Can my patient lodge a workers compensation claim if they think they contracted COVID-19 at work?
In some circumstances an adverse reaction to the COVID-19 pandemic may be a compensable workplace injury. To be compensable, a worker will need to establish their employment was either a substantial or the main contributing factor to the injury. Each claim will be assessed on its own merits.
Temporarily feeling unwell after a worker receives the vaccine will not be compensable, but a pathological change in an affected body part may be.
Consideration will be given to whether an employer required or encouraged the worker to get the vaccine, whether the worker was vaccinated during work hours, and any other factors that influenced the worker to be vaccinated. When lodging a claim, employers and workers will be required to provide information on the link between work and the adverse reaction to the vaccine.
Do I need to continue providing Certificates of Capacity to my patients during the COVID-19 pandemic?
Injured workers are required to produce Certificates of Capacity from their treating doctor for any period in which they are entitled to weekly payments. This is part of the legislation under which icare operates.
During a pandemic situation, it may be difficult for a patient to see a doctor on a specific day. However, the legislation contains special provisions that may assist you in continuing to provide certificates to patients.
Certificates can be issued for more than 28 days in special circumstances, the person giving the certificate must state the special reasons for the longer period on the certificate. This may be appropriate when a patient’s injury is stable and their capacity is unlikely to change over the period of the certificate.
Longer certificates reduce the risk for workers and doctors potentially being exposed to coronavirus.
Are allied health practitioners allowed to provide Certificates of Capacity?
Yes, amendments to the regulations have been made to allow SIRA-approved physiotherapists and psychologists to issue Certificates of Capacity. The initial Certificate of Capacity must still be issued by a medical practitioner (the Nominated Treating Doctor).
These changes are designed to relieve pressure on general practitioners and the overall health system during the COVID-19 pandemic; they are also time limited and will be in place for a further12 months (from April 2021) unless repealed earlier.
SIRA has produced a Certificate of capacity/Certificate of fitness for treating physiotherapists or psychologists and has released a training package for treating physiotherapists and psychologists on how to complete the Certificate.
Can I deliver telehealth consultations for workers compensation patients instead of in person?
Yes, telehealth consultations can be delivered by medical practitioners and SIRA-approved allied health practitioners. Telehealth refers to any consultation delivered via electronic means, including videoconference or telephone.
The re-gazetted Fees Orders took effect from 17 April 2020 and additional changes have been made to the following:
- Workers Compensation (Medical Practitioner Fees) Order 2020 No.3
- Workers Compensation (Surgeon Fees) Order 2020 No.2
- Workers Compensation (Orthopaedic Surgeon Fees) Order 2020 No.2
- Workplace Injury Management and Workers Compensation (Medical Examinations and Reports Fees) Order 2020 No.2
- Workplace Injury Management and Workers Compensation (Injury Management Consultants Fees) Order 2020 No.2
- Workers Compensation (Physiotherapy, Chiropractic and Osteopathy Fees) Order 2020 No.3
- Workers Compensation (Psychology and Counselling Fees) Order 2020 No.3
- Workers Compensation (Accredited Exercise Physiology Fees) Order 2020 No.3
- Workers Compensation (Independent Consultant Fees) Order 2020 No.3
- Workers Compensation (Hearing Aid Fees) Order 2020 No.2
Do I need pre-approval to provide telehealth consultations to workers compensation patients?
General Practitioners do not need to seek pre-approval for telehealth services.
Medical specialists do not need to seek pre-approval for telehealth services for consultations within three months of the worker's date of injury.
All other telehealth services require pre-approval, including those provided by SIRA-approved allied health providers. You should obtain pre-approval through the normal pre-approval process and must be consented to by the health provider, worker and claims service provider.
All practitioners must consider the appropriateness of this mode of service delivery for each worker on a case-by-case basis. Practitioners are responsible for delivering telehealth services in accordance with the principles of professional conduct and the relevant professional and practice guidelines to ensure that all care is taken to ensure the safety, appropriateness and effectiveness of the service.
Are there changes to the expectations for Workplace Rehabilitation Providers during the COVID-19 pandemic?
The role of Workplace Rehabilitation Providers continues to be important in terms of facilitating an injured worker’s return to work. Expectations remain unchanged at this time in relation to the focus on return to work and recovery at work. We realise that strategies for return to work may look different and innovative approaches may be required as the COVID-19 pandemic progresses.
What are the impacts of COVID-19 on surgery and other medical procedures?
Restrictions on elective surgery due to COVID-19 have been lifted gradually from 28 April 2020 with category 2 and some category 3 procedures approved to recommence. Refer to the Department of Health website for details on the procedures permitted.
The simplified time-based clinical urgency categories are as follows:
- Category 1: Procedures that are clinically indicated within 30 days
- Category 2: Procedures that are clinically indicated within 90 days
- Category 3: Procedures that are clinically indicated within 365 days
Category 1 surgeries are for life-threatening conditions and include urgent procedures such as limb amputations and heart surgery. Category 2 can include surgeries such as a colonoscopy or amputation of a digit. While Category 3 is generally for non-urgent procedures, such as plastic or reconstructive surgeries, where patients can wait up to a year until admission.
Where an injured worker is unable to return to work due to business disruption, can a Workplace Rehabilitation Provider be engaged to ensure an injured worker progresses with their treatment plan?
The primary role of a Workplace Rehabilitation Provider is to facilitate return to work, and medical monitoring is not typically part of this role. However, where suitable duties have been withdrawn, a new Return to Work goal for the injured worker should be identified. Building capacity for employment may be appropriate as part of this strategy and should be discussed with the Case Manager.
Will expectations for Rehabilitation Providers to achieve successful return to work outcomes change during the pandemic?
Rehabilitation Providers are still expected to focus on achieving successful return to work outcomes. Their primary focus should be to support workers to return to work and stay in employment.
Under the current unprecedented circumstances icare is closely monitoring emerging trends within the scheme, and outcomes with relation to services from third party service providers. icare will partner with providers to support the most effective and efficient services for our customers as needs become apparent in this rapidly changing environment.
Is a worker able to complete a final review of hearing aids (after the 30-day trial) with the hearing aid provider over teleconference or video conference?
It is appropriate to perform the final review of hearing aids remotely if both the worker and the provider agree to this mode of consultation. It is possible to undertake this step of the process remotely and remain compliant with the relevant SIRA Guidelines. Note however that there is a requirement to complete the initial hearing assessment in person.
For any assessments conducted in-person, it is important that any current Public Health (COVID-19 Mandatory Face Coverings) Orders are adhered to. Information on current Orders can be found on the NSW Health website.
Can my patient lodge a workers compensation claim if they have received the COVID-19 vaccine for work, and have had an adverse reaction?
In some circumstances an adverse reaction to the COVID-19 vaccine may be a compensable workplace injury. To be compensable, a worker will need to establish their employment was either a substantial or the main contributing factor to the injury. Each claim will be assessed on its own merits.
Temporarily feeling unwell after a worker receives the vaccine will not be compensable, but a pathological change in an affected body part may be. Consideration will be given to whether an employer required or encouraged the worker to get the vaccine, whether the worker was vaccinated during work hours, and any other factors that influenced the worker to be vaccinated. When lodging a claim, employers and workers will be required to provide information on the link between work and the adverse reaction to the vaccine.