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DOCUMENT 6

The content of this document is OFFICIAL

Early Intervention, Rehabilitation and Return to Work: A Guide for Case Managers

Document Control ……………………………………………………………………………………………………………………… 3
Purpose………………………………………………………………………………………….………………..….4
Who does this guide apply to? …………………………………………………………………………………………………….. 4
What legislation is relevant to this guide? ……………………………………………………………………………………… 4
Review of employment actions ……………………………………………………………………………………………………. 4
Rehabilitation Management Systems (RMS)………………………………………………………………….….4 6.1. Rehabilitation Management System…………………………………………………………………..………..4 6.2. Audit Program………………………………………………………………..……………………………………5 6.3. Rehabilitation Authority……………………………………………………………………………………..……5 6.4. Workplace Rehabilitation Provider………………………………………………………..…………………….5 6.5. Employee………………………………………………………………………………….……………………….5
Rights and Responsibilities……………………………………………………………….………………………..6 7.1. The Employee………………………………………………………………………………………………….….6 7.2. National Disability Insurance Agency (The Employer)…………………………………………………………6 7.3. Supervisors…………………………………………………………………………..………………………….…6 7.4. Disability Liaison Officer (DLO)…………………………………………………….……………………………7 7.5. Early Intervention (EI) Officer……………………………………………………………………………………7 7.6. Rehabilitation Case Manager (RCM)………………………………………………….…………………….….8 7.7. Workplace Rehabilitation Provider (WRP)……………………………………………………………………..8 7.8. HR Business Partner (HRBP)……………………………………………………….…………………………..9 7.9. Treating Medical Practitioners…………………………………………………………………………………..9 7.10. Legally Qualified Medical Practitioners (LQMP)……………………..……………………………………….9 7.11. Comcare………………………………………………………………………………………………………….9 7.12. Commonwealth Superannuation Corporation (CSC)………………………………………………………..9

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Delegations…………………………………………………………………………….……………….……….…10

8.1. Safety, Rehabilitation and Compensation Act 1988 (SRC Act)………………………………….…………10

8.2. Public Service Act 1999 and Public Service Regulations 2023……….……….……………..……………11

Risk Identification, Assessment and Control………………………………………………………..………….11
Case Administration and Records Management……………………………………………..………………11

10.1 Case Notes and Record Keeping………………………………………..……………………………………11

10.2 New Case Administration..…………………………………………………………………………………….12

10.2. Case Handovers…………………………………………………..……………………………………………12

10.3. Case Management Arrangements During Periods of Leave…………………….…………..……………13

10.4. Naming Conventions…………………………………………………………………………………………..13

10.5. Case File Security……………………………………………………………………………………….……..13

The Comcare Scheme - SRC Act……………………………………………………. ………………………..13

11.1. Comcare Premium……………………………………………………………………….…………………….14

Early Intervention…………………………………………………………………………………………………15

12.1. Early Intervention Funding…………………………………………………………………..………………..15

12.2. Early Intervention Assessments………………………………………………………………………………17

Workers Compensation Claims…………………………………………………………………………………17

13.1. Employee and Supervisor Responsibilities………………………………………………………………….17

13.2. New Claim Process……………………………………………………………………..……………………..19

13.3. Actions Required when a non-compensable condition becomes compensable………………………..22

13.4. Submission of an Employer Statement under a s71 Notice……………………………………………….22

13.5. Arranging and Managing a s37 Rehabilitation Program……………………………………………………22

13.6. Workplace Rehabilitation Provider Service Codes………………………………………………………….25

13.7. Managing non-compliance…………………………………………………………………………………….25

13.8. Superannuation and leave accrual for employees on incapacity payments……………………………..26

13.9. Closure of a compensable case and/or return to pre-injury hours…………………………..……………26

Managing non-compensable cases…………………………………………………………………………….26
Referral for Rehabilitation Services…………………………………………………………………………….29
Suitable Duties for Compensation Cases……………………… ……………………………………………29

16.1. Medical Redeployment……………………………………………………………………………..…………31

16.2. Work Trials………………………………………………………………………………………………………32

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Independent Medical Examinations (IME)………………………………………………………………………………………..32

17.1. Non-compensable Conditions……………………………………………………………………………………………..32

17.2. Compensable Conditions…………………………………………………………………………………………………….35

17.3. IME Supplementary Reports………………………………………………………………………………………………37

Partial Invalidity……………………………………………………………………………………………………………………………37
Invalidity Retirement…………………………………………………………………………………………………………………….38

19.1. Invalidity Retirement for Compensable Injuries…………………………………………………………………………..40

19.2. Invalidity Retirement for Non-compensable Injuries……………………………………………………………………41

Other Relevant Information…………………………………………………………………………………………………………….42

20.1. Leave……………………………………………………………………………………………………………………………….42

20.2. Dispute in Medical Evidence…………………………………………………………………………………………………42

20.3. Reduction in Classification……………………………………………………………………………………………………43

Privacy……………………………………………………………………………………………………………………………………….43

21.1. Information Handling and Consent……………………………………………………………………………………….44

21.2. Privacy Breaches……………………………………………………………………………………………………………….44

1. Document Control

Document Control

Document Name	Early Intervention, Rehabilitation and Return to Work: A Guide for Case Managers
Date	30/05/2023
Status	FINAL
Version	3
Owner	Workplace Support Team

Approval Status Log

Version	3
Reviewed and approved by	Assistant Director, Workplace Supports
Approval date	30/05/2023

Note: Document uncontrolled in hardcopy

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2. Purpose

The information contained within this guide outlines best practice processes in the management of National Disability Insurance Agency (NDIA) employees, following an incident, illness or injury. The information is to be used as a guide only, and is designed to complement the knowledge and experience of Disability Liaison Officers (DLOs), Early Intervention Officers and Rehabilitation Case Managers (RCMs).

3. Who does this guide apply to?

This guide applies to:

NDIA DLOs, EI Officers and RCMs; and
HR Personnel within the People and Culture (P&C) Division who provide advice to NDIA employees.

4. What legislation is relevant to this guide?

The information contained in this guide is based on the responsibilities of the NDIA under the following legislation:

Public Service Act 1999 (PS Act)
Safety Rehabilitation and Compensation Act 1988 (SRC Act)
Superannuation Act 1976
Superannuation Act 1990
Superannuation Act 2005
Fair Work Act 2009
Privacy Act 1988 (Privacy Act)
Work Health and Safety Act 2011 (WHS Act)
Disability Discrimination Amendment Act 2002

5. Review of employment actions

Employees should speak to their manager in the first instance in relation to employment related decisions and actions.

Employees may be entitled to request a review of decisions and/or actions as per the NDIA Review Rights policy.

People and Culture Division can provide support and assistance to both employees and managers involved in a review process.

6. Rehabilitation Management Systems

6.1. Rehabilitation Management System

A Rehabilitation Management System (RMS) is the framework of processes and procedures used to ensure that an organisation can achieve its rehabilitation objectives.

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A RMS includes a documented statement of senior management’s commitment to provide effective rehabilitation to their employees. It assesses the employer’s performance against rehabilitation objectives and is used to inform strategic direction. A RMS will help the NDIA to:

Assist injured employees to achieve a durable return to work (RTW);
Recognise and strengthen successful steps in workplace rehabilitation;
Demonstrate compliance with relevant legislation;
Recognise and understand compliance obligations;
Provide effective rehabilitation arrangements;
Promote continuous improvement;
Ensure good communication with employees;
Provide for internal and external accountability;
Put adequate control structures in place to manage risk.

6.2. Audit Program

The NDIA will undertake annual audits of the Rehabilitation Management System (RMS) as required by the guidelines.

Further information can be found in the RMS Audit Procedure.

6.3. Rehabilitation Authority

Under the SRC Act, the CEO is the rehabilitation authority for employees who have suffered a workplace illness or injury.

Under section 41A of the SRC Act, the rehabilitation authority (CEO) delegates in writing all or any of its functions and powers under Part III to an officer or person employed by the rehabilitation authority’s employer.

6.4. Workplace Rehabilitation Provider

A Workplace Rehabilitation Provider (WRP) is a person or organisation, approved under section 34F of the SRC Act by Comcare to provide workplace and vocational rehabilitation services.

Employees are referred to a contracted Workplace Rehabilitation Provider by the Rehabilitation Case Manager.

6.5. Employee

These guidelines apply to all employees of the NDIA including non-ongoing employees. Some parts of this policy in relation to the SRC Act apply to former employees, where NDIA is the rehabilitation authority for a compensation claim. In relation to rehabilitation programs under the SRC Act, all employees are advised of their rights and responsibilities in writing. Employees have a responsibility to attend assessments and undertake the rehabilitation program.

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7. Rights and Responsibilities

7.1. The Employee

The employee has a right to:

Receive appropriate compensation entitlements and rehabilitation for compensable injuries under the SRC Act;
Privacy in accordance with the Privacy Act;
Access documents that relate to their claim under s 59 of the SRC Act;
Seek a reconsideration of certain determinations (as defined under s 60 of the SRC Act);
Request reasonably practicable adjustments to the workplace; and
To be supported by a Disability Liaison Officer (DLO), Early Intervention Officer (EI Officer) Rehabilitation Case Manager (RCM), and/or a Workplace Rehabilitation Provider (WRP), if required.

Employee responsibilities include:

Notifying their supervisor at the first opportunity after becoming ill or injured;
Reporting work-related illnesses or injuries via an incident report to the Work Health and Safety team;
Maintaining ongoing contact with their supervisor and RCM throughout the absence and the RTW process;
Submitting a leave request and associated medical certificates for all absences in line with the leave policy;
Indicating to their supervisor and/or RCM when they require assistance to remain at work and/or RTW;
Cooperating in the rehabilitation and RTW process;
Undergoing independent medical assessments as required by the NDIA;
Actively participating in all rehabilitation and RTW processes; and
Performing their duties in accordance with Work Health and Safety Act 2011 and/or medical restrictions.

7.2. National Disability Insurance Agency (The Employer)

The NDIA has a primary duty of care to ensure, so far as is reasonably practicable, the health and safety of its employees under the Work Health and Safety Act 2011. This includes ensuring that the health and safety of people is not put at risk from work carried out as part of the conduct of the business.

