Where there is incapacity only
The nature of an employee's compensable condition will usually provide an indication about the extent of expected associated incapacity. However, if this is unclear, the Guide to Setting Review Datesmay provide some assistance about the expected duration of a particular condition.
|
Example |
|
An employee with an accepted claim for a back strain has lodged a certificate for a week of incapacity. This certificate is the second the employee has submitted and his incapacity now totals three weeks. |
|
The Guide indicates that the average duration of liability for a back strain is four weeks. When considering this period of incapacity, the claims manager weighs up the evidence provided on the claim and is satisfied that conditions he has determined in the past under similar circumstances have generally resolved within four weeks of the date of injury. |
|
He determines the incapacity and specifies in a letter to the employee that it is likely his compensable condition will resolve after four weeks (that is, another week's liability). |
Where incapacitated, the employee must provide certificates from his or her treating doctor for set periods for time off work. Under no circumstances should an open-ended certificate be accepted.
|
Example |
|
An employee submits a certificate for an open-ended period of incapacity as follows: |
|
“From 12/03/1996 to ?” |
Open-ended certificates must be returned to the employee to be correctly completed by his or her treating doctor.
Where medical certificates are submitted consistently:
|
Example |
|
An employee submits: |
|
certificates one after another for periods of incapacity; or |
|
certificates on a more sporadic basis (such as once every three or four weeks) but for more than a week's incapacity at a time. |
the Medical Review Certificate should be issued to the treating doctor for completion.
This will provide a clear indication about the employee's fitness for duty and focuses on return to work as an expected outcome of the incapacity process.
Payment for this service will equate with reasonable costs paid for completion of medical reports.
Letters
Where further incapacity has been determined, a letter should be issued, together with a copy of the Additional Advice to Claimants information notice.
Prior to the letter being sent, a review date commensurate with the current circumstances of the employee's claim will need to be nominated. A Medical Review Certificate should also be provided at this time.
Source URL: https://clik.dva.gov.au/military-compensation-reference-library/historical-information/comcare-operations-manual/volume-seven-review-processes/part-one-evidence-and-investigation/full-claim-review/claim-review-following-initial-liability/where-there-incapacity-only