Work trial guidance material

Introduction

Research shows that work promotes recovery and reduces the risk of long-term disability and work loss. The focus of the NSW workers compensation system is supporting workers to recover at, or return to work following a work related injury.

Section 53 of the Workplace Injury Management and Workers Compensation Act 1998 (1998 Act) allows the State Insurance Regulatory Authority (SIRA) to develop, administer and coordinate vocational rehabilitation schemes for workers.

If a worker and employer meet SIRA’s eligibility criteria and program requirements, the worker and employer’s use of the program will be accepted and the insurer will administer the program costs.

A work trial is a SIRA initiative that provides work-based opportunities for a worker injured at work to upgrade their capacity, develop skills and/or gain on the job experience.

Program benefits

A work trial places a worker (the trainee) with a suitable host employer (the host) for a short period of time when the worker’s pre-injury employer is unable to provide suitable work, or the worker is returning to work with a different employer and on the job training is required. The trainee continues to receive weekly payments during the work trial and does not receive payment from the host.

Eligibility

A worker is eligible if:

• they are receiving, or are entitled to receive, weekly payments under the Workers Compensation Act 1987 (1987 Act)
• they have capacity to work however their pre-injury employer is unable to provide suitable work
• a commutation or work injury damages settlement has not been accepted.

An employer may be eligible if they:

• have no workers compensation liability to the trainee
• have no current employer/employee relationship with the trainee
• hold a current workers compensation policy with an insurer or a self-insurer’s licence
• are not grouped with the pre-injury employer for workers compensation insurance or insured under the same group self-insurer licence as the pre-injury employer.

Note: Work trial hosts may not have more than one trainee involved in a work trial at any given time. This maximises the training and employment opportunities for the trainee. An exception may be considered for a large host with multiple departments or work sites in consultation with the insurer.

NSW state government employers may use a work trial within other state government departments.

A Commonwealth or interstate employer may be eligible for the program providing they meet the criteria.

Principles

An application for the work trial program must address the following principles:

1. The goals of the work trial must be established before commencing the search for a suitable work trial
2. The proposed work trial position must be clearly linked to the worker’s return to work goal
3. The work trial is appropriate to the worker’s skills, functional and work capacity and is the most suitable option for the worker
4. The work trial will assist the worker to secure employment or upgrade their capacity to return to their pre-injury employer.

Preparing for a work trial

The worker, insurer, employer or provider may determine that a work trial is a suitable strategy to help the worker return to work.

An assessment of suitability, along with the development of the work trial proposal and implementation of the program is to be managed by an approved workplace rehabilitation provider. The person conducting the assessment must meet the minimum qualifications of a rehabilitation consultant¹, however they may use an employment consultant to assist in locating a work trial for the worker.

A work trial checklist  has been developed to help providers ensure the work trial is suitable and is in accordance with this guidance material.

Note: If the worker is to be involved in locating a work trial, the provider must ensure that the worker understands and can explain the benefits, eligibility criteria and requirements of the program to a potential host.

Suitability of the role

A workplace assessment² must be conducted to match the capacity of the trainee to the essential requirements of the job, and assess the trainee’s ability to perform the tasks safely.

Specific work trial goals (such as skill development or upgrading work capacity) should be clearly documented so the workplace assessor can determine whether the proposed work trial is the most suitable placement for the trainee.

It is essential that the trainee and host are present and participate in the workplace assessment to confirm the host’s capacity and willingness to offer duties that will increase the trainee’s work capacity and/or skills.

Where there are multiple work sites, the demands of all work sites should be considered; however, only one workplace assessment is required.

Any concerns raised during, or as a result of, the workplace assessment should be discussed with the host in order to identify a solution to enable the worker to safely commence the work trial.

Where specific equipment or workplace modifications are required, refer to the SIRA equipment and workplace modification guidance material. The provider must ensure that any equipment or changes to the work environment are implemented prior to commencement.

Where specific skills, certification, or licences are required for the role, the provider should discuss eligibility for education and training assistance (under section 64C of the 1987 Act - note this does not apply to exempt workers) and/or the SIRA training program with the insurer.

Providers are to consider and address any issues relating to confidentiality, for example where the role involves access to personal information (eg medical receptionist, office worker). The provider should be satisfied that the trainee is aware of and will be trained by the host employer regarding any confidentiality or code of conduct requirements at that workplace.

Suitability of the host

The provider will use the workplace assessment to assess the suitability of the host’s workplace, for example:

• Is the workplace culture positive?
• Is the host committed to workplace health and safety?
• Does the host have previous experience using vocational programs?
• Is there potential for employment of the trainee on conclusion of the work trial?