If an employee’s health status presents a risk to the health and safety or themselves and/or others whilst engaged in work, they can be stood down by the appropriate delegate until such time that they are deemed medically fit to return to work.

The Workplace Support team will offer support to the employee, including having their capacity for work assessed and their rehabilitation and return to work arrangements established and implemented.

7.3. Supervisors

Supervisors of NDIA employees are responsible for the health, wellbeing and safety of their staff. They are required to participate in, and monitor the progress of the rehabilitation and RTW of their employees.

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Responsibilities include:

Notifying the Workplace Support Team as soon as it is identified that an employee may require support;
Ensuring that an Incident Report has been sent to the Work, Health and Safety Team if the illness or injury is work related;
Providing a safe work environment in line with the Work Health and Safety Act 2011;
Maintaining ongoing contact with their employees and the RCM throughout the absence from work and RTW process;
Actively working with the RCM and other parties to identify suitable duties for ill and/or injured employees;
Ensuring that leave is approved where required, with appropriate supporting documentation;
Cooperating in the rehabilitation and RTW process;
Managing workloads to ensure that team members are not adversely disadvantaged by the absence of the ill or injured employee;
Ensuring that administrative requirements are completed as required. This may include but is not limited to:

o Completing relevant section of claims for compensation within 5 days of receiving it; o Employer Statements; o Statement of Claims; o Incident Reports; and o Work Reports for medical assessments.
Actively working with all relevant stakeholders to identify alternate work arrangements for their employee based on the medical recommendations.

7.4. Disability Liaison Officer (DLO)

The DLO is responsible for assisting new and existing employees with disability who require workplace adjustments to enable them to fulfil the requirements of their role. This supports access and inclusion for all employees of the NDIA. DLOs may source Assistive Technology for employees and arrange associated training for its use. DLOs provide ongoing supports for up to twelve weeks.

7.5. Early Intervention (EI) Officer

The EI Officer is responsible for acting early to prevent, or to provide early assistance to employees with illness or injury. These may be work-related or non work-related illnesses or injuries (physical or psychological), that are low complexity and non-compensible in nature.

EI Officers may engage Workplace Rehabilitation Providers to conduct Ergonomic Workstation Assessments and Early Intervention Assessments (EIA) in order to identify workplace adjustments, modifications and/or strategies to support an employee’s rehabilitation and/or return to work.

EI Officers also provide assistance to supervisors with short-term absence management and RTW arrangements for their employees (for absences less than 13 weeks, where a sustainable RTW is likely).

When critical psychosocial incidents occur, the EI Officer may work with the business area and the Work Health and Safety Team to provide immediate assistance and support to those involved.

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7.6. Rehabilitation Case Manager (RCM)

The RCM is responsible for coordinating and managing the rehabilitation and return to work of employees with an illness or injury, on behalf of the NDIA. As part of this process, they provide guidance to the supervisor on the day-to-day management of the rehabilitation and return to work process.

The illness or injury may be compensatory (i.e. any cases where a claim for compensation is lodged, whether accepted, or declined) or non work-related. The complexity of the case can vary. Examples of cases managed by RCMs includes:

Cases where the employee has both physical and psychological conditions;
Cases where the employee has a disability and there are additional, long-term support requirements at work;
Cases where the employee has a psychological condition/s and there are behavioural and or performance issues at work;
Cases where the employee has a psychological condition/s and there are bullying and/or harassment issues at work;
Cases where the employee has had a long-term absence from work (3-6 months or longer);
Cases where the employee has “Long Covid”, lasting over twelve weeks post-virus (with earlier management of these cases being overseen by an EI Officer);

The RCM acts on behalf of NDIA to meet its injury management responsibilities and obligations under both of the Acts outlined above.

Responsibilities include:

Initiating, coordinating and monitoring the rehabilitation and/or RTW process in consultation with all stakeholders; including Workplace Rehabilitation Providers;
Assisting supervisor/s to access appropriate supports to facilitate the employee’s RTW process;
Providing advice, assistance and professional guidance on absence management;
Making decisions under delegation in relation to rehabilitation responsibilities under the SRC Act and the Public Service Act;
Coordinating Independent Medical Examinations (IMEs), which may include Fitness for Duty (FFD) Assessments;
Coordinating Work Trials or Work Placements when the ill/injured employee will not be returning to their original (pre-injury) role;
Overseeing invalidity and partial invalidity processes, where an employee has permanent or partial disability or incapacity due to an injury at work;
Ensuring that rehabilitation and RTW process are cost effective and within industry standards;
Ensuring that Comcare have up-to-date information relating to a claim at all times, including relevant documentation (e.g. medical certificates, s37 Rehabilitation Programs, reports from treating doctors, WRP Progress Reports, Closure Reports, etc.)

7.7. Workplace Rehabilitation Provider (WRP)

The WRP may be engaged to assist the employee in their safe and durable RTW, or if they are already at work, that there has been workplace adjustments to assist them in remaining at work. The WRP will assist in with both compensable and non-compensable illness/injuries and will be requested to conduct an Early

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Intervention Assessment (EIA) in line with either the Public Service Act or SRC Act to ensure that all essential information regarding the rehabilitation and RTW is gathered from all stakeholders.

Responsibilities include:

Providing expert, objective advice to the RCM to assist the timely, safe and durable RTW of an injured employee;
Engaging the injured employee, treating doctor and supervisor in the development and implementation of a tailored RTW plan or rehabilitation program;
Actively monitoring the RTW plan or rehabilitation program and regularly talking with all parties to ensure that the goals are achieved; and
Complying with Comcare’s criteria and standards for Workplace Rehabilitation Providers.

7.8. HR Business Partners (HRBP)

Responsibilities include:

Providing direction and intervention on bullying/harassment cases;
Providing direction and intervention on performance related matters;
Providing direction and intervention on cases where there are issues with supervisor compliance (e.g. failure to offer suitable duties and or failure to support/monitor the employee through the RTW process);
Providing direction and intervention on cases where there are issues with employee compliance; and
Acting as a central point of contact for disputes that may arise during the RTW/absence process.

7.9. Treating Medical Practitioners

Treating medical practitioners provide medical assessments and treatment and provide advice regarding fitness for work, rehabilitation and work capacity.

Treating medical practitioners play a vital role in the rehabilitation and RTW.

7.10. Legally Qualified Medical Practitioners (LQMP)

Legally Qualified Medical Practitioners (LQMPs) are registered medical practitioners who are under contract to the NDIA to provide impartial medical assessments (Independent Medical Examinations) to employees where required.

The medical practitioner will provide a report about the nature of an employee’s condition, the treatment they may require and/or the type of work (if any) they may be able to undertake.

7.11. Comcare

The SRC Act established Comcare as the Federal Government’s workers’ compensation authority. Comcare manages compensation claims for Australian Government employees.

Comcare makes determinations regarding liability, incapacity payments, treatment expenses, permanent impairment and non-economic loss, aids and appliances, household services and attendance care services, and approval of other payments and services under the SRC Act.

7.12. Commonwealth Superannuation Corporation (CSC)

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The Commonwealth Superannuation Corporation (CSC) may determine that an employee is eligible for medical treatment on the basis that they are permanently or partially incapacitated for work.

Eligibility and payments of benefits differ across the three superannuation schemes – Commonwealth Superannuation Scheme (CSS), Public Sector Superannuation Scheme defined benefit (PSSdb), and Public Sector Superannuation Scheme Accumulation Plan (PSSap).

8. Delegations

8.1. Safety, Rehabilitation and Compensation Act 1988 (SRC Act)

For the Commonwealth, Commonwealth Authority or licensee, section 41A of the SRC Act allows the rehabilitation authority to delegate in writing all or any of its functions and powers under Part III to an officer or person employed by the rehabilitation authority’s employer.

Rehabilitation Case Manager Delegations

Sub-sections 36(1) & (3) of the SRC Act – may arrange for assessment of an employee’s capability of undertaking a rehabilitation program or shall do so at the written request of the employee. The employee may also be required to undergo an examination.
Sub-section 37(1) of the SRC Act – determine that an employee should undertake a rehabilitation program.

In determining if an employee should undertake a rehabilitation program, a RCM shall have regard to the requirements of section 37 (3) of the Act The matters for consideration are:

(a) any written assessment given under subsection 36(8) (b) any reduction in the future liability to pay compensation of the program is undertaken (c) the cost of the program (d) any improvement in the employee’s opportunity to be employed after completing the program (e) the likely psychological effect on the employee of not providing the program (f) the employee’s attitude to the program (g) the relative merits of any alternative and appropriate rehabilitation program (h) any other relevant matter.

and:

a) If an employee is determined to undertake a rehabilitation program (whether it be in respect of the same or a different injury), a RCM shall have regard to whether:

the employee completed the program;
the program resulted in any improvement in the employee’s capacity to work or activities of daily living; or
if the employee did not complete that program, whether the employee had a reasonable excuse for failing or refusing to complete that program; and

b) Section 15 of the Disability Discrimination Act 1992

Non-compliance

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Where the RCM considers that the employee may have, without reasonable excuse, refused, failed to attend or undertake, or obstructed an examination or rehabilitation program, the RCM shall:

(a) assess the extent of the refusal, the manner in which the employee failed to cooperate or the nature of the obstruction to ascertain the severity of the employee’s non-compliance;

(b) as soon as reasonably practicable, ask the employee to provide an explanation for such refusal, failure or obstruction; including in that request adequate guidance or instruction as to the evidence required and timeframes for response;

and

(c) consider whether the employee had a reasonable excuse for such refusal, failure or obstruction taking into account the employee’s explanation or failure to provide one.

Directors, Branch Managers and Chief People Officer – People and Culture Division

Sub-section 36(4) of the SRC Act – rehabilitation programs – suspend rights to compensation and proceedings under the SRC Act for refusal or failure to undergo an examination (without reasonable excuse) or obstructing an examination.
Sub-section 37(7) of the SRC Act – rehabilitation programs – suspend rights to compensation and proceedings under the SRC Act for refusal or failure to undertake a rehabilitation program, without reasonable excuse.

8.2. Public Service Act 1999 and Public Service Regulations 2023

Independent Medical Examinations and outcomes are managed in accordance with section 20 of the Public Service Act 1999 and section 11 of the Public Service Regulations 2023 (Public Service Regulations). RCMs and Directors within the People and Culture Division hold the delegation for this and can direct an employee to undergo a medical examination.

