OR SERVICE DELIVERY PRINCIPLES - EFFECTIVE 1 JULY 2015
Contents ............................................................................................................................................................................................... 1
1. ABOUT THIS SCHEDULE ........................................................................................................................................................... 5
2. SERVICE TYPES .......................................................................................................................................................................... 5
3. REFERRAL CONTEXT ................................................................................................................................................................ 6
Worker choice of OR Provider ..................................................................................................................................................... 6
OR Approval form .......................................................................................................................................................................... 6
4. PROCEDURAL CONSIDERATIONS ......................................................................................................................................... 6
Worker representative ................................................................................................................................................................... 6
Worker Privacy Considerations ................................................................................................................................................... 7
OR Consultant Title ....................................................................................................................................................................... 7
5. INJURY EMPLOYER’S OBLIGATIONS ..................................................................................................................................... 7
Injury employer’s RTW obligations ............................................................................................................................................. 7
Determining whether RTW with the injury employer has been exhausted ........................................................................... 8
6. REPORTING .................................................................................................................................................................................. 8
REPORT TEMPLATES & RECIPIENTS .................................................................................................................................... 8
WHEN OR REPORTS SHOULD NOT BE PROVIDED TO the INJURY EMPLOYER ....................................................... 8
WHEN OR REPORTS SHOULD NOT BE PROVIDED TO A WORKER.............................................................................. 8
Complete reports ........................................................................................................................................................................... 9
RECOMMENDATIONS FOR OTHER TYPES OF OR SERVICES, IN REPORTS............................................................. 9
when progress reports are not required (for oes) ................................................................................................................... 10
7. FUNDING REQUESTS ............................................................................................................................................................... 10
FUNDING REQUESTS & TEMPLATES .................................................................................................................................. 10
OR Provider Travel ...................................................................................................................................................................... 10
CONTACTS UPON RECEIPT OF OR APPROVAL FORM .................................................................................................. 11
Managing the expectations of the parties associated with a worker’s RTW ....................................................................... 12
Workplace meetings .................................................................................................................................................................... 12
8. SERVICE DELIVERY PRINCIPLES - RTW PRE INJURY EMPLOYER ............................................................................ 12
REQUIRED ACTIVITIES AS part of AN INITIAL REPORT .................................................................................................. 12
CONTENTS OF AN INITIAL REPORT .................................................................................................................................... 13
activities as part of oes & CONTENTS of progress reports .................................................................................................. 13
CONcURRENT OES and NES SERVICING ........................................................................................................................... 14
services during 13 week sustainable RTW period .................................................................................................................. 14
OES WHERE WORKER ON PIH, NOT AT PID ..................................................................................................................... 14
OES beyond six months of servicing without RTW ................................................................................................................ 14
9. SERVICE DELIVERY PRINCIPLES – WOKRPLACE SUPPORT SERVICES (WSS) ..................................................... 15
procedural INFORMATION ........................................................................................................................................................ 15
PRinciples of WSS service delivery .......................................................................................................................................... 15
Managing the expectations of the parties ................................................................................................................................ 15
Focus initially the RTW goal with the injury employer ................................................................................................................... 16
Worker with a potential CWC within 3 months ........................................................................................................................ 16
when to cease wss ...................................................................................................................................................................... 16
10. BETTER @ WORK - SERVICE DEFINITION ...................................................................................................................... 17
BETTER @ WORK SERVICES ................................................................................................................................................ 17
activities for better @ work INITIAL REPORT ......................................................................................................................... 18
Better @ Work PROGRESS REPORTS .................................................................................................................................. 20
Better @ Work RTW CASE CONFERENCE with the agent ................................................................................................. 20
Better @ Work - conclusion ....................................................................................................................................................... 21
11. SERVICE DELIVERY PRINCIPLES – RTW NEW EMPLOYER ........................................................................................ 22
CAPACITY SUPPORT SERVICE (CSS) ................................................................................................................................. 23
JOB SEEKING SERVICE (JSS) ................................................................................................................................................ 24
TRANSFERABLE SKILLS ANALYSIS SERVICE (TSA) ....................................................................................................... 26
130 WEEK VOCATIONAL REPORT - purpose and CONTENT .......................................................................................... 27
Subsequent 130 WEEK VOCATIONAL REPORT - Purpose ............................................................................................... 28
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Worksafe Incentive Scheme for Employers (WISE) ............................................................................................................... 28
13. TRAINING AND REDEPLOYMENT ....................................................................................................................................... 29
Identifying redeployment opportunities - Pre injury employer ............................................................................................... 29
Identifying a training course - new employer ........................................................................................................................... 29
retraining ....................................................................................................................................................................................... 29
Worker participation in training .................................................................................................................................................. 30
Enrolment in a training course ................................................................................................................................................... 30
14. SUSPENDING AND CEASING OR SERVICES .................................................................................................................. 30
When OR services should be suspended or ceased ............................................................................................................. 30
suspension – worker retraining .................................................................................................................................................. 31
Ceasing OES if NCC first 3 months .......................................................................................................................................... 31
Recommencing services - PRE INJURY EMPLOYER .......................................................................................................... 31
Recommencing services - new employer ................................................................................................................................ 32
Services previously suspended or ceased ...................................................................................................................................... 32
After non sustainable RTW ............................................................................................................................................................. 32
After a sustainable RTW ................................................................................................................................................................. 32
After incentive paid employment ceases or medical evidence received work is no longer suitable ............................................. 32
NES during weekly payment ‘non entitlement period’ ............................................................................................................ 32
15. RTW INCENTIVES - GENERAL ............................................................................................................................................. 33
RTW incentive most usually paid once .................................................................................................................................... 33
RTW incentive not payable in certain circumstances ............................................................................................................. 33
16. RTW INCENTIVES - FOR OR SERVICES PRE INJURY EMPLOYER ............................................................................ 34
Worker absent for > 5 working days during 13 week sustainability period ......................................................................... 34
17. RTW INCENTIVES - FOR OR SERVICES NEW EMPLOYER .......................................................................................... 34
Worker’s privacy following a RTW with a new employer ....................................................................................................... 34
General conditions for paying an incentive - FOR RTW NEW EMPLOYER ...................................................................... 34
RTW with injury employer after NES commenced ................................................................................................................. 35
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OR PROVIDER WISE PLACEMENTS ..................................................................................................................................... 35
RTW incentive not payable in certain circumstances ............................................................................................................. 35
Worker absent for more than 5 working days during 13 week sustainable RTW period .............................................................. 35
Self-employmentas an option during NES ...................................................................................................................................... 35
Specific conditions for paying a second incentive .................................................................................................................. 35
18. GP RTW CASE CONFERENCE ............................................................................................................................................. 36
Reasons for arranging a GP RTW Case Conference ............................................................................................................ 36
Advising the agent ....................................................................................................................................................................... 36
Worker to be advised if others have been invited to the conference ................................................................................... 36
Scheduling a GP RTW Case Conference ................................................................................................................................ 37
Confirming the agreed actions from a GP RTW Case Conference ..................................................................................... 37
Information about GP RTW Case Conference in next OR provider report ......................................................................... 37
Expected outcome from a GP RTW Case Conference ......................................................................................................... 38
OR provider fees for GP RTW Case Conference ................................................................................................................... 38
GP fees for GP RTW Case Conference ................................................................................................................................... 38
19. GP RTW QUESTIONNAIRE .................................................................................................................................................. 38
20. FURTHER INFORMATION ...................................................................................................................................................... 39
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1. ABOUT THIS SCHEDULE
Occupational Rehabilitation (OR) services are recognised by WorkSafe Victoria (WorkSafe) to support a
worker to return to work (RTW).
This Schedule provides information on the service delivery principles and requirements.
This Schedule must be read in conjunction with the “OR Fee Schedule” and replaces prior information and
guidance released by WorkSafe.
Other information that should be accessed for delivering OR services includes:

Relevant sections of WorkSafe Online Claims Manual

Relevant legislation

Guidance provided or released by WorkSafe related to occupational rehabilitation services

Relevant information at WorkSafe.vic.gov.au.
2. SERVICE TYPES
OR services approved by WorkSafe fall into two main categories, namely those aimed at facilitating return to
work with the pre injury employer and those for return to work with a new employer. The specific services
are listed as follows:
Return to work pre injury employer:

Original Employer Services (OES):
o
For primary physical injury claims
o
Workplace Support Services for primary mental injury claims (WSS)
o
The Better @ Work (B@W).
Return to work new employer:

