Workers compensation
Guidelines for the provision of relevant services have been published
SIRA has published the Guidelines for the Provision of Relevant Services (Health and Related Services), which apply to relevant service providers providing services in the NSW workers compensation and CTP (for accidents on or after 1 December 2017) schemes.
The following sections of the guidelines apply to workplace rehabilitation providers providing relevant services in the workers compensation scheme:
- Part 2: Requirements for telehealth services
- Part 5: Billing requirements for the provision of relevant services under the workers compensation legislation
- Part 6: Invoicing requirements for relevant services under the workers compensation legislation (excluding pharmaceutical services)
This webpage has been updated to include content from the Guidelines and the associated legislation.
Workplace rehabilitation providers help people recover through work.
Workplace rehabilitation provider applications can be submitted from October to December. SIRA will then assess the workplace rehabilitation provider applications from 1 January to 30 March the following year.
Research on the benefits of workplace rehabilitation
Early engagement of workplace rehabilitation providers has been shown to improve return to work outcomes in the NSW workers compensation scheme.
SIRAs analysis shows that early engagement of a workplace rehabilitation provider within 13 weeks of injury can improve return to work rates by up to 5 per cent.
For psychological claims (either as a primary or secondary injury), return to work outcomes can be improved by 20 per cent.
This results in lower weekly and medical costs for these claims, particularly when the workplace rehabilitation provider is appointed early in the claims process.
You can read more about the research results in the analysis of claims data conducted by EY for SIRA.
In brief
Workplace rehabilitation services are usually delivered at the workplace, in consultation with all parties and may involve:
- assessing the activities a worker can currently perform
- assessing available suitable work options
- advising about modifications for the work environment or work practices to reduce work demands, for example providing equipment to make the worker’s job easier
- working with the worker, their employer and doctor to design a plan to help the worker recover at work
- advising about work options when the worker is unable to recover at work with their pre-injury employer
- facilitating workplace discussions with the worker, their employer and other relevant parties when a workplace relationship issue is impacting a worker’s recovery at work (workplace facilitated discussion service stream)
- assisting a worker to obtain work with a new employer and requires the provision of specialist job seeking assistance.
The insurer is responsible for payment of reasonably necessary workplace rehabilitation services in accordance with section 60 of the Workers Compensation Act 1987 (1987 Act).
The insurer is responsible for early and timely engagement of an approved provider to support a worker’s recovery at work. This requires the insurer to discuss the need for referral and choice of provider with the employer, worker and nominated treating doctor (if appropriate) and ensure all parties understand the role of the provider and what can be expected from the provider’s involvement.
What to expect from your workplace rehabilitation provider fact sheet provides workers and employers with information about workplace rehabilitation and the role of the provider.
Provider/assessor search
Find an approved workplace rehabilitation provider.
The SIRA approved workplace facilitated discussion rehabilitation providers and specialist job-seeking services are listed below.
Workplace facilitated discussion rehabilitation providers
32 and Sunny | Prestige Health Services Australia (PHSA) |
Active Occupational Health Services | Proactiv People Solutions |
Acumen Health | The Procare Group |
At work Occupational Health & Safety Pty Ltd | Prowork Consultants |
Beneco | Recare Services |
Carfi | The Recovre Group |
Fastrack Health | Rehab Focus Enterprise |
Greenlight hc | Rehab Management |
Imac Injury Management and Assessment Centre | Rehab Options Provider Services |
Interact Injury Management | Rehab co |
Interactive Health Solutions | Rehabilitation Services by Altius |
Ipar Rehabilitation | Resilia |
JK Corporate Resourcing | Santegis Pty Ltd |
Keystone Professionals | The ORS Group |
Konekt | The Rehab Group |
MP Safety Management | The Rehabilitation Specialists |
Mend Services | Work rehab Pty Ltd |
Pinnacle Rehab | Workfocus |
Platinum Rehabilitation Group |
Specialist job-seeking services
Specialist job seeking service stream is for workers seeking employment with a new employer who may benefit from support from a Workplace rehabilitation provider with job-seeking specialist skills. The specialist job seeking model identified by a workplace rehabilitation provider will outline the services delivered and may include the following:
- negotiate a job placement strategy that outlines the job placement services to meet the worker's needs
- prepare the worker to independently seek and obtain a new employment
- facilitate job search and placement support for job seekers
- provide assistance with elements of job seeking skills
- adddress and overcome the barrier for return to work.
If a workplace rehabilitation provider is applying for the specialist job seeking service stream, the application must:
- meet all conditions of approval outlined in the Workers compensation workplace rehabilitation provider approval framework
- identify an evidence based specialist job seeking model
- be based on the guiding principles of developing a model
- outline the specific cohort the model can assist
- clearly differentiates how it is different from workplace rehabilitation management.