9. Risk Identification, Assessment and Control

Risk identification, assessment and control is the cornerstone of not only workplace health and safety practitioners, but also business operations in general. For injury management and the Rehabilitation Management System (RMS), the RMS Risk Profile outlines potential risk impacts to the RMS.

10. Records Management

10.1. Case Notes and Record Keeping

All phone conversations, discussions, and/or meetings that occur during the course of managing a case or claim for compensation, must be recorded in writing by the DLO, EI Officer, or RCM as an accurate record, made at the time, or as soon after the event (incident, discussion, phone call, meeting) as practicable.

Case notes will:

State who the RCM has spoken to, the purpose of the conversation and discussion;
Contain the date of the conversation/discussion;

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Accurately record any explanations or undertakings that were received or given;
Capture emerging barriers or trends;
Contain objective observations;
Be confined to the facts, and
Be brief, clear and concise.

Records pertaining to injury reports, RTW, rehabilitation and medical treatment will adhere to privacy and confidentiality requirements as defined in the Privacy Act 1988.

Case notes must not:

State any irrelevant personal observations or views, particularly any comments of a non-factual nature;
Contain personal information relating to another person unless that information is relevant.

DLOs, EI Officers and RCMs have a professional, ethical and legal responsibility to ensure follow the guidelines above, noting that case records can be subpoenaed as court documents (e.g. AAT, Fairwork.)

DLOs, EI Officers and RCMs also have an administrative responsibility of ensuring that their case folders in MS Outlook, the shared drive and the active case tracker/spreadsheet are up-to-date.

RCMs are responsible for using the Workload Resource Tool to accurately categorise each of their cases in the Active Tracker on a weekly basis, and to review this with their Assistant Director during fortnightly case reviews.

The purpose of this tool is to ensure accurate and qualitative reporting of workloads and to enable suitable work allocation to Case Managers.

Category A – High complexity comp or non-comp, performance/conduct/behaviour issues and/or workplace conflict. Spans multiple jurisdictions (internal or external), co-morbidity or disability, in-depth investigation/s (e.g., s71, FOI requests, IMEs, reconsiderations, AAT cases), WRP engagement.
Category B – Moderate complexity comp or non-comp (WRP engaged, may involve one or more “Category A” elements, regular stakeholder engagement and meetings)
Category C – Low complexity comp or non-comp (WRP engaged, proactive provider, minimal meetings, monthly progress reports, non-compensable)
Category D – light-touch comp e.g., nil rehab, long-tail claims, inactive compensation claim, Comcare follow-ups)
Category E – light-touch non-comp, e.g. work coming up in 6 months. Leave coding and medical certificate follow-ups required.

*N.B. Case categories are interchangeable (cases may move between categories at different points of the lifecycle of the case).

For each case, the RCM must also add the employee’s superannuation fund to the spreadsheet.

10.2. New Case Administration

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When a new case comes into any work stream (DLO, EI or RCM), the receiving team member must establish whether the case has previously been managed within Workplace Supports. To do so, they must check all records, including archived files and closed files. If the employee has been managed as a case in the past, the case manager must examine the previous records to gain an understanding of the history. This, coupled with the new information, should be used to determine where the re-opened case should sit, i.e. within the DLO, EI, or RCM work stream.

10.3. Case Handovers

When a case needs to be referred from a DLO or EI Officer to a RCM, the DLO or EI officer must complete a Case Handover document with all relevant information to provide to the RCM. They must also ensure that the employee’s case file in MS Outlook and SharePoint folder is up-to-date.

In SharePoint, there should be a primary folder for the employee, which contains three subfolders named DLO, EI and RCM. If a search in the shared drive reveals that there is historical information relating to the employee, it must also be stored in this location in a folder titled “Historical”. The Case Manager must file all case notes and correspondence (reports, medical certificates, etc.) in the relevant subfolder, depending on the case management area that it relates to.

Case Management Arrangements During Periods of Leave

During periods of leave taken by members of the Workplace Support Team (e.g. annual leave), case handover arrangements must be made.

Team members must add all of their cases to the Case Handover Template which is saved in SharePoint/R: drive, and have a case handover discussion with the Assistant Director (AD), Workplace Supports, prior to going on leave. When completing the Case Handover Template, the Case Manager must note any follow-up actions required while they are on leave.

The assisting Case Manager must update the template with any actions that occur during the primary Case Manager’s absence (e.g. email filed in Outlook, report received and filed in the “Open Case” folder in Sharepoint).

When the primary Case Manager returns from leave, they can review the actions completed on each case and any follow-up actions required of them.

10.4. Naming Conventions

The following naming conventions should be adhered to when naming documents.

YYYY.MM.DD, Description, Surname, First Name

E.g. 2022.05.10 Medical Certificate, Smith, John

10.5. Case File Security

All emails related to a case must be filed in the relevant MS Office folder. All documentation relevant to the case must be saved in the relevant Sharepoint folder.

11. The Comcare Scheme - SRC Act

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The rehabilitation and workers’ compensation regulatory functions provide an integrated and cost-effective approach to prevention, compensation and workplace rehabilitation across the jurisdiction.

The rehabilitation and compensation components of the Comcare scheme are characterised by:

A ‘no fault’ scheme, with limited access to common law;
An integrated and cost-effective approach to injury prevention, occupational rehabilitation and workers compensation;
Employer responsibility for the occupational rehabilitation and RTW of injured employees;
Comcare approval of rehabilitation program providers;
A comprehensive benefit structure with an entitlement to incapacity payments for 45 weeks at 100 per cent of normal weekly earnings, and a graded reduction thereafter, from between 100 per cent and 75 per cent of normal weekly earnings, depending on the hours worked during a given week;
Coverage of allowable medical, rehabilitation and related costs associated with the treatment of work related Injury and diseases;
Lump sum payments for permanent impairment due to work related injury or disease; and
Entitlement to incapacity payments until age 65.

11.1. Comcare Premium

The premium is the amount of money that an agency (e.g. NDIA) is required to pay to Comcare to cover the provision of benefits provided to injured employees for things such as income support, medical and home help assistance and other benefits. Comcare will assess each agency’s claim performance as an estimate of the lifetime cost of each claim. Lifetime cost means payments to date plus an estimate of future costs for each claim.

Estimates of lifetime costs increase or decrease for each claim, depending on the changing pattern of actual costs and time off work for the claim. While most claimants have only days or weeks off work, some will accumulate many months off work and a small percentage will continue to receive benefits and accumulate time off work over many years.

At the time the claim is accepted, the estimate of the lifetime cost is based on the minimal information available about the claim. This includes the claimant’s age, gender, normal weekly earnings, type of injury, and the delay between the injury and acceptance of their claim.

As more information about the development of each claim becomes available, the estimate of lifetime cost for each claim is updated. Important factors in claim estimation include:

The claimant’s cumulative time off work and the pattern of time off work (the number and length of periods off work);
Whether the claimant is at work or off work, and how long that has been the case;
If the claimant is on a graduated RTW program, the number of hours they spend at work each week;
The claimant’s pattern of medical and rehabilitation costs; and
Whether a third party recovery action has been initiated, and the progress of that action.

The premium responds to trends in the claim performance for the individual agency, as well as trends across the whole system, and is intended to act as a direct financial incentive for agencies to reduce workers’ compensation costs by effective health, safety and rehabilitation measures.

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To reduce premium rates, the following must occur:

A reduction the number of claims, by preventing injuries in the first instance; and
Returning injured employees back to work as quickly as possible (even just a few hours a week), as payments for time off work make up the largest component of the costs.

12. Early Intervention

The NDIA recognises that early intervention is about identifying the early signs of work-related injury or illness and taking quick and effective action to support employees, which in turn:

Prevents long term absence from the workplace and the development of chronic illness;
Supports a positive and supportive workplace culture;
Recognises staff and the value of their contribution to the workplace; and
Reduces workers compensation costs.

The earlier it is observed that an employee is experiencing potential signs of ill health or injury, the sooner the NDIA can take steps to support them. The NDIA has early intervention funding which may be used for particular medical costs, or to engage a Workplace Rehabilitation Provider (WRP) to provide rehabilitation and RTW services.

The success of Early Intervention requires employees to:

Report any illness or injury to their manager as soon as possible;
Participate in Early Intervention Assessments (EIAs) and RTW programs where required; and
Keep their manager informed about their injury and treatment.

The NDIA’s Early Intervention approach aims to embrace the following principles:

A timely and appropriate response, with a focus on workplace interventions;
Managers and team leaders play a central role;
Collaboration between key stakeholder is required to identify solutions that will maintain the staff member at work or to RTW;
Early and professional assessments will assist with identifying employees’ needs; and
All staff have responsibility to create a supportive work environment for work colleagues who may be affected by injury or illness.

12.1. Early Intervention Funding

The NDIA has established a centralised funding and payment model for approved workplace adjustments and early intervention expenses. The Workplace Support Team are responsible for the assessment, approval and payment of workplace adjustments and EI expenses for APS employees, with the exception of Auslan and Live Captioning. This remains the responsibility of the employee’s business area.

EI expenses are generally covered by the staff reimbursement process. In some circumstances, it may be appropriate for the NDIA to organise an upfront payment to the health provider.

The NDIA’s early intervention funding may be used for:

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Short-term external WRP services such as Early Intervention Assessments (EIAs), RTW services, including Early Intervention Rehabilitation Programs (EIRPs) and workstation ergonomic assessments. For example, for a period of up to 12 weeks;
Reimbursing the costs of medical intervention such as: o General practitioner consultation(s) o Limited treatment by registered allied health professionals. For example, up to six treatment sessions of physiotherapy, psychology or occupational therapy
Providing support aids, including ergonomic equipment, non-standard furniture, equipment or software.

Generally, early intervention funding will not be provided for

Investigative medical costs, such as CT scans or MRIs;
Invasive treatment such as surgery;
Prescription medication; and
Massage, unless a medical practitioner makes a referral for remedial massage to a registered allied health professional.

Please refer to the WHS&S Centralised Purchasing and Payment of Workplace Adjustments and Early Intervention Support Payments Standard Operating Procedure (SOP) for detailed funding approval and purchasing instructions.

