The Role of the Primary Treating Medical Practitioner

Transcription

1 The Role of the Primary Treating Medical Practitioner The Role of the Primary Treating medical Officer 1

2 Please note This information is for guidance only and is not to be taken as an expression of the law. It should be read in conjunction with the Workers Rehabilitation and Compensation Act 1988, the Workers Rehabilitation and Compensation Regulations 2001 and any other relevant legislation. Copies of the legislation can be purchased from Print Applied Technology: call (03) or freecall It is also available on the Internet at This guide was produced by staff from WorkCover Tasmania. We welcome your feedback on this guide. Send to: justice.tas.gov.au

3 Introduction The successful implementation of the Tasmanian Return to Work and Injury Management Model (the Model) requires many of its key features to be incorporated into the Worker s Rehabilitation and Compensation Act 1988 (the Act). Amendments to the Act took effect 1 July 2010 and provide the necessary legislative framework to implement the Model. These amendments introduce a number of changes for injury management and return to work. The Act validates the central role and responsibilities of the Primary Treating Medical Practitioner. This guide will help the Primary Treating Medical Practitioner, employers, workers, Return to Work Co-ordinators, Injury Management Co-ordinators and Workplace Rehabilitation Providers understand the role and functions of the Primary Treating Medical Practitioner in the injury management process. The Role of the Primary Treating medical Officer 1

4 What is a Primary Treating Medical Practitioner? A Primary Treating Medical Practitioner is the medical practitioner (usually the injured worker s general practitioner) chosen by an injured worker to participate in the injury management process. The Primary Treating Medical Practitioner performs a central role in the primary care, recovery and medical management of an injured worker. The Primary Treating Medical Practitioner is part of the injury management framework and has continuing contact with the injured worker throughout the injury management and return to work process. They are a source of important information; for example, diagnosis of the workplace injury, work restrictions, the certification of incapacity, and the co-ordination of treatment. They can play a positive role in facilitating co-operation between the injured worker, the employer, the insurer, the Return to Work Co-ordinator, the Injury Management Co-ordinator and the Workplace Rehabilitation Provider. They also play an important role in co-ordinating and delivering specialist medical care. 2

5 Important note: accreditation A medical practitioner cannot be an injured worker s Primary Treating Medical Practitioner unless they are accredited by the WorkCover Tasmania Board (the Board). The Board may grant accreditation to a medical practitioner: who is resident in Tasmania, or who provides a service and who wishes to issue medical certificates, or who wishes to certify for total or partial incapacity, and subject to the conditions or restrictions the Board deems fit. For more information on accreditation, refer to the Application for Accreditation, Reading Guide Tasmanian Medical Practitioners and Extracts from the Worker s Rehabilitation and Compensation Act See Further Resources on page 11 for details. The Role of the Primary Treating medical Officer 3

6 What are the functions of the Primary Treating Medical Practitioner? The Primary Treating Medical Practitioner is responsible for: providing medical certificates diagnosing the nature of a worker s workplace injury providing primary medical care for the worker s workplace injury co-ordinating medical treatment for the worker s workplace injury, including referring the worker to those who may deliver specialist medical care and co-ordinating the delivery of any specialist medical care monitoring, reviewing and advising on the worker s condition and treatment advising on the suitability of the work that the worker may be expected to perform, and specifying any restrictions on this work taking part in the development of return to work plans and injury management plans. Selecting the Primary Treating Medical Practitioner An injured worker must choose their Primary Treating Medical Practitioner. They cannot be coerced into choosing a Primary Treating Medical Practitioner nominated by the employer or the insurer. If the injured worker decides to change their Primary Treating Medical Practitioner, they must authorise the previous Primary Treating Medical Practitioner to release relevant medical records to the new Primary Treating Medical Practitioner. 4

7 How will a Primary Treating Medical Practitioner communicate with others? A timely response to requests for information by all participants involved in an injured worker s return to work reduces delays in the injury management process. The more familiar a Primary Treating Medical Practitioner is with the worker s workplace and with the processes in place for return to work, the better the treatment and outcome for the injured worker. Co-operating and communicating with the employer, insurer, Return to Work Co-ordinator, Injury Management Co-ordinator and Workplace Rehabilitation Provider can help achieve this. Maintaining regular contact with these parties, and responding promptly to phone calls and requests for information, are ways the Primary Treating Medical Practitioner can do this. Where disputes arise about the medical management of an injured worker, everyone must take all reasonable measures to work together. The Role of the Primary Treating medical Officer 5

8 How does the role of the Primary Treating Medical Practititoner relate to the Return to Work Co-ordinator, the Injury Management Co-ordinator and Workplace Rehabilitation Provider? As represented in the diagram below, the Primary Treating Medical Practitioner is a point of contact for the injured worker, employer, Return to Work Co-ordinator, Injury Management Co-ordinator and Workplace Rehabilitation Provider throughout the injury management process. They all complement each other through their collaboration and their commitment to returning the injured worker to early, safe and sustainable return to work. Primary Treating Medical Practitioner Co-ordinator Injury Management Workplace Injured Worker Provider Rehabilitation Employer Return to Work Co-ordinator 6

