SCHEDULE 2 - ORIGINAL EMPLOYER SERVICES (OES) DESCRIPTIONS & CODES EFFECTIVE 1 JULY 2013
1.
EXPLANATORY INFORMATION ................................................................................................................................................................4
2.
WORKER RELATED CONSIDERATIONS AND RESPONSIBILITIES................................................................................................................5
3.
4.
5.
6.
7.
2.1
Worker representative ..................................................................................................................................................................5
2.2
Worker Privacy Considerations .....................................................................................................................................................5
2.3
Managing the expectations of the parties associated with a worker’s RTW ................................................................................5
2.4
Workplace meetings .....................................................................................................................................................................5
2.5
Discussing NES when the RTW Goal is with the injury employer ..................................................................................................6
AGENT RESPONSIBILITES .........................................................................................................................................................................7
3.1
Agent RTW responsibilities ...........................................................................................................................................................7
3.2
Agent OES Responsibilities ............................................................................................................................................................7
3.3
Agent prior approval of OES services needed before services can be provided ...........................................................................8
3.4
Worker choice of OR Provider .......................................................................................................................................................8
3.5
OR Referral form ...........................................................................................................................................................................8
OR PROVIDER RESPONSIBILITES ..............................................................................................................................................................9
4.1
OR provider activities ....................................................................................................................................................................9
4.2
OR Consultant Title .....................................................................................................................................................................10
OES SERVICE OPTIONS ..........................................................................................................................................................................11
1.
Worker has a CWC but not at work.............................................................................................................................................11
2.
Medical evidence suggests Potential CWC within 3 months ......................................................................................................11
3.
Worker at work less than PIH ......................................................................................................................................................11
4.
At work PIH but not at PID ..........................................................................................................................................................12
OES REPORTS.........................................................................................................................................................................................13
6.1
OES report templates ..................................................................................................................................................................13
6.2
Provision of OES reports .............................................................................................................................................................13
6.3
Complete OES reports .................................................................................................................................................................13
6.4
NES not to be recommended in OES reports ..............................................................................................................................14
6.5
Monthly Progress Report not required .......................................................................................................................................14
OES FUNDING ........................................................................................................................................................................................15
7.1
OES Funding Requests .................................................................................................................................................................15
2013.2 Schedule 2 OES effective 1 July 2013 released 1 February 2014
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7.2
OES funding sought via email ......................................................................................................................................................15
7.3
OES Provider Travel .....................................................................................................................................................................15
7.4
OR provider fees for GP RTW Case Conference purposes ..........................................................................................................16
8.
TRAINING AND REDEPLOYMENT ...........................................................................................................................................................17
8.1
Identifying a training course .......................................................................................................................................................17
8.2
OR provider cannot identify suitable employment and different competency required ...........................................................17
8.3
Worker participation in training..................................................................................................................................................17
8.4
Agent approval of a training course ............................................................................................................................................17
8.5
Agent advice to worker, training course approval ......................................................................................................................18
8.6
Enrolment in a training course ....................................................................................................................................................18
8.7
Training Course Monitoring ........................................................................................................................................................18
8.8
Identifying redeployment opportunities .....................................................................................................................................19
9.
RC715 OES SERVICES .............................................................................................................................................................................20
9.1
Suspending RC715 OES services ..................................................................................................................................................20
9.2
Ceasing RC715 OES services ........................................................................................................................................................20
9.3
Recommencing RC715 OES services............................................................................................................................................20
Services previously suspended or ceased .........................................................................................................................................20
After non-sustainable PIH .................................................................................................................................................................21
RC715 OES services during weekly payment ‘non entitlement period’ ............................................................................................21
10.
RTW INCENTIVES ...............................................................................................................................................................................22
10.1
RTW incentive most usually paid once........................................................................................................................................22
10.2
RTW incentive not payable in certain circumstances .................................................................................................................22
10.3
Casual workers who RTW in PIH but to PID ................................................................................................................................22
10.4
Worker absent for more than 5 working days ............................................................................................................................22
10.5
OES services ‘inactive’ during 13 week sustainable RTW period ................................................................................................23
11.
INJURY EMPLOYER’S OBLIGATIONS ..................................................................................................................................................24
11.1
Injury employer’s RTW obligations .............................................................................................................................................24
11.2
Determining whether RTW with the injury employer has been exhausted ................................................................................24
Agent Senior Review required to consider NES before 52 Weeks ....................................................................................................24
NES approval .....................................................................................................................................................................................25
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OES & NES services at the same time ...............................................................................................................................................25
11.3
Worker privacy where they are receiving OES and NES services at the same time ....................................................................25
11.4
RTW incentive payable for a RTW TO injury employer after NES commenced ..........................................................................26
12.
GP RTW CASE CONFERENCE..............................................................................................................................................................27
11.1
Reasons for arranging a GP RTW Case Conference .....................................................................................................................27
11.2
Advising the agent .......................................................................................................................................................................27
11.3
Worker to be advised if others have been invited to the conference ........................................................................................27
11.4
Scheduling a GP RTW Case Conference ......................................................................................................................................27
11.5
Confirming the agreed actions from a GP RTW Case Conference ...............................................................................................28
11.6
Information about GP RTW Case Conference in next OR provider report ..................................................................................28
11.7
Expected outcome from a GP RTW Case Conference .................................................................................................................28
11.8
OR provider fees for GP RTW Case Conference purposes ..........................................................................................................29
11.9
GP fees for GP RTW Case Conference purposes .........................................................................................................................29
13.
OES SERVICES AND FEES ...................................................................................................................................................................30
WORK REPORT...........................................................................................................................................................................................30
Monthly Progress Reports .........................................................................................................................................................................32
OES services ...............................................................................................................................................................................................34
RTW incentives ..........................................................................................................................................................................................35
Non-mental injury claims ..........................................................................................................................................................................36
Mental injury claims ..................................................................................................................................................................................36
12 Week Sustainability Incentives 100% PIH & PID or PD at 13 week sustainable RTW date ...................................................................37
Subsequent Work Report ..........................................................................................................................................................................37
Suspension and Cessation of RC715 OES services .....................................................................................................................................38
Identifying an appropriate retraining course or redeployment ................................................................................................................39
Provider Travel ..........................................................................................................................................................................................40
Attachment 1 - GP RTW Case Conference: Worker Letter ........................................................................................................................41
Attachment 2 - GP RTW Case Conference: GP Letter ................................................................................................................................43
Attachment 3 - GP RTW Case Conference Action Plan ..............................................................................................................................45
2013.2 Schedule 2 OES effective 1 July 2013 released 1 February 2014
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1. EXPLANATORY INFORMATION
Original Employer Services (OES) are occupational rehabilitation (OR) services recognised by WorkSafe
Victoria (WorkSafe) to support a worker to return to work (RTW) with the injury employer.1
This Schedule should be read in conjunction with the WorkSafe Online Claims Manual and any other
guidance provided or released by WorkSafe Victoria related to those OR services known as OES services.
The information contained in this Schedule replaces prior information and guidance released by WorkSafe.
Within this OES information - a reference to:

