Referral to an independent consultant
A referral for an independent consultant review should occur early in the recovery process in order to achieve the best outcome for the worker.
Any member of the support team may recommend a referral to an independent consultant. The insurer will approve the referral with the information provided from any third party. A standard referral template should be used and is available on our website.
The independent consultant should be (where possible) of the same discipline as the allied health practitioner managing the worker.
A referral may be initiated in the following ways:
At the request of the insurer
The insurer should consider a referral to an independent consultant where an allied health practitioner requests treatment continues beyond 16 sessions, or if, after discussion with the treating allied health practitioner, there is concern about:
- the treatment duration, frequency and/or whether treatment is reasonably necessary
- treatment that has continued for an extended period without any improvement in functional outcomes, particularly in relation to a worker’s capacity
- the treatment approach most likely to achieve positive work outcomes for the worker
- barriers to recovery at work and/or psychosocial risk factors for delayed recovery and work loss.
The insurer should confirm the appropriateness of the referral to an independent consultant using their own internal resources (for example injury management advisor, team leader). They should also ensure that there is no conflict of interest between the independent consultant and allied health practitioner.
At the request of the allied health practitioner
As an allied health practitioner, you are encouraged to request involvement of an independent consultant where barriers to recovery, progress, return to work or active participation are evident, and you consider that an independent opinion and/or expert advice is likely to be beneficial in the management of the worker’s injury.
SIRA supports the proactive involvement of an independent consultant in these cases in order to achieve the best outcome for the worker.
Contact the insurer by telephone or note your request and rationale in the space provided on the AHRR.
At the request of another member of the support team
Other members of the support team, such as the employer, doctor, workplace rehabilitation provider or worker, can request an independent consultant review if recovery progress has been delayed, or if guidance regarding treatment management options is required.