Wednesday 22 November 2017
The final report can be downloaded by clicking here.
The report makes 18 recommendations and is currently under review by SISA. For completeness it needs to be read in conjunction with the interim report issued earlier this year. SISA has formulated a response to each of the recommendations and provided it to the Committee secretary at Parliament.
The results of this inquiry will no doubt feed into the mandated review of the operation of the Act that is due to commence in the coming months.
The Committee's recommendations are as follows:
Recommendation 1
The Committee received evidence highlighting the importance of early intervention and it notes that the provision of such strategies is an object of the Return to Work Act. The Committee also received evidence that due to the complexity of some claims, there may be a delay between claim lodgement and compensability being determined.
Considering the importance of early intervention, and noting that on average, only around 5 per cent of claims end up being rejected, the Committee recommends early intervention strategies be implemented as soon as practically possible for all claims, and where appropriate, even prior to determination. To ensure that workers whose claims are ultimately rejected are not faced with the need to cover the costs of these services, the Committee also recommends the re-introduction of provisional liability in the Scheme, limited to only cover payment of early intervention services.
Recommendation 2
While acceptance rates for claims of psychiatric injury fluctuate from year to year, the Committee notes that in 2016/17 this rate was the lowest it has been in five years. The Committee is concerned that the changes in the compensability tests, in particular for psychiatric injuries, is more limiting than what was intended. Therefore, the Committee recommends the Minister for Industrial Relations amend section 7(1)(2)(b)(i) of the Return to Work Act, replacing ‘the significant cause’ with ‘a significant cause’.
Recommendation 3
The Committee notes that every workers’ compensation jurisdiction differs in the terminology used to describe those workers who can access ongoing support. For example, the Committee notes that in New South Wales, a reform of their Scheme saw the term seriously injured worker removed. It was replaced with the term worker with high needs for those with a permanent impairment greater than 20 per cent, and the term worker with highest needs for those with assessed as being greater than 30 per cent.
The Committee recommends the Minister for Industrial Relations considers New South Wales’ approach and replaces the term seriously injured worker.
Recommendation 4
The Committee recommends the Minister for Industrial Relations consider the inclusion of a narrative test to supplement the already prescribed whole person impairment assessment processes. The Committee also recommends that should a narrative test be included in the Scheme, accredited doctors be trained in its use and application.
Recommendation 5
The Committee received evidence stating that some medication, including medication used to treat psychiatric injury, can be expensive and may not be covered by the Pharmaceutical Benefits Scheme. Further, the Committee recognises that for those workers who have returned to work, some require ongoing treatment to maintain their capacity, and without such treatment the worker may be unable to continue working.
Considering the above, the Committee recommends the Minister for Industrial Relations amends the Return to Work Act to broaden the coverage of medical expenses so there will be no time limit for coverage of:
- reasonable costs associated with medication; or
- treatment for which there is evidence that the treatment is required to maintain a worker to remain at work.
Recommendation 6
ReturnToWorkSA have [sic] provided the Committee with examples where it has paid for return to work services beyond the cessation of a worker’s income support. Given the importance of such services in supporting injured workers with their recovery and return to work, the Committee recommends the Minister for Industrial Relations ensures that all injured workers have access to return to work services for the full duration allowed in the Return to Work Act, including for the 12 month period after income support ceases.
Recommendation 7
The Committee recognises it is important for ReturnToWorkSA to be aware of claims where there is the potential for future surgery. However, the Committee does not find it reasonable for a worker to be denied payment for their work-related surgery because the surgery occurred outside of their medical support period and they had not sought pre-approval for surgery.
The Committee recommends the Minister for Industrial Relations amends the Return to Work Act so that the reasonable costs of future surgery associated with a compensable work-injury are payable by the Scheme without the precondition the surgery was pre-approved.
Recommendation 8
The current method of calculating the 104 week entitlement to income support is calendar based. As a result, a worker may only receive 104 weeks of income support if their incapacity is 104 consecutive weeks. Evidence presented to the Committee suggests that an initial return to work is not always successful, despite the best efforts of the worker and their employer. Sometimes, a second and third attempt may be required.
To address this anomaly, the Committee recommends that the Return to Work Act be amended so that the method of the 104 week income entitlement is based on the aggregate period of the incapacity for worker, whether consecutive or not.
Recommendation 9
The Committee received evidence both for and against the inclusion of common law in the Return to Work Scheme. Considering this evidence, in addition to the lack of common law cases to date, the Committee recommends common law and its inclusion in the Scheme be reviewed as part of the mandated review.
Recommendation 10
The Committee notes the disparity between small, medium and large sized employers and the resources available to them in order to offer injured workers suitable employment. This disparity, along with the provision of additional resources should be considered with this recommendation.
The Committee recommends the Minister for Industrial Relations ensure ReturnToWorkSA holds all employers accountable in providing suitable employment for their injured workers, as soon as the worker is certified fit to return to work.
The Committee also recommends RTWSA develop a key performance measure for agent compliance with section 18; and with the outcomes to be provided to the Committee every 12 months.
Recommendation 11
The Committee recommends the Minister for Industrial Relations review the compliance of the Corporation to meeting the Statement of Service Standards prescribed in Schedule 5 of the Return to Work Act, and report the findings to the Committee within 12 months.
Recommendation 12
The Committee recommends the Minister for Industrial Relations direct ReturnToWorkSA to review the information available on its website and the methods in which it disseminates information about the Scheme to injured workers to ensure it is easily accessible for all workers. Further, the Committee notes the digital divide that exists in the community. As such, it is important ReturnToWorkSA also makes information freely available to workers and other stakeholders through print, telephone and other mediums to suit the varied ways people may wish to access information about the Scheme.
Recommendation 13
The Committee recommends the Minister for Industrial Relations review and advise the Committee of the impact that the reduction of rehabilitation / return to work service provider spend has had on the outcomes of the Scheme.
Recommendation 14
The Committee notes in 2015/16, 25 per cent of the accepted claims were with employers based outside of the Adelaide hills and metropolitan area. Evidence received by the Committee, in particular from individual injured workers, did not reflect well on ReturnToWorkSA’s regional engagement strategy. The Committee recommends the Minister for Industrial Relations require ReturnToWorkSA to review and advise on improvements of their services for regional and remote injured workers to ensure high quality services are afforded to all South Australians, regardless of location.
Recommendation 15
The Committee notes ReturnToWorkSA’s ReCONNECT service helps people transition to community based and job search support services after income support has ceased. However, the Committee holds it important that workers who are most likely to require this support are provided with access to this information earlier to provide them sufficient time to plan.
The Committee recommends the Minister of Industrial Relation cause RTWSA to hold regular forums / information sessions where they can connect workers who are most likely going to exit the Scheme at 104 weeks with agencies (such as Centrelink) who can explain the support mechanisms which may be available for them prior to their income support ceasing.
Recommendation 16
The Committee recommends that the Minister for Industrial Relations consider amending the Return to Work Act to provide allow workers with a psychiatric injury to receive payments for economic loss and non-economic loss similar to those who suffer physical injuries.
Recommendation 17
The Committee recommends the Minister for Industrial Relations amend the Return to Work Act to require that workers receive financial advice for any lump sum payments of over $50,000.
Recommendation 18
The Committee notes some employers reported it was unclear as to why they had experienced premium increases when the Scheme’s average premium rate had gone down. The Committee therefore recommends the Minister for Industrial Relations require ReturnToWorkSA to communicate to an employer the reason for any change to their premium.