An “injury workplace” means a reference to the injury or at other workplace of the injury employer

The ‘legislation’ means a reference to Victorian workers compensation legislation

A “Qualified rehabilitation professional” means a person who satisfies the qualifications, knowledge
and experience for being a Workplace Rehabilitation Consultant as defined by the Nationally
Consistent Approval Framework for Workplace Rehabilitation Providers (NCF) 2

“Suitable employment” means a reference to pre-injury or suitable employment at an injury
workplace unless it is referenced in the context of new employment with a new employer

A “Vocational Advisor” means a person who has received formal qualifications in and/or experience
and skills in recruitment, employment or disability placement services
A “worker” means a reference to a worker including a person (a worker representative) that the worker has
requested to assist and support them in the RTW process.
1
WorkSafe also recognise as an OES service for mental injury claims where a workplace relationship breakdown is a key contributor to claim lodgement. These
services can be found in 2013.1 Schedule 4 – Workplace Support Services (WSS) descriptions & codes effective 1 July 2013 released 1 February 2014.
2
A qualified rehabilitation professional or a vocational advisor will most usually be referred to as an OR Consultant.
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2. WORKER RELATED CONSIDERATIONS AND RESPONSIBILITIES
2.1 WORKER REPRESENTATIVE
The legislation allows a worker to be represented, assisted and supported in the RTW process.3 A worker
may request their representative be involved in meetings with, or arranged by the agent or an OR provider
with the injury employer or the worker’s treating health practitioner (THP). OES reports or information
prepared by an OR provider for a worker should be provided to the worker representative.
A worker may verbally advise the agent or an OR provider that a person is acting as their worker
representative.4 On being made aware of a worker representative, the agent and an OR provider should
liaise with them when scheduling any meetings with the worker so the representative can be present.
2.2 WORKER PRIVACY CONSIDERATIONS
The agent and an OR provider must only communicate about information that is relevant to the provision of
OES services and at all times, a worker’s privacy must be maintained. Similarly information collected about
other parties in the workplace or outside the workplace must be afforded the same considerations and
protections.
It is recommended that an OR provider advises a worker that information they share may be included in
OES reports which are sent to them, their THP, the injury employer and the agent.
2.3 MANAGING THE EXPECTATIONS OF THE PARTIES ASSOCIATED WITH A WORKER’S RTW
The agent and an OR provider must exercise care in managing the expectations of the worker, the worker’s
THP and the injury employer throughout OES service provision.
As the various parties may perceive the issues and barriers delaying or impeding the worker’s RTW
differently, it falls to the OR provider as the independent RTW expert to test and verify the different
perceptions particularly when they relate to:

the worker’s capacity for work;

the most recent medical opinion from the worker’s THP; and

the tasks or jobs that may be available at the injury workplace allowing for any work restrictions.
2.4 WORKPLACE MEETINGS
When the OR provider is scheduling workplace meetings, consideration must be given to separate meetings
with the worker and the injury employer. Depending on the circumstances that led to the claim and what
3
The legislation also states that a worker representative cannot include a legal practitioner.
4
The agent or an OR provider cannot request a worker provide advice about their worker representative in writing.
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issues or barriers to RTW has been identified, a joint meeting may not be appropriate particularly as the first
meeting at the workplace. If both parties agree to joint meeting then it may be scheduled after a separate
worker and employer meeting.
At an injury workplace, the OR provider may engage with several individuals and therefore they must
establish who has the authority to make a decision about changes to the worker’s pre-injury hours (PIH) or
pre-injury duties (PID) or other matters where a RTW solution lies within the control of the injury employer.
Where the claim is for a mental injury it may be more appropriate for the OR provider to schedule meetings
with the worker at a location other than the workplace initially.
2.5 DISCUSSING NES WHEN THE RTW GOAL IS WITH THE INJURY EMPLOYER
During OES servicing, a worker or the worker's THP or the injury employer may ask about the type of
options that may be available if a RTW with the injury employer is not achieved. An OR provider may
mention New Employer Services (NES) but they must be clear that changing the worker’s RTW goal to a
new employer using NES services is an agent decision.
WorkSafe has several publications that may be helpful if a worker or the worker's THP or the injury
employer is seeking more information about why an agent may consider a RTW with a new employer
including a specific NES publication for workers. These publications can be found on WorkSafe’s website
www.worksafe.vic.gov.au .
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3. AGENT RESPONSIBILITES
3.1 AGENT RTW RESPONSIBILITIES
The agent will consider OES service approval as part of their regular review of the worker’s individual
circumstances and RTW needs. These considerations may include but are not limited to:

Communicating with the worker and the injury employer about the availability of suitable employment;

Deciding with the worker, the worker’s THP or an independent medical examiner (IME) whether there
are any medical issues or concerns that may be impacting or impeding the worker’s RTW to an injury
workplace;

Establishing then managing the worker, the worker’s THP and the injury employer expectations about
the RTW Goal and the proposed RTW date;

Revising their activities in response to new information or medical opinion received about the worker’s
current work capacity (CWC) including any work restrictions;

Reviewing available information or medical reports including IME and OR provider reports to identify
those activities most likely to result in the worker achieving then sustaining a RTW at an injury
workplace;

Arranging for supplementary or new information to be collected via medical or IME reports when gaps in
information are identified; and

Supporting the injury employer to satisfy their RTW obligations under the legislation.
Initially the worker’s RTW Goal will be a RTW at PIH preferably in their PID. Sometimes if PID is no
longer suitable employment for the worker, the availability of productive duties (PD) at an injury
workplace should be considered.
3.2 AGENT OES RESPONSIBILITIES
The agent must:

Approve OES services as well as agree activities with the OR provider consistent with this Schedule;

Ensure the Novus OES process requirements are met;

Determine at particular points in time whether OES services should continue to be approved for a worker
or should be suspended or ceased; and

Ensure that an OR provider’s service provision as well the service outputs (OES reports and invoices)
conform with WorkSafe’s expectations and OES guidelines as found in this Schedule.
An agent requiring clarification about their responsibilities or WorkSafe’s expectations and OES guidelines
as found in this Schedule should contact WorkSafe via [email protected]. WorkSafe
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will provide a response within 48 working hours. WorkSafe may seek further information during this period
and any determination will then be made within 48 hours of this further advice being received by WorkSafe.
3.3 AGENT PRIOR APPROVAL OF OES SERVICES NEEDED BEFORE SERVICES CAN BE PROVIDED
OES services will be approved by the agent because the services are required following the worker’s work
related injury; the services are reasonable and necessary for the worker’s circumstances and the costs
associated with those services are reasonable.
When considering OES services, the agent should determine whether there is medical evidence that the
worker has a CWC. For OES purposes, the worker’s CWC may be established from a worker’s THP
certificate or an IME report.
3.4 WORKER CHOICE OF OR PROVIDER
The agent must ensure that the worker is given a list of at least three OR providers (where available) to
choose from. A worker will select an OR provider from this list or if they do not choose an OR provider, the
agent will choose an OR provider on their behalf. Once the choice of OR provider is confirmed, the agent
will forward an OR Referral form to them requesting that OES services commence.
3.5 OR REFERRAL FORM
An agent will advise an OR provider that OES services have been approved by sending them an OR
Referral form requesting a Work Report. The form must have relevant medical opinion/information
attached confirming the worker’s capacity for work including medical restrictions or potential capacity for
work.
The agent may vary what is included with an OR Referral form if they reasonably believe that the provision
of the medical opinion/information is not necessary or an exemption to this or any other information applies.
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4. OR PROVIDER RESPONSIBILITES
4.1 OR PROVIDER ACTIVITIES
An OR provider is an independent expert who is expected to revise and amend their activities in response to
changes in the worker’s RTW circumstances at particular points of time. The activities completed by an OR
provider should vary depending on whether the worker is at work or not at work when OES services are
approved or what type of weekly payments they may be receiving. The types of OR provider activities may
include but are not limited to:

Actively engaging and regularly updating the worker, the worker’s THP, the injury employer and the
agent to create a common understanding about the RTW process or any actual or perceived barriers to
RTW and the expected time it will take for a RTW to be achieved;

Preparing ‘complete’ OES reports reflecting the worker’s capacity for work including any work
restrictions, the progress made to resolve any actual or perceived RTW barriers, what agreed activities
that have been completed or will be completed prior to the next agent case conference and proposing a
RTW date if the worker has not returned to work during the month;

Visiting the injury workplace to:
o
review the duties and the tasks associated with the worker’s pre-injury employment;
o
identify the tasks and duties associated with suitable employment that may be available at an
injury workplace;
o
facilitate meetings between the worker and the injury employer and provide a brief summary of
the meeting’s purpose and key outcomes and activities agreed following the meeting at the next
agent case conference or in the next report submitted to the worker, the worker’s THP, the injury
employer and the agent.

Assisting the worker and the injury employer with RTW planning to facilitate an offer of pre-injury or
suitable employment; and

Overseeing a RTW and actively engaging the worker, the worker’s THP or an IME, the injury employer
and the agent to resolve any concerns or issues to ensure the RTW is maintained.
As OES services continue the above activities should be reviewed and amended by an OR provider
especially as actual or perceived barriers to RTW or changes in the worker’s duties or tasks are actioned or
resolved.
An OR provider with concerns or queries about the worker’s recovery from injury or their response
to other barriers to their RTW should contact the agent in the first instance. An agent may seek
supplementary information from the worker’s THP or an IME as part of responding to an OR
provider’s concerns or queries.
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4.2 OR CONSULTANT TITLE
OR providers will use the following signature block for all correspondence related to OR service provision
with the exception of emails:
OR Consultant Name
Service provided: Occupational Rehabilitation
Professional Background - Physiotherapist
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5. OES SERVICE OPTIONS
1. WORKER HAS A CWC BUT NOT AT WORK
Where the worker is receiving Payment Type 3 weekly payments because they have a CWC but are not at
work, the agent should approve a Work Report. The report will help the agent determine whether RC715
OES services may be required to assist and support the worker RTW in PIH and PID as soon as is
practicable. The agent and an OR provider will negotiate whether other OES services in addition to RC715
OES services are required.
2. MEDICAL EVIDENCE SUGGESTS POTENTIAL CWC WITHIN 3 MONTHS
Where the worker is receiving Payment Type 1 weekly payments because they have no CWC and are not at
work and the agent has medical evidence suggesting the worker may have a potential for CWC within 3
months, the agent should approve a Work Report. The report will help the agent determine whether
RC715 OES services may facilitate a change in the worker’s capacity for work resulting in them RTW
preferably in PIH and PID within 3 months. The agent and an OR provider will negotiate whether other
OES services in addition to RC715 OES services are required.
Sometimes prior to the 3 month period ending, the agent may receive an IME or THP report suggesting
CWC or a RTW may be achieved within the next month. In this case, the agent should contact an OR
provider and discuss the continuation of RC715 OES services for a further 4 weeks. If the agent forms the
view in the discussion that RTW is a real possibility, they should approve a further 4 weeks of RC715 OES
services.
If at the end of the agent approved period (i.e. up to 4 months), the worker does not have a CWC or a
barrier has been identified impacting on the worker actively participating in RC715 OES services then an
OR provider must contact the agent to advise they are ceasing RC715 OES services. A RC765 Cessation
Report is submitted. No Monthly Progress Report is required.
If the worker’s circumstances change after a RC765 Cessation Report has been submitted, the agent may
as part of their regular review process consider the approval of RC715 OES services again.
NB: WorkSafe does not allow RC715 OES services to be suspended when the worker is participating
in this OES Service Option.
3. WORKER AT WORK LESS THAN PIH
Where a worker is working at less than their PIH and is receiving Payment Type 2 weekly payments, the
agent needs to determine:

Has a Work Report has been completed and RC715 OES services commenced for the worker
previously; and

Has the worker’s circumstances have changed since the submission of that Work Report or the date
when RC715 OES services were suspended or ceased.
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If the agent decides to approve a Work Report or a Subsequent Work Report or commence or
recommence RC715 OES services, the number of hours approved and the degree of OR provider
engagement is expected to be less than what may be needed for a worker who is not at work when
OES servicing is approved by the agent. The agent and an OR provider will negotiate whether other
OES services in addition to RC715 OES services are required.
4. AT WORK PIH BUT NOT AT PID
Where a worker is working at PIH (i.e. not receiving weekly payments) but PID is unlikely without RC715
OES services, the agent needs to determine whether:

a Work Report has been completed and RC715 OES services commenced for the worker previously;
and

the worker’s circumstances have changed since the submission of that Work Report or the date when
RC715 OES services were suspended or ceased.
If the agent decides to approve a Work Report or a Subsequent Work Report or commence or
recommence RC715 OES services, the number of hours approved and the degree of OR provider
engagement is expected to be minimal when compared for a worker who is not at work when OES
servicing is approved by the agent. The agent and an OR provider will negotiate whether other OES
services in addition to RC715 OES services are required.
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6. OES REPORTS
6.1 OES REPORT TEMPLATES
An OR provider is required to use WorkSafe approved OES report templates. OES reports are provided to
the worker, the worker’s THP, the injury employer and the agent to create a common understanding about
the types of activities that may be needed to achieve a sustainable RTW for the worker and the progress
being made towards that RTW Goal. OES reports must clearly reflect the OR provider’s independent
opinion formed at the time the report was completed.
6.2 PROVISION OF OES REPORTS
An OR provider has the discretion not to provide a OES report to a worker if they determine an exception
applies under the Privacy Act or Health Records Act, for instance:
o
it would pose a serious threat to the life or health of the worker or any other person; or
o
there would be an unreasonable impact on the personal privacy of a person other than the worker
(although in the absence of the individual’s consent, the individual’s personal details or statements can
be blanked out meaning the OES report could still be released).
An agent and/or OR provider requiring clarification about the release of an OES report to a worker may
contact WorkSafe via [email protected]. WorkSafe will provide a response within 48
working hours. WorkSafe may seek further information during this period and any determination will then be
made within 48 hours of this further advice being received by WorkSafe.
6.3 COMPLETE OES REPORTS
An OR provider must submit a ‘complete’ OES report to the worker, the worker’s THP, the injury employer
and the agent within the nominated timeframe. These reports should contain sufficient information to enable
all parties but most particularly the agent to have confidence about the progress made to date against the
agreed activities from previous reports. If a report cannot be submitted within the nominated timeframe an
OR provider must advise the agent the reason for the delay and the expected date of submission.
When completing their most recent OES report, an OR provider is expected to consider and review
the opinion and information found in previous OES reports. However, opinion or information
previously provided in a report should only be referenced in a subsequent OES report where it is
pertinent or relevant to the worker’s circumstances and RTW needs at the time the latest report is
completed.
OES reports must only contain information and opinion relevant to the OES service being provided. An OR
provider should not provide comment on the worker’s treatment or make suggestions about other
treatment options.
If an OR provider forms a view when preparing an OES report that the worker does not have a CWC
or there is an actual or perceived barrier to RTW preventing them from being able to actively
participate in OES services then the agent must be contacted prior to completing and distributing
the report, to discuss the reasoning and to consider options.
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6.4 NES NOT TO BE RECOMMENDED IN OES REPORTS
An OR provider should not include in the OES reports any opinion or advice about the possibility of
a new RTW Goal or NES servicing until this has been discussed and approved by the agent.
This allows the agent to form their view about the most appropriate claims management for a worker without
a worker or the worker's THP or the injury employer having their expectations raised about any particular
outcome in advance of that agent decision. If the agent does support NES being considered an OR
provider may reference in a report that the agent is considering this possibility.
6.5 MONTHLY PROGRESS REPORT NOT REQUIRED
Changing worker circumstances or RTW may mean an OR provider is not required to submit a Monthly
Progress Report including a 6 or 12 Month Progress Report. For more detail, see:

Suspending RC715 OES services, page 20

Ceasing RC715 OES services, page 20

OES services ‘inactive’ during a 13 week sustainable RTW period, page 23

RC730 Placement Report, page 35
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7. OES FUNDING
7.1 OES FUNDING REQUESTS
An OR provider is required to use WorkSafe approved OES funding request templates.
Where an OR provider submits a Funding Request the request must only include the actual OES
services and the cost of those services that an OR provider reasonably expects to provide in the
time period nominated within the Funding Request.
An OR provider must not seek agent approval for ‘possible’ or ‘potential’ OES services outside the period
referenced in the funding request. If the worker’s circumstances change after a Funding Request has been
submitted to the agent then an OR provider must seek further agent approval of further OES services. The
agent and/or an OR provider requiring clarification about Funding Requests may contact WorkSafe via
[email protected].
7.2 OES FUNDING SOUGHT VIA EMAIL
An OR provider may seek funding approval via email which includes:

the time period the funding request applies to;

the service item code, the name of the each service, the cost and the number of hours already approved
for each service to date; and

how many hours for each service have actually been ‘used/invoiced for’ up to the date of the email.
7.3 OES PROVIDER TRAVEL
Most OES services will be provided by an OR provider from their nearest location to the worker’s injury
workplace. A worker may claim travel expenses to attend OES services provided at a location of an OR
provider.
An OR provider may also seek approval for Provider Travel when services may be provided at a location
other than the OR provider’s nearest location because the worker:

Has no or restricted access to public transport between their residence and the workplace or to the
location where an OR provider has scheduled an appointment;

Cannot drive and no-one is available to drive the worker to the workplace or to the location where an OR
provider has scheduled an appointment; or

Cannot drive due to a medical restriction.
An OR provider must separately list RC799 Provider Travel on their invoice and ensure that the
appropriate OR provider location number is referenced.
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7.4 OR PROVIDER FEES FOR GP RTW CASE CONFERENCE PURPOSES
Provider Travel may also be approved for the time spent by the OR provider in travelling to and from their
nearest location to the GP’s rooms.
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8. TRAINING AND REDEPLOYMENT
8.1 IDENTIFYING A TRAINING COURSE
The agent should consider approving a training course to enhance a worker’s employability where their
existing level of transferable skills and abilities has limited the identification of suitable employment. A
retraining course may also assist a worker be redeployed within the injury employer.
An OR provider must ensure that the worker understands that a training course approval relies on the agent
determining that a course is reasonable and necessary to enhance the worker’s employability.
An OR provider should not recommend a worker participate in a retraining course simply because a worker
suggests they have a preference for a particular type of employment or because they show a reluctance to
work in the type of suitable employment identified by an OR provider in the Work Report or a Retraining or
Redeployment Report.
OR provider identifies suitable employment but a particular competency required
Suitable employment has been identified by an OR provider using the worker’s existing level of transferable
skills and abilities but they recommend a particular competency (most usually a certificate or a licence) be
obtained to fully satisfy the particular requirements of that suitable employment.
8.2 OR PROVIDER CANNOT IDENTIFY SUITABLE EMPLOYMENT AND DIFFERENT COMPETENCY REQUIRED
Sometimes the worker’s existing level of transferable skills and abilities do not satisfy the requirements of
the suitable employment available. The OR provider may then recommend the worker obtain a different
competency to satisfy the particular requirements of the suitable employment that may be available.
8.3 WORKER PARTICIPATION IN TRAINING
When approving a training course, the agent must be satisfied that the worker can complete the course as
soon as it is practicable. If the worker is at work at the time the course commences, the agent must
consider whether the worker can remain at work or continue to participate in RC715 OES services at the
same time they are participating in the course. If the agent forms the view the worker may be
disadvantaged they should consider whether to suspend or cease RC715 OES services until the course
can be completed.
8.4 AGENT APPROVAL OF A TRAINING COURSE
The agent should approve a retraining course within 10 working days of an OR provider submitting a
Retraining or Redeployment Report when they are satisfied the worker requires a particular competency
for the identified suitable employment or the suitable employment that may be available and the type of
course being recommended by an OR provider:

Will assist and support the worker to commence that suitable employment as soon as it is practicable;
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
Is reasonable and necessary for the worker i.e. obtaining that competency is key to the worker being
able to meet the particular requirements of that suitable employment;

The worker is able to actively participate in the course; and

There are no actual or perceived barriers to the worker completing the course within the specified
timeframe.
The agent should also seek relevant information from the worker, the worker’s THP or an IME prior to
making a decision about a course. The agent should also contact the training course provider to establish
what the worker is expected to do to successfully complete the course.
An agent requiring clarification about training course approval should contact WorkSafe via
[email protected] prior to discussing this option with the worker or the
worker’s THP and the OR provider. WorkSafe will provide a response within 48 working hours. WorkSafe
may seek further information during this period and any determination will then be made within 48 hours of
this further advice being received by WorkSafe.
8.5 AGENT ADVICE TO WORKER, TRAINING COURSE APPROVAL
After approving the retraining course, the agent may advise the worker verbally however the training course
details must be confirmed in a letter that includes:

Title of the training course, duration and cost;

The name of the training provider and the location where the training course will be provided;

Confirm the need for regular contact with the agent to be maintained (this may include nominating
approximate dates for the contact);

The expectation that the worker advises the agent if they stop attending the course;

The requirement that the worker actively participate in the training course because it is an OR service.
The agent may determine the format of the letter as there is no WorkSafe approved letter template. On
receiving an invoice, the agent will pay for an approved training course using Payment Type Code 170.
8.6 ENROLMENT IN A TRAINING COURSE
The worker should be encouraged to directly contact the training provider to complete the enrolment
requirements. WorkSafe also expects the OR provider who completed the Retraining or Redeployment
Report will support and assist the worker with their course enrolment without seeking additional
costs.
8.7 TRAINING COURSE MONITORING
The agent may approve RC715 OES services to support and assist the worker after they commenced the
training course. This training course monitoring service would usually be provided by telephone.
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The agent should negotiate the frequency of that contact with an OR provider. A training course of more
than six months or a worker experiencing difficulty in completing the course modules may suggest that more
training course monitoring is required. RC715 OES services for training course monitoring purposes may
also include contact with the course provider.
8.8 IDENTIFYING REDEPLOYMENT OPPORTUNITIES
Some employers may have multiple workplaces and when considering what suitable employment may be
available to the worker, the agent and the employer should consider what suitable employment may be
available at all workplaces of the injury employer.
To assist the agent and the employer determine the suitability of that employment, a Retraining or
Redeployment Report may be approved to identify whether the worker has the necessary transferable
skills and abilities to perform the tasks and duties associated with the job or whether they have the
competencies to be able to effectively participate in a job interview including how to handle injury-related
questions.
If an OR provider forms the view that the worker requires support and assistance to prepare a resume or
application covering letters or would benefit from interview skill and technique coaching, they should contact
the agent immediately to seek approval for RC715 OES services. Alternatively, an OR provider may form
the view that the worker may require some retraining to enable them to undertake the suitable employment.
Redeployment activities should be referenced in any discussions with the agent and in a Progress Report
including a 6 or 12 Month Progress Report.
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9. RC715 OES SERVICES
9.1 SUSPENDING RC715 OES SERVICES
The agent may consider suspending RC715 OES services where medical evidence supports the worker
has no CWC or will have no CWC for more than 4 weeks but is expected to have a CWC within 13
weeks. This may be prompted by the agent responding to information received from an OR provider in an
email, telephone call or an OES report. The agent may contact the worker, the worker’s THP or an IME or
an OR provider to discuss the possibility of RC715 OES services being suspended.
An OR provider should not discuss or raise the possible suspension of RC715 OES services with the
worker, the worker’s THP or the injury employer or include this possibility in any OES reports until this has
been discussed and approved by the agent.
On receiving the agent advice to suspend RC715 OES services, an OR provider will forward a Suspension
Report to the worker, the worker’s THP, the injury employer and the agent. No Progress Report including
