As a specialist, what information am I required to include in the initial consultation report to the insurer?
As per the Workers Compensation (Medical Practitioner Fees) Order the report will contain:
- the patient’s diagnosis and present condition
- the patient’s likely capacity for pre-injury work or suitable employment
- the need for treatment or additional rehabilitation
- medical co-morbidities that are likely to impact on the management of the worker’s condition (in accordance with privacy considerations).
What other doctors are involved in the worker’s claim, and am I as the nominated treating doctor required to communicate with them when requested?
An insurer may refer a worker to an injury management consultant when there are barriers to a worker’s recovery at or return to work. When you agree to be the nominated treating doctor to a worker, you are obliged to communicate with all relevant parties involved in their return to work.
No, an employer cannot insist that they or their representative is present during a consultation. However, if an employer (or their representative) accompanies the worker to the consultation, you can invite them in at the conclusion, to update them and work together in recover at work planning. The employer’s representative can be invited to attend a case conference provided the worker consents.
Can I edit sensitive medical information not related to the worker’s injury from the report for the insurer?
Yes, you can redact information that is not related to the workers compensation claim.