 RTWP s will be developed based on the advice of the employees treating medical practitioner and in consultatio n with the employee. In some situations, EIs RTWCs may outsource this function to an accredited workplace rehabilitation provider. An example of a situation where an accredited Rehabilitation provider may be used is where an onsite assessment is required to identify available suitable duties. RTWP s will be reviewed in line with progress certificates of capacity and/or on the advice of the employees treating medical practitioner. Should a worker not comply with an agreed RTWP, EI s Workers Compensation Insurer may issue the injured worker a formal warning or suspend the injured workers entitlement. EI s Return to Work Obligations EI s Obligations Make return to work information available and consult about how the information is made available. Provide Employment. How EI will meet its obligations EI will make return to work information available to its workers through this policy. This policy will be available to workers to access through their online dashboard. To the extent that it is reasonable to do so, EI will provide suitable employment to an injured worker if they have a current work capacity. Where an injured worker no longer has incapacity, EI will provide preinjury employment. To the extent that it is reasonable to do so, EI will provide pre-injury or suitable employment to an injured worker for a period of 52 weeks of the workers incapacity. This will commence from the date a WorkSafe Certificate of Capacity or a Workers Injury Claim Form in which weekly payments are claimed is received from the worker or from when the WorkSafe Agent notifies us of receipt of same (whichever is the earliest). Plan return to work EI will, to the extent that is reasonable to do so, commence return to work planning for an injured worker from the time that EI receive either: a) Workers Injury Claim Form in which weekly payments are claimed; b) Worksafe Certificate of Capacity; c) Notification from the Worksafe Scheme agent that they are in receipt of the same. As part of that planning, EI will; a) Obtain relevant information about the injured workers capacity for work; b) Consider reasonable workplace support, aids or modifications to assist the workers return to work; c) Assess and propose options for suitable employment or preinjury employment; d) Engage in consultation about the return to work of the worker; and Issue Date: 01/12/2014 Reference: WS013 Rehabilitation and Return to Work Policy VIC Page 6 of 8

7 e) Monitor the workers progress. Consult about the return to work of a injured worker. EI will, to the extent that it is reasonable to do so, consult with the injured worker, the injured worker s health practitioner and where involved the occupational rehabilitation provider in relation to the injured workers return to work. EI will consult with the parties listed above by: a) Sharing information about the workers return to work; b) Providing a reasonable opportunity for them to consider and express their views about the worker s return to work, and c) Take those views into account. EI will consult directly with the injured worker about their return to work. The injured worker is able may be assisted by a representative during any consultation (except for a legal practitioner). The injured worker may be represented, assisted and supported during the return to work process. Nominate and appoint a Return to Work Coordinator. Resolution of return to work issues. As a large employer, EI will at all times have a Return to Work Coordinator nominated and appointed. The Return to Work Coordinator will have an appropriate level of seniority and will be competent to assist EI meet our Return to Work Obligations under part VIIB of the Act. EI will attempt to resolve issues surrounding an injured workers return to work in accordance with the procedure specified in the Return to Work Direction No (Ministerial Direction) (The Return to Work Issue Resolution Procedure). The direction is able to be found on the worksafe victoria website: under forms and publications. Injured Workers Return to Work Obligations An injured workers primary obligation is to participate and cooperate in planning for their return to work. An injured worker is able to do this by: a) Making reasonable efforts to return to work in suitable or pre-injury employment at their place of employment or at another place of employment; b) Actively use and cooperate with an occupational rehabilitation service where provided; c) Actively participate and cooperate in assessment s of their work capacity, rehabilitation and/or future employment prospects at the request of EI or EI s Worksafe Scheme agent; d) If required, actively participate and cooperate with the representative of EI s Worksafe Scheme Agent in an interview to enhance their opportunities to return to work; e) To attempt to resolve the issue in accordance with the procedure for resolving return to work issues. Issue Date: 01/12/2014 Reference: WS013 Rehabilitation and Return to Work Policy VIC Page 7 of 8

8 If an injured worker does not comply with one or more of the above obligations, the workers weekly payments may be suspended or terminated in accordance with the Act by our agent. Additional details regarding the rights and obligations of an injured worker are available in WorkSafe s Return to Work Obligations Information for workers face sheet available from the worksafe victoria website. Injured Workers Rights An injured workers rights are: a) to be provided with return to work information and be consulted about how that information is to be made available; b) to the extent that it is reasonable for EI to do so, to be provided with suitable employment if they have a current work capacity or pre-injury employment if they no longer have an incapacity for work for a period of 52 weeks in accordance with the act; c) to be consulted by EI about planning their return to work; d) to be provided with clear, accurate and current details of their return to work arrangements as part of planning for their return to work; e) to the extent that it is reasonable for EI to do so, to be consulted and be provided with information about their return to work. The injured worker must be given a reasonable opportunity to consider and express their views about their return to work and have those views taken into account; f) to be represented, assisted and supported (except by a legal practitioner) during any stage of return to work process, including in the consultation process. About this policy Related Policies N/A Approved By: Compliance and Risk Manager Authorised By: General Manager Contact VIC Return to Work Coordinator Issue Date: 01/12/2014 Reference: WS013 Rehabilitation and Return to Work Policy VIC Page 8 of 8

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