Injury management consultants

Published: 12 August 2019
Last edited: 1 March 2021

An injury management consultant is a registered medical practitioner approved by SIRA and experienced in occupational injury and workplace-based rehabilitation.

Injury management consultants are facilitators who can help the nominated treating doctor, worker, employer, insurer and other service providers to progress the worker’s recovery at or return to work and optimise health and work outcomes.

An injury management consultant assesses the situation, examines the worker (if necessary) and mediates between the parties to find possible solutions.

Injury management consultants are not responsible for directing treatment of a worker, although they may comment on treatment in respect to overcoming barriers to recovery at/return to work.

A consultation may be in-person with the worker, or involve a file review, followed by a discussion with the nominated treating doctor and other relevant stakeholders (for example, allied health practitioners, rehabilitation providers and the employer).

When to engage an injury management consultant

A referral to an injury management consultant may be arranged when there is a specific return to work or injury management issue or the worker is at risk of delayed recovery.

Issues may include:

  • confused goals
  • complexity of the injury or the workplace environment
  • poor communication between insurer, employer or nominated treating doctor
  • perceived conflict between the recommendations of the nominated treating doctor and workplace requirements
  • unexpected changes in work capacity
  • disagreement about the suitability of work
  • difficulties in upgrading duties at work as anticipated
  • current treatment (or lack of treatment) which may be creating a barrier to recovery at work
  • where treatment is not achieving the desired outcomes.

Where a nominated treating doctor, employer or worker identifies the need for an injury management consultant for any of the reasons stated above, they may contact the insurer to organise a referral.

S14. Referral to an injury management consultant
Principle
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.

What will the injury management consultant do?

The injury management consultant will first review the worker’s file. They may also assess the worker.

The injury management consultant will then talk to the nominated treating doctor about possible options and will attempt to mediate a solution to the issue. They may also talk to the employer or allied health professionals as part of this process.

The consultant will write a report which is to be provided to the insurer, worker and nominated treating doctor. A copy of the report may also be provided to the employer and any other party involved in the engagement of the injury management consultant. The report will summarise the action to be taken, along with the agreed outcomes, timeframes and milestones to reach the outcomes.

If the injury management consultant and the nominated treating doctor cannot agree on the action plan for the worker, the consultant may suggest alternative actions to the insurer, such as a referral for an independent medical examination (see 'Independent medical examinations') or an approved workplace rehabilitation provider (see 'Workplace rehabilitation provider').

The injury management consultant is not to comment on causation or liability. They cannot undertake a functional capacity evaluation or work capacity assessment for the insurer.

Part 6 of the Workers compensation guidelines (the Guidelines) and the injury management consultant fact sheet provides more information about injury management consultants.

Workers Compensation Commission

A worker or an employer can request the Personal Injury Commission (the Commission) to resolve a dispute about the suitability of work duties.

When this occurs, the Commission may request an injury management consultant to conduct a workplace assessment and provide an opinion regarding the availability of suitable duties.

The role of the injury management consultant for the Commission is to help resolve a dispute about return to work. For further information, refer to the Commission website.

Complaints about injury management consultants

If the worker has concerns about the conduct of the injury management consultant during the examination, they should raise those issues with the consultant at the time of the examination. 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 Health Care Complaints Commission, Medical Council of NSW or SIRA on 13 10 50 or by email at [email protected].

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