Background

For some time it has been widely recognised that workers' compensation claims for stress related illness have been increasing in incidence and cost.  Anecdotal evidence suggested that these claims were generally treated with a degree of apprehension by those responsible for making a decision on liability due to a number of factors, but especially:

• the mystique surrounding the condition known as 'stress' - claims for stress related conditions were viewed as somehow different because of the general lack of understanding of the condition; and

• the expectation that the claim would require extensive and lengthy investigation.

On completion of the Quality of Working Life project Comcare Australia endorsed a need for effective claims management and return to work strategies that specifically address the rising incidence and cost of stress related compensation claims.

The development of the investigation strategy for stress-related claims was not initially linked with the Quality of Working Life Project but has since been developed further in response to the strategies identified by the project and is currently in use by Comcare Australia as a national approach to claims management in this area.

In November 1991 Claims Managers in the Queensland Office of Comcare Australia met with approved rehabilitation providers, expert in the area of stress related illness, with the idea of developing a strategy for simplifying the investigation and decision-making process in relation to stress-related claims.  The aims of the project were to 'demystify' stress for Claims Managers, reduce delays associated with claim determination and improve the prospects of achieving successful return to work outcomes for employees.

The model formulated in these early stages was documented and trialled in the Queensland office for 12 months.  The results of the pilot appeared convincing.  Stress related claim turnaround times improved by up to 50% and claim costs were reduced by approximately 35% in the eighteen months following implementation of the strategy.

This guide documents the investigation process refined during the pilot.