Proposed changes to improve worker outcomes
Positive outcomes for workers, including being satisfied with the experience, is central to the programme.
We’re considering a number of improvements when workers do get injured to ensure effective cover decisions are made and return to work is appropriate.
Routing of new claim information
We know the submission of ACC45 forms can cause issues so we are considering:
- Us acting as a clearing house for all forms so we can effectively redistribute these and remove the guesswork for medical providers, or:
- Improving communication with medical providers so they can easily identify the right place to send forms.
Separation of cover decision and liability decision
We want to improve how and when cover decisions are made so are considering:
- Separating cover decisions and liability decisions so that treatment and compensation for injured workers can begin without delay. AEs can then make liability decisions and work with us to transfer claims where non-work injuries occur, or:
- We make all cover decisions to avoid delays, but liability decisions and claims management still stays with the AE or TPA.
Determining capacity to work
We want to make sure there are good and consistent practices when determining capacity to work so are considering:
- Providing high-level principles, or:
- Prescribing a best-practice approach through consultation with medical professionals, AEs, and TPAs.
We’ll also set out specific claims management performance measures which are in line with our own expectations of service.
To get a better understanding of how it could work, see our scenario on when a worker is injured.