When an Early Intervention Rehabilitation Program (EIRP) is required for a case where there is no claim for compensation, the ongoing funding for the program must be tracked by the Rehabilitation Case Manager (RCM). The steps for recording this is outlined below when a Workplace Rehabilitation Provider (WRP) recommends an EIRP:

RCM receives a funding request from the WRP for an EIRP
RCM saves the funding request to the shared drive (R drive)
RCM requests funding approval from their Assistant Director and case notes this request
Once the funding is approved, the RCM completes the below funding request template and returns it to the WRP
When the WRP requests more funding and submits another request, this amount is added the other funded amount and is reflected as a total amount in the second row “Total costs approved including this request – GST inclusive). This enables the RCM to track how much money has been spent on the rehabilitation program at any given time.

SECTION 4: Agency delegate approval – for agency use only
Costs approved to date – GST inclusive
Total costs approved including this request – GST inclusive
Comments
Agency representative name
Agency representative signature
Phone
Date	Enter details
ORAMS Referral ID Number

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12.2. Early Intervention Assessments

An Early Intervention Assessment (EIA) may be conducted by a Workplace Rehabilitation Provider (WRP) for non-compensable physical or psychological injuries or illnesses. The aim of an EIA is to identify early signs of injury or illness and recommend strategies for the employer to take quick and effective action to support the employee. This in turn:

prevents further or long-term absence from the workplace and the development of chronic illness
supports a positive and supportive workplace culture
recognises staff and the value of their contribution to the workplace.

The assessment should include the following information-gathering activities:

appraisal of the workplace ergonomic environment (onsite or at a home location)
discussion with the supervisor and treating practitioner
identifying barriers to return to work (including consideration of workplace issues) and proposed strategies to address these barriers
information on a medical diagnosis and expected recovery timeframe, and a concise and relevant history of injury and/or illness
workplace restrictions
potential suitable duties where appropriate

Following the assessment, the WRP will email the report to the Case Manager for review. After reading the report, the Case Manager should determine, with involvement of the WRP, whether the report should be released directly to the employee, or through their treating medical practitioner. In some cases, where there is particularly sensitive information contained within the report, it may be best to release it through the employee’s doctor.

13. Workers Compensation Claims

Compensation can be claimed if an APS employee sustains an illness or injury that they believe was caused, or contributed to, by their work. The claim must be lodged with Comcare who will determine liability. The claim will be administered under the Safety, Rehabilitation and Compensation Act 1988.

Where an employee has an illness or injury that has not been accepted as compensable by Comcare, the management of the case is dealt with under the Public Service Act 1999 and APS and NDIA policies.

13.1. Employee and Supervisor Responsibilities

Employee

When an injury or illness occurs in the workplace, the employee should seek medical attention and obtain a medical certificate. The Comcare ’Medical Certificate for Workers Compensation (SRC132) is the preferred certificate as it contains information required by Comcare. However, any original medical certificate is acceptable providing it contains the following information:

The date of injury and the date medical treatment was first obtained
A clear medical diagnosis of the claimed condition
An explanation of how the doctor considers the condition is related to employment

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Any pre-existing or contributory factors to the medical condition
Any treatment or restrictions required for the condition and the likely duration of the treatment including specialist referrals and rehabilitation
Any period of time required off work
A medical opinion of employee’s capacity for work including what duties can be undertaken and any work modifications required
A review date by the doctor

Once an employee has completed a claim for compensation they are to provide the claim to their supervisor to complete the appropriate section including signature before sending it back to the RCM.

Incapacity Payments and Employee Claims for Time Off Work (CFTOW)

The employee may be entitled to receive income support while they are unable to work or are on a rehabilitation program. This is known as incapacity payments.

To claim incapacity payments, the employee must either submit an online CFTOW form or submit a paper-based form with their corresponding medical certificate. Further guidance on how to complete these claims can be found on the Comcare website.

To ensure timely and accurate coding of compensation leave, the RCM should note when the employee’s medical certificates are due, and remind the employee to send their latest medical certificate with their CFTOW form to Comcare as soon as possible.

If an employee suffers a work-related compensible injury two years prior to age pension age, they may be entitled to payments for a maximum of 104 weeks (whether consecutive or not) during which time they are incapacitated.

Supervisor

Supervisors have a responsibility to assist in the claims process by completing the appropriate part of the claim form and providing relevant information in relation to the cause of the illness or injury as requested by Comcare under s71 of the SRC Act in line with the stipulated timeframes.

Leave Coding Reponsibilities for Supervisors

Supervisors also have responsibility for coding leave relating to compensable conditions where the employee is absent from work due to incapacity.

There are two types of leave that can be accessed for any absence from work associated with a compensation claim that is yet to be determined:

Personal Leave Compensation Related without evidence
Personal Leave Compensation Related with evidence

Both of these leave types will reduce the employee’s personal leave credits until such time that the claim has been determined. The Personal Leave will be re-credited if the employee’s claim is accepted and will be recoded by payroll to Compensation Leave once they have been notified of the change in claim status by the employee’s Rehabilitation Case Manager.

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Compensation Leave must be coded by the supervisor when an employee has a claim for workers compensation that has been accepted. There are two types of compensation leave:

Compensation Leave < 45 weeks is leave relating to an absence for an accepted claim where the employee has been absent from work for less than 45 weeks.
Compensation Leave > 45 weeks is leave relating to an absence for an accepted claim where the employee has been absent from work for more than 45 weeks.

The 45 weeks of leave accrual commences at the end of the pre-determination period. This means that the day after Comcare issue the section 14 determination is the day that the countdown towards 45 weeks begins. This is when post-determine compensation leave begins. Section 116 of the SRC Act states that an employee is not entitled to be granted any kind of leave of absence with pay during, or in respect of, any period when the employee is or was on post-determination compensation leave.

Once incapacity payments reach 45 weeks, the rate of incapacity compensation payments is reduced by an ‘adjustment percentage’. This also impacts on Personal Leave and Annual Leave accruals for the employee, so accurate coding is essential. When the employee has surpassed 45 weeks of incapacity, it may be more beneficial for them to claim their own leave entitlements rather than claiming incapacity from Comcare (e.g. an employee on a GRTW may wish to apply for their own leave for the hours they would normally be working.)

Long service leave continues to accrue both during and at the expiry of the first 45 weeks of compensation leave.

Supervisors must appropriately code all leave related to workers compensation in Essentials. Failure to do so may result in the employee being overpaid.

Once a claim reached 40 weeks of paid incapacity payments, Comcare will send a notification letter to both the employee and employer. The intention of issuing these letters at this point in time is to enable sufficient time for the supervisor to change the employee’s leave coding In Essentials from Compensation Leave < 45 weeks to Compensation Leave > 45 weeks.

Further letters are forwarded to both the employee and employer once the payment has been adjusted when paid incapacity payments reach 45 weeks.

13.2. New Claim Process

The NDIA is required to submit new workers compensation claim forms (Comcare SRC016 form – ‘Claim for Workers Compensation’) to Comcare within five working days of a claim being lodged by an employee. The five day timeframe is measured from the time that the first employee at the NDIA receives the claim (e.g. manager).

A RCM will sometimes be contacted about a new workers compensation claim by the employee’s supervisor or by the employee lodging the claim. In these cases, the RCM must respond to and contact the supervisor or the employee who has requested their assistance within a 24-hour business period.

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If the injury or illness is, or could be work related, provide the employee with the Claim for Compensation Guide and ensure that both the employee and supervisor are aware of their responsibilities in the process.

Manual claim form:

Step 1

On receipt of a manual compensation claim form, the RCM must check that the employee section of the claim has been completed and the following documents have been attached:

Medical release authority
Employee location details
Medical certificate relevant to the absence period on claim form.

Step 2

The RCM completes the employer section of the claim form (including the date that the claim was received by the line manager or RCM) and sends it to the line manager to review and sign. Where the RCM, in considering the supervisor’s statement (or absence of statement), believes that further information should be provided to Comcare, tick ‘yes’ at question 9 of the employer section.

Step 3

If the claim is not complete, it is the responsibility of the RCM to return it to the employee and/or their supervisor for completion. Note the incomplete areas to the employee and/or supervisor, and ensure that they are aware of Comcare’s timeframes (five days from receipt of claim) regarding timely lodgement of claims.

Step 4

The RCM must obtain salary and Normal Weekly Earnings (NWE) details from payroll and ensure that this information is provided to Comcare as part of the claim process.

Step 5

The completed claim can be emailed to Comcare:

General.enquiries@comcare.gov.au

Step 6

Engage a Workplace Rehabilitation Provider (WRP) for the ill/injured employee. An Early Intervention Assessment (EIA) may be appropriate for some new compensable injuries.

Complete the ORAMS referral in the ORAMS online portal (Rehabilitation Assessment Examination form (SRC116)), which will automatically be sent to the employee, Comcare, the supervisor, WRP and the RCM.

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If, due to exceptional circumstances (e.g. employee is not away from work), a decision is made to not engage a Workplace Rehabilitation Provider to conduct an EIA, the RCM must document the decision and reasons for this.

Step 7

Comcare will advise the employee and RCM of the following in relation to the claim:

Compensation claim status
Any delays relating to the claim (if applicable).

Step 8

The RCM must email payroll once a claim has been determined at pay.compservice.centre@servicesaustralia.gov.au to provide the following information:

Employee name
Date of birth
AGS number
Claim number
Claim accepted or denied
Date of determination
Date of injury (only include if claim the claim is accepted):
If accepted, date of incapacity (S19)
Accepted condition/s (physical/psychological)


Employee name
Date of birth
AGS number
Claim number
Claim accepted or denied
Date of determination
Date of injury (only include if claim the claim is accepted): If accepted, date of incapacity (S19)
Accepted condition/s (physical/psychological)

Electronic claim form:

An email will workflow to the Workplace Supports Team inbox once a claim is submitted by an employee electronically. The RCM must then log into the Comcare Online Forms portal, open the claim and complete the employer section online, seeking additional information from the employee’s supervisor where relevant.

The RCM should follow steps 4, 6, 7 and 8 outlined above, noting that step 5 is not applicable for electronic claims, because the claim is automatically sent to Comcare once the claim is submitted through their online portal.