Conflict of interest

Work trials may not be considered suitable where there is either a professional or personal relationship between the proposed host and the trainee which may give rise to a conflict of interest. This is particularly important where the host has a provider-client relationship or is a member of the trainee’s family.

If a potential conflict of interest is identified, the provider will assess suitability for the work trial and discuss this with the insurer. The provider should outline why the program should be approved as well as the strategies that will be implemented to address the conflict of interest.

Insurance

The provider must also ensure the host and trainee have the necessary insurance coverage before developing a work trial proposal.

Professional indemnity insurance

If the work trial involves the provision of professional services in accordance with an established discipline (for example nursing, teaching, engineering), the host must have professional indemnity insurance covering the professional staff that will provide direction and supervision to the trainee as the nominated supervisor is responsible for work performed by the trainee.

Public liability insurance

The work trial host must have public liability insurance cover appropriate to their circumstances.

Workers compensation

A host must hold a current workers compensation policy with an insurer or a self-insurer’s licence.

Note: During the work trial, the trainee is not a ‘worker’ as defined by the 1987 Act and they have no claim against the host’s workers compensation insurance. If the trainee experiences changes to their existing injury or a new injury during the work trial period, this will be managed by the insurer as part of the workers claim.

Motor vehicle insurance - host

Where the trainee is required to drive in the course of performing work trial duties, it is expected that a vehicle will be provided by the host. Vehicles owned by the host must have comprehensive motor vehicle insurance.

Where it is essential for the trainee to drive in the course of performing work trial duties and the host employer is unable to provide a vehicle, the vehicle that will be used by the trainee must have comprehensive insurance.

Motor vehicle insurance - trainee

Any vehicle used by the trainee to travel to and from the work trial must have third-party property insurance³ as a minimum level of insurance coverage.

Length of work trial

A trainee may participate in one or more work trials for a combined total of up to 12 weeks. The length of the work trial will be dependent on the goals of the work trial, the host’s capacity to provide supervision and/or training, and the likelihood of employment with the host on completion of the work trial.

Extension of a work trial beyond 12 weeks will be considered by the insurer where it can be demonstrated that the extension will secure employment or a return to pre-injury employment for the worker.

Confirmation of agreement

Developing the work trial proposal

The provider develops a recover at work plan in consultation with the trainee and the host, using information from the workplace assessment. The plan must be described in writing, with copies given to both the trainee and host.

A work trial agreement must be completed and signed by the trainee, host and provider prior to the program commencement.

The provider should ensure:

• all parties understand their responsibilities and agree with the goals of the work trial
• the host employer has confirmed their capacity and commitment to provide adequate supervision and training to achieve the work trial goals
• the host is aware that the trainee will be attending in a supernumerary capacity, that all work must be appropriately supervised and that the nominated supervisor will be responsible for work performed by the trainee
• the trainee and host are aware of the notification requirements should the trainee experience a recurrence or aggravation of their existing injury, or sustain a new injury
• evidence of the workplace assessment is retained on the trainee’s file.

The duration, contact information for associated parties and essential costs linked to the trainee’s involvement in the work trial needs to be outlined in the SIRA vocational program – details form. This may include costs for equipment, travel or accommodation.

Equipment, education or training requests must be made with reference to the principles and requirements outlined in the relevant guidance material.

The provider must ensure a copy of the recover at work plan, work trial agreement and vocational program – details form are given to the trainee and the host.

Program endorsement and quality assurance review

SIRA requires providers to implement an internal quality assurance review of all work trial proposals. The provider must follow their service provision and internal quality assurance processes to confirm the worker and employer meet eligibility and program requirements, the work trial is appropriate for the trainee, the host employer is suitable, and that the application meets the SIRA work trial principles.

A work trial cannot commence without the appropriate review and confirmation that the proposal meets the work trial guidelines.

If the proposal is less than 12 weeks, or costs less than the amounts outlined below for travel, equipment or clothing, the provider should confirm the work trial’s commencement date, details and associated costs with the trainee, host and insurer by signing the vocational program – details form.

Insurer endorsement of the work trial

If the proposal includes any of the following, the proposal and supporting documentation is submitted to the insurer for review:

• $1500 or more for work trial related travel costs
• $1000 or more for work trial related equipment
• $300 or more for work trial related clothing
• participation in the proposed work trial will mean the worker has participated in one or more work trials exceeding a combined total of 12 weeks.