9 Functions of the Injury Management Co-ordinator An Injury Management Co-ordinator is a person appointed by the insurer of an employer. An Injury Management Co-ordinator ensures the injury management process runs smoothly by coordinating and planning the injury management process. An Injury Management Co-ordinator is responsible for ensuring that a return to work plan or injury management plan is developed. The Primary Treating Medical Practitioner must be consulted on the development of the plan (and any amendments to it) and should be given a copy of the plan. The Injury Management Co-ordinator must make direct contact with the Primary Treating Medical Practitioner: by telephone or in person (as paid consultations for both) as soon as practicable after the worker is assigned to the Injury Management Co-ordinator to discuss work capacity, specific options for alternative duties and staged return to work. For more information, get your free copy of The Role of the Injury Management Co-ordinator. See Further Resources on page 11 for details. Functions of the Return to Work Co-ordinator The Return to Work Co-ordinator provides the worker with workplace-based support and assistance throughout the injury management and return to work process. They will liaise with the Primary Treating Medical Practitioner as necessary. For more information, get your free copy of The Role of the Return to Work Co-ordinator. See Further Resources on page 11 for details. The Role of the Primary Treating medical Officer 7

10 Services provided by a Workplace Rehabilitation Provider A Workplace Rehabilitation Provider is an organisation that provides expert advice and professional rehabilitation services to injured workers, particularly in more complex and difficult cases. It will liaise with the Primary Treating Medical Practitioner as necessary. For more information, get your free copy of The Role of the Workplace Rehabilitation Provider. See Further Resources on page 11 for details. Independent Medical Reviews and Medical Examinations If an injured worker claims compensation or receives weekly payments, their employer or employer s insurer may require the injured worker to submit to an independent medical review. An independent medical review is done by a medical practitioner: other than the injured worker s Primary Treating Medical Practitioner with expertise relevant to the worker s injury. It may include: one or more examinations A A analysis of any diagnostic test results or other medical records of the injured worker. 8

11 The employer or employer s insurer must discuss their reasons for calling for an independent medical review with the Primary Treating Medical Practitioner. The injured worker is then only required to submit to an independent medical review: after this discussion has taken place after the employer has told the injured worker (in writing) of the reasons for the review. Once the independent medical review is completed, the medical practitioner who carried out the review must prepare a report for the employer or employer s insurer not the injured worker. The employer or employer s insurer then must provide the Primary Treating Medical Practitioner with a copy of the report within seven days of receiving the report. It is the Primary Treating Medical Practitioner who then provides the injured worker with the report. The rationale behind the Primary Treating Medical Practitioner providing the report to the injured worker is that the Primary Treating Medical Practitioner is much better placed to understand the report, discuss sensitive issues or medical terms, and decided if a further report needs to be requested. Specialists Where an injured worker has been referred to a specialist, the specialist should ensure that the Primary Treating Medical Practitioner is informed of: the results of any diagnostic tests any treatment provided changes to prescribed medication the specialist s diagnosis and prognosis. The Role of the Primary Treating medical Officer 9

12 Workers Compensation Certificates To make a claim for compensation, an injured worker must obtain a Workers Compensation Medical Certificate from an accredited medical practitioner. The medical certificate is the first step of the return to work process. How an injured worker is certified will determine if they will stay at work after an injury at normal capacity or reduced capacity, or if they will be off work. There are two medical certificates; the Initial and the Continuing/Final. They are designed to establish a worker s capacity for work, expedite their return to work, and reduce the need for the insurer or employer to request medical reports. Initial Workers Compensation Medical Certificate An Initial Certificate validates a new workers compensation claim. It should only be completed upon the worker s first consultation. It may also be used as a clearance certificate where the worker s injury is minor and no further intervention is required. Continuing/Final Workers Compensation Medical Certificate A Continuing/Final Certificate supports an ongoing entitlement to workers compensation. It should only be completed upon visits subsequent to the worker s initial consultation. For more information, refer to the guidelines on Completing the Initial Workers Compensation Medical Certificate and Completing the Continuing/Final Workers Compensation Medical Certificate. The guideline Medical Certificate Certification of Workplace Injuries helps medical practitioners in their certification practices so that early, safe and durable return to work may be achieved for injured workers. See Further Resources on page 11 for details. 10

13 Further Resources There are other publications available from WorkCover that help explain the processes and people involved: A Guide to Workers Compensation in Tasmania GB112 Application for Accreditation Impairment (internet only) Application for Accreditation (internet only) Completing the Continuing/Final Workers Compensation Medical Certificate (internet only) Completing the Initial Workers Compensation Medical Certificate (internet only) Extracts from the Workers Rehabilitation and Compensation Act 1988 (internet only) Guideline for Developing Return to Work Plans and Injury Management Plans (internet only) Injury Management: Making it Work GB197 Medical Certificate Certification of Workplace Injuries (internet only) Reading Guide Tasmanian Medical Practitioners (internet only) Return to Work and Injury Management Model (internet only) The Role of the Injury Management Co-ordinator GB194 The Role of the Return to Work Co-ordinator GB229 The Role of the Workplace Rehabilitation Provider GB256. For your free copies of any of these and other useful guidance material, go to and search for the code numbers listed above. Alternatively, call WorkCover Tasmania on The Role of the Primary Treating medical Officer 11

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16 For more information contact WorkCover Tasmania Phone: (within Tasmania) (03) (Outside Tas) Fax: (03) ISBN: x GB257 June 2010