Notifying the Workplace Integrity and Work, Health and Safety Teams of a new claim

Upon receipt of a new claim for compensation, the Rehabilitation Case Manager must contact People and Culture’s Workplace Integrity and Work, Health and Safety Teams to determine whether they have any

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involvement with the employee (e.g. notification of an incident and/or injury) that might be relevant to the claim. This can be done by emailing redacted: s47E(d) - certain operations of agencies @ndis.gov.au and redacted: s47E(d) - certain operations of agencies @ndis.gov.au.

13.3. Actions required when a non-compensable condition becomes compensable

Where a case that was initially non-compensable becomes compensable, funding relating to the compensable case must be recovered from Comcare. Refer to Accounts Receivable Procedures on the intranet.

13.4. Submission of an Employer Statement under a s71 Notice

Comcare has the authority, under section 71 of the SRC Act to obtain documents and information from an employer relating to a claim. The Comcare Claims Officer will specify the information required, along with a deadline to the NDIA’s Rehabilitation Case Manager (RCM) assigned to the claim. The statement provided by the employer in response to the claim must be factual, objective, and supported by documentary evidence where applicable.

The RCM must email the employee’s supervisor to obtain the information requested on Comcare’s s 71 notice. The RCM must compile this information into a Statement of Facts and provide it to Comcare with the additional documentation as attachments.

The SRC Act provides that in some situations, injured workers are excluded from receiving compensation. Comcare will consider exclusionary provisions under the Act when determining a claim. These areas include:

A reasonable appraisal of the employee’s performance
A reasonable counselling action (formal or informal) taken in respect of the employee’s employment
A reasonable suspension action in respect of the employee’s employment
A reasonable disciplinary action (formal or informal) taken in respect of an employee’s employment
Anything reasonable done in connection with the employee’s failure to obtain a promotion, reclassification, transfer, or benefit, or to retain a benefit, in connection with his or her employment (section 5A (2))

Compensation is also not payable to an injured employee if the injury is:

intentionally self-inflicted (section 14(2))
caused by that employee’s serious and wilful misconduct (section 14(3))
the result of that employee making a false representation, connected with their employment, that they did not suffer from a disease (section 7(7)).

If the employee is not longer working for the NDIA, but their information that was formerly contained within Essentials is required (e.g. leave history report, etc.), the RCM can email the Workplace Planning and Reporting team at redacted: s47E(d) - certain operations of agencies @ndis.gov.au.

13.5. Arranging and Managing a s37 Rehabilitation Program

When a compensation claim has been accepted and/or a s36 assessment or examination is completed, a s37 Rehabilitation Program may be developed. The NDIA, being the Rehabilitation Authority, may make a determination under the SRC Act that an employee who has suffered a work related injury or illness, which results in an incapacity for work or impairment, should undertake a rehabilitation program (s37).

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The rehabilitation program is developed in consultation with the RCM, WRP, employee, supervisor and medical treaters. It documents the rehabilitation goals, WRP services and costs, the responsibilities of all parties, and the expected outcome and timeframes for the rehabilitation program. A date is agreed upon for the program to begin, and when it is expected to end.

After this process has been completed, the employee, RCM, WRP and supervisor all sign the program to acknowledge their involvement in it. Copies of the rehabilitation program are then provided to the employee, the treating medical practitioner, the RCM, the WRP and the Comcare Claims Manager.

The RCM has overall responsibility for completing this document and has delegation and responsibility under the SRC Act for reviewing the draft, ensuring consultation with all parties and completing and signing the determination section.

The employee, RCM and supervisor sign the rehabilitation program to indicate that they have been involved in the consultation and development of the program. The only signature required to render this a legal determination under s37 (3) is the signature of the RCM, having delegation under the SRC Act. It must be signed and dated by the RCM prior to or on the start date of the program in order to be valid.

The RCM is also responsible for ensuring that the determination under section 37(1) of the SRC Act is documented correctly. In doing so, the RCM needs to ensure that all the matters have been considered as detailed in subsection 37(3)(a)–(h), and in particular that section 37(3)(f), the employee’s attitude to the program, has been considered. Failure to consider all the matters and to adequately document this may lead to the rehabilitation program being invalid.

The RCM must ensure that a proposed rehabilitation program is discussed with the employee. The employee must be given adequate time to consider the proposed rehabilitation program, before all parties sign it. Every concern raised by the employee must be considered, and these discussions must be carefully and thoroughly documented. This is generally addressed in Part 3 a–h considerations.

The table below contains some of the considerations that may be relevant in addressing s37(3)(a)-(h) when developing a rehabilitation program:

| S37(3)(a)
Any written assessment given under s36(8) | Consider:

Current medical certificates
Current medical reports
Any other rehabilitation or specialist assessments, for example, Early Intervention Assessment (EIA) reports, section 36 assessments
Any additional comments (if there are conflicting medical opinions). | | S37(3)(b)
Any reduction in future liability to pay compensation if the program is undertaken | Consider:
Whether achieving a durable return to work (particularly if a person returns to pre-injury capacity) will result in a reduction/cessation of incapacity benefits |

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	• The potential for short-term and long-term activities to enable a return to work.
S37(3)(c) The cost of the program	Consider: • The goal of the rehabilitation program • The nature of the proposed rehabilitation services • Whether the program’s cost is reasonable and within industry standards.
S37(3)(d) Any improvement in the employee’s opportunity to be employed after completing the program	Consider: • Both long and short-term goals, such as provision of alternative duties or work trials to allow the employee to upgrade physical or psychological work capacity.
S37(3)(e) The likely psychological effect on the employee of not providing the program	Consider: • The person’s current psychological state and medical recommendations • The potential for worsening of symptoms if a program isn’t provided.
S37(3)(f) The employee’s attitude to the program	Consider: • The employee’s attitude to the proposed rehabilitation program, including the reason’s given by the employee, with appropriate weight being given to the issues raised.
S37(3)(g) The relative merits of any alternative and appropriate rehabilitation program	Consider: • If the rehabilitation program and its activities are consistent with the most appropriate rehabilitation goal • Whether the hierarchy of return to work has been followed when considering any alternative rehabilitation program.
S37(3)(h) Any other relevant matters	Consider: • Medical support for the program, particularly if this is conflicting • The requirement for the relevant authority to provide suitable employment or to take all reasonable steps to help the employee find suitable employment

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redacted: s22 Family or other psychosocial issues
redacted: s22 Workplace issues such as workplace investigations, grievances, conflict.

When determining a rehabilitation program, the RCM should take into consideration the purpose of the program, which is to assist an employee to be maintained at or return to work. This should be guided by the Return to Work Hierarchy:

same employer, same job (same duties)
same employer, similar job (modified duties)
same employer, different job (different duties)
new employer, same job (same duties)
new employer, similar job (modified duties)
new employer, different job (different duties)

13.6. Workplace Rehabilitation Provider Service Codes

Comcare have several WRP Service Codes, which are used for billing purposes depending on the type of service or assessment provided. The codes can be found on Comcare’s website.

The Service Code to be used for the consultation period during which a s37 Rehabilitation Program is under development is Code 90 – non-billable charges of XXX (number of hours on consulting). Once the s37 Rehabilitation Program is signed off and in place, the WRP should then add a line on Code 92 – development of Rehabilitation Program of XXX (number of hours on consulting). Code 92 should also be used for any Rehabilitation Program Alterations,

In addition to this, Code 90 is to be used for return to work support services (i.e. third party services such as vocational counselling not provided by the WRP, external training, etc.) and Code 94 is to be used for WRP travel, where applicable.

13.7. Managing non-compliance

Under section 36(4) of the SRC Act, an employee can be found to be non-compliant if they fail, refuse or obstruct, without reasonable excuse, to attend or participate in a rehabilitation examination or assessment with the purpose of determining their capability to undertake a rehabilitation program.

Under section 37(7) of the SRC Act, an employee can be found to be non-compliant if they fail, refuse or obstruct, without reasonable excuse, to undertake and participate in their rehabilitation program.

Non-compliance under the SRC Act can lead to suspension of compensation entitlements excluding compensation for medical treatment. The authority to make a determination to suspend compensation under the SRC Act is with the appropriate delegate from the rehabilitation authority.

Non-compliance may include, but is not limited to:

failure to attend a rehabilitation assessment or examination;
failure to comply with the requirements of a rehabilitation program;
failure to seek suitable work.

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A person delegated by the rehabilitation authority may make the decision to suspend benefits under the SRC Act. This delegation sits with EL2 level or above within the People and Culture division.

13.8. Superannuation and leave accrual for employees on incapacity payments or income protection

Incapacity payments from compensation are not a pension and in general do not include any superannuation entitlements. However, this is determined by the Superannation Scheme that the employee belongs to. It is the responsibility of the employee to check with their Superannuation fund to determine if payments will be made during periods of compensation leave.

Similarly, if an employee is in receipt of any income protection payments through a personal insurer, employer superannuation contributions would not be paid to the employee. This is because income protection is not paid by the employer, but by the insurer.

Section 130 of the Fair Work Act 2009 (the Fair Work Act) bars the accrual of any National Employment Standards (NES) leave (including ‘sick leave’ as paid personal leave and ‘recreation leave’ as paid annual leave) during a period when an employee is absent from work because of an injury for which the employee is receiving workers’ compensation. However, it does not bar accrual of NES leave during such a period if permitted by a compensation law.

Section 116 of the SRC Act is a compensation law that permits the accrual of sick leave and recreation leave entitlements during each of the first 45 weeks of post-determination compensation leave; and the accrual of long service leave entitlements during the whole of the post-determination compensation leave period. Annual leave and personal leave cease to accrue once 45 weeks of incapacity has been reached, except for public holidays (annual and personal leave do accrue on these days).

13.9. Closure of a compensable case and/or return to pre-injury hours

Upon closure of a compensation case and/or a return to pre-injury hours, the Rehabilitation Case Manager must notify Payroll as soon as possible and complete all other administrative tasks, including finalising case notes, closing the case on the case tracker and moving the case record into “closed case files”.

14. Managing Non-compensable Cases

When required, rehabilitation programs need to be developed for ill and injured employees who are not the subject of a compensation claim, or where a claim has not yet been lodged or determined. These procedures support both the employee and the NDIA by ensuring that rehabilitation occurs in a timely manner by acting early.

Step 1

Referral received from either the employee, supervisor or HR Business Partner via the HR Service Desk. This will be triaged by the Early Intervention Team and referred to Workplace Supports when required.