The proposal must be submitted to the insurer five working days before the planned commencement of the work trial. The insurer will review the proposal against the guidance material and advise the provider if the work trial should proceed. The provider should then confirm the following details in writing:

• the work trial’s commencement date
• the specific work trial details and associated costs.

Payment

A completed vocational program – claim for payment form and relevant invoices or receipts must be submitted to facilitate payment.

Payments should be made in line with the amount(s) approved. Payment should only be made where there is evidence of cost/expenditure (e.g. purchase order, tax invoice, receipts or record of travel such as a travel log or fares).

The insurer / agent must have controls in place to prevent duplicate payments being made and claimed.

Up to $300 may be paid in advance (where appropriate) for travel. Claims for travel expenses should be supported by a travel log which includes dates of travel, cost of fares/kilometres and destinations.

Workplace Rehabilitation Provider

If the provider has paid for travel, equipment or clothing costs the provider should claim reimbursement for these costs from the insurer.

Nominal insurer scheme agent

When the claim is with a Nominal Insurer scheme agent, the agent is responsible for administering payment of vocational program expenses.

Agent for icare Insurance for NSW

When the claim is an agent for icare Insurance for NSW⁴, the agent is responsible for administering payment of vocational program expenses less than $10,000.

Self-insurer or specialised insurer

When the claim is with a self or specialised insurer⁵, the insurer is responsible for administering payment of vocational program expenses less than $2,000.

SIRA

When the claim is with an agent for icare Insurance for NSW, self-insurer or specialised insurer and the costs exceed the amounts above, SIRA will make payments.

These payments will be processed when a vocational program – claim for payment form, vocational program – details form, work trial agreement and the relevant invoices or receipts is received at [email protected].

NOTE: A minimum of ten working days is required to enable processing and payment of approved costs.

Insurer / agent reimbursement

Insurers and agents can request reimbursement from SIRA for program costs. Insurers and agents are to ensure that all claims for reimbursement can be substantiated. Substantiated means programs are approved and supported by appropriate evidence of the expenses.

Self and specialised insurers

Reimbursements from SIRA can be claimed within six months of the costs being incurred by submitting a claim for payment, evidence of payment and relevant receipts.

Nominal insurer and agent for icare Insurance for NSW

Reimbursements from SIRA can be claimed by a tax invoice. The invoice should be accompanied by an itemised breakdown by claim and program type of the costs incurred.

For more information about making a claim for reimbursement contact [email protected].

Commencing the work trial

Trainee

During the work trial, the trainee agrees:

• to follow the recover at work plan and advice of the provider
• to follow the directions of the host (where these do not contradict the provider’s advice), and
• to comply with the policies and procedures of the workplace.

It is in the trainee’s best interest to maximise the training opportunities of their work trial. They should discuss any concerns or difficulties with the host and/or the provider to allow issues to be addressed promptly and effectively.

Work trial host

In the work trial agreement the host agrees to provide an appropriate level of training and supervision for the trainee.

It is the host’s responsibility to provide direction and feedback, and to oversee work performed by the trainee. This may involve verbal instruction, observation, supervised attempts and the opportunity to practice tasks or skills, depending on the nature of the work. Effective, timely instruction and feedback maximises the trainee’s opportunity for learning and skill development.

Workplace rehabilitation provider

The provider is responsible for proactively managing all aspects of the work trial to maximise the trainee’s outcome and ensure work trial goals are achieved. Monitoring should include:

• ensuring necessary equipment is available to the trainee on commencement and that it is used appropriately so the trainee can meet their responsibilities (see work trial agreement)
• ensuring the host provides the necessary level of supervision and performance feedback, as well as opportunities for training in the agreed tasks
• ensuring work duties are performed safely and in accordance with the recover at work plan
• predicting and identifying barriers or issues
• using a collaborative problem-solving approach to implement solutions
• communicating progress and outcomes of the placement as agreed with the trainee, employer and insurer.

Change in circumstances

A worker must immediately withdraw from the work trial if a commutation or work injury damages settlement is accepted.

A host must not make any payments to the trainee. If payments are made, the work trial must cease and employment arrangements be negotiated instead.

Note: A vocational program - closure report should be submitted to the insurer if the work trial is withdrawn prior to commencement or if the work trial ceases prior to the anticipated completion date due to unforeseen circumstances.

Work trial extensions/amendments

Any extension or amendment to the work trial must be negotiated with the host/trainee. The application for extension/amendment must include sufficient information to demonstrate the change is necessary and that it will facilitate achievement of the trainee’s goals.