New Employer Services (NES):
o
Job Seeking Service (JSS)
o
Capacity Support Service (CSS)
o
Transferable Skills Analysis Service (TSA)
Agents are responsible for identifying the right claim, at the right time for a referral to these services.
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3. REFERRAL CONTEXT
The agent is responsible for managing injured worker claims and Victorian insured employer premiums.
The agent is also responsible for managing the return to work obligations of workers and employers and
identifying when or what return to work assistance is required.
Based on information gathered from workers, employers and treating health practitioners (THPs), agents will
identify those claims that could benefit from OR services, decide when those services are most appropriate
and the type of service.
Workers and employers might also request assistance with OR services, however the cost of those services
can only be approved by an agent.
For more information, refer to relevant sections of WorkSafe Online Claims Manual.
WORKER CHOICE OF OR PROVIDER
Once the need for an OR service has been identified, the agent must ensure that the worker is given a list of
at least three OR providers (where available) to choose from. A worker will select an OR provider from this
list or if they do not choose an OR provider, the agent will choose an OR provider on their behalf.
For more information, refer to relevant sections of WorkSafe Online Claims Manual.
OR APPROVAL FORM
Once the requirements of OR choice have been satisfied, an agent will advise an OR provider that OR
services have been approved by sending them an OR Approval Form. Whenever possible and appropriate,
the form must have relevant medical opinion/information attached confirming the worker’s capacity for work
including medical restrictions or potential capacity for work.
4. PROCEDURAL CONSIDERATIONS
WORKER REPRESENTATIVE
The legislation allows a worker to be represented, assisted and supported in the RTW process. A worker
may request their representative be involved in meetings with, or arranged by the agent or an OR provider
with the injury employer or the worker’s THP. OR reports or information prepared by an OR provider for a
worker should be provided to the worker representative.
A worker may verbally advise the agent or an OR provider that a person is acting as their worker
representative. On being made aware of a worker representative, the agent and an OR provider should
liaise with the representative in addition to the worker when scheduling any meetings with the worker so the
representative can be present.
Note that the legislation states that a worker representative cannot include a legal practitioner.
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WORKER PRIVACY CONSIDERATIONS
The agent and an OR provider must only communicate about information that is relevant to the provision of
OR services and at all times, a worker’s privacy must be maintained. Similarly information collected about
other parties in the workplace or outside the workplace must be afforded the same considerations and
protections.
It is recommended that an OR provider advises a worker that information they share may be included in OR
reports which are sent to them, their THP, the injury employer and the agent.
For more information, refer to relevant sections of WorkSafe Online Claims Manual.
OR CONSULTANT TITLE
OR providers will use the following signature block for all correspondence related to OR service provision
with the exception of emails:
OR Consultant Name
Service provided: Occupational Rehabilitation
Professional Background – Physiotherapist
5. INJURY EMPLOYER’S OBLIGATIONS
INJURY EMPLOYER’S RTW OBLIGATIONS
When reviewing whether an injury employer’s RTW obligations have been satisfied, the agent must confirm
that other RTW opportunities at any workplace of the injury employer have also been fully exhausted. The
exhausting of RTW opportunities may include the provision of retraining courses to address competency or
skill gaps that may be limiting a worker’s suitability to perform a job at a workplace of the injury employer.
Redeployment in another job at a workplace of an injury employer may also be considered.
Changing a worker's RTW goal to a new employer is a serious consideration for an agent. WorkSafe
expects the RTW goal with the injury employer to remain the primary focus for the agent even where
information is received that may suggest the injury employer has difficulty identifying RTW solutions for the
worker or the worker is reluctant to engage in offers of pre-injury or suitable employment at an injury
workplace.
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DETERMINING WHETHER RTW WITH THE INJURY EMPLOYER HAS BEEN EXHAUSTED
OR providers should contact the agent whenever an employer is unable to offer or continue offering suitable
duties, so that the agent has an opportunity to determine whether the injury employer’s RTW obligations
have been exhausted before considering a change to the RTW goal (e.g. job seeking for a new employer).
The opinion and information included by an OR provider in OR reports is important when the agent is
deciding whether RTW obligations with the injury employer have been exhausted.
Information that would be helpful to an agent when determining whether injury employer RTW obligations
have been met might include whether:

There is medical evidence suggesting the worker cannot undertake or does not have a capacity for any
of the duties or jobs available at the injury workplace

The worker has relocated and a RTW is no longer practicable at the injury workplace

The worker has resigned from the pre-injury employment

The employer no longer has pre-injury or suitable employment available at an injury workplace

The employer has terminated the worker’s pre-injury employment

The employer has ceased to trade.
6. REPORTING
REPORT TEMPLATES & RECIPIENTS
An OR provider is required to use WorkSafe approved templates for reports.
OR reports for the purpose of RTW with the pre-injury employer can be provided to the worker, the worker’s
THP, the injury employer and the agent to create a common understanding about the types of activities that
may be needed to achieve a sustainable RTW for the worker and the progress made towards that RTW
goal.
WHEN OR REPORTS SHOULD NOT BE PROVIDED TO THE INJURY EMPLOYER
OR reports, advice or updates about a worker’s participation in an NES service must not be submitted or
provided to the injury employer, even if the worker remains at work with them while receiving NES.
WHEN OR REPORTS SHOULD NOT BE PROVIDED TO A WORKER
An OR provider has the discretion not to provide a report to a worker if they determine an exception applies
under the Privacy Act or Health Records Act, for instance:
o
It would pose a serious threat to the life or health of the worker or any other person, or
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o
There would be an unreasonable impact on the personal privacy of a person other than the worker
(although in the absence of the individual’s consent, the individual’s personal details or statements can
be blanked out meaning the OR report could still be released).
COMPLETE REPORTS
An OR provider is required to submit a 'complete' report to the relevant parties within the respective
timeframe specified in the OR Fee Schedule.
OR reports should contain sufficient information to enable all parties but most particularly the agent to have
confidence about the progress made to date against the agreed activities from previous reports.
If a report cannot be submitted within the nominated timeframe an OR provider must advise the agent the
reason for the delay and the expected date of submission.
OR reports must only contain information and opinion relevant to the OR service being provided. An OR
provider should not provide opinion on the worker’s treatment or make suggestions about other treatment
options.
When completing their most recent OR report, an OR provider is expected to consider and review the
opinion and information found in previous OR reports. However, opinion or information previously provided
in a report should only be referenced in a subsequent OR report respectively where it is pertinent or relevant
to the worker's circumstances and RTW needs at the time the latest report is completed.
If an OR provider forms a view when preparing an OR report that the worker does not have a CWC or there
is an actual or perceived barrier to RTW preventing the worker from being able to actively participate in OR
services then the agent must be contacted prior to completing and distributing the report, to discuss the
reasoning and to consider options.
OR reports must clearly reflect the OR provider’s independent opinion formed at the time the report was
completed.
RECOMMENDATIONS FOR OTHER TYPES OF OR SERVICES, IN REPORTS
An OR providers must not make recommendations for another type of OR service in any reports. Instead,
the OR provider must contact the agent to discuss.
This allows the agent to form their view about the most appropriate claims management for a worker without
a worker, the THP or the injury employer having their expectations raised about any particular outcome in
advance of that agent decision.
Examples of instances where an OR provider should contact an agent to discuss recommendations prior to
submitting the next report might include:

Recommendations for retraining

Recommendations for continuation of active RC715 OR services during a 13 week sustainability period
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
When considering service suspension or cessation

When NES is identified as a more appropriate service option while OES is being delivered.
WHEN PROGRESS REPORTS ARE NOT REQUIRED (FOR OES)
Changing worker circumstances or RTW may mean an OR provider is not required to submit the next
Progress Report.
If a Placement Report is required then that replaces the next Progress Report that would have been due.
If a 6 Month Progress Report is due within 2 weeks of an RC701 Progress Report, then the 6 Month
Progress Report replaces the RC701 Progress Report that would have been due.
Furthermore, Progress Reports are not required during a 13 week sustainability period (subject to
negotiation with the agent).
7. FUNDING REQUESTS
FUNDING REQUESTS & TEMPLATES
An OR provider is required to use WorkSafe approved OR funding request templates, which may be
submitted via email.
Where an OR provider submits a Funding Request the request must only include the actual OR services
and the cost of those services that an OR provider reasonably expects to provide in the time period
nominated within the Funding Request.
An OR provider must not seek agent approval for ‘possible’ or ‘potential’ OR services outside the period
referenced in the funding request. If the worker’s circumstances change after a Funding Request has been
submitted to the agent then the OR provider must seek further agent approval of OR services.
OR PROVIDER TRAVEL
Most services will be provided by an OR provider from their nearest location to the worker’s injury
workplace. Most NES will be provided by an OR provider from their nearest location to where the worker
resides.
An OR provider may also seek approval, from a WorkSafe Agent, for Provider Travel when services may be
provided at a location other than the OR provider’s nearest location because the worker:
 Has restricted or no access to public transport between their residence and where an OR provider has
scheduled an appointment
 Cannot drive and no-one is available to drive the worker to the location where the OR provider has
scheduled the appointment
 Cannot drive due to a medical restriction
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 The worker secures a new job and an NES Workplace Report is arranged at a workplace of the new
employer.
An OR provider must separately list RC799 or RC899 Provider Travel on their invoice and ensure that the
appropriate OR provider location number is referenced.
Refer to the agent Case Manager for any queries regarding reimbursement for worker travel expenses
associated with participating in OR services. Also refer to WorkSafe Online Claims Manual.
CONTACTS UPON RECEIPT OF OR APPROVAL FORM
It is a requirement that the OR consultant contacts the agent, injury employer, and worker within 3 working
days of receiving the OR Approval Form to clarify and establish (beyond the content of the Approval Form):
 Reasons for the OR Approval
 Clarify current circumstances
 Establish information on prior RTW attempts
 Establish the issues and RTW barriers
 Check the worker and employer's availability so that they can schedule a meeting with relevant parties
as soon as practicable.
If the worker has been referred for NES, then the initial contacts will also serve to clarify with the worker
their understanding of why this service has been approved.
This information is expected to assist the OR consultant to form a preliminary view prior to the first servicing
activities.
Note that the injury employer is not contacted for NES referrals.
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MANAGING THE EXPECTATIONS OF THE PARTIES ASSOCIATED WITH A WORKER’S RTW
The agent and an OR provider must exercise care in managing the expectations of the worker; the worker’s
THPs and the injury employer throughout OR service provision.
As the various parties may perceive the issues and barriers delaying or impeding the worker’s RTW
differently, it falls to the OR provider as the independent RTW expert to test and verify the different
perceptions particularly when they relate to:

The worker’s capacity for work

The most recent medical opinion from the worker’s THP

The tasks or jobs that may be available allowing for any work restrictions.
WORKPLACE MEETINGS
When the OR provider is scheduling workplace meetings, consideration must be given to separate meetings
with the worker and the injury employer. Depending on the circumstances that led to the claim and what
issues or barriers to RTW has been identified, a joint meeting may not be appropriate particularly as the first
meeting at the workplace. If both parties agree to a joint meeting then it may be scheduled after a separate
worker and employer meeting.
8. SERVICE DELIVERY PRINCIPLES - RTW PRE INJURY EMPLOYER
These minimum requirements apply across all types of OES including WSS and Better @ Work.
REQUIRED ACTIVITIES AS PART OF AN INITIAL REPORT
As part of the Initial Report, the OR consultant will establish or verify:
 The worker’s pre-injury duties/tasks and hours of work
 Any other duties/tasks that may be available for the worker full or part time at an injury workplace
 Whether the injury employer has commenced RTW planning
 Whether the worker has returned to work with the injury employer or if they returned to work why this
may or may not have continued
 The current medical evidence related to the worker’s capacity for work including any work restrictions
 Whether a RTW date has been suggested by the agent or the worker, the worker’s THP or the injury
employer.
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When completing this service, the OR provider must:
 Conduct a face to face meeting with both the worker and employer
 Attempt to engage the worker’s THP(s).
CONTENTS OF AN INITIAL REPORT
An Initial Report will include:
 A review of the medical evidence related to the worker’s CWC including any work restrictions
 List any identified actual or perceived barriers to RTW
 The worker’s work status
 Confirm the worker’s pre-injury duties and tasks
 Recommend the duties and tasks the worker may be able to perform
 Identify the pre-injury or suitable employment that may be available at the injury workplace
 State whether the injury employer has commenced RTW planning and nominate an expected RTW
date.
The report must provide a clear rationale for recommendations to commence or not commence an OR
service.
ACTIVITIES AS PART OF OES & CONTENTS OF PROGRESS REPORTS
Progress Reports must summarise the information collected by the OR provider at the time the report was
completed and include:
 A review of the medical evidence related to the worker’s CWC including any work restrictions
 An update on the pre-injury or suitable employment options
 The progress made toward the achievement of those options
 The progress made to resolve any identified actual or perceived barriers to RTW as part of the agreed
activities
 Whether the injury employer is carrying out any RTW planning
 The date and who attended any facilitated meetings held between the worker and the injury employer
and the proposed RTW date (if possible) if the worker has not achieved a RTW during the month.
The report should contain sufficient information to substantiate any recommendation being made by an OR
provider and any further funding being sought for OR services.
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CONCURRENT OES AND NES SERVICING
An RC715 OES and an NES job seeking service may be provided concurrently, however NES
commencement should prompt the OR provider and agent to discuss how long RC715 needs to continue to
maintain the worker at work.
The agent should be involved in monitoring RTW pre injury employer to maintain the worker at work, and
the OR provider and agent should have a common understanding of the expected date when any
maintenance at work arrangement may cease.
If the OR provider delivering an NES job seeking service to the worker is different to the OR provider
delivering RC715 services then the agent must ensure the worker understands the RTW goal has changed
to a new employer.
SERVICES DURING 13 W EEK SUSTAINABLE RTW PERIOD
Where a worker achieves pre injury hours but during the 13 week sustainable RTW period the worker also
returns to pre injury or productive duties, RC715 OR services must become ‘inactive’.
During an ‘inactive’ period an OR provider may choose to maintain limited contact with the worker, the
worker’s THP, the injury employer or the agent to accomplish a sustainable RTW. There is no payment to
be made for this contact and no Progress Report is required to be submitted during an OR ’inactive’ period.
If the worker’s circumstances change, an OR provider should contact the agent immediately and discuss
whether RC715 OR services need to become ‘active’ again.
It is not expected that the OR provider will submit progress reports during the 13 week sustainability period
unless the worker’s circumstances change.
OES WHERE WORKER ON PIH, NOT AT PID
If the agent decides to approve an Initial Report, to commence or recommence RC715 OR services, the
number of hours approved and the degree of OR provider engagement is expected to be minimal when
compared to a worker who is not at work when OR servicing is approved by the agent.
If the worker has not returned to PID within 3 months or at any point of time within the 3 months of OES,
then OES ceases.
OES BEYOND SIX MONTHS OF SERVICING WITHOUT RTW
If the worker has not returned to PIH within 6 months of servicing then OES is to cease. The agent may
conduct a review of the progress made at that point and should only approve further servicing if continuing
OES will result in a RTW.
If the agent approves further serving there is to be a review each month up to maximum of three months of
additional servicing.
Where a RC 730 has been paid prior to or after six months of OES serving then the normal rules around the
13 week sustainability period apply.
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9. SERVICE DELIVERY PRI NCIPLES – WOKRPLACE SUPPORT SERVICES (WSS)
PROCEDURAL INFORMATION
All primary mental injury claims are referred for an RC756 Initial Report (WSS), when an assessment is
needed to determine what services are needed to facilitate RTW with the pre-injury employer (noting that
WSS is a type of OES service).
If WSS commencement is recommended, then the OR provider utilises OES service codes and WSS report
templates for the duration of the WSS.
On all primary mental injury claims, a WSS approved OR consultant must be assigned by the OR provider.
The RTW intervention and strategy may differ across mental injury claims with or without features of a
workplace relationship issue. The agent must indicate on the OR Approval Form those primary mental injury
claims where a workplace relationship issue is a RTW barrier.
PRINCIPLES OF WSS SERVICE DELIVERY
When considering who the primary parties may be in a workplace relationship issue, the parties may include
but are not limited to:
 The worker and another person who works with them in their team or work group
 A worker and their direct manager or another manager the worker has come in contact with
 A worker and another person who directly reports to that worker.
In some instances, the injury employer may indicate they are supportive of the worker’s RTW but where the
worker remains distressed, upset or worried about the relationship issues or they continue to suggest these
issues have not been satisfactorily resolved by the injury employer then their RTW potential continues to be
significantly impacted upon and WSS may be appropriate.
WSS may be offered concurrently with other employer or worker actions responding to a relationship issue
(e.g. formal investigation procedures or complaints in other jurisdictions such as the Fair Work
Commission). This should be considered on a case by case basis. Whatever the reasons for the
workplace relationship breakdown and/or the stated position of the injury employer unless an agent
is confident that the workplace issues have been resolved and are no longer a RTW barrier then
WSS remains a practical solution for rebuilding and re-establishing the workplace relationship to
facilitate a RTW.
MANAGING THE EXPECTATIONS OF THE PARTIES
Given the types of claims where WSS will be most appropriate, care must be exercised by the agent and the
OR provider in managing the expectations of the various parties including the worker, the worker’s THP and
the injury employer. At the injury employer, there may be several individuals involved depending on the
circumstances that led to the claim.
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FOCUS INITIALLY THE RTW GOAL WITH THE INJURY EMPLOYER
WorkSafe requires the RTW goal with the injury employer to remain the primary focus for the agent even
where information received suggests there may be difficulties with the injury employer identifying RTW
solutions for the worker or the worker is reluctant to engage in offers of pre-injury or suitable employment.
Both the agent and the OR provider should explain to the various parties that WSS is designed to explore
and determine the potential for a RTW in pre-injury or suitable employment and the WSS reports are useful
resources for establishing a common understanding, identifying and resolving any actual or perceived
barriers to RTW and determining a set of activities to achieve that RTW goal.
WORKER WITH A POTENTIAL CWC WITHIN 3 MONTHS
Where the agent has received medical evidence suggesting the worker does not have a CWC but potential
exists for this to alter, the agent should approve a RC756 WSS Initial Report to determine what actions may
be required to assist and support the worker develop a CWC within 3 months. In preparing this report, an
OR provider will review the medical evidence related to the worker’s CWC including any work restrictions,
identify any actual or perceived barriers to RTW, identify potential RTW opportunities at the injury workplace
then determine a set of activities to assist and support the worker to RTW preferably at their PIH and
carrying out their PID within 3 months.
WHEN TO CEASE WSS
If the worker has not achieved a CWC within 3 months or will have no CWC at any point of time within the 3
months of WSS, then WSS services cease. The only exception to this is where an IME report is received
during the 3 months of WSS services suggesting a potential CWC is still possible. In this case, the agent
may consider limited ongoing WSS services to enable further opportunity for a CWC to be achieved within a
reasonable timeframe (most likely 1 month). If the worker has not achieved a CWC within that reasonable
timeframe then WSS services cease.
If the OR provider forms the view when preparing to complete a WSS Progress Report that the worker has
no CWC or will have no CWC within 3 months or there is a RTW barrier preventing them from actively
participating in WSS services or the workplace relationship issue is seriously damaged and possibly
irretrievable then the agent must be contacted immediately.
An OR provider should not discuss or raise the possible cessation of WSS services or raise the possible
change of the RTW goal to new employer and the approval of NES to support and assist that goal with the
worker, the worker’s THP or the injury employer or include in any WSS reporting until this has been
discussed and approved by the agent.
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10. BETTER @ WORK - SERVICE DEFINITION
BETTER @ WORK SERVICES
Better @ Work is a type of OES service offering additional support to workers and their employers from
small or medium sized organisations. Better @ Work is an early intervention service for workers who are
most at risk of remaining off work beyond six months.
This service aims to facilitate RTW prior to the date the RTW Index is measured (182 calendar days post
the date the Agent received the claim; hence there are references to RTW within 6 months or 26 weeks).
Features of Better @ Work
Duration
Support to
workers
Better @ Work is an OES service aimed at returning injured workers to their pre-injury
employer within the first 26 weeks of a claim. If RTW is not achieved by the RTW Index
date, the OES service model applies for any ongoing services.
Injured workers from small and medium sized organisations are identified as early as
possible by agents either through a systematic triage review (in the first few days of
claims acceptance), or through a review of claims with no RTW at 16 weeks.
Workers from small to medium employers in need of OR services may also be referred to
Better @ Work at other times as required.
Support to
small and
medium
employers
Main point
of contact
with GP
Better @ Work services delivered early in the life of a claim will offer small and medium
employers coaching on workers compensation processes and their RTW obligations so
that they are better able to support their injured workers.
Better @ Work service providers are encouraged to be the main point of contact with the
GP (or other certifier) improving effectiveness of GP communication and engagement in
RTW – reduce “contact clutter” and red tape.
GP RTW Case Conference should occur within 4 weeks of OR referral on all appropriate
cases where the GP is not already engaged.
Better @
Work:
Workplace
Intervention
The Workplace Intervention is a strategic intervention to facilitate RTW. It is expected that
the intervention may result in a RTW.
As part of that intervention, an OR provider will actively engage with the worker and
employer to identify any barriers to RTW and provide necessary coaching to employers
to enable them to better support their workers.
17
Better @
Work:
RTW Case
Conference
Following the Workplace Intervention (Initial Report), the OR provider will be required to
participate in the RTW Case Conference (usually via telephone). During the RTW Case
Conference, agents and ORP’s are required to participate in discussions regarding RTW
barriers, required actions to address the barriers.
Better @
Work:
Reports
Progress Report frequency is every 6 weeks (refer to the OR Fee Schedule item number
RC701). The frequency of these reports is linked to the RTW Case Conferences with the
agent. Progress Reports should be submitted 2 working days prior to the scheduled 6
weekly RTW Case Conferences.
Verbal updates may be requested by agents between 6 week reports, where report due
dates and ongoing RTW Case Conference dates do not align.
RTW Index
Incentive
The RTW Index Incentive is payable in addition to other OES incentives for achieving
RTW by the RTW Index measurement date. (See OR Fee Schedule for detail.)
ACTIVITIES FOR BETTER @ WORK INITIAL REPORT
As part of the Better @ Work Initial Report the OR consultant should follow the standard OES approach
previously mentioned. However, given that employers in small and medium sized business are often
inexperienced in workers compensation and RTW, the OR consultant should also provide small business
coaching to the employer to ensure they are better able to support their injured workers.
Better @ Work Workplace Intervention
The Workplace Intervention forms part of the activity required for an Initial report. It is a strategic
intervention that is expected may result in a RTW. The Workplace Intervention should have the following
characteristics:

The first contact with the worker, employer and agent should be focussed on progressing RTW during
the intervention

The OR provider must perform the workplace assessment at the workplace. If this is not practical, the
OR service is not to proceed without agent approval

As part of the intervention, the OR provider will actively engage with the worker and employer to identify
any barriers that the worker and/or employer may see as inhibiting RTW progression

This active engagement is most effectively commenced when an OR provider separately seeks the
views of the worker and the employer in individual meetings, where the situation and location encourage
them to be candid and open.
18
To assist OR providers to conduct small and medium employer coaching, WorkSafe has designed a Better
@ Work employer checklist. The checklist should be provided to the employer and completed with them to
ensure they understand how to support the injured worker’s return to work. Small and medium employer
coaching is only required for claims referred in the first 4 weeks of claim acceptance.
If the need has been identified by the OR provider for a GP RTW Case Conference or other THP contact
prior to the RTW Case Conference occurring, the OR provider should seek agreement from the agent to
extend the timeframes if required.
Better @ Work Initial Report

In instances where the OR provider recommends that OR servicing does not commence, the ORP must
contact the agent to discuss the recommendation, prior to sending the Initial Report. If the agent agrees
with the OR provider’s view then the Initial Report should contain sufficient information to support why
OR services should not proceed

The report is to be sent to all stakeholders 2 working days prior to RTW Case Conference (refer to the
earlier section on Reporting & Report Recipients)

If the employer has already developed RTW Arrangements, then this is to be sent to the agent with the
Initial Report

If the employer has not completed RTW Arrangements then the OR provider is to complete the Initial
RTW Proposal as part of the Initial Report which can be used to help the employer meet their RTW
obligations. The Initial RTW Proposal can also be used as a basis of the discussion between the agent
and the OR provider as well as THPs.

The report needs to be succinct and relevant. Information that is already available is not necessarily
required unless it has a relevance to the RTW. For example, the nature and the circumstances of the
injury are already known. What is required is how the injury impacts on the worker’s functional ability to
RTW in either their pre-injury or suitable employment.
There are a number of key pieces of information which must be addressed in the report, including:

The worker’s RTW status

Confirmation of the worker’s pre-injury duties and tasks

Recommendations about the duties and tasks the worker may be able to perform

What pre-injury or suitable employment maybe available at the injury workplace.

Whether the employer understands their role in RTW and is engaged in RTW planning (employer
coaching may have been required for this)

The expected RTW date (if possible)

Key observations that might help with RTW

Barriers and recommendations to address identified barriers.
19
Note: The small and medium employer coaching is primarily applicable for new claims in the first four weeks
following claim acceptance. Claims referred to Better @ Work as a result of the 16 week review are not
necessarily required to receive the coaching as employers should be well informed by this stage.
BETTER @ WORK PROGRESS REPORTS
Content of Better @ Work Progress reports is as for OES reports.
BETTER @ WORK RTW CASE CONFERENCE WITH THE AGENT
On receipt of the OR Approval Form, the OR provider is required to schedule a workplace intervention and
confirm the date and time of the RTW Case Conference. This should fall within the 10 working days after the
date of receipt of the OR Approval Form.
Initial RTW Case Conference and Action Plan
The RTW Case Conference is conducted on the telephone between the OR provider and agreed agent
parties (Case Manager, Injury Management Advisor/Return To Work Specialist).
The initial RTW Case Conference should include as a minimum:

The decision whether the service is to commence, delay commencement, or not commence

The worker’s RTW status

Certified Current Work Capacity and any other information (e.g. IME reports)

Barriers to RTW

Action Plan to address barriers/facilitate RTW

Next conference date, as agreed by all parties.
In instances where the OR provider’s recommendation is that OR does not commence, a telephone
conversation between the OR provider and the agent satisfies the requirement for al RTW Case
Conference.
An Action Plan will be developed by the agent and sent to the OR provider. It will include an outline of the
agreed actions from the RTW Case Conference including:

The required action

Who is to complete the action

When the action is to be completed.
A date and time for the next case conference is to be made at the end of the RTW Case Conference. This
should take place within 6 weeks.
20
Subsequent RTW Case Conferences
It is expected that the OR provider will use RTW Proposals/Arrangements, the 6 weekly Progress Report
and the progress against the Action Plan as the basis for discussion in subsequent RTW Case
Conferences. They should also aim to bring as much up to date information about the worker and other
stakeholders as possible.
It is expected that the agent will review the next report prior to the conference and collate any other
information which is deemed relevant. It is also expected that in subsequent RTW Case Conferences the
progress against the action plan will be discussed and if necessary changed as a result of new
circumstances and a lack of RTW progress.
Ideally, at the RTW Case Conference, the OR provider will be involved via telephone for the part of the
conference that discusses the worker’s RTW and any RTW barriers that may have been identified.
If the OR provider is not able to be contacted during the RTW Case Conference:

The agent and OR provider can discuss the progress against the agreed action plan prior to, but not
after the meeting

In instances where the OR provider needs to be contacted before the Conference, the Agent is required
to confirm in writing the action plan following OR provider discussion and Conference discussions.
The subsequent RTW Case Conference is not limited to, but should include at a minimum, consideration of
the following:

Participants involved in the conference

The RTW status

Certified Current Work Capacity and any other information (e.g. IME reports)

Barriers to RTW

Action Plan to address barriers/facilitate RTW

Review of agreed actions from previous RTW Case Conference

Next RTW Case Conference date (subsequent RTW Case Conferences as agreed by all parties until the
RTW Index date. RTW Case Conferences are not required once a RTW has occurred.).
BETTER @ WORK - CONCLUSION
After the RTW Index measurement date, claims in receipt of Better @ Work services will transition into
standard OES. There is no need to advice any stakeholders about this transition.
21
11. SERVICE DELIVERY PRINCIPLES – RTW NEW EMPLOYER
Agents are responsible for determining whether the RTW goal should shift from RTW pre injury employer to
RTW new employer. In making this decision, agents will consider whether the pre injury employer has
fulfilled their RTW obligations and whether the worker has a potential for or a current capacity for work.
Agents are responsible for identifying the appropriate type of service for an injured worker. New Employer
services fall into three main categories depending on the capacity of the worker at the time of the referral
decision as follows:
1. Capacity Support Service (CSS):

For workers with an IME capacity only or a limited certified CWC
2. Job Seeking service (JSS):
•
For workers with a certified CWC or
•
For workers who have completed a Capacity Support Service and may not have a certified
capacity, but have an IME capacity
3. Transferable Skills Analysis service (TSA):

For workers without a CWC (who satisfy relevant criteria).
These flowcharts show at a high level the different requirements for work capacity across the three NES
service types:
Certified capacity
Agent
determines
worker’s CWC &
decides on NES
referral type
IME capacity
Limited certified
capacity
No capacity
Job Seeking Service
(JSS)
Capacity Support
Service (CSS)
Transferable Skills
Analysis Service
(TSA)
22
Pathways to NES & Reporting
TSA
Completed and
submitted
JSS
Certified capacity >
or
IME capacity only
after CCS completed
4 Wks
RTW Job Seeking
Plan
Active job seeking, ORP brokerage,
worker meetings/contacts
12 wks
Every 8 wks
8 wks
JS Report & review of
RTW Job Seeking Plan
TSA
Completed and
submitted
Agent
determines
worker’s CWC &
decides on NES
referral type
CSS
Limited certified
capacity or
IME capacity only
OR Approval Form
TSA
No capacity
(certified and IME)
6 Week Service Period
TSA
Focus on
transferable skills
and vocational
options
Retraining may be
Considered in any
NES Service
Agent/OR Case
Conference
CAPACITY SUPPORT SERVICE (CSS)
The purpose of this 6 week service is to engage the worker, certifying practitioner and other treating
practitioners to establish or increase a worker’s certified capacity for suitable employment with a new
employer, to optimise the success of JSS.
Workers who may be referred to this service will meet one of the following capacity criteria:
•
Have a limited certified capacity or
•
Have a capacity for employment based on current IME opinion but are certified with no capacity for employment.
Workers with a limited certified capacity are those that are fit for less than 50% of their pre injury hours.
Where the number of hours that the worker is certified fit to undertake are not stipulated in the certificate,
the Agent is responsible for confirming this with the certifying practitioner to ensure referral to the
appropriate service is made.
Workers who have completed a Transferable Skills Analysis Service (TSA) may also be referred to CSS
where they meet one of the capacity criteria above.
Structure and content of the CSS
OR providers will utilise their expertise and judgment to structure the CSS to ensure it is customised to the
individual needs of the worker. OR providers will implement a 6 week strategy aimed at engaging the
worker, treaters, and the certifying practitioner for the purpose of obtaining or increasing a certified capacity.
The following flow chart depicts a possible structure for CSS:
TSA
Completed and
submitted
Commence JSS/
Discuss with Agent
6 Week Service Period
Certified capacity
for ≤ 50% PIH
or
IME capacity only
CSS Approval Form
GP RTW CC & Action
Plan
Worker meetings
(frequency as
necessary)
GP RTW CC & Action
Plan
23
GP RTW Case Conferencing
GP RTW Case Conferencing is expected to be a feature of this service. While it is up to the OR provider to
determine if and when these conferences are required, they may consider whether an initial conference
could assist in establishing the GP’s expectations for the intervention and a subsequent conference to
review progress and capacity.
Refer to GP RTW Case Conferencing principles (section 18)
Transferable Skills Analysis (TSA)
The OR provider submits to the worker, Agent and certifying practitioner a TSA report which details the
workers identified transferable skills and vocational options within 10 working days of completion of the 6
week service. This report will indicate whether the worker has or is expected to be certified with a capacity
for suitable employment. The TSA report template must be used.
Where workers automatically transition into JSS at the completion of CSS, a further TSA will not be
required.
Evidence of capacity change
At the conclusion of CSS, where the worker has a certified CWC it is expected that JSS will automatically
commence and the provider will invoice accordingly.
Where the worker has a limited CWC (i.e. for less than 50% of their pre-injury hours) and the OR provider is
of the opinion that continued involvement will result in an upgrade of hours, JSS can still commence; OR
providers can continue to work with treaters as part of this process to support an upgrade in hours. Where
the number of hours that the worker is certified to undertake are not stipulated in the certificate, the Agent is
responsible for confirming this with the certifying practitioner to ensure clear expectations for all parties.
By week 5 of CSS, where the worker remains certified as unfit for all work but has an IME to indicate CWC
or where worker has a potential CWC based on treater discussions/IME, the OR provider must discuss
commencement of JSS with the Agent to ensure it is the optimal service at the optimal time.
JOB SEEKING SERVICE (JSS)
The purpose of this service is to provide job seeking assistance to those workers who are ready to
commence new employment and to provide workers with the skills and competencies necessary for
independent job seeking.
There are two pathways for entry to this service:
•
Workers with a certified capacity
•
Workers who have completed CSS and remain certified as unfit for all work however have a CWC based on
IME opinion (Agent approval required)
24
Structure of the Job Seeking Service
The intention of JSS is to provide the OR provider with sufficient flexibility for meaningful engagement with
the worker about vocational options prior to finalising a Transferable Skills Analysis including transferable
skills and suitable vocational options. Upon submitting the TSA report, it is expected that the worker and OR
provider will intensively job seek over the remaining 12 week JSS period. The JSS structure and reporting is
represented by the following flowchart:
TSA
Completed and
submitted
RTW Job Seeking
Plan
Every 8 wks
Certified capacity
or
IME capacity only
after CCS
completed
Active job seeking, ORP brokerage,
worker meetings/contacts
12 wks
8 wks
JS Report & review
of RTW Job Seeking
Plan
Agent Approval
Transferable Skills Analysis (TSA)
A TSA including identification of transferable skills and potential vocational options is produced 3 weeks
post commencement of the service (except for workers who previously completed CSS). The main focus of
this initial period of JSS in the lead up to the submission of this report is to develop rapport and support the
worker with their attitudinal and emotional adjustment for active job seeking, as well as working towards
documenting tangible vocational goals, developed in consultation with the worker.
The OR provider should focus on these key elements in the initial stages of JSS
•
•
•
Worker engagement
Preparation of the TSA
Job Seeking skills training.
The TSA is due for completion and submission to the worker, Agent and certifying practitioner at the
conclusion of week 3 of JSS. Relevant documentation such as the worker's resume should also be
attached.
Joint RTW Job Seeking Plan
During JSS the focus is on both the worker and OR provider to actively job seeking. OR providers will utilise
their expertise and judgment during this time to deliver job seeking services that best meet the needs of the
worker and assists them to develop effective job seeking skills and secure suitable employment.
Within 10 working days of completion of the 12 week period, the OR provider will submit to the worker,
Agent, and certifying practitioner a Joint RTW Job Seeking Plan (using the appropriate template). This Plan
will detail the activities undertaken by both the OR provider and the worker in attempting to achieve the
RTW goal including brokerage activities undertaken, worker meetings and contacts as well as highlighting
the reasons why the goal is yet to be achieved.
25
As it is an expectation that the worker will be equipped to independently job seek at the completion of JSS,
the plan will also highlight the job seeking skills and the level of competency that the worker has acquired
throughout this process.
Where there have been changes to the Initial TSA (for example, if potential vocational options have altered
as a result of availability on the open labour market) then this should also be reflected in the RTW Job
Seeking Plan.
The plan will define the worker's independent job seeking activities that support achievement of the RTW
goal and indicate what OR provider support and service will be available before the next review point.
8 weekly Job Seeking Report & review of RTW Job Seeking Plan
Upon conclusion of the 12 week JSS, workers must have the skills and competencies to continue to job
seeking independently and will continue to receive ongoing job seeking assistance with 8 weekly review
points.
The 8 weekly Job Seeking Report will detail the activities undertaken by both the OR provider and worker in
the 8 week period, highlight barriers and consider why a RTW goal is yet to be achieved as well as detailing
the strategy for the next review period.
Once the worker has received approximately 52 weeks of OR servicing in total (including CSS and JSS
periods), the Agent should arrange a worker interview with all parties including worker, OR provider and if
possible certifying practitioner. The aim of this interview is to review what has been done to date and
determine whether other strategies can be offered to assist in achieving the RTW goal.
Servicing beyond 52 weeks should continue where a strategy has been determined that is likely to result in
achieving a RTW outcome i.e. retraining/treatment provided to increase workers transferable
skills/functional abilities.
TRANSFERABLE SKILLS ANALYSIS SERVICE (TSA)
The purpose of this service is to conduct an assessment, followed by a case conference with the OR
provider, that identifies transferable skills and potential vocational options for use by the Agent when
formulating their case management plan and for engaging the worker and certifying practitioner. A TSA
forms the basis of CSS and JSS however it can also be used independently of these services for workers
who have no capacity for employment based on certification and IME opinion.
This service recognises that the engagement of workers in discussion and planning regarding potential
employment options and the steps required to realise that potential, can provide work based goals that
complement functional goals.
The TSA will also serve as a document that the Agent can use for testing work capacity via communication
with the treating practitioner or to provide when seeking an IME opinion.
While a TSA will not be appropriate for all workers who are certified with no capacity for employment, a
referral for the service can be made where the Agent is of the opinion that:
26
• there is medical evidence (IME and/or certifying practitioner) to indicate that the workers injury is
recovering and there is a potential for a CWC in the short term
• The worker has expressed an interest in identifying potential employment options and RTW
• The Agent is of the opinion that conducting a TSA will be the catalyst in commencing RTW discussions
with the worker and certifying practitioner and facilitating capacity change
Submission of a TSA (independent of CSS and JSS) and Case conference
Upon completion of a TSA, the OR provider submits a report (using the appropriate template) to the worker,
Agent and certifying practitioner. This is to be within 10 working days of the assessment being completed.
Upon receipt of the report, the Agent should undertake a case conference, preferably with OR provider
involvement to discuss the validity of commencing CSS or other relevant services such as retraining.
The OR provider can also advise the Agent of any other pertinent information obtained through the TSA
process when submitting the TSA report to the Agent via email or other means.
Use of TSA in subsequent NES
Updates to the TSA may be required throughout the workers involvement in JSS when there have been
significant changes to the worker’s transferable skills, functional capabilities (e.g. following completion of
training) or change of OR provider. Where the OR provider feels that an updated TSA is relevant in
refocussing the worker’s job seeking efforts (such as in an 8 week review period), this should be discussed
with the Agent.
130 W EEK VOCATIONAL REPORT - PURPOSE AND CONTENT
The agent approves a 130 Week Vocational Report to assist them determine a worker’s entitlement to
weekly payments post the second entitlement period (i.e. to continue weekly payments after 130 weeks of
weekly payments has been paid).
The 130 Week Vocational Assessment Report will summarise the information collected by the OR provider
at the time the report was completed and include:

A review of the medical evidence related to the worker’s CWC including any work restrictions

A list of any actual or perceived barriers to RTW

The worker’s transferable skills and abilities

The prioritised suitable employment opportunities identified for the worker based on a labour market
analysis relevant to the worker and where the worker resides.
The OR provider must attempt to engage the worker’s THP when preparing to complete a 130 Week
Vocational Report.
27
The report should contain sufficient information to substantiate an OR Provider’s observations and/or
comments.
An OR Provider may determine the format of a 130 Week Vocational Report as there is no WorkSafe
approved report. As a guide WorkSafe would recommend reference be made to the TSA format
SUBSEQUENT 130 WEEK VOCATIONAL REPORT - PURPOSE
The agent approves a Subsequent 130 Week Vocational Report when they wish to:

Confirm that the prioritised suitable employment identified in a Vocational Report remain relevant after
the worker has participated in a job seeking service

Review a previous 130 Week Vocational Report at a particular point of time

Confirm the findings of a prior 130 Week Vocational Assessment Report by that the prioritised suitable
employment options identified for a worker remain relevant by completing a comprehensive live labour
market analysis based on the worker’s transferable skills and abilities and where they reside

Review the prioritised suitable employment identified previously in a 130 Week Vocational Assessment
Report or TSA Report with the worker’s THP.

Supplement a previous TSA report with a labour market analysis and/or confirm that suitable employment
options identified in a prior TSA report remain relevant
The agent and an OR provider will adopt the same service requirements, processes and timelines for the
approval and submission of a Subsequent 130 Week Vocational Report as for a 130 Week Vocational
Report.
WORKSAFE INCENTIVE SCHEME FOR EMPLOYERS (WISE)
A worker who has NES approved by an agent may also access WISE. WISE is a 12 month financial
incentive of up to $26,000 paid to a new employer who offers ongoing employment of 15 hours or more a
week. Most employers are eligible for WISE including interstate employers where the worker resides
outside Victoria.
OR providers are required to understand policy and processes relating to WISE and promote use of WISE
for workers participating in a job seeking service.
More information about WISE can be found in WorkSafe Online Claims Manual and on Worksafe’s website
www.worksafe.vic.gov.au.
28
13. TRAINING AND REDEPLOYMENT
IDENTIFYING REDEPLOYMENT OPPORTUNITIES - PRE INJURY EMPLOYER
Some employers may have multiple workplaces and when considering what suitable employment may be
available to the worker, the agent and the employer should consider what suitable employment may be
available at all workplaces of the injury employer.
To assist the agent and the employer determine the suitability of that employment, a
Retraining/Redeployment Report may be approved to identify whether the worker has the necessary
transferable skills and abilities to perform the tasks and duties associated with the job or whether they have
the competencies to be able to effectively participate in a job interview including how to handle injury-related
questions.
If an OR provider forms the view that the worker requires support and assistance to prepare a resume or
application covering letters or would benefit from interview skill and technique coaching, they should contact
the agent to seek approval for RC715 OR services.
Alternatively, an OR provider may form the view that the worker may require some retraining to enable them
to undertake the suitable employment.
An OR provider must ensure that the worker understands that a training course approval relies on the agent
determining that a course is reasonable and necessary to enhance the worker’s employability.
IDENTIFYING A TRAINING COURSE - NEW EMPLOYER
An OR provider may recommend a training course to enhance a worker’s employability where their existing
level of transferable skills and competencies has limited the identification of suitable employment.
RETRAINING
Retraining can be provided where the OR provider determines this will assist in enhancing suitable
employment options and achieve the RTW goal. Retraining can also be used by the OR provider as a
means of motivating and engaging the worker in vocational oriented activity to support development of their
CWC.
The OR provider does not need to seek Agent approval for retraining courses to a maximum of $1000
and/or 16 weeks duration. Courses outside these criteria may still be recommended, however require Agent
approval. OR providers will need to provide written justification to the Agent in the approved format to
receive approval in these instances.
Where it is anticipated that multiple courses are required (for example a basic and intermediate course, a
suite of computer courses etc.) Agent approval is not required providing that the combined courses do not
exceed the maximum cost and duration criteria.
29
JUSTIFICATION FOR A TRAINING COURSE
An OR provider should not recommend a worker participate in a retraining course simply because a worker
suggests they have a preference for a particular type of employment or because they show a reluctance to
work in the type of suitable employment identified by an OR provider; the training identified must be to
enhance employability or support the development of a current work capacity and should be aligned
wherever possible to the workers pre injury role.
WorkSafe will monitor retraining to ensure appropriate courses within the criteria and consistent with the
circumstances of the claim are being recommended.
WORKER PARTICIPATION IN TRAINING
When recommending a training course, the OR provider must be satisfied that the worker can complete the
course as soon as practicable and that course requirements do not exceed the worker’s functional
restrictions.
If the worker is at work at the time the course commences, the OR provider must consider whether the
worker can remain at work or continue to participate in OR services at the same time they are participating
in the course.
ENROLMENT IN A TRAINING COURSE
The worker should be encouraged to directly contact the training provider to complete the enrolment
requirements. Where assistance is required, the OR provider can support this process.
POST RETRAINING REPORT
Upon completion of the retraining course, the OR provider will submit a report to the Agent to advise of the
transferable skills obtained.
It is the expectation that the OR provider and agent will be responsible for monitoring the workers progress
and participation throughout the course.
14. SUSPENDING AND CEASING OR SERVICES
WHEN OR SERVICES SHOULD BE SUSPENDED OR CEASED
The OR provider may recommend to the agent that OR services are:

