The provider is asked to undertake:
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Workplace consultation
By going into the workplace and interviewing the people involved the provider will be able to report on and make observations about the events leading up to the employee's claim. Comcare retains the role of deciding what is accepted as fact.
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Employee interview
This will avoid delays caused through waiting for the employees to prepare a statement of reasons for associating the illness with work. In many cases, by reason of the type of condition suffered, the employee finds this difficult to do.
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Psychological assessment
By identifying the functional characteristics of the employee's condition the provider can assist in determining whether the employee suffers from a genuine psychological condition.
In addition, the provider can provide an opinion as to the relative contributing factors that lead to the development of the condition. With this in mind the provider should be asked to report on the nature of the condition, the factors responsible, how those factors influence the condition and when those factors are likely to resolve.
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Treating doctor liaison
In many cases, part of the difficulty with medical investigation is trying to obtain a specific diagnosis from the treating doctor. Providers are able to communicate with the doctor on a professional level and elicit an opinion based on the objective testing that has been carried out. Providers should discuss with the doctor factual information that they have gathered, eliciting any discrepancies in the history given to the doctor. These discrepancies should be documented.
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Preliminary return to work recommendations
This assessment does not replace a formal return to work assessment arranged under section 36 of the Safety Rehabilitation & Compensation Act 1988 by the case manager. It is intended that the provider will give some indication of return to work strategy however so that vocational rehabilitation is not unnecessarily delayed.
In line with the Return to Work Guidelines, the provider is expected to furnish a report to Comcare within 10 working days of referral. This significantly reduces the time taken to gather the information necessary to determine liability.
The referral process is intended to be a means of quick and effective information gathering. The decision on liability is then based on a comprehensive summary of the facts, collected from all significant stakeholders and provided by an impartial but skilled professional.
THE PROVIDER DOES NOT MAKE OR RECOMMEND THE DECISION ON LIABILITY - THIS IS THE ROLE OF THE COMCARE CLAIMS MANAGER.