Speech pathology management plan
The Speech pathology management plan should be completed where more than 10 treatment sessions will be delivered within a practice, or as
requested by the case manager.
ReturnToWorkSA expects speech pathologists to integrate the principles of the Clinical Framework for the Delivery of Health Services (2012) in their
daily practices and reflect these principles within this management plan.
Claims agent lodgement and contact details:
Post
Email
Fax
Phone
Employers Mutual
Gallagher Bassett
EnABLE Unit
GPO Box 2575, ADELAIDE SA 5001
faxes@employersmutualsa.com.au
(08) 8127 1200
(08) 8127 1100
GPO Box 1772, ADELAIDE SA 5001
FaxReception@gb.rtwsa.com
(08) 8177 8451
(08) 8177 8450
GPO Box 2668, ADELAIDE SA 5001
EnABLE@rtwsa.com
13 18 55
(08) 8233 2051
Worker and employment details
Name:
Claim number:
Date of injury:
Case manager (if known):
Pre-injury employer:
Occupation/title:
Current hours/week:
Pre-injury hours/week:
Current duties status:
Pre-injury duties
Alternative/modified duties
Unfit for work
Other, please explain
Do you have an understanding of the critical physical demands of the pre-injury role?
Yes
No
If no, please give details:
Clinical assessment
Aphasia
Apraxia of
speech
Cognitive
communication
deficit
Dysarthria
Dysfluency
Dysphagia
Voice disorder
Other, please outline:
Is your diagnosis different to the worker’s medical certificate?
Yes
No
Specific area(s) being treated:
If the worker is currently unable to participate fully at work, what key impairments prevent their full participation?
Potential barriers to recovery and return to work
Have you identified any non-clinical barriers or issues that may impede the worker’s recovery and return to work? (e.g. worker’s beliefs
about injury/pathology, worker’s expectations about return to work, workplace matters)?
Yes
No
EVALUATION
If yes, please outline:
Do other parties need to be notified/involved in addressing these barriers?
Case manager
Treating doctor
Yes
No
Return to work consultant
Other, please outline
If action is recommended, please outline:
Management to date (at this practice) (If treatment has NOT been provided prior to this plan, go to Proposed management
section below).
Date of this practice’s initial speech pathology consult:
Has the worker made the progress you expected?
If no, please outline relevant factors:
Total consults to date:
Yes
No
Proposed management (at this practice)
Treatment goals
Intervention strategies
Measures of progress
Number of
sessions
required
1.
2.
PLANNING
3.
4.
Are your treatment strategies occupationally-specific so as to improve the worker’s capacity to meet the demands of their pre-injury
duties or suitable employment?
Yes
No
If yes, please outline:
Return to work
If the worker is currently unable to participate fully at work, do you think the worker will return to full pre-injury duties and hours?
Yes
No
If yes, in what timeframe?
If no, outline why:
Do you recommend a graduated return to work schedule for the worker?
Yes
No
Have you communicated your recommendations or the graduated return to work to the treating doctor(s)?
Yes
No
Treating speech pathologist’s details
Print name:
Practice name:
Address:
Phone number:
Email:
Fax number:
How would you prefer the case manager to notify you of the receipt of the plan?
Email
The worker has been involved in the development of this management plan
Yes
A copy of this plan has been provided to the case manager, treating doctor and worker
Yes
Treating speech pathologist’s signature:
Date:
Claims agent use only
Speech pathologist notified of receipt of plan:
Yes Date notified:
Case manager name:
Fax
Phone
Post
Speech pathology management plan – explanatory guide
The Speech pathology management plan should be initiated
and completed by the treating speech pathologist when it is
known more than 10 treatments are required to manage a
worker with an injury.
The completed plan should be submitted to the relevant case
manager, and copies provided to the treating doctor and
worker.
The plan should be invoiced using item number E0MP.
Please note: Management plans are practice-specific for individual workers.
Worker and employment
details
• It is expected that the speech pathologist will gain an understanding of the worker’s pre-injury role to ensure delivery of
speech pathology management that is focused on early return to work and restoration to usual functional activities.
• Modified duties refer to any changes or restrictions that are applied to a worker’s pre-injury duties to facilitate
work participation where the injury prevents full participation.
• Alternative duties refer to the worker performing different duties to those in their pre-injury role.
Clinical assessment
• Your diagnosis may differ from the certifying doctor’s injury description on the Work Capacity Certificate. This
information will assist the claims management process by highlighting the need to obtain clarity around the diagnosis.
• If your diagnosis differs from that of the certifying doctor, it may be appropriate to have a verbal conversation in which
this diagnosis or appropriative management can be clarified for consistency.
• Key impairments refer to the deficits resulting from the work-related injury that are impeding the worker’s functional
capacity to participate in their pre-injury role or suitable duties.
Management to date
• If treatment has been provided prior to this management plan, confirm the date of initial consultation and the total
number of treatments provided to date.
• A ‘treatment’ refers to all consultation types inclusive of initial and subsequent.
• The speech pathologist should indicate whether their treatment to date has achieved the expected recovery in the
timeframe they estimated and if the worker has not made the expected progress, briefly outline why they think this
may be the situation.
• Speech pathology management that has failed to make measured progress towards functional goals, activity-related or
participation related goals may be inappropriate for a number of reasons. In these circumstances, it is expected the
speech pathologist will reassess the treatment approach, consider other strategies which may include ceasing
treatment.
Potential barriers to
recovery and return to
work (Principle 2 of the
Clinical framework)
• The speech pathologist should list in order of priority any non-clinical barriers or issues identified that may impede the
Proposed management
• Outline the proposed number of treatments required, the duration of the treatment and the anticipated treatment
completion date.
• Briefly outline proposed treatment strategies and specify whether an ‘adaptation’ or an ‘accommodation’ approach will
be utilised. It is expected that passive treatment strategies are used appropriately as the injury demands and there is
timely progression to more active and self-efficacious strategies.
• The speech pathologist should outline how their management strategy will address the worker’s physical impairment
findings reported under the Clinical assessment section. Management should be condition-specific and occupationspecific so that they simulate work parameters.
• If psychosocial screening indicates the presence of non-injury risk factors to poor or delayed recovery, outline these risk
factors and the speech pathology management strategies recommended (e.g. improve the worker’s understanding of
their injury/pathology or pain thereby promoting empowered decision-making and active coping responses).
Psychosocial barriers pertaining to industrial matters, the claim/compensatory system or psychological barriers should
be brought to the attention of the case manager, treating doctor/relevant health provider or other relevant party for
assessment.
• Outline the strategies implemented to support the worker’s self-management and reduced dependence on
professional support. Speech pathology management should work towards a model of self-management and
independence. It is expected that speech pathologists will not facilitate patient dependency on passive techniques by
administering regular ongoing treatment for a prolonged period. Workers should be provided with sufficient skills for
self-management.
(Principle 2, 3, 4 & 5 of
the Clinical framework)
worker’s recovery or return to work. If the speech pathologist believes these barriers require further assessment by
another party please tick the appropriate boxes and outline the suggested action that is recommended e.g. case
manager to arrange case conference, treating doctor to review need for further management.
Return to work
• The speech pathologist should provide their opinion about the likelihood of the worker returning to full pre-injury
capacity. An understanding of the critical demands of the pre-injury role or suitable duties is presumed (refer to Work
details section). Where this outcome is likely, the speech pathologist should outline the estimated timeframe for full
participation at work.
• If the speech pathologist feels that the worker may not be able to return to their pre-injury duties this should be
indicated with the relevant factors that lead them to this opinion.
• The speech pathologist is expected to provide information to the treating doctor to assist them certify the capacity of
the worker.
Treating speech
• Following review of the management plan the case manager will notify the treating speech pathologist to acknowledge
receipt of the plan and support of the proposed management. The speech pathologist should indicate their preferred
method of communication for this process.
• It is important that the worker is actively involved in the development of the management plan and that a copy of the
plan is made available to them.
• A copy of the plan is required to be sent to the case manager and the treating doctor or referrer.
pathologists details
The following free information support services are available:
If you are deaf or have a hearing or speech impairment you can call ReturnToWorkSA through the National Relay Service (NRS):



TTY users can phone 13 36 77 and ask for 13 18 55.
Speak & Listen (speech-to-speech) users can phone 1300 555 727 and ask for 13 18 55.
Internet Relay users connect to NRS on www.relayservice.com and ask for 13 18 55.
For languages other than English call the Interpreting and Translating Centre on 1800 280 203 and ask for an interpreter to call ReturnToWorkSA on
13 18 55. For Braille, audio or e-text call 13 18 55.
ReturnToWorkSA
Enquiries: 13 18 55
400 King William Street, Adelaide SA 5000
info@rtwsa.com
www.rtwsa.com
© ReturnToWorkSA 2015
Amended: March 2015