a 6 or 12 Month Progress Report is required.
9.2 CEASING RC715 OES SERVICES
The agent may consider ceasing RC715 OES services where medical evidence supports the worker has
no CWC or will have no CWC for more than 13 weeks. This may be prompted by the agent responding
to information received from an OR provider in an email, telephone call or an OES report. The agent may
contact the worker, the worker’s THP or an IME or an OR provider to discuss the possibility of RC715 OES
services being ceased. This may also be considered if the worker has not been able to progress hours at
work or PIH is unlikely in the foreseeable future.
An OR provider should not discuss or raise the possible cessation of RC715 OES services with the worker,
the worker’s THP or the injury employer or include this possibility in any OES reports until this has been
discussed and approved by the agent.
On receiving the agent advice to cease RC715 OES services, an OR provider will forward a Cessation
Report to the worker, the worker’s THP, the injury employer and the agent. No Progress Report including
a 6 or 12 Month Progress Report is required.
9.3 RECOMMENCING RC715 OES SERVICES
SERVICES PREVIOUSLY SUSPENDED OR CEASED
When considering whether RC715 OES services should be recommenced, the agent may approve a
Subsequent Work Report.
RC715 OES services may be recommenced where the worker continues to require support and
assistance to RTW with the injury employer and medical evidence supports the worker has a potential
CWC or has regained their CWC or can now actively participate in OES services.
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If the agent approves RC715 OES services recommence, an OR provider will submit a Monthly
Progress Report for as long as RC715 OES services continue. If the worker achieves a RTW to 100%
PIH, the Monthly Progress Report would be replaced by a RC730 Placement Report.
AFTER NON-SUSTAINABLE PIH
The agent may approve further RC715 OES services after the worker achieved their PIH but this was
not sustained for 13 weeks. These OES services would focus on what actions may be required to
achieve a sustainable PIH preferably in PID as soon as is practicable.
In some cases, the agent may approve a Subsequent Work Report or request an IME report to assist
them make the decision to recommence RC715 OES services. On deciding to recommence RC715
OES services, the agent will contact the OR provider and the worker to advise the ‘point of time’ when
RC715 OES services will recommence from.
After RC715 OES services recommence, an OR provider will submit a Monthly Progress Report for
as long as RC715 OES services continue. If the worker achieves a RTW to 100% PIH, the Monthly
Progress Report would be replaced by a RC730 Placement Report.
RC715 OES SERVICES DURING WEEKLY PAYMENT ‘NON ENTITLEMENT PERIOD’
A worker may lose their entitlement to weekly payments for a specified period known as a ‘non
entitlement period’.
The agent may approve a RC700 Work Report or RC715 OES services for a worker during a nonentitlement period and if the worker returns to suitable employment at the injury workplace, an RTW
Incentive is payable.
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10. RTW INCENTIVES
A RTW Incentive is payable when the agent and an OR provider agree that the conditions for paying the
incentive can be satisfied including the submission of an appropriate invoice. Which RTW Incentive may
be payable will depend on the number of hours being worked excluding overtime and shift allowance. OES
commencement is demonstrated by the OR provider submitting a RC700 Work Report or a RC755
Subsequent Work Report then after the report was submitted, RC715 OES services were provided to the
worker.
10.1
RTW INCENTIVE MOST USUALLY PAID ONCE
Most usually a RTW Incentive is only paid once on a claim, however if a worker has RC715 OES services
cease for more than 13 weeks and then the agent recommences RC715 OES services, the agent may
consider paying a RTW Incentive again.
The agent may request a worker provide copies of their payslips or other employment evidence to help
determine which RTW Incentive may be payable. However a worker is not required to comply unless the
worker is also seeking to have weekly payments paid for all or some of that 13 week sustainable RTW
period. An OR provider should not ask a worker to provide them or the agent with copies of their
payslips or other employment evidence.
An OR provider may forward information or evidence to assist the agent make a decision about a worker’s
sustainable RTW at 100% PIH. The agent should consider this information or evidence when determining
whether a RTW Incentive payment is appropriate.
10.2
RTW INCENTIVE NOT PAYABLE IN CERTAIN CIRCUMSTANCES
A RTW Incentive is not payable if the worker resigned from employment or ceased work due to a new
compensable injury or a secondary stress condition or a non-compensable medical condition.
10.3
CASUAL WORKERS WHO RTW IN PIH BUT TO PID
A RC730 RTW Incentive can be paid for a casual worker on weekly payments at the OES commencement
date and not on weekly payments when they achieve a CWC for their PIH if the worker cannot return to PID
due to the injury employer being unable to offer ongoing casual suitable employment. A RC740 RTW
Incentive can be paid if after the 13 week sustainable RTW period if the same circumstances apply.
10.4
WORKER ABSