Evaluation of allied health certification
A certificate of capacity / certificate of fitness describes an injured person’s capacity for work and other activities. Previously, only a treating medical practitioner had the authority to complete and issue all Certificates of Capacity (under the Workers Compensation Scheme) and all Certificates of Fitness (under the Compulsory Third Party Scheme).
What changed?
On 17 April 2020 temporary COVID-19 legislative changes commenced giving treating physiotherapists and psychologists the authority to issue second and/or subsequent certificates of capacity/fitness in relation to workers compensation and CTP claims. Treating medical practitioners are still required to issue an injured person with their first certificate. The changes were initially put in place for a period of 12 months.
Changes extended to 2022
In April 2021, these arrangements were extended for a further 12 months meaning approved treating physiotherapists and psychologists can continue to provide certification of an injured person’s ability to work until 17 April 2022 for workers compensation claims,31 March 2022 for CTP claims.
Why were these changes introduced?
The amendments were intended to relieve pressure on general practitioners and the overall health system due to the COVID-19 pandemic. The changes were also to make it easier for claimants to obtain up-to-date certification as required by their insurer, without needing to re-visit their treating doctor.
Evaluation of the changes
In late 2020, SIRA commissioned Monash University to complete an evaluation of the response to and effectiveness of these temporary legislative changes.
Survey of allied health practitioners
Between 1 December 2020 and 15 January 2021, Allied Health practitioners operating in NSW were surveyed to capture their perspectives on certifying capacity.
A total of 480 surveys were completed (210 by physiotherapists and 270 by psychologists). In summary, the survey found:
- 48 physiotherapists and 33 psychologists reported completing a certificate of capacity / fitness
- the majority of respondents reported writing 2-5 certificates (56.8%)
- the minority reported writing more than 10 certificates (12.3%)
- it was most common that the certificate written was early in the course of injury, with 82.7% reporting certifying within the first five certificates.
The survey found that Allied Health practitioners have a high level of confidence that they are able to certify capacity; and that continuing to do so was a good match to their skills and knowledge and would benefit patients, employers and insurers. The most common area identified for improvement was to allow for greater detail around the injured person’s psychological capacity.
Factors contributing to low rates of certification by this group included:
- the large proportion of respondents being unaware of the ability to certify
- the reported relatively low caseloads of compensable patients; and
- an expectation that the treating doctor would complete the certification.
For more information, read the Monash University report Evaluation of Allied Health Certification in NSW, summary of practitioner survey and insurer interviews.
Note: at the time the Monash report was completed, the provisions were in place until April 2021. These provisions have now been extended for a further 12 months (unless repealed earlier).
Comparative analysis
The evaluation process also included a comparative analysis of a sample of certificates submitted to insurers since April 2020, where at least one certificate per claim was completed by an allied health practitioner. The high-level findings include:
- The claimants were predominantly male (68%), 30-39 years of age (30%), and worked as labourers (30.5%) or technicians and trade (21%)
- Most claimants sought medical services for traumatic injuries to the joint/ligament and muscle/tendon (42%) or musculoskeletal system (27.5%), with most injuries occurring to the upper limb (46%)
- Allied Health practitioners completed 117 (3.7%) valid certificates for these claims, comprising of 12 no capacity, 78 partial capacity and 27 full capacity certificates
- Allied Health practitioners also provided a greater proportion of complete certificates than Medical practitioners (90% versus 47%, respectively).
Read the Monash University comparative analysis.
What happens next?
Monash University will continue to review over the next 12 months and provide a final report. SIRA will review and use the report to inform future enhancements to certificate of capacity/fitness arrangements.
More information
Visit the Certificate of fitness / certificate of capacity page or view our video guides for treating physiotherapists and treating psychologists on assessing a person’s capacity to work: