CTP programs to support recovery at work

Overview of CTP Programs to Support Recovery at Work

The State Insurance Regulatory Authority (SIRA) under section 3.41 of the Motor Accident Injuries Act 2017 (MAIA) may institute, administer, or coordinate vocational and return to work support schemes for injured persons recovering from a motor accident.

Research shows that work promotes post-injury recovery and reduces the risk of long-term disability and work loss. One of the primary objectives of MAIA includes supporting injured persons to recover at or return to work after a motor vehicle accident.

SIRA has developed four targeted programs to provide funding and support to help injured persons recover at or return to work when assistance is required. The programs have been designed to complement the services delivered as part of the injured person’s treatment, rehabilitation, and care arrangements, and to achieve the most direct path back to ongoing employment.

The programs include the provision of financial assistance to employers who:

• offer employment to eligible persons unable to find suitable employment, and
• provide (or assist in the provision of) vocational support to those persons.

The programs to support recovery at work available under the CTP scheme are:

1. Recover at Work Assist
2. JobCover Placement Program
3. JobCover6 and
4. Transition to Work

A summary of each program is outlined below including eligibility for assistance under each program, the process for making an application, obligations for all stakeholders once approved and completion requirements including reimbursements.

Applications for assistance under each of the programs and reimbursements must be sent to SIRA by the CTP insurer managing the claim.

SIRA assesses all applications for assistance under the CTP Programs to Support Recovery at Work programs before providing approval. SIRA requires CTP insurers to submit a completed application by the employer and the injured person, which must include the insurer’s endorsement of application under the relevant program. The insurer has the responsibility to ensure that all parties involved in the application are aware of their requirements for the assistance under the programs.

CTP Recover at Work Assist

Helping an injured person recover at work may present financial difficulties for the employer as they may need to pay an additional person to complete the usual duties of the injured person, in addition to paying the person’s wages as they recover at work.

The CTP Recover at Work Assist program enables eligible employers to offer suitable work to an injured person through a graded recover at work plan by minimising the financial burden to the employer. The program:

• provides the employer with up to $400 per week for up to 12 weeks
• allows the injured person to recover at work using a graded recover at work plan.

This program will help relieve the burden for eligible employers, who would otherwise not be able to offer suitable work to the injured person, delaying their recovery.

Eligibility of injured persons

An injured person is eligible to participate in the program if:

• they are certified as having current fitness for work as per a certificate of fitness
• they are currently receiving, or entitled to receive, weekly payments under MAIA.

Employer eligibility

An employer is eligible to participate in the program if:

• they employ an eligible injured person and were the injured person’s employer before the accident
• they have indicated in writing that they require financial support to have the eligible injured person recover at work
• they demonstrate a commitment to the person’s injury management and recovery at work

Assistance payment provided to the employer (Recover at Work Assist payment)

The Employer Assist payment is designed to offset the costs* associated with having an injured person recover at work when the person has reduced capacity and is recovering at work via a graded recover at work plan.

Note *: Offsetting costs for supporting an injured person in return to work will be considered on individual merits (for example an employer can provide evidence and claim the costs of employing someone to assist the injured person carry out their pre-injury duties).

Payments are calculated on a weekly basis and are available to the employer for up to 12 weeks, up to a maximum amount of $4,800 for each injured person employed by the employer. The payments can be claimed by the employer from the insurer at the end of 4, 8 and 12 weeks respectively.

If the person continues to have only partial capacity for work at the completion of the program, a workplace rehabilitation provider may be required to further develop a plan aimed at assisting the injured person to achieve pre-injury work status. However, no further Recover at Work Assist payments can be made to the employer.

Starting the program

To begin a Recover at Work Assist program, a workplace rehabilitation provider (provider) must ensure that the following activities are completed: (Evidence of this process will be required to support application).

1 Workplace assessment

A workplace assessment by a provider is an important first step to developing a successful recover at work plan.

The workplace assessment provides the opportunity to determine the suitability and safety of the duties being offered. It is important that the injured person and employer are present at and participate in the assessment.

Any concerns identified during, or as a result of, the workplace assessment should be discussed with the injured person and the employer and a satisfactory solution developed.

For some injured persons, specific equipment or modifications to the workplace may be required to achieve a safe and durable recovery at work.

2 Recover at work plan

A recover at work plan is developed by the provider in consultation with the injured person, employer and treating doctor.

The plan may be up to 12 weeks in duration. It must clearly state the injured person’s work goal and outline specific opportunities to upgrade the injured person’s fitness and capacity for work.

The employer and injured person must both agree to the plan in order to confirm their commitment to return the injured person to work in a safe and timely manner.

3 Eligibility confirmation and endorsement

Before assistance under the program starts, the insurer must confirm that the injured person and employer meet the respective eligibility criteria. Once confirmed, the insurer must sign the CTP Programs to Support Recovery at Work – Application Form’ confirming their endorsement of assistance under the program.

The insurer must obtain approval for assistance under the program from SIRA in writing and then inform the provider that the employer can use the program. The provider will then ensure the injured person and employer each receive a copy of the completed CTP Programs to Support Recovery at Work – Application Form, Terms of CTP Programs to Support Recovery at Work and their recover at work plan.

4 Monitoring

The insurer and provider are responsible for undertaking appropriate reviews to ensure work duties are performed safely and in accordance with the recover at work plan.

All stakeholders involved should communicate regularly to review upgrades in work capacity and confirm progress towards the recover at work goal. SIRA, at anytime, may request updates on progress with recovery at work goals.

Accessing the Recover at Work Assist payment

The insurer can pay the Recover at Work Assist payments, following a claim by the employer as a lump sum at the end of 4, 8 and 12 weeks respectively. It is the responsibility of the insurer to pay the employer, and then seek reimbursement of the funds from SIRA.

Please see below CTP Programs to Support Recovery at Work Reimbursements from SIRA

Change in circumstances

If employment arrangements change and the injured person returns to pre-injury duties, the Recover at Work Assist payment will be calculated on the number of weeks that the employer needed support (i.e. up to the date the person was certified fit for their pre-injury duties). For example, if a person returns to their pre-injury duties after six weeks, the maximum assist payment to the employer would be $400 per week for six weeks.

CTP JobCover placement program

The JobCover placement program provides incentives to employers to employ a person who has a claim for a motor vehicle related injury and is unable to return to employment with their pre-accident employer.

The program is designed to offset the cost of employing an eligible injured person and is available to employers that satisfy the Eligibility Criteria set out below, including that the injured person is employed for a minimum period of 12 months.

Program benefits

The JobCover program provides the new employer with:

• incentive payments of up to $27,400 for up to 12months*
• protection against the cost of workers compensation claims associated with the existing injury for up to 2 years.

Note: An offer of employment for a JobCover Placement Program is not required for 12 months if the person has already claimed under JobCover6. Up to 12 months of a combination of both JobCover and JobCover6 programs can be used for up to two employers.

Incentive payment to employers

The incentive payment to employers under the program is designed to offset the costs associated with engaging and training a new employee.

The payment is payable over the first 52 weeks of work up to a maximum amount of $27,400.

The maximum amount payables:

• $400 per week for weeks 1 to 12 (maximum of $4,800)
• $500 per week for weeks 13 to 26 (maximum $7,000)
• $600 per week for weeks 27 to 52 (maximum $15,600).

Payment can be claimed from the insurer, by the employer at the end of 12, 26 and 52 weeks respectively, or as a lump sum at the end of the program.

Payments are calculated on a weekly basis. The amount paid will be either the gross weekly wage paid to the person (excluding superannuation and allowances), or the weekly maximum amount as set out above, should the gross wage exceed the weekly incentive payment amount.

Protection from costs associated with the existing injury

New employers may be concerned about the financial impact on their business if a person’s existing injury impacts their new role. These concerns may be alleviated by a workplace assessment (refer to ‘Suitability of the role’ below).

If there is a change to a person’s existing injury (that is not related to a work-related incident in the new employment) during the first 2 years of the new employment, which results in their compensation claim being accepted, new employers will be reimbursed for any claims excess incurred as a result.

Eligibility

A person is eligible for the JobCover program if:

• at the time of program commencement, they are receiving, or are entitled to receive, weekly payments under MAIA
• they have a current certificate of fitness for work but are unable to return to employment with their pre-accident employer

Employer eligibility

An employer may be eligible if they:

• are a different employer to the pre-accident employer
• hold a current workers compensation policy with an insurer or a self-insurer’s licence
• are not grouped with the pre-accident employer for workers compensation insurance or insured under the same group self-insurer licence as the pre-accident employer
• provide a minimum of 64 paid hours per month or a return to pre-injury hours. Fewer than 64 hours may be considered if it can be demonstrated that the person will progress to meet this requirement within a reasonable timeframe
• have offered employment for a minimum of 12 months
• are not in receipt of any other wage subsidy for the person
• can demonstrate adherence to their jurisdiction’s workers compensation and workplace health and safety legislation.

Suitability of the employer

Conflict of interest

An employer may not be eligible for the program if a professional or personal relationship

between the proposed new employer and the injured person is likely to give rise to a conflict of interest. This is particularly important where the new employer has a provider- client relationship or is a member of the injured person’s family.

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

Types of employment

The JobCover program is designed to provide the injured person with durable employment that continues beyond the 12 months* of employer incentive payments. A variety of employment arrangements are considered suitable. These include:

• full or part-time work
• temporary employment, on either full or part-time basis, where there is a fixed-term agreement greater than 12 months*.

The following employment arrangements are not considered suitable under the program:

• seasonal work
• temporary employment where there is no fixed term agreement, or the agreement is less than 12 months*
• establishment of a small business or other self-employment arrangement.

The insurer should obtain and provide with their endorsement to SIRA, evidence of the employment being entered into in writing from the new employer (e.g., a letter of offer of employment or contract).

Concurrent programs

If a person obtains employment with two employers at the same time, the program can only be offered to one employer.

Change of employer

The benefits of the program are not transferable between employers. However, if employment ceases and the person remains eligible for the program, the program may be offered to a new employer. If employment arrangements change and a person is no longer employed before the completion of the 52 weeks, the incentive payable will be calculated on the number of weeks that the person has been employed.

For example, if a person is employed for 22 weeks, the maximum incentive payable to the employer would be $400 per week for the first 12 weeks and $500 per week for the next 10 weeks.

Change in circumstances

If there is a significant change in circumstance that may affect eligibility for the program (for example, the injured person resigns from the job or the employer ceases trading), the CTP insurer should be notified by the injured person or the employer within seven days of becoming aware of the change.

Where an injured person’s weekly payments cease after the program commences, the program may continue, and the employer will still be eligible for all of the agreed benefits.

If ongoing claim liability is disputed following program commencement, or the person recovers damages for their motor accident injury, the insurer must advise SIRA immediately. In this instance, SIRA will review individual circumstances and determine whether the program merits are still being supported by the change in circumstances. It would be at the discretion of SIRA to decide to continue an employer and injured persons eligibility to incentive payments.

Preparing for the program

If it is decided that a JobCover program would help the injured person gain employment with a new employer, the insurer should confirm the injured person’s eligibility for the program by including it in their recovery plan.

The insurer is responsible for notifying the injured person and workplace rehabilitation provider (if involved) about any changes in eligibility for the program.

If immediate or short-term barriers prevent the injured person from starting work, the insurer should talk to them about their eligibility for CTP Transition to Work Assistance (refer to Transition to Work Assistance section below).

In some circumstances, a provider will conduct a workplace assessment to match the capacity of the injured person to the essential job requirements and assess their ability to perform the tasks safely.

Where specific equipment, workplace modifications, skills, certification, or licences are required for the role, the insurer should discuss this with the injured person, employer, and the workplace rehabilitation provider. Training and equipment can be explored under ‘Treatment and Care’ applying the reasonable and necessary criteria.

Confirming agreement

Once the eligibility of both the injured person and the employer has been confirmed by the insurer, they are responsible for the completion of the CTP Programs to Support Recovery at Work – Application Form. The insurer must ensure that all parties are aware and in agreement with the conditions as mentioned in the Terms of CTP Programs to Support at Work and is also required to provide a copy of the completed form and the SIRA Terms to the person and the new employer.

The insurer submitting the application must ensure that all parties:

• Understand the program benefits
• Agree to their roles and responsibilities
• Have completed and signed the form
• Have received a copy of the signed form, SIRA Terms and program information sheet

Conflict of interest

Where there is either a professional or personal relationship between the proposed new employer and the person, or a business relationship between any of the parties involved which may give rise to a conflict of interest, the provider should outline why the program should be approved. This should include the strategies that will be implemented to address the conflict of interest.

The application will need endorsement from SIRA to proceed if there is a conflict of interest identified.

Insurance

The insurer must ensure the employer has the necessary insurance including workers compensation coverage before developing a JobCover Placement Program proposal.

Accessing the JobCover Placement Program payment

The employer incentive payment is claimed by (and paid directly to) the new employer as a lump sum at the end of 12, 26 and 52 weeks respectively.

Please see below CTP Programs to Support Recovery at Work Reimbursements from SIRA

CTP JobCover6

The CTP JobCover placement program provides incentives to employers to employ persons who have a claim for a motor vehicle related injury and are unable to return to employment with their pre-accident employer.

The person is employed in accordance with industrial relations procedures and work health safety legislation. The program is designed to offset the cost of engaging a person with an existing injury.

JobCover6 supports an employer for a shorter period (12 to 26 weeks), in comparison to the JobCover Placement which provides long term support (12 months).

Program benefits

JobCover6 helps injured persons recovering from a motor vehicle accident locate suitable work where ongoing employment cannot be confirmed with a new employer.

The program supports employers to offer employment for up to 6 months duration to a person recovering from a motor vehicle accident, where they are looking for new employment.

JobCover6 provides benefits to a new employer to help offset the costs of engaging and training a new employee. The benefits include:

• incentive payments of up to $10,400 for up to 6 months
• protection against the cost of workers compensation claims associated with the existing injury for up to 2 years.

The program benefits can be used individually, as a combination, or as a total package to meet the needs of the employer and person.

Incentive payment to employers

An incentive payment to employers is payable for up to 6 months of work to a maximum amount of $10,400.

Payments are calculated on a weekly basis. The amount paid will be either the gross weekly wage paid* to the person, or $400 per week should the gross wage exceed the weekly incentive payment amount.

The employer may claim the incentive payment from the insurer at the end of the placement. If the placement is 12 weeks or longer, the employer and insurer should negotiate a payment schedule which is easy to administer and will maximise the person’s recovery at work outcome.

Protection from costs associated with the existing injury

New employers may be concerned about the financial impact on their business if a person’s existing injury impacts their new role. These concerns may be alleviated by a workplace assessment – refer to ‘Suitability of the role’ below.

If there is a change to a person’s existing injury during the first 2 years of their employment which results in a worker’s compensation claim being accepted, new employers will be reimbursed for any claims excess incurred as a result.

Eligibility

A person is eligible if they:

• have capacity for work and they are looking for new employment
• are receiving, or are entitled to receive, weekly payments under MAIA An employer may be eligible if they:
• are a different employer to the pre-accident employer
• have offered employment to a person for an agreed period and hold a current workers compensation policy with an insurer or a self-insurer’s licence
• provide a minimum of 64 paid hours per month or a return to pre-injury hours. Fewer than 64 hours may be considered if it can be demonstrated that the person will progress to meet this requirement within a reasonable timeframe
• are not grouped with the pre-accident employer for workers compensation insurance or insured under the same group self-insurer licence as the pre-accident employer.
• the employer is not in receipt of any other wage subsidy for the person
• can demonstrate adherence to their jurisdiction’s workers compensation and workplace health and safety legislation.

Concurrent programs

If a person obtains employment with two employers at the same time, the person is only eligible to use either the JobCover or JobCover6 program with one employer.

If an employer seeks to utilise either JobCover or JobCover6 programs for more than one person at the same time, each person should be working to their maximum certified capacity and the employer is to demonstrate they are able to provide adequate training and supervision.

Ongoing employment

If an employer offers ongoing employment after the end date of JobCover6 program, the employer may be eligible to transfer to the JobCover program for a further 6-month period.

A maximum of 12 months in total is available to a person for JobCover and JobCover6 programs.

Change of employer

The benefits of the program are not transferable between employers. However, if employment ceases and the person remains eligible for the program, the program may be offered to a new employer.

Principles

An application for the JobCover6 program must meet the following principles. The work:

• is appropriate to the person’s skills, functional and work capacity and is the most suitable option for the person’s circumstances
• will assist the person to remain engaged and active and supports their recover at work plan
• is safe and suitable for the person.

Preparing for the program

The person, insurer, employer or an approved workplace rehabilitation provider may determine that JobCover6 is a suitable strategy to help a person recover at work in new employment over a shorter period.

If a person, employer or workplace rehabilitation provider believes the program will assist a person to recover at work, they should discuss eligibility with the insurer as soon as possible. All applications for CTP Vocational programs are to be made to SIRA via the insurer. The insurer is responsible for notifying the person and provider if eligibility for the program changes.

Suitability of the role

A variety of employment arrangements are considered suitable. These include:

• full or part-time work
• casual work
• temporary work, where there is a fixed-term agreement.
• seasonal work.

Confirmation should be obtained in writing from the new employer (e.g. a letter of offer of employment or contract).

Establishment of a small business or other self-employment arrangement is not considered suitable under the program.

Workplace assessment

In some circumstances, a provider will conduct a workplace assessment to match the capacity of the person to the essential job requirements and assess the person’s ability to perform the tasks safely.

Where an assessment is required this may occur remotely, however, the provider must ensure that the employer has adequate controls in place to manage the person’s safety.

Where equipment or workplace modifications and/or certification or licences are required, the provider must ensure that this is implemented prior to commencement of employment. The provider should discuss the needs with the insurer.

Note: Any equipment, education or training, workplace modification, certification or licences required should be discussed with the person. This is to be supplied by the insurer under treatment and care, applying the reasonable and necessary criteria.

Conflict of interest

Where there is either a professional or personal relationship between the proposed new employer and the person, or a business relationship between any of the parties involved which may give rise to a conflict of interest, the provider should outline why the program should be approved. This should include the strategies that will be implemented to address the conflict of interest.

The application will need endorsement from SIRA to proceed if there is a conflict of interest identified.

Insurance

The insurer must ensure the employer has the necessary insurance coverage before developing a JobCover6 proposal.

Confirming agreement

Once the eligibility of both the person and the employer has been confirmed by the insurer, they are responsible for the completion of the CTP Programs to Support Recovery at Work – Application Form. The insurer must ensure that all parties are aware and in agreement with the conditions as mentioned in the Terms of CTP Programs to Support Recovery at Work, and is also required to provide a copy of the completed form and the SIRA Terms to the person and the new employer.

The insurer submitting the application must ensure that all parties:

• Understand the program benefits
• Agree to their roles and responsibilities
• Have completed and signed the form
• Have received a copy of the signed form, SIRA Terms and program information sheet

Accessing the JobCover6 payment

The employer incentive payment is claimed by and paid directly to the new employer by the insurer as a lump sum at the end of 12 and 26 weeks.

Up to $400 per week incentive payment will be calculated on the number of weeks the person participates in employment as per the JobCover agreement form (up

to a maximum $10,400). The amount paid per week will be either $400 or the person’s weekly wage if the amount is less than $400.

Please see below CTP Programs to Support Recovery at Work Reimbursements from SIRA.

Change in circumstances

If there is a significant change in circumstance that may affect eligibility for the program (for example, the person resigns from the job or the employer ceases trading), the CTP insurer must be notified by the person within seven days of becoming aware of the change.

Where a person’s weekly payments cease after the program commences, the program may continue, and the employer will still be eligible for all of the agreed benefits.

If ongoing claim liability is disputed following program commencement, or the person recovers damages for the motor accident injury, the insurer must advise SIRA immediately. If this occurs, it is up to SIRA to decide whether to continue to make incentive payments to the employer.

CTP Transition to Work

The CTP Transition to Work program provides funding to address immediate or short-term barriers or needs that prevent a person from obtaining or accepting an offer of employment with a new employer.

There are two payment tiers under the Transition to Work program:

• Tier 1 – up to $200 to help a worker prepare for job seeking or to commence work. The payment can be used more than once provided the cumulative costs do not exceed $200.
• Tier 2 – up to $5,000 to address an immediate or short-term barrier(s) preventing a worker from accepting a new employment offer (e.g. travel, transitional childcare arrangements, clothing). The payment can be used more than once provided the cumulative costs do not exceed $5,000.

Eligibility

An injured person is eligible if:

• they are receiving or are entitled to receive weekly payments under MAIA or have recently ceased receipt of weekly payments due to commencing employment
• they are unable to return to work with their pre-accident employer because of the injury, and there is an immediate or short-term barrier or need that prevents the person obtaining or accepting an offer of employment
• for Tier 2 applications – they have a confirmed offer of employment with a new employer that is:
  • for a period of three months or more, and
  • for a minimum of 64 paid hours per month, or equivalent to pre-injury hours if this is less than 64 paid hours per month. Fewer hours may be considered if it can be demonstrated that the person will progress to meet this requirement within a reasonable time frame.

Program principles

An application for the Transition to Work program must address the following principles:

1. The item or service must address an immediate or short-term barrier or need that prevents a person from participating in job seeking (Tier 1) or accepting an offer of employment (Tier 2).
2. The item or service must be cost-effective and demonstrate that other options are less effective in addressing the barrier or need.
3. The application must demonstrate the person’s capacity to maintain their financial arrangements independently when the Transition to Work payment has ceased.

Transition to Work Examples

Travel

Persons should use public transport where available and appropriate. If it is necessary to use a private vehicle, the vehicle must be appropriately registered and have compulsory third-party (CTP) insurance as a minimum. Private transport costs are reimbursed at 55 cents per kilometre.

Transitional childcare

Costs for childcare with a registered childcare provider will be considered, provided the person can maintain the costs associated with the childcare arrangements independently when the Transition to Work payments have ceased.

Clothing and related expenses

Reasonable costs for suitable clothing and personal grooming will be considered where the application meets the principles of Transition to Work. Uniforms or other clothes that are essential for commencing employment will be considered, but not the costs of standard issue uniforms, personal protective equipment and items of clothing that should be provided by the employer as part of their obligations under the Work Health and Safety Act 2011.

Application process

Preparing an application

The CTP Insurer is responsible for determining the injured person’s eligibility for the

Transition to Work program and is required to engage with an approved workplace rehabilitation provider to complete the CTP Programs to Support Recovery at Work – Application Form.

Assessing an application

Tier 1 program costs (costs under $200) do not require prior approval by the insurer. The provider must follow their service provisions and internal quality assurance processes to confirm the application meets SIRA Transition to Work requirements and principles. They must also inform the insurer in writing of the specific costs relating to the application.

Tier 2 program costs must be approved by the insurer before they are incurred. The insurer will advise the person and the person submitting the application of the decision within 10 working days of receiving a complete application.

If the application is not approved, the insurer must advise the person of the SIRA appeal process. Refer to CTP vocational support programs appeals below.

Accessing Transition to Work Payment

A completed CTP Programs to Support Recovery at Work – Reimbursement Form and relevant invoices or receipts must be submitted to facilitate payment.

Please see below CTP Programs to Support Recovery at Work Reimbursements from SIRA

CTP Programs to Support Recovery at Work Reimbursements from SIRA

To request reimbursement from SIRA, the insurer must submit the following for all approved programs:

1. A completed CTP Programs to Support Recovery at Work – Reimbursement Form signed by all parties

• Copies of any relevant supporting information including, but not limited to payslips of the person
• Evidence of the person employed to support the person’s return to work (de-identified appropriately) OR
• Evidence of person employed to support the person’s return to work with written consent provided by the person employed

2. Evidence to support that the insurer has made payment to the relevant party

3. Invoice to SIRA from the insurer outlining clearly the program being invoiced for

For the CTP Insurer: The insurer invoice must meet the minimum requirements set up by the Australian Taxation Office -  https://www.ato.gov.au/business/gst/tax-invoices/

4. Any other documentation / evidence that is requested by SIRA

Claim for payments should be submitted to SIRA promptly after the completion of the vocational program, but no later than 30 days after completion.

Accessing the Recover at Work Assist payment

To receive payment, the employer / insurer must:

• only claim for the wages of the person up to a maximum of $400 per week (this does not include superannuation or allowances)

Accessing the JobCover Placement Program / JobCover 6 payment

To receive payment, the employer / insurer must:

• only claim for wages paid to the person, this includes paid annual/recreational/sick leave
• not claim any other employer incentive payment for the person from another agency (e.g. another labour market wage subsidy program or any other employer incentive payment programs).
• Insurers must have controls in place to prevent duplicate payments being made and claimed. Payment should only be made where there is evidence of the person’s wages.

Note: An employer cannot claim for payments made to the person when the person is absent from work and in receipt of weekly entitlements.

Accessing Transition to Work Payment

To receive payment, the employer / insurer must:

• Invoice for products / services approved
• Proof of payments made – from insurer to person / third party vendor (remittance details / payment receipts)

Privacy and information sharing

It is the responsibility of the CTP insurer to ensure that all parties (injured person, employer and any other party involved) have received, read, understood, and agreed to the Terms of CTP Programs to Support Recovery at Work.

CTP Programs to Support Recovery at Work Appeals

Disagreement on eligibility

If there is disagreement about eligibility or use of the CTP Programs to Support Recovery at Work prior to submission of an application, the person and/or workplace rehabilitation provider should try to resolve the matter directly with the insurer in the first instance.

If the problem cannot be resolved, contact CTP Assist on 1300 656 919 or email [email protected].

Where a CTP Programs to Support Recovery at Work – Application Form has been submitted to the insurer and they have not signed the form indicating program approval, the person can request a review by the insurer.

If agreement has not been obtained following an internal review, an appeal can be lodged with SIRA by emailing [email protected].

The appeal must outline the reason(s) a review is requested and provide information to support the request. SIRA may ask for additional information from the person, person submitting the application, and/or the insurer.

SIRA will notify the person and the insurer of the outcome of the appeal within 10 working days of receiving an appeal and all the necessary supporting information.