Medical and related services

Independent consultants

An independent consultant is an allied health practitioner approved by SIRA to provide an independent peer review of allied health practitioner treatment in the NSW workers compensation system.

Independent consultants are required to abide by SIRA’s conditions of approval, and are divided into two treatment groups according to their expertise:

• physical (physiotherapists, chiropractors and osteopaths)
• psychological (psychologists and counsellors).

They are experienced in the assessment, treatment and management of work-related injuries. They can help ensure appropriate and effective treatment for workers.

What does an independent consultant review involve?

An independent consultant may conduct one of the following:

Stage 1 File review

This involves a review of allied health recovery requests (AHRRs) and/or other relevant documentation, to help the insurer determine reasonably necessary treatment services or equipment prescription. This is only to occur where the specialised skills of an independent consultant are required.

Stage 2 File review and discussion with treating allied health practitioner

A stage 2 review involves the consideration of all AHRRs and other relevant documentation, as well as a discussion with the treating allied health practitioner.

The discussion with the treating practitioner is likely to include current treatment outcomes, proposed treatment, and intervention to build the worker’s capacity for employment.

Stage 3 Assessment of worker and discussion with treating allied health practitioner

If after reviewing the referral information, the independent consultant determines an assessment of the worker is required for an effective review, they will ask the insurer to advise the worker of what is involved and arrange an appointment.

The consultant will contact the treating practitioner to discuss current treatment outcomes, proposed future treatment, and intervention to build the worker’s capacity for employment.

After the review, the independent consultant will write a report with their recommendations within approximately 10 working days. The report will be provided to the insurer, treating practitioner, and nominated treating doctor.

Further information can also be found in Insurer guidance GN 6.5 Independent consultants.

Complaints about independent consultants

If a worker has concerns about the conduct of an independent consultant during the consultation, they should raise those issues with the consultant at the time. The consultant should record the complaint and forward this to the referrer with their report, advising the worker to do the same.

Alternatively, the worker should raise their concerns with the referring party as soon as possible after the consultation, and the insurer should take action in accordance with its complaints management process.

If the issue is not satisfactorily resolved, the worker may forward their complaint to the Australian Health Practitioner Regulation Agency, the Health Care Complaints Commission, or contact SIRA on 13 10 50.