The relevant section (section 7) of the vocational program – details form must be completed a minimum of five working days before the requested change is implemented.  The recover at work plan and work trial agreement should be updated as appropriate and the insurer should be in agreement with the return to work strategy.

Where the changes meet one of the following criteria (including costs previously incurred), the extension/amendment request is sent to the insurer for approval:

• $1500 or more for work trial related travel costs
• $1000 or more for work trial related equipment
• $300 or more for work trial related clothing
• the amendment to the work trial will mean the worker has participated in one or more work trials exceeding a combined total of 12 weeks.

If the extension/amendment request does not include any of the above criteria, the provider informs the trainee, host and insurer in writing by signing the updated vocational program - details form confirming the amended details and costs. The recover at work plan should be updated and copies provided to the host and trainee.

Notification of injury

If the trainee experiences a change to their existing injury or sustains a new injury that results in a change in the trainee’s return to work status, the need for treatment, cessation, or delay in completion of the work trial:

• the trainee must promptly notify the host
• the trainee or the host must notify the provider within 24 hours of the injury
• the provider must notify the insurer and SIRA within 48 hours of receiving notification from the trainee or host (by phone and/or email)
• the insurer will forward an injury notification form to the provider (for completion by the trainee and the host)
• the provider is responsible for facilitating completion of the notification form, and ensuring it is returned to the insurer within one week of injury notification.

The insurer will review the completed injury notification form as well as any additional evidence, before determining liability for the injury. Where liability is accepted, the insurer:

• manages the work trial injury as part of the existing claim to which the work trial was related
• updates/reviews the injury management plan to include recommended management of the work trial injury
• recommends the same service providers assist in the management of the existing claim and work trial injury
• includes the cost of managing the work trial injury in the premium calculation for employers whose premiums are claims experience adjusted.

Notification of damages

In the instance where the trainee’s actions result in damage to plant or equipment:

• the trainee must advise the host immediately
• the host must advise the provider within 24 hours of the incident
• the provider must advise SIRA  by emailing [email protected] within 24 hours of receiving notification from the host.

SIRA will notify the provider in relation to further necessary action.

Note: SIRA may reimburse additional expenses for other claims made on the host’s insurance policies, if they resulted from the trainee’s actions. Additional expenses are limited to the premium excess or increase directly resulting from the trainee’s actions.

Liability for negligence remains the responsibility of the host.

Completing the work trial

On completion of the work trial, the provider must evaluate its success against the goals set in the work trial agreement. It is recommended that the provider conduct a work trial closure meeting to:

• discuss the trainee’s participation
• discuss the host’s satisfaction with the trainee’s performance and the work trial program
• advise the host of the employment incentives available under the SIRA  JobCover Placement Program
• determine the host’s capacity to offer the trainee paid employment.

The provider must submit a vocational program – closure report to the insurer within five working days of completion of the work trial.

On conclusion of the work trial if the host offers the trainee employment, the host may be eligible for incentives under the JobCover placement program. Refer to the JobCover placement program guidance material for more information.

Review process

If there is disagreement about eligibility or use of the work trial program, the worker should try to resolve the matter with the insurer in the first instance.

If the worker is unable to resolve the matter in the first instance with the insurer, please call us on 13 10 50 or email [email protected].

For information on what to do when a request to use a SIRA funded program has not been approved, find out how to request a review of a program decision.

Further information

The following work trial resources are available:

• Work trials
• Work trial checklist
• Work trial agreement
• SIRA training program guidance material
• SIRA equipment and workplace modifications program guidance material
• Vocational program – details form
• Vocational program – claim for payment form
• Vocational program – closure report
• JobCover placement program guidance material
• JobCover placement program – agreement
• JobCover placement program – employer incentive payment claim form

Related legislation

• Workplace Injury Management and Workers Compensation Act 1998

References

1. Guide: Nationally consistent approval framework for workplace rehabilitation providers (catalogue no. HWCA08001).
2. As outlined in the Heads of Workers Compensation Authorities (HWCA)’s Guide: Nationally consistent approval framework for workplace rehabilitation providers, Appendix A pages 29-30, and SIRA’s NSW Supplement.
3. Third party property insurance is different to third party personal (CTP ‘green slip’) insurance, which does not meet the minimum insurance requirement.
4. An agent for icare Insurance for NSW provides workers compensation insurance to most public sector employers except those who are self-insurers. icare Insurance for NSW contracts insurance agents to manage policies and claims on its behalf.
5. Self-insurers are employers approved by SIRA to manage their own workers compensation claims. Specialised insurers hold a restricted licence to provide workers compensation insurance for a specific industry or class of business or employers.