LESLEY MORRISON General Manager Recovery and Support, Comcare

Transcription

1 LESLEY MORRISON General Manager Recovery and Support, Comcare 1

2 Comcare Update SRC Act, Comcare and Seacare Reviews underway New Deputy CEO, Ms Cathy Skippington commenced New Service Delivery Directors Canberra and Melbourne commenced S41 Guidelines implemented Revised psychological treatment policy introduced in September

3 Premium Point Plan activities commenced with a focus on : Long tail claims reviews Employer/Comcare agreed activities Early identification of complex claims Continued development of clinical policy Rehabilitation systems audits and prevention campaigns..so what are we seeing? 3

4 Claims per 1000 FTE employees Total Cost ($M) Claims incidence rate by injury / disease (premium payers) M to 30 Sep 2012 Injury Disease Disease Injury

5 Number of Accepted claims at month 22 Progressive Incapacity costs at month 22 ($M) Cost of incapacity for work Number of claims versus cost of incapacity (premium payers) No of claims Incapacity 5

6 Claims Lodgement Data Two key timeliness KPI s: > Days from received by employer to Comcare Measure M to Sep-12 # Claims 4,179 3,974 3,856 4,005 3,948 # Claims lodged within timeframe 1,989 1,876 1,794 1,948 1,857 KPI 47.6% 47.2% 46.5% 48.6% 47.0% Median days - DOI to Employer Received Date > Days from received by Comcare to initial decision Measure M to Sep-12 # Claims Determined 10,709 10,346 10,459 9,488 8,891 # Det. within timeframe 8,381 7,823 7,971 7,948 7,201 KPI 78.3% 75.6% 76.2% 83.8% 81.0% 6

7 Claims Continuance Rate Data Two key KPI s: > Claims Continuance Rate 13 weeks Measure M to Sep-12 # Claims (4 Weeks) ,064 1,124 1,115 # Claims (13 Weeks) KPI 46.2% 48.8% 52.2% 52.1% 52.1% > Days from received by Comcare to initial decision Measure M to Sep-12 # Claims (4 Weeks) ,080 1,151 1,175 # Claims (26 Weeks) KPI 24.8% 31.0% 29.9% 31.7% 31.6% 7

8 Per Cent Claims per 1000 FTE employees Accepted mental stress claims One week or more lost time Premium Payers SRCOLA Act amendments % % 18.4% 15.4% 19.0% 19.5% 19.3% M to 30 Sep 12 Year accepted claim reached one week incapacity 0.0 Percentage of total claims with one week or more lost time Incidence rate 8

9 Average total claim cost* $('000) Average total cost of mental stress claims Premium Payers / / / / /2012 Mental Stress All claims (excl. mental stress) 9

10 The current picture of Mental Stress In , 11% of accepted claims were attributed to Mental stress which made up 32% of total costs. Mechanism of incident % of all accepted claims % of total claim costs* Average total cost per claim ($) Body stressing 45% 39% 76,470 Falls, trips & slips 23% 15% 56,975 Mental stress 11% 32% 250,690 Hit by moving objects 8% 5% 54,920 Vehicle incidents and other 4% 2% 39,948 Hitting objects with the body 3% 3% 86,090 Chemicals and other substances 3% 1% 44,932 Sound and pressure 1% 2% 109,319 Heat, radiation and electricity 1% Less than 1% 17,764 Biological factors Less than 1% Less than 1% 87,795 All mechanisms of incident 100% 100% 87,438 10

11 Workplace Bullying & Harassment and Work Pressure In : 44% of accepted mental stress claims were due to work related harassment and/or workplace bullying 35% of accepted mental stress claims were due to work pressure 11

12 Rehabilitation Management System New section 41 guidelines were released in July 2012 Rehabilitation Management Systems Audits 30 June Rehabilitation Management systems fully implemented Audit tool and work book available at: 12

13 Survey Research Program Injured workers Work Health & Safety Managers Managers of Workers Compensation, Rehabilitation & Injury Management Health & Safety Representatives Claims / Case Managers Comcare Claims Service Officers 13

14 Survey Information Can Help Other Information Injured Workers OHS Managers Rehab Managers HSRs CSOs Claims Managers Other Information Recovery & Support Work Heath & Safety Improved Recovery Improved Safety 14

15 Work Status of Respondents 60% 55% 50% 40% 30% 20% 19% 15% 10% 8% 0% Currently working, took time off Currently working, no time off Not working, previous RTW attempt Not working, never tried to RTW Figure 1: Work status at time of interview. 15

16 Readiness to RTW Table 1: Reported Readiness of Injured Workers to Return To Work. Not Ready To Work, But Working Those working reported that they were: Not physically ready 24% Not emotionally ready 22% Neither physically nor emotionally ready 15% Ready To Work, But NOT Working Those not working reported that they were: Physically ready 46% Emotionally ready 48% Both physically nor emotionally ready 30% 16

17 Impact of Work on Recovery We know from the work of Dame Carol Black and her team that Work is Good For You Perceptions of injured workers a little different > Work helped recovery.. 29% > Work hindered recovery... 31% > Work had no impact on recovery 35% 44% of those with mental stress claims felt that work helped 17

18 Resilience Something else was influencing recovery and RTW other than: Type of injury or illness Age, gender, regional location, and so on Job or organisation Resilience is The ability to bounce back Cope with stressful situations Make the most out of things that aren t quite going right 18

19 Resilience &Types of Injuries / Illnesses 70% 63% 60% 55% 57% 58% 50% 40% 30% 20% 31% 14% 16% 21% 14% 29% 17% 25% 10% 0% Mental disorder Musculoskeletal Other Disease Other Injury Low Medium High Figure 2: Resilience and injury type. 19

20 Points to Ponder Why are some people returning to work when they aren t ready to, while others are ready to but aren t returning to work? Would setting expectations around RTW early in an injured workers claim help them to facilitate an earlier recovery? How do we build personal resilience and positively impact someone s recovery? 20