External

Step 1Identify difficult or contentious stress-related claims;

Step 2Contact the case manager to negotiate preferred provider and workplace access;

Step 3Personally contact the employee to explain the referral procedure and purpose;

Step 4Contact the provider to make appointment for employee;

Step 5Write to employee with appointment details;

Step 6Refer original file to provider.  Also include covering letter confirming appointment and setting out employer contact details and treating doctor details;

Step 7Follow-up receipt of report from provider within 10 days of referral;

Step 8Make the decision and advise employer and employee.  Copy of the investigation report should be sent to both parties.  It may be necessary in some cases to release the report to the employee through the treating medical practitioner.

Liaison with case manager

It is most important that this referral to a provider for assessment is arranged by the claims manager in consultation with the case manager because:

  • the case manager is able to facilitate access to the workplace; and

  • the case manager may have a preference for dealing with a particular provider who is familiar with the structure and culture of the organisation.

Material referred to provider

All original documentation and the original file are referred to the provider by Comcare.  Because of the requirement for fast turnaround times on referrals and reports from providers, the file is returned to Comcare within a very short time.  This means that a case summary is not required.

The covering letter to the provider should include the following:

  • confirmation of appointment time and date;

  • name of the employer;

  • name and contact phone number for the agency case manager;

  • name and contact phone number for the employee's supervisor; and

  • treating doctor details, if known.

It will also be appropriate for the claims manager to highlight any significant issues which have arisen or make observations about the material that is being forwarded.

It may also occur that there is relevant information that should be passed on that does not appear in the documentation, although this will be uncommon.