- Workers Compensation Act 1987
- Workplace Injury Management and Workers Compensation Act 1998
- Workers' Compensation (Dust Diseases) Act 1942
- Workers Compensation (Bush Fire, Emergency and Rescue Services) Act 1987
- Workers Compensation Regulation 2016
- Workers Compensation (Dust Diseases) Regulation 2018
- Workers Compensation (Bush Fire, Emergency and Rescue Services) Regulation 2017
- Workers compensation guidelines
- NSW workers compensation guidelines for the evaluation of permanent impairment
- Workers compensation medical dispute assessment guidelines
- Guidelines for workplace return to work programs
- Workers compensation market practice and premiums guidelines
- Guidelines for the approval of treating allied health practitioners 2016 No 2
- Workers compensation licensed insurer business plan guidelines
Standards of practice
- Overarching claims management principles
- Standard of practice principles
- S1. Worker consent
- S2. Worker access to personal information
- S3. Initial liability decisions – general, provisional, reasonable excuse or full liability
- S4. Liability for medical or related treatment
- S5. Recurrence or aggravation of a previous workplace injury
- S6. Recoveries
- S7. Interim pre-injury average weekly earnings calculation
- S8. Insurer making weekly payments
- S9. Reduction in payments of compensation
- S10. Payment of invoices and reimbursements
- S11. Changes in capacity
- S12. Injury management plans
- S13. Additional or consequential medical conditions
- S14. Referral to an injury management consultant
- S15. Approval and payment of medical, hospital and rehabilitation services
- S16. Case conferencing
- S17. Section 39 Notification
- S18. Retiring age notification
- S19. Section 59A notification
- S20. Permanent impairment assessment reports
- S21. Negotiation on degree of permanent impairment
- S22. Insurer participation in disputes and mediations
- S23. Recovery of overpayments due to insurer error
- S24. Factual investigations
- S25. Surveillance
- S26. Arrangement for payments to Medicare Australia
- S27. Notification and recovery of Centrelink benefits from lump sum payments
- S28. Interpreter services
- S29. Cross-border provisions
- S30. Closing a claim
- S31. Death claims
- S32. Managing claims during the COVID-19 pandemic
- Workers compensation benefits guide
- Fees and rates orders
- Standards of practice
S14. Referral to an injury management consultant
Injury management consultants (IMCs) are facilitators who should be used to mediate between relevant parties to progress a worker’s recovery at or return to work and optimise health and work outcomes.
Injury management consultants will be engaged to assist workers identified as at risk of delayed recovery and in circumstances where a specific issue has been identified.
Insurers are only to refer to an IMC when:
and attempts have been made to resolve the issue.
Evidence on claim file
Before making a referral to an IMC an insurer is to contact the worker to discuss the intended referral, explain the role of the IMC and the reasons for referral.
If the insurer is considering a file review, the insurer is to ask the worker if they would like to be involved in discussions with the IMC, via a telephone call as part of a case conference with the NTD or relevant treatment provider. Alternatively, if the worker wishes to be more actively involved, the insurer is to offer a face-to-face appointment with the IMC instead of a file review.
Evidence on claim file
If an insurer refers to an IMC, the insurer is to advise the NTD that the referral has been made, provide the reasons for referral, and advise that the nominated treating doctor can be paid for time taken to communicate with the IMC.
Advice provided to the doctor within five days after the referral in made
When referring a worker:
|Evidence on claim file|
Insurers are to provide the worker with the following information before attending any appointment with an IMC:
|Written notification provided to the worker at least 10 working days before an IMC appointment|
When making a referral to an IMC, the insurer is to provide the IMC with sufficient information to support the referral, including:
Note: Referrals must not include questions concerning liability.
|Referral information to be provided to IMC at least 10 working days before an IMC appointment|
Insurers are to make subsequent IMC referrals to the same IMC unless that IMC:
|Evidence on claim file|
Injury management consultants (IMCs) should be used to provide expert advice and assistance regarding a worker’s recovery at/ or return to work.
An IMC is a registered medical practitioner experienced in occupational injury and workplace-based rehabilitation. An IMC can help progress a worker’s recovery at/return to work through communication with the Nominated Treating Doctor and other stakeholders as required.
Referral to an IMC is appropriate when a worker is identified as at risk of delayed recovery or there is a specific return to work or injury management issue.
An IMC helps the nominated treating doctor, worker, insurer and employer progress a worker’s recovery at/return to work and optimise health and work outcomes. An IMC is to assess the situation, examine the worker (if necessary), and discuss possible solutions with all parties (specifically the nominated treating doctor). IMCs are not involved in the treatment of a worker, though they may comment on treatment in respect to recovery at/return to work. The IMC may also visit the workplace.
An IMC does not provide an opinion on causation or liability; or undertake a functional capacity evaluation or work capacity assessment for the insurer.
The worker and the nominated treating doctor are to be provided with information about the role of the IMC and the consultation process.
Consultation with an IMC is not an examination under section 119 of the 1998 Act and there is no impact on benefits or entitlements if the worker elects not to participate.