Suspended where medical evidence supports the worker has no CWC or will have no CWC for more
than 4 weeks but is expected to have a CWC within 13 weeks,
30

Ceased where medical evidence supports the worker has no CWC or will have no CWC for more
than 13 weeks. For RTW with the pre injury employer, cessation may also be considered if the
worker has not been able to progress hours at work or PIH is unlikely in the foreseeable future.
SUSPENSION – WORKER RETRAINING
JSS and CSS can be suspended while a worker is participating in a retraining course, unless the OR
provider is of the opinion that the worker can successfully market themselves to prospective employers
during course completion.
An OR provider should not discuss or raise the possible suspension of any OR service with the worker and
the certifying practitioner or include this possibility in any reports until this has been discussed and approved
by the agent.
On receiving the agent advice to suspend services, an OR provider will forward any outstanding reports to
the worker, the certifying practitioner and the agent.
CEASING OES IF NCC FIRST 3 MONTHS
Where a worker has been referred to OES with no CWC and is not work and the agent has medical
evidence suggesting the worker pay have a potential CWC within 3 months, the agent may approve an OES
Initial Report.
The report will help the agent determine whether OES may facilitate a change in the worker's capacity for
work resulting in RTW.
If at the end of the 3 month period the worker does not have a CWC or a barrier has been identified
impacting on the worker actively participating in OES, then the OR provider must contact the agent to advise
they are ceasing OES.
OES may continue for a 4th month if prior to the end of the 3rd month, the agent receives an IME or THP
report suggesting CWC or a RTW may be achieved within the next month. In this case, the agent should
contact the OR provider to discuss the continuation of OES for an additional 4 weeks.
RECOMMENCING SERVICES - PRE INJURY EMPLOYER
SERVICES PREVIOUSLY SUSPENDED OR CEASED
OR services may be recommenced where the worker continues to require support and assistance to RTW
with the injury employer and medical evidence supports the worker has a potential CWC or has regained
their CWC or can now actively participate in OR services.
The OR provider should discuss with the agent whether a new Initial Report is required.
31
AFTER NON-SUSTAINABLE PIH
The agent may approve further RC715 OR services after the worker achieved their PIH but this was not
sustained for 13 weeks. These OR services would focus on what actions may be required to achieve a
sustainable RTW outcome as soon as is practicable.
RECOMMENCING SERVICES - NEW EMPLOYER
When considering whether a NES service should be recommenced, the agent should establish what
services the worker had already completed/partially completed and whether the worker has an IME capacity
only, a certified capacity or a limited certified capacity (for less than 50% of their pre-injury hours). The
Agent can then determine appropriate services based on the criteria for CSS, JSS and TSA.
It is expected that the CSS and JSS will only be paid once for each worker. However if the Agent or OR
provider feels that a service should be re-offered (for example if services were ceased for a significant
period), this should be discussed with all parties.
SERVICES PREVIOUSLY SUSPENDED OR CEASED
NES may be recommenced where the worker continues to require support and assistance to RTW with a
new employer and medical evidence supports the worker has a potential CWC or regained their CWC or
can now actively participate in JSS or CSS.
AFTER NON SUSTAINABLE RTW
The agent may approve on going 8 week reviews if after the worker had previously achieved a RTW but this
was not sustained for 13 weeks.
AFTER A SUSTAINABLE RTW
The agent may approve on going 8 week reviews after the worker had previously achieved a RTW but after
the RTW was sustainable for 13 weeks, the RTW did not continue.
AFTER INCENTIVE PAID EMPLOYMENT CEASES OR MEDICAL EVIDENCE RECEIVED WORK IS NO LONGER
SUITABLE
The agent may approve a JSS or CSS to support the worker find a new job with a different employer.
NES DURING WEEKLY PAYMENT ‘NON ENTITLEMENT PERIOD’
A worker may lose their entitlement to weekly payments for a specified period known as a ‘non entitlement
period’. The agent may approve a JSS or CSS for a worker during a non-entitlement period and if the
worker achieves a RTW, a RTW Incentive is payable. To determine which RTW Incentive should be paid,
the agent calculates the number of weeks that would have been paid to the worker at the date the JSS or
CSS commenced assuming that the non-entitlement period had not been applied.
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15. RTW INCENTIVES - GENERAL
A RTW Incentive is payable when the agent and an OR provider agree that the conditions for paying the
incentive can be satisfied. Which RTW Incentive may be payable will depend on the number of hours being
worked excluding overtime and shift allowance.
An OR commencement (for OES) is demonstrated by the OR provider submitting an RC700 or RC756 or
RC200 Initial Report then after the report was submitted, RC715 OR services were provided to the worker.
An OR commencement (for NES) is demonstrated by the OR provider submitting an RC 811, which
indicates that a service was provided to the worker (OR providers should refer to the business rules for the
RTW Scorecard for specific OR codes representing OR commencement).
RTW INCENTIVE MOST USUALLY PAID ONCE
Most usually a RTW Incentive is only paid once on a claim, unless OR services had ceased for more than
13 weeks and subsequently the agent approved OR recommencement. In this case, the agent may
consider paying a RTW Incentive again.
An OR provider may forward information or evidence to assist the agent make a decision about a worker’s
sustainable RTW at 100% pre injury hours (PIH). The agent should consider this information or evidence
when determining whether a RTW Incentive payment is appropriate.
RTW INCENTIVE NOT PAYABLE IN CERTAIN CIRCUMSTANCES
A RTW Incentive is not payable if:

The worker ceased work due to a new compensable injury

The worker ceased work due to a secondary mental injury

The worker ceased work due to a non-compensable medical condition

The worker resigned

The employer withdrew duties

The employer ceased trading

The employer terminated the worker’s employment
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16. RTW INCENTIVES - FOR OR SERVICES PRE INJURY EMPLOYER
Refer to the OR Fee Schedule for information on OES RTW Incentives including a description of how to
count the 13 week sustainability period.
WORKER ABSENT FOR > 5 WORKING DAYS DURING 13 WEEK SUSTAINABILITY PERIOD
Where a worker receiving weekly payments at OR commencement (Original Employer Services) has more
than 5 working days off work in the 13 week sustainable RTW period due to the compensable injury, a
further 13 week sustainable RTW period can be calculated from when the worker commences pre injury
hours again. If during this second 13 week sustainable RTW period they are again absent for more than 5
working days due to the compensable injury then no RTW Incentive is payable. In calculating the more than
5 working days during a 13 week sustainable RTW period, a part day is counted as 1 day.
17. RTW INCENTIVES - FOR OR SERVICES NEW EMPLOYER
WORKER’S PRIVACY FOLLOWING A RTW WITH A NEW EMPLOYER
The agent may request a worker provide copies of their payslips or other employment evidence to help
determine which RTW Incentive may be payable. However a worker is not required to comply unless the
worker is also seeking to have weekly payments paid for all or some of that 13 week sustainable RTW
period. An OR provider should not ask a worker to provide them or the agent with copies of their payslips or
other employment evidence.
GENERAL CONDITIONS FOR PAYING AN INCENTIVE - FOR RTW NEW EMPLOYER
Most usually a RTW Incentive is only paid once on a claim. WorkSafeWorkSafe expects that prior to
submitting an appropriate invoice for a RTW Incentive, an OR provider and the agent will agree that an
incentive is payable by mutually discussing and confirming the following:
1. Was the RTW achieved with a new employer during a JSS or CSS service, including the 8 week review
periods?
2. Was a 12 week sustained change in capacity achieved during CSS
3. How many weeks of weekly payments had been paid at the date the NES service commenced?
4. Was the worker receiving weekly payments on the date the NES service commenced?
5. What was the number of hours being worked by the worker 13 weeks after the date they returned to
work?
6. What was the amount of wages the worker was receiving 13 weeks after the date they returned to work?
7. Which RTW Incentive service code is being sought by the OR provider?
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RTW WITH INJURY EMPLOYER AFTER NES COMMENCED
A RTW incentive may be paid when the OR provider who is providing NES negotiates a RTW with the injury
employer and the agent and an OR provider agree that the conditions for paying the incentive can be
satisfied.
If the OR provider has previously commenced RC 715 OR services for the worker, an RC750 RTW
Incentive is payable. If the OR provider has NOT previously commenced RC715 OR services to the worker,
an RC891 RTW incentive is payable.
OR PROVIDER WISE PLACEMENTS
The OR provider may not seek a WISE placement and sustainability payment as well as an NES placement
and NES RTW incentive payment.
Where a worker was participating in a JSS or CSS at the time a WISE placement was achieved, an NES
RTW Incentive may be paid.
A WISE OR provider placement fee using Payment Type Code 216 may be paid when the agent and an OR
provider agree that a WISE placement was secured after a JSS or CSS was completed.
RTW INCENTIVE NOT PAYABLE IN CERTAIN CIRCUMSTANCES
WORKER ABSENT FOR MORE THAN 5 WORKING DAYS DURING 13 WEEK SUSTAINABLE RTW PERIOD
Where a worker was receiving weekly payments at NES commencement has more than 5 working days off
work in the 13 week sustainable RTW period due to the compensable injury, a further 13 week sustainable
RTW period can be calculated from when the worker commences work
again. If during this second 13
week sustainable RTW period they are again absent for more than 5 working days due to the compensable
injury then no RTW Incentive is payable. In calculating the more than 5 working days during a 13 week
sustainable RTW period, a part day is counted as 1 day.
SELF-EMPLOYMENTAS AN OPTION DURING NES
During NES, an OR provider may form the view that self-employment is a reasonable RTW outcome for this
worker. An OR provider should not discuss or support the worker following self-employment as their RTW
outcome until this has been discussed and approved by the agent.
A RTW incentive is not payable where the RTW solution is self-employment
SPECIFIC CONDITIONS FOR PAYING A SECOND INCENTIVE
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If the worker is participating in a JSS or CSS and a second RTW is achieved with a different employer then
a second incentive can be paid. In this instance, the agent is only authorised to pay RC891 as a second
RTW incentive.
18. GP RTW CASE CONFERENCE
A GP RTW Case Conference is a face to face meeting arranged by an OR provider with the worker and the
worker’s GP at the GP’s rooms. An OR provider can only arrange two GP RTW Case Conferences per
claim. The face-to-face component of a GP RTW Case Conference should take approximately 30 minutes to
complete. An OR provider may seek up to two hours in total for the time spent on arranging and attending
the GP RTW Case Conference and the sending of an Action Plan.
REASONS FOR ARRANGING A GP RTW CASE CONFERENCE
The types of reasons for arranging a GP RTW Case Conference may include but are not limited to:

An IME or worker self-reporting suggest the worker has a work capacity however, the GP continues to
provide medical certificates that the worker does not have a CWC

The OR provider has identified suitable employment, however the GP says the worker does not have a
CWC

The GP and IME have a differing opinion about the worker’s degree or type of capacity or the suitability
of employment available either at the injury or a new workplace

There has been a RTW at the injury workplace with restrictions to pre injury duties (PID) or pre-injury
hours (PIH) and the GP will not vary their opinion about the worker’s capability to increase the duties or
hours.
ADVISING THE AGENT
When an OR provider determines that a GP RTW Case Conference is needed they should telephone or
email the agent. A GP RTW Case Conference can proceed unless the agent advises them within three
working days of that contact that a GP RTW Case Conference is not approved.
WORKER TO BE ADVISED IF OTHERS HAVE BEEN INVITED TO THE CONFERENCE
An OR provider may also invite the agent to attend a GP RTW Case Conference. Alternatively if the RTW
goal is with the injury employer then they may also be invited to attend. The worker should be advised prior
to the GP RTW Case Conference where the agent or injury employer has indicated they will attend a
conference. Employer representatives must not be invited to a GP RTW Case Conference once RTW pre
injury employer has ceased as an option.
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SCHEDULING A GP RTW CASE CONFERENCE
The worker, the GP and any other party are contacted and a mutually suitable time for the GP RTW Case
Conference is agreed. The worker must be advised prior to the GP RTW Case Conference when the agent
or pre-injury employer has agreed to attend the conference.
If the worker or GP decline to participate in a GP RTW Case Conference then the OR provider must contact
the agent immediately.
At least one working day prior to the scheduled GP RTW Case Conference, an OR provider will confirm via
email or facsimile the date, time and location of the conference with all parties who have agreed to attend.
The GP RTW Case Conference Agenda letter is required to be sent to the worker and a separate letter to
the GP (refer to WorkSafe letter templates). A GP Information Sheet must be included with the GP letter to
explain why a GP RTW Case Conference has been arranged. The Agenda letter and Information Sheet also
explains how the GP may seek payment for their involvement.
CONFIRMING THE AGREED ACTIONS FROM A GP RTW CASE CONFERENCE
An OR provider may complete a GP RTW Case Conference Action Plan and gain agreement from the
participants to the each action prior to the conference being concluded. An OR provider may give a copy of
the GP RTW Case Conference Action Plan to the worker, the GP and any other parties attending the
conference at the meeting’s conclusion or alternatively within five working days (refer to WorkSafe
template).
An OR provider must also email or facsimile a copy of the GP RTW Case Conference Action Plan to the
agent within five working days of the date of the GP RTW Case Conference.
INFORMATION ABOUT GP RTW CASE CONFERENCE IN NEXT OR PROVIDER REPORT
Where the next OR Report falls due within five working days of the date of the GP RTW Case Conference
then an OR provider should include information with that report. The GP RTW Case Conference Action
Plan can be attached or alternatively the following can be included under report sections for
‘COMMENTS/ADDITIONAL INFORMATION’:

The date of and who was present at the conference

The key discussion points.
A summary of the agreed actions which may include but are not limited to the GP:

Changing or issuing a medical certificate amending the worker’s capacity for work including any
medical restrictions or the number of hours that can be worked

Increasing the hours being worked or agreeing to do so when the next medical certificate is due

Agreeing to a RTW arrangement prepared by the injury employer.
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EXPECTED OUTCOME FRO M A GP RTW CASE CONFERENCE
Following a GP RTW Case Conference, all parties (not the employer for job detached workers) should have
a better understanding of:

The OR provider’s role as an independent RTW expert

The importance of the GP’s opinion and medical certificate when determining the suitability of
employment available or identified

The types of duties and hours of work available or identified

For RTW pre injury employer, what the employer and worker need to do to meet their RTW obligations

What has been agreed and included in the Action Plan.
OR PROVIDER FEES FOR GP RTW CASE CONFERENCE
An OR provider may seek up to two hours in total for the time spent on arranging and attending the GP
RTW Case Conference and the sending of an Action Plan. The inclusion of the Action Plan details in an OR
report is payable as part of the fee for that particular report (e.g. next OES progress report or NES report).
An OR provider may not seek additional payment under the GP RTW Case Conference fee for this activity.
An OR provider will submit an invoice for RC270 for the time spent on arranging and attending the GP RTW
Case Conference and the sending of an Action Plan as well as actual Provider Travel for the time spent in
travelling to and from their nearest location to the GP’s rooms.
GP FEES FOR GP RTW CASE CONFERENCE
The GP submits an invoice including their patient’s name, claim number and the date of the conference to
the agent. The agent will pay for the RTW Case Conference within 28 days of receiving the GP’s invoice. A
GP who also saw the worker on the same day for their regular consultation may seek payment for that
consultation on the same invoice.
19. GP RTW QUESTIONNAIRE
When an OR provider determines that a GP RTW Questionnaire is needed they should telephone or email
the agent for approval of the cost. A GP RTW Questionnaire can proceed unless the agent advises it is not
approved.
The following principles must be considered when requesting a GP RTW Questionnaire:

OR providers must confirm with the agent that a new request for information will not duplicate a recent
request sent by the agent (i.e. advise the agent that a RTW Questionnaire request will be sent by the
OR provider and asking for agent contact should they feel this is inappropriate)
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
OR providers may determine the most appropriate questions based on individual cases (no more than 5
questions)

The GP RTW Questionnaire may be used across any OR service

GP RTW Questionnaires should be limited to obtaining information. i.e not used to pay for signing RTW
plans

The GP RTW Questionnaire may be used across any OR service

A maximum of two GP RTW Questionnaires may be requested during an OR service

The OR provider is to advise the GP to invoice the agent using code MPRTW02 at a cost of $78.09
(excluding GST, accurate as at 27 January 2015) which is subject to indexation on 1 July annually.

GP RTW Questionnaires are primarily aimed at GPs however may also be completed by other types of
medical practitioners. Allied health practitioners are not eligible to complete a GP RTW Questionnaire
MPRTW02.

Information obtained from the GP RTW Questionnaire must be provided to the agent (either via a copy
forwarded to the agent or as a summary provided within the next OR report).
20. FURTHER INFORMATION
An agent and/or OR provider requiring clarification about OR policy, process and schedules may contact
WorkSafe via occupational_rehab@worksafe.vic.gov.au.
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