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20.25.3 Administration of suspensions

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Rehabilitation coordinators have the responsibility for informing the client that continuation of his/her payments is subject to a rehabilitation plan, the content of that plan including the client's specific responsibilities, and monitoring compliance with the plan.

It is also the rehabilitation coordinator who is to write to a non-compliant client and advise that person that the suspension is effective. The rehabilitation coordinator must also liaise with the claims manager responsible for administering the client's weekly payments and advise him/her of the suspension. It is desirable that the rehabilitation coordinator liaise with the claims manager in advance if it is known that the client is likely to default – i.e. if an ultimatum about attendance etc. has been issued to the client. This will allow the claims manager to effect a prompt cessation – i.e. from the date that the suspension becomes effective – and to reduce overpayments.

The claims manager must then:

  • cease the weekly payments immediately, effective from the date the client was suspended (i.e. the date he or she defaulted)
  • endorse the Defcare process screen (within the incapacity module) for every file relating to that client with a note that no payment is to be made after the suspension, effective till further notice
  • place copies of the rehabilitation coordinator's letter advising suspension on every injury file relating to this client
  • place 'stop payment' notices in the relevant DOLARS payment record (note medical reimbursements, household services etc. are also suspended)

If and when the client finally complies with the rehabilitation program, it is the Rehabilitation Coordinator's responsibility to inform the claims manager of the date the client became compliant. The Rehabilitation Coordinator must do this on the same day he/she learns the client has in fact obeyed the direction.

The claims manager must then:

  • return the client to weekly payments urgently, effective as from the date the client became newly compliant
  • amend the various Defcare notes to record the end date of the suspension and the warning that no payment should be made for incapacity during that period.
  • Likewise, the document file (hard copy) should be similarly noted.