In circumstances when an RCM receives a case handover from the Early intervention team, the RCM must ensure that the consent forms have been obtained and signed by the employee and are still valid. The RCM must also ensure that these consent forms are filed appropriately.

Step 2

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The RCM contacts the supervisor to gather information:

Is the employee at work?
If not, do they have medical certification?
Have they been advised of the rehabilitation process and are they willing to participate?
What is the nature of their condition?
Is the condition work related?

Step 3

RCM contacts the employee to gather information, discuss the rehabilitation process and advise them of the next steps. After speaking with the employee, the RCM should consider whether the case is suitable for in-house case management, where engagement of an external WRP is not required.

Step 4

If a rehabilitation program is required, and the RCM needs to engage a WRP, they should review the ORAMS portal to select an appropriate provider and to obtain service costs. They should then do the following:

Obtain funding approval from the delegate for the associated costs.
Provide an overview of the rehabilitation/return to work process to the employee and supervisor.
Select an WRP from the ORAMS portal.

Selecting a WRP may also be beneficial if the case becomes compensable in the future. The choice of WRP should be influenced by their:

Level of expertise with the injury/illness suffered by the employee;
Gender or ethnicity if this is relevant to the employee;
Location; and
Availability

RCMs are to record all case activity on the case notes template.

Step 5

The Rehabilitation Program is developed by relevant stakeholders. The elements of a sound RTW program may include:

Structured graduated return to work details
Workplace assessment/s
Contact with supervisor and health practitioners
Work related issues which may impact on a successful RTW
Pre-injury duties
The availability of suitable duties
Any potential barriers to RTW

Stakeholders include:

Employee

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Supervisor/manager
WRP
Medical practitioner/s
HR Business Partners (HRBPs)

When developing the Rehabilitation Program, take into account:

Any written assessment provided by a medical practitioner or rehabilitation provider;
Any potential improvement in the injured or ill employee’s opportunity to be employed after completing the plan;
The relative merits of any alternative and appropriate Rehabilitation Program;
The expertise required to assist the injured or ill employee to return to sustainable work as quickly and safely as possible.

The Program should also include administrative details such as regular meetings with the supervisor, WRP (and RCM if required), to confirm progress towards the rehabilitation goals.

Step 7

Once the Rehabilitation Program has commenced, the RCM must monitor the employee’s progress and review on a regular basis until the rehabilitation goals are achieved. Regular contact should also be maintained with the supervisor during this time.

The WRP is expected to maintain regular contact with the employee and their medical provider and to keep the RCM informed of the employee’s progress. The WRP is also expected to provide regular updated RTW plans to key stakeholders. The RTW plans reflect any improvement in the employee’s condition and their increased work capacity, as certified by the employee’s medical practitioner.

Step 8

When the employee has been medically cleared to return to pre-injury hours and duties, the WRP completes a final review then provides a Closure Report. The RCM may arrange a final meeting with relevant stakeholders prior to proceeding to formal closure of supports.

Step 9

If the employee was not found fit to undertake a Rehabilitation Program, the RCM should consult with their Assistant Director for guidance on management of the case.

Step 10

If the employee continues to be unfit for work based on medical evidence, it may be appropriate to consider an Independent Medical Examination to establish the employee’s capacity for employment.

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15. Referral for Rehabilitation Services

Referrals for rehabilitation services are only valid if made by members of the Workplace Support Team via the Occupational Rehabilitation and Medical Services (ORAMS) Portal.

The Occupational Rehabilitation and Associated Medical Services (ORAMS) Service Requirements document outlines all of the assessments, evaluations, examinations and programs that can be requested under the ORAMS servicing arrangements.

16. Suitable Duties for Compensation Cases

Employees may not always be able to return to their pre-injury duties or hours straight away, therefore, managers will need to identify and provide suitable duties to accommodate any medical restrictions, with a focus on the duties that the employee can do, the inherent requirements of the job and the workplace adjustments that can be provided.

The NDIA has an obligation, under section 40 of the SRC Act, to provide suitable duties for employees who have a compensable injury or disease and, is undertaking or has completed a rehabilitation program.

Suitable duties means duties which are appropriate to the employee’s capacities, skills, age, training, language and experience and in consideration of medical limitations. Providing suitable duties may involve:

Modification of current duties
Alternative duties, and/or
Modified hours while on a RTW plan.

RCMs may also consider a Work Trial as part of a Rehabilitation program. If an employee is unable to return to the NDIA, the RCM should investigate alternative strategies in order to ensure successful RTW. A ‘work trial’ involves the placement of the injured or ill employee with a host employer for a defined period of time (generally not in excess of three months), however the employee continues to be employed and paid by their respective area within NDIA.

The RTW hierarchy states the goal of a Rehabilitation program, starting with the aim of returning the employee to their original duties at the same workplace. Where the goal is not attainable, the program goals to be implemented under the hierarchy are as follows:

same employer, same job (same duties)
same employer, similar job (modified duties)
same employer, different job (different duties)
new employer, same job (same duties)
new employer, similar job (modified duties)
new employer, different job (different duties)

For non-compensable cases, employees are required to actively pursue redeployment opportunities.

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Step 1

In consultation with the WRP, supervisor/manager and the ill/injured employee (if appropriate), evaluate the medical evidence to decide whether the employee should return to the same (or similar) job in the same workplace. If it is not possible to continue with the Rehabilitation Program - go to Step 2.

Step 2

Based on the medical evidence, decide if it is possible for the employee to perform modified duties in the same workplace:

Discuss the possibilities with the supervisor/manager and employee;
Based on medical evidence, agree on any modifications required – the provision of ergonomic equipment, limiting keyboard work, working from a quiet room etc.;
Assist the work area with providing and required workplace modifications. This needs to be actioned quickly to enable the RTW to occur as soon as the employee is medically fit to return to the workplace;
Continue with the Rehabilitation program.

If modified duties/same workplace is not possible – got to Step 3.

Step 3

Based on medical evidence, decide if it is possible for the employee to undertake alternative duties in the same workplace:

Discuss the possibilities with the supervisor/manager and the employee to assist in identifying suitable duties;
Agree on suitable duties to be performed by the employee;
Continue with the Rehabilitation program and ensure that the employee is closely monitored.

If different duties/same workplace is not possible – go to Step 4.

Step 4

Based on medical evidence, decide if it is possible for the employee to perform the same or modified duties in a different workplace within NDIA:

Discuss the possibilities with the supervisor/manager and the employee (if appropriate) to assist in identifying any suitable positions/duties;
Based on medical evidence, identify any modifications required for the employee to undertake the duties of an appropriate position, or to perform suitable duties in a different workplace;
Assist the work area with providing any required workplace modifications to enable the employee to undertake the duties of an identified position or undertake suitable duties, in the alternate workplace;
Continue with the Rehabilitation Program and ensure that the employee is closely monitored.

If same or modified duties/different workplace is not possible – go to Step 5

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Step 5

Based on medical evidence, decide if it is possible for the employee to perform a different job in a different workplace within NDIA.

Discuss the possibilities with the supervisor/manager and the employee (if appropriate) to assist in identifying any suitable positions/duties;
Determine the position to be filled, and/or the suitable duties to be performed by the employee;
Continue with the Rehabilitation Program and ensure that the employee is closely monitored.

If the medical evidence advises that the employee cannot perform the same, modified or new duties within their current or other NDIA workplace – go to Step 6.

Step 6

At this stage, the RCM should investigate a work trial placement.

Where an employee, for medical reasons, is unable to return to NDIA, an option to be explored is a placement for the injured employee with a host employer. In such circumstances, the employee continues to be paid by NDIA, with NDIA being responsible for rehabilitation and any compensation matters.

This option provides the injured or ill employee with the opportunity to explore more permanent opportunities whilst building new skills and allows the employee to establish a positive working relationship with a potential new employer.

Step 7

Conduct reviews monthly in order to:

Review outcomes of the Rehabilitation program or placement;
Determine further rehabilitation or RTW activities; and
Ensure all activities and decisions are noted in the case notes.

16.1. Medical Redeployment

If the employee’s capacity has not resulted in a return to pre-injury duties and it is likely that this incapacity will continue, it is recommended that the RCM advise the work area that the employee should be considered for medical redeployment status, and profile the case for suitable employment via a work trial.

If the case relates to an accepted compensation claim, the decision to deem an employee as a medical redeployee, commences the suitable employment profiling process.

The Rehabilitation Case Manager and/or Workplace Rehabilitation Provider should seek to empower the employee to be proactive in their own job-searching and provide them with the skills and confidence required

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to do so. Vocational rehabilitation services should be tailored to the employee based on their assessed needs in order to assist them to achieve a meaningful and sustainable employment outcome.

16.2. Work Trials

Work Trial Phase

The work trial phase may achieve a number of outcomes for the injured employee. It may enable an injured employee to gradually increase their capacity for work in an environment better suited to their physical or psychological restrictions. It may provide an injured employee with an opportunity to gain new skills and the opportunity to demonstrate capacity and capability for certain duties and/or work hours. It may provide allow the injured employee to gain work experience and a recent employment referee if they have been unable to work for some time.

With these goals in mind, a work trial placement should always be time limited to the achievement of these goals, and actively monitored and reviewed to ensure it remains a valuable activity for the injured employee. Extension of a work trial placement beyond 12 weeks requires justification of the continued benefits to be gained from the extension.

At the conclusion of a temporary work trial placement, the employee and the host manager/supervisor are able to make an informed decision in relation to permanent redeployment, if this is deemed appropriate.

Australian Public Service Work Trials

If a suitable position cannot be sourced within NDIA, consideration should then be given to sourcing a work trial placement within another APS Agency. It is recommended that an offer of a worksite assessment be arranged prior to the commencement of any work trial placement. Independent Medical Examinations.

17. Independent Medical Examinations (IME)

17.1. Non-compensable Conditions

Where a non-compensable condition is affecting an employee’s performance or ability to remain at work, the employee can be directed by a NDIA delegate to attend a medical examination for a health assessment under section 20 of the Public Service Act 1999 and section 11 of the Public Service Regulations 2023 (Public Service Regulations).

