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  1. 1. CLAIMS & INJURY MANAGMENTOHS5110 BY CAITLIN HOWARD
  2. 2. CONTENTS
  3. 3. OBJECTIVES OF THE SESSION
  4. 4. Claims and injury management Workers’ compensation is a legislative privilege Provides compensation- both financial and rehabilitation services Provided to workers suffering injury/disability arising out of or during the course of employment  Including accidents or illness/diseases Compulsory for an employer to have Workers’ Compensation Insurance Policy
  5. 5. Responsibilities of injury management personnel General Manager Supervisor Occupational Health Nurse (OHN) Line Management Injury Management coordinator (IMC)
  6. 6. Process of injury claims Employee to inform Supervisor Injury is to be treated ASAP
  7. 7. Process of injury claims Employee referred for medical review – medical professional (OHN - gatehouse onsite) Inform GM within the 12hrs of being reported to OHN Complete an injury incident report
  8. 8. Process of injury claims Reported in company data management system (DMS) Injury to be reviewed by Doctor – provide a ‘First’ medical certificate
  9. 9. Process of injury claim Establish a Case Management Team to coordinate the employee’s return to work Create a Return to Work Plan
  10. 10. Process of injury claim Notify company workers compensation department Any Restricted Work Cases (RTW) or Lost Time Cases(LTC) need to document:  Occurrence report  Mining injury report form  Mines record book
  11. 11. Process of injury claim Lodge a claim- use Form 2B (workers comp form on Workcover website) Employee information kit offered by company File a claim for insurance payout
  12. 12. Example of workers comp form
  13. 13. Process of injury claims Injury Management – review Injury Management case closure  injury management process is complete when employee can sustain normal duties without restrictions If employee is unable to return to normal duties, case referred to HR for further management
  14. 14. W.A. legislation & relevant resources Workers’ Compensation and Injury Management Act 1981 Workers’ Compensation and Injury Management Regulations 1982 Workcover WA Department of Mines & Petroleum (DMP) Resources Safety
  15. 15. Injury claim optimal practice Effective risk management & early intervention Develop working relationship with rehabilitation agency and specialised medical practice Competent injury/rehabilitation management Commitment by injured worker to return to work
  16. 16. Summary: Injury & illness management flowchart Injury/illness reported to IMC, supervisor & department manager Notification of injury/illness received by OHNYE Is injury/illness work N S related? O Medical certification is provided to company, incident is recorded in HSEC DMS as appropriate JCS reviewed by employees medical providedYE Are restricted duties N Employee returns to work S required? O as normal Return to work plan developed and implemented as per the company Rehabilitation and Return to Work processes Employee follows Return to Is employee entitled toYE N work plan until S workers compensation? O resolution/finalisation Workers Compensation procedures followed
  17. 17. Conclusion Legislation for the management of injury is important in successful company management Appropriate resources and injury care legislation are essential for minimising both financial and physical cost for employee and employer
  18. 18. ReferencesJournals Cornally, S. (1986). Managements participation in rehabilitation. Success versus failure. Journal of Occupational Health & Safety – Australia & New Zealand, 3(4), 382 – 387. Weaver, M. (2006). Specialist medical practices in industrial health. In Barrett, T. & Browne, D. (Eds.) Rehabilitation. Work and Beyond. (pp. 51 - 66). Perth: Vineyard. Yates, R. (2006). Employers perceptions of claims/injury management and rehabilitation in South Australia. Asia Pacific Journal of Human Resources, (44) 1, 102–122,Websites Department of Mines & Petroleum (DMP) Resources Safety. (2006). (Retrieved March 13, 2013) from http://www.dmp.wa.gov.au/ WorkCover Western Australia. (2005). Guidelines for Injury Management in the Workplace. (Retrieved March 11, 2013) from http://www.workcover.wa.gov.au WorkCover Western Australia. (2005). Workers‟ Compensation Code of Practice (Injury Management) 2005. (Retrieved March 11, 2013) from http://www.workcover.wa.gov.au WorkCover Western Australia. (2005). Workers‟ Compensation and Injury Management in WA. Guidance Notes for the Code of Practice (Injury Management) 2005. (Retrieved March 11, 2013) from http://www.workcover.wa.gov.au

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