SIRA has approved the below workplace rehabilitation providers to deliver specialist job seeking services in the corresponding cohort:
Workplace rehabilitation provider | Approved cohort |
|---|---|
Actual Rehab Pty Ltd | Culturally and Linguistically Diverse (CALD) Populations or those of Non English Speaking Backgrounds (NESB) Mature Aged Workers Workers located in rural areas |
Advanced Personnel Management | For mature aged, and culturally and linguistically diverse workers |
Career Management Services | Recruitment model of job seeking for all workers |
Greenlight HC | For workers with acquired and traumatic brain injury and mature workers aged between 50 – 65 years |
Head2work | For workers with brain injury |
| IOH Health | Ex-offender Aboriginal and Torres Strait Islander |
Keystone Professional | For workers with brain injury or neurological conditions |
JK Corporate Resourcing | For culturally diverse workers and workers with psychological injury |
Konekt | For workers with brain injury |
My Social Support Network | For workers with socially isolated, mature age (>45), and experiencing a work-related psychological injury |
| ORS | At least one diagnosed primary or co-morbid mental health condition and have not yet returned to work after 6 months or more due to illness or injury |
Prestige Health Services Australia | For workers with brain injury |
| Proactiv People Pty Ltd | Mental disease |
Rehabco | For workers with psychological injury or illness including affective disorders and trauma related disorders including PTSD |
Rehabilitation Services by Altius | For mature workers |
| Resilia | Psychological injury |
| WorkFocus Australia | Psychological conditions |
Any changes to the workplace rehabilitation provider’s approval for this service will be reflected in the above table.
Fees and invoicing
There are no gazetted fees for workplace rehabilitation providers in the NSW workers compensation system.
Providers are required to obtain insurer approval before commencing service provision and must present itemised invoices before payment can be made. Insurers are to only refer to SIRA approved workplace rehabilitation providers.
What your invoices will need to include
Invoices for relevant services rendered must include:
- the injured worker’s first and last name, and claim number
- payee name, address, telephone number and email address
- payee Australian Business Number (ABN)
- name of the relevant service provider who delivered the relevant service
- the workplace rehabilitation provider’s:
- SIRA approval number (where applicable), and
- AHPRA number/professional association accreditation/membership number
- relevant SIRA payment classification code or Australian Medical Association (AMA) Fees List item number (where applicable)
- service cost for each SIRA payment classification code or AMA Fees List item number and service duration (if applicable)
- date of service
- date of invoice (must be on the day of or after last date of service listed on the invoice).
Invoices must be submitted within 30 calendar days of the service being provided.
The same requirements also apply to interstate workplace rehabilitation providers. For workers rehabilitation providers who are approved in their home jurisdiction and/or Comcare may, with confirmation from the insurer, be able to manage a one-off case under the NSW workers compensations system without going through the full application/approval process. In this instance, the provider should use the payment classification code 999 on their invoice to the insurer.
Do I need a SIRA provider approval number?
Submit an application to SIRA, following the process outlined in the Workplace rehabilitation provider approval framework. If the provider can demonstrate compliance with the Conditions of Approval and the application is approved, the provider is granted up to a three-year Certificate of Approval.
How do I get a SIRA provider number?
Submit an application to the jurisdiction in which approval is being sought, demonstrating how you will meet the Conditions of Approval. If the application is approved, the provider is granted a three-year Instrument of Approval (Certificate of Approval in NSW).
Meeting the Conditions of Approval
The main focus of the NSW workers compensation system is to support workers to recover through work following a work-related injury.
To obtain and maintain SIRA approval to deliver workplace rehabilitation services in the NSW workers compensation system, a provider must comply with the conditions of approval for workplace rehabilitation providers (clause 25 of the Regulation).
There are four conditions of approval:
- Services must be delivered in accordance with the approved service delivery model
- Reporting and evaluation requirements.
- Staff who deliver services must be appropriately qualified
- The provider must implement quality management systems and governance
Providers must adhere to the Conditions of Approval throughout their approval period or will have their Certificates of Approval cancelled and will not be able to provide services in the workers compensation scheme.
You are also required to undertake yearly independent evaluations. You may also undergo a SIRA-initiated periodic evaluation and/or an exception evaluation by an independent evaluator. The evaluation methodology for the workplace rehabilitation provider approval framework will be available from 1 January 2022.
Recovery at work measures are the primary measure used to monitor outcomes related to workplace rehabilitation service provision. SIRA will prescribe minimum outcomes measures for services to be delivered, these will be available from 1 January 2022.
Then, during the three years of approval, you are required to undertake annual self-evaluations. You may also undergo a SIRA-initiated periodic evaluation and/or an exception evaluation by an independent evaluator.
Refer also to the Guidelines for the Provision of Relevant Services (Health and Related Services) for other requirements workplace rehabilitation providers must comply with.
Forms you might need
The below link is for additional information sent from providers who have already submitted their applications within the required timeframe. The next round for new applications commences in October of any given year. SIRA will then assess the workplace rehabilitation provider applications in the first quarter of the following calendar year.
Publications you might need
- Guidelines for the Provision of Relevant Services (Health and Related Services)
- Workplace rehabilitation provider approval framework
- What to expect from your workplace rehabilitation provider fact sheet
- Workers compensation guidelines
- Workers compensation guide for allied health practitioners
- A quick guide to workers compensation - information for workers