11 Direction to attend medical examination

(1) This section applies if:

(a) an Agency Head believes that the state of health of an APS employee in the Agency:

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(i) may be affecting the employee’s work performance; or

(ii) has caused, or may cause, the employee to have an extended absence from work; or

(iii) may be a danger to the employee; or

(iv) has caused, or may cause, the employee to be a danger to other employees or members of the public; or

(v) may be affecting the employee’s standard of conduct; or

(b) an APS employee is to be assigned new duties and the Agency Head believes the employee’s state of health may affect the employee’s ability to undertake the duties; or

Note: Examples of absences that could be treated as extended absences are:

(a) an absence from work of at least 4 continuous weeks; and

(b) a combined total of absences from work, within a 13-week period, whether based on a single or separate illness or injury, of at least 4 weeks.

Delegation for Independent Medical Examinations (to assess an employee’s fitness for duty) are listed below in the current Schedule of HR Delegations, which have been updated due to the new Public Service Regulations 2023.

Column 1: Item	Column 2: Subject	Column 3: Power, function and/or duty	Column 4: Position(s)	Column 5: Source(s)
19.2	Fitness for duty	Where any of the s11(1) of the PS Regs apply, direct an employee in writing to undergo an examination, within a specified timeframe, by a nominated medical practitioner to assess the employee’s fitness for duty and direct the employee to provide a report of	SES Band 1 or above for employees under their control; and APS 5 or above in People and Culture.	PS Regs s11(2)

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Column 1: Item	Column 2: Subject	Column 3: Power, function and/or duty	Column 4: Position(s)	Column 5: Source(s)
		the examination within a specified timeframe.
19.3	Nominate a medical practitioner	Nominate a registered medical practitioner to assess an employee’s fitness for duty in the NDIA.	SES Band 1 or above for employees under their control; and APS 5 or above in People and Culture.	PS Reg 10 and 11
13.7 (Listed under Recruitment)	Medical – health clearance	For APS employees whose engagement in the NDIA is subject to a condition dealing with health clearances, direct an employee, in writing, to undergo a medical examination by a nominated medical practitioner to assess the employee’s fitness for duty and/or provide a report of the examination within a specified timeframe.	EL2 or above for employees under their control; and SES Band 3; and APS5 or above in People and Culture.	PS Regs 1020

An Independent Medical Examination (IME) is a health assessment conducted by a Legally Qualified Medical Practitioner (LQMP) who is nominated by the RCM and who is not the employee’s treating doctor. Therefore, they can provide an unbiased opinion. The LQMP will liaise with the employee’s treating doctor if required.

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The purpose of an IME is to provide advice to the NDIA on an employee’s fitness for duty, including their ability to comply with their mutual responsibilities under NDIA’s Enterprise Agreement (EA) and Public Service Act responsibilities. It provides a basis for managing the case.

Failure to comply in a direction to attend an IME may result in action under the NDIA’s Code of Conduct.

Step 1

Arrange a time with a Legally Qualified Medical Assessor (LQMA).

Step 2

Complete the following documents:

An appointment letter for the employee;
An email to the Manager outlining the details of the appointment and requesting relevant information, which may include a Work Report, Timeline of Events, etc.

Provide a copy of all documents to the employee and the treating GP.

Step 3

Develop the IME letter and questions for the LQMA, include all relevant information (e.g. Work Report, Timeline of Events, leave summary, Position Description, EIA, medical certificates) and supply to the LQMA prior to the assessment, in accordance with the company’s timeframes. Ensure that a copy of the information sent to the LQMA is also supplied to the employee and the treating GP.

Step 4

Once a copy of the report has been received from the LQMA, develop outcome letters/emails for the employee, the treating GP and supervisor. Ensure that a copy of the report is released to the employee in line with the LQMA’s recommendations. If appropriate, ensure that a RTW plan is also developed.

17.2. Compensable Conditions

Where a compensable condition is affecting an employee’s performance or ability to remain at work, the employee can be directed by an NDIA delegate to attend a medical examination for a health assessment under the s36 of the SRC Act.

A s36 assessment is conducted by Legally Qualified Medical Practitioner (LQMP) who is nominated by the NDIA and is not the employee’s treating doctor. Therefore, they can provide an unbiased opinion. The LQMP will liaise with the employee’s treating doctor if required.

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The purpose of a health assessment under s36 of the SRC Act is to provide advice to NDIA on an employee’s ability to participate in a rehabilitation program, including their ability to comply with their mutual responsibilities under both the SRC Act and Public Service Act.

Failure to comply with a direction to attend an s36 assessment may result in suspension of compensation payments. Recommendations and information in the s36 report will be managed in accordance with the SRC Act.

An NDIA delegate should consider the following before directing an employee to attend an examination:

The adequacy of the information and opinions provided by:

a. any available reports from medical practitioners or other treatment providers relating to the employee’s injury or fitness for work; and b. any previous rehabilitation assessments;
The nature of the employee’s injury;
Any apparent restrictions on the employee’s capacity to work and activities of daily living; and
Whether the employee has failed or refused to undertake or complete a rehabilitation program without a reasonable excuse.

Step 1

Arrange an appointment with a LQMP for a s36 assessment.

Step 2

Complete the following documents:

Comcare’s 116 Form
An s36 appointment letter for the employee¹
A letter to the manager outlining the details of s36 appointment and requesting a Work Report.

Provide a copy of all documents to the employee, the treating GP and Comcare.

Step 3

Develop the s36 IME letter and questions, include all relevant information (i.e. 116 Form, workplace statement, EIA, medical certificates) and supply to the LQMA in accordance with the timeframes required.

¹ That letter should identify the assessor or panel, date, time and place of the examination; and setting out the reasons for, and rights to request a review of the determination.

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Ensure that a copy of the information sent to the LQMP is also supplied to the employee, the treating GP and Comcare.

Step 4

Once a copy of the report has been received from the LQMP, develop outcome letters/emails for the employee, the treating GP and supervisor. Ensure that a copy of the report is released to the employee in line with the LQMP’s recommendations. If appropriate, ensure that a suitable Rehabilitation Program is also developed. Ensure that a copy of the documents are provided to Comcare.

17.3. IME Supplementary Reports

Once the IME has been completed and the IME Report has been received by the RCM, a Supplementary Report can be requested if additional questions need to be asked of the LQMP. There are additional costs associated with requesting a Supplementary Report.

If clarification relating to one or more of the original questions is required, the RCM may request this from the LQMP. This is separate from a Supplementary Report request and additional charges should not be applied.

If either a clarification or Supplementary Report is required, the RCM should contact the Account Manager of the company (e.g. MLCOA) to discuss this and to make a formal request.

18. Partial Invalidity

In non-compensable cases and where an employee is under age 65, a partial invalidity pension (PIP) may be payable by CSC to Commonwealth Superannuation Scheme (CSS) and Public Sector Superannuation defined benefits (PSSdb) members who experience a decrease in salary due to permanent physical or psychological incapacity. The decrease in salary may be due to a reduction in working hours or a reduction in classification (or both).

A PIP is a separate supplementary benefit and is not deducted from any future super entitlements.

In order to access a PIP, an ongoing decrease in salary due to the medical condition is to be demonstrated to the CSC.

Step 1

The RCM must be satisfied that the injured employee has been maintaining the same hours and/or reduction is classification for at least six months and that the medical condition is stable and/or is not likely to improve significantly. The RCM must also be satisfied that genuine attempts to return the injured employee to pre-injury hours and/or duties have been made.

Step 2

The employer refers the injured employee to a CSC Approved Medical Practitioner (AMP) for an IME to assess their fitness for duty.

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If the IME recommends Partial Invalidity, follow the steps below.

Step 3

Ensure that the appropriate application to is provided to the employee, based on their superannuation fund. Once the employee has completed their section they are to forward the form to the RCM for completion.

Step 4

The RCM sends the following documents to PSS or CSS for determination:

Covering letter
Application form
Position Description
Evidence of reduction in hours and/or classification
Medical documentation, including IME Report
Leave records

Step 5

If a PIP is approved and a certificate has been received, the RCM must forward the information to payroll to action.

19. Invalidity Retirement

Invalidity retirement refers to termination under the Public Service Act 1999 on the grounds of an employee’s inability to perform duties because of physical or mental incapacity. Invalidity Retirement is only considered when all other options for managing illness and injury have been exhausted.

The decision as to whether an employee should be invalidity retired is based on medical advice. An employee can only be invalidity retired when the employee has been medically deemed to be totally and permanently incapacitated for employment (i.e. the employee’s ill health, whether physical or psychological, makes it unlikely that they will engage in gainful employment for which they are reasonably qualified by education, training or experience). CSC will consider medical recommendations and issued an Invalidity Retirement Certificate (IRC) if they are satisfied that an employee can be retired on invalidity grounds.

Age parameters apply for invalidity retirement, depending on the CSC fund that the employee is part of:

Commonwealth Superannuation Scheme (CSS) employees under age 65 will need an IRC for invalidity retirement;

Public Sector Superannuation Scheme (PSS) employees under age 60 will need an IRC for invalidity retirement;

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Public Sector Supperannuation Accumulation Plan (PSSap) employees under age 60 will need an IRC for invalidity retirement.

Employees over these age limits complete the age retirement application form and should provide medical evidence.

Documentation required for an IRC application to CSC varies, depending on the scheme which the employee is covered under. This is outlined below.

Required for all schemes:

Any medical records
Duty statement
Any other relevant medical documents, including rehabilitation reports, graduated return to work reports, and any other treating doctor or independent specialist reports

Required for CSS and PSS:

Treating doctor’s report dated within last six months
Accredited Medical Practitioner (AMP) report dated within the last six months
Recommendation by compensation provider

Required for PSSap:

Reports from at least two registered medical practitioners dated within the last twelve months
Employee’s resume
Documents related to compensable conditions (e.g. Comcare decisions or medical reports)

If the employee is approved for an IRC by CSC, a copy of the IRC and decision are sent to the NDIA and the employee.

The invalidity retirement date should be set by the employer in consultation with the employee. The benefit cannot be accessed until a termination date has been set. The delegation for invalidity retirement is held by EL2 and above in the People and Culture Division.

Invalidity retirement may be considered for compensable injuries however, Comcare need to be consulted as part of the process. Comcare’s support for an invalidity retirement is not essential for an application to CSC.

For employees with a terminal illness, the usual documents are required for an application, however, you can seek a report from the employee’s treating medical specialist instead of an Approved Medical Practitioner (AMP).

