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Compensation claims procedures
Historical Information
Comcare Operations Manual
Volume Eight - Rehabilitation
Part Three-Comcare'S Role
Section 38
- Prior To Taking Action To Suspend
External
It is important to ensure that, where it becomes clear that non-compliance with the RTWP will be an issue with the employee, the Case Manager discusses the potential situation and capacity to suspend claim activity with:
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the employee, so the Case Manager is quite clear about why the employee has decided not to comply. This also serves to remind the employee of his or her obligations under the Act;
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the rehabilitation provider, to obtain expert input in relation to the employee's particular case. This is a critical part of the discussion process, as the provider may be aware of issues the employee has chosen not to supply to the Case Manager;
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the claims manager responsible for the claim, as a precursor to formal notification about the current status.
Once all necessary discussion has been undertaken, if the employee still chooses not to comply with the program as set up by the Case Manager, a formal letter should be sent to the employee with a copy of the RTWP, outlining the reasons why the program is considered to be non-compliant. Seven days are usually provided for the employee to comply, before suspension of the claim is considered further.
A notice of the employee's rights and obligations should be enclosed and drawn to his or her attention in the body of the letter. A copy of this letter should also be sent to Comcare (directly to the relevant claims manager) with a request to suspend the employee's claim if compliance does not occur.