Your patient can choose their own Nominated Treating Doctor (NTD). Most often the NTD will be a General Practitioner, but a specialist can also act as one.
Medical professionals and other health practitioners play an important role in ensuring patients receive the right treatment at the right time and are supported when recovering and returning to work.
As an NTD, you are likely to have a strong influence on your patient’s beliefs about their recovery and readiness to return to work. The first conversation can significantly impact their likelihood of returning to work. It's important to talk to your patient about the health benefits of returning to work when appropriate.
GPs are often the first point of contact with a person who has been injured at work, and are the entry point to the rest of the health care system.
You may also have contact with the patient's employer to discuss their capacity for work and discuss suitable work options. Many employers are able to offer modified hours or duties to support their recovery at work.
A completed and up-to-date certificate of capacity is essential for your patient to receive the best care, and to ensure they receive a wage reimbursement and any other types of payment they are entitled to. The certificate of capacity is also required for any additional service providers to receive payment. In addition to providing usual clinical intervention and management, as a NTD, your role also includes:
- Setting expectations of recovery, including recovery at work and return to work
- Identifying barriers and potential psychosocial risk (non-injury related) factors that may delay recovery and prevent return to work
- Completing a certificate of capacity
- Collaborating with your patient, the insurer, employer and other service providers to develop plans that assist their return to, and recovery at, work
- Participating in the development of an Injury Management Plan
- Arrange and monitor appropriate treatment for your patient where the treatment is reasonably necessary as a result of the workplace injury
- Provide information to the insurer regarding your patient’s capacity and treatment needs.
You are entitled to payments for services provided, including the time you spend speaking with the insurer and the employer.
The claims process
Date of injury
You will be required to provide your patient with a certificate of capacity.
Your patient is encouraged to report their injury to their employer as soon as possible. They can also notify the insurer directly online.
The employer must notify the insurer of the injury within 48 hours. Your patient will often provide them with a copy of their certificate of capacity.
Within 7 days, the insurer will determine whether your patient has been approved to receive provisional payments.
This may include up to 12 weeks of weekly payments, as well as reasonably necessary medical and related treatment up to $7500 whilst liability is being determined. Your patient will continue to be eligible for medical and related treatment during this time.
4 to 12 weeks
During this time, you will work with the insurer and other service providers to assist with your patient’s return to, and recovery at, work.
This may include participating in the development of an injury management plan by the insurer, and ensuring your patient is receiving the right intervention to assist them with achieving their recovery and return to work goals.
Psychosocial concerns are best addressed as soon as they are identified.
After 130 weeks of receiving payments, a decision will be made about your patient’s capacity for work. The outcome of this decision will determine whether your patient will continue to receive weekly payments.
Patients that continue to receive payments beyond 130 weeks will cease to receive these payments at five years, unless they have whole person impairment of 21 per cent or greater. These patients may continue to receive weekly payments until retirement age (plus one year).
Access to reasonably necessary medical treatment will extend for up to two years after weekly benefits have ceased. This may extend further in certain situations depending on your patient’s level of whole person impairment.
Responding to requests for information
During a workers compensation claim, insurers, legal representatives and other stakeholders may request further information regarding your patient and their injury.
If the insurer requires additional information when assessing the claim, you may be contacted to provide further clarity about the nature of their injury, their capacity or treatment needs.
If another party requests information you’ve already provided to the insurer, you can refer them to the case manager assigned by the insurer.
Payment rates for these reports are determined by the relevant SIRA fees and rates orders 2020 (See Medical Practitioners).
To learn more about your role as the NTD and for further information about the workers compensation system, refer to the SIRA guide for general practitioners.