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An employee who is retired due to permanent invalidity will be required to pay tax on their superannuation.

If a Rehabilitation Case Manager is assisting an employee to apply for an IRC, the RCM can contact the Commonwealth Superannuation Corporation (CSC) by emailing employer.service@csc.gov.au for any enquiries. This may also include requesting an estimate of what their benefit would be.

19.1. Invalidity Retirement for Compensable Injuries

Step 1

The RCM must be satisfied that the injured employee has been absent from work for at least six months and that the medical condition is stable and/or is not likely to improve significantly. The RCM must also be satisfied that genuine attempts to offer suitable employment to the injured employee have been made.

Step 2

The employer refers the injured employee to a CSC approved medical practitioner for an Independent Medical Examination (to assess the employee’s fitness for duty).

If the outcome is a recommendation of invalidity retirement, follow steps 3 onwards.

Step 3

The RCM requests, in writing, that Comcare support an application for invalidity retirement. The employer provides documentary evidence (i.e. IME Report and any other relevant medical documentation) to support the request. Comcare has 28 days to provide a response regarding an application for invalidity retirement.

Step 4

Comcare will review the medical evidence to determine whether they support the application.

Step 5

Comcare will advise the RCM, in writing, of the decision to support (or not support) the application.

Step 6

If supported by Comcare, the employee completes the invalidity retirement application form based their superannuation fund.

Step 7

The completed form, along with all relevant evidence (including Comcare’s response) is forwarded to CSC for determination.

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Step 8

If an IR certificate has been received, the RCM is to inform the employee of this and request a nominated separation date in writing. Once this has been received, complete a “Notice of Termination of Employment” (under subsection 29(1) of the Public Service Act 1999) to be signed by the delegate (EL2 or above in the People and Culture Division) which includes:

The employee’s medical history
A copy of the IR certificate
The date of termination specified in the notice
A separate “Notice of Termination of Employment” letter to the employee for the delegate to sign

Step 9

Once the letter to the employee has been signed by the delegate, provide the original to the employee and a copy to Comcare.

Step 10

The IRC must be emailed to payroll (payroll.services@servicesaustralia.gov.au) as soon as it is received. If employee is not ceasing employment immediately, they may be in receipt of Pre-Assessment Payments (PAP). Entitlement to PAP ceases on the pay day after the date on the IRC. Payroll must be informed immediately to ensure that the employee is not overpaid.

19.2. Invalidity Retirement for Non-compensable Injuries

Step 1

Step 2

The employer refers the injured employee to a CSC approved medical practitioner for an Independent Medical Examination (to assess the employee’s fitness for duty).

If the outcome is a recommendation of invalidity retirement, follow steps 3 onwards.

Step 3

The employee completes the IRC application form, based on their superannuation fund. Once the employee has completed their section, they are to forward the form to the RCM for finalising.

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Step 4

Forward the completed form, along with all relevant evidence to CSC for determination.

Step 5

The employee’s medical history
A copy of the IR certificate
The date of termination specified in the notice
A separate “Notice of Termination of Employment” letter to the employee for the delegate to sign

Step 6

Once the letter to the employee has been signed by the delegate, provide the employee with the original copy.

Step 7

20. Other Relevant Information

20.1. Leave

Leave can be disruptive to the rehabilitation and RTW process as such, NDIA does not encourage employees taking any kind of leave (other than maternity or personal leave) whilst they are on incapacity payments or undergoing a graduated RTW for either a compensable or non-compensable illness or injury. Employees are required to have a conversation with their RCM prior to booking any leave outside of maternity or personal leave to deem if the leave is appropriate.

20.2. Dispute in Medical Evidence

Concerns regarding the validity or authenticity of medical evidences provided should be referred to the People and Culture’s Employee Relations Team for appropriate investigation and action. If the medical evidence relates to a compensable illness or injury, the matter should be referred to Comcare.

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20.3. Reduction of Classification

The appropriate delegate may reduce an employee’s classification in accordance with s23 (4)(f) of the Public Service Act 1999 on the ground that the employee is unable to perform duties at the higher classification level because of physical or mental incapacity if:

The employee’s health precludes a transfer at their substantive level, or
It is considered that it would be in the interests of the efficient administration of NDIA to transfer the employee at leave, and
Any medical restrictions have been considered.

Any reduction in classification is to result in duties which the employee:

Is qualified to perform
Is able to perform (either immediately or within a reasonable period)
Could reasonably be expected to perform.

An employee cannot be assigned duties at a lower classification without their consent, other than in exceptional circumstances such as those described above. Such a reduction cannot be for a specified time (i.e. it is an ongoing reduction).

The delegate must inform the employee in writing of a reduction of classification and the reason for the reduction of classification.

By agreement between the NDIA and the employee (and with their written consent), an employee can be assigned duties at a lower classification for a temporary period. In these cases, the substantive classification of the employee remains the higher classification.

If, based on agreement, the employee’s reduction in classification is for an ongoing period, any subsequent move by the employee to a higher classification is a promotion and must be a process based on merit.

It may be necessary to provide training to help the employee perform efficiently in the new position.

21. Privacy

The NDIA is legally obliged to protect the privacy participants and past and present employees by placing restrictions on the use and/or disclosure of personal information. All information, including medical information will be managed in accordance with the Privacy Act 1988.

The NDIA has a few key documents relating to privacy:

The NDIA’s Privacy Policy, which provides you with information about how the NDIA handles, and protects, personal information;
The NDIS Information Handling Operational Guidelines, which explains how the NDIA collects, stores, uses and shares personal information, including sharing information outside the NDIA; and

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The NDIA’s Privacy Management Plan. The implementation of a Privacy Management Plan is a requirement under section 9 of the Privacy (Australian Government Agencies – Governance) APP Code 2017 (the Code) developed under section 26G of the Privacy Act 1988 (Cth). The NDIA’s Privacy Management Plan is a document that identifies specific, measurable goals and targets that the NDIA is taking to meet its ongoing privacy compliance obligations.

The Information Law and Privacy team can be contacted for specific advice relating to privacy matters.

In the Workplace Supports area, relevant information relating to an employee will be provided to those individuals or organisations who have a need to access the information if it directly:

Relates to an employee’s work and/or
Impacts on the way the employee interacts with people in the workplace.

Access should not extend automatically to supervisors or managers but should follow the need-to-know principle.

When there is a need to engage a WRP in relation to a claim for compensation, there is no requirement for the employee to provide their written consent on a separate Consent Form. By lodging their claim, they are consenting to the provision of rehabilitation and/or return to work support under the SRC Act, which may involve liaising with their treating doctor/s and engaging the services of external rehabilitation providers.

For non-compensable claims, there are two separate consent forms that the employee must sign before the DLO, EI Officer or RCM can liaise with their treating doctor/s or engage WRP services. These are the Authority and Consent for the Collection and Release of Medical Information and ORAMS Employee Consent Request forms.

21.2. Privacy Breaches

Any potential or actual breaches of privacy should be reported to the NDIA’s Privacy Team at privacy@ndis.gov.au. The responsibilities of the Privacy Team include:

Responding to the privacy incident including, which includes coordinating remediation to address the incident;
Working with the NDIA relevant area to action the required remediation;
Assessing privacy incidents against the Australian Privacy Principles (APPs) to consider whether a breach has occurred and the nature of the breach;
Seeking legal advice as needed, including advice on whether a Notifiable Data Breach has occurred, in particular where there is a potential risk of harm;
Recording privacy incidents on the NDIA’s Privacy Incident Register once closed;
Notifying affected individuals where necessary.

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Early Intervention, Rehabilitation and Return to Work: A Guide for Case Managers

Early Intervention, Rehabilitation and Return to Work: A Guide for Case Managers

Table of Contents

1. Document Control

Document Control

Approval Status Log

2. Purpose

3. Who does this guide apply to?

4. What legislation is relevant to this guide?

5. Review of employment actions

6. Rehabilitation Management Systems

6.1. Rehabilitation Management System

6.2. Audit Program

6.3. Rehabilitation Authority

6.4. Workplace Rehabilitation Provider

6.5. Employee

7. Rights and Responsibilities

7.1. The Employee

7.2. National Disability Insurance Agency (The Employer)

7.3. Supervisors

7.4. Disability Liaison Officer (DLO)

7.5. Early Intervention (EI) Officer

7.6. Rehabilitation Case Manager (RCM)

7.7. Workplace Rehabilitation Provider (WRP)

7.8. HR Business Partners (HRBP)

7.9. Treating Medical Practitioners

7.10. Legally Qualified Medical Practitioners (LQMP)

7.11. Comcare

7.12. Commonwealth Superannuation Corporation (CSC)

8. Delegations

8.1. Safety, Rehabilitation and Compensation Act 1988 (SRC Act)

Rehabilitation Case Manager Delegations

Non-compliance

Directors, Branch Managers and Chief People Officer – People and Culture Division

8.2. Public Service Act 1999 and Public Service Regulations 2023

9. Risk Identification, Assessment and Control

10. Records Management

10.1. Case Notes and Record Keeping

10.2. New Case Administration

10.3. Case Handovers

Case Management Arrangements During Periods of Leave

10.4. Naming Conventions

10.5. Case File Security

11. The Comcare Scheme - SRC Act

11.1. Comcare Premium

12. Early Intervention

12.1. Early Intervention Funding

12.2. Early Intervention Assessments

13. Workers Compensation Claims

13.1. Employee and Supervisor Responsibilities

Employee

Incapacity Payments and Employee Claims for Time Off Work (CFTOW)

Supervisor

Leave Coding Reponsibilities for Supervisors

13.2. New Claim Process

Step 1

Step 2

Step 3

Step 4

Step 5

Step 6

Step 7

Step 8

Notifying the Workplace Integrity and Work, Health and Safety Teams of a new claim

13.3. Actions required when a non-compensable condition becomes compensable

13.4. Submission of an Employer Statement under a s71 Notice

13.5. Arranging and Managing a s37 Rehabilitation Program

13.6. Workplace Rehabilitation Provider Service Codes

13.7. Managing non-compliance

13.8. Superannuation and leave accrual for employees on incapacity payments or income protection

13.9. Closure of a compensable case and/or return to pre-injury hours

14. Managing Non-compensable Cases

Step 1

Step 2

Step 3

Step 4

Step 5

Step 7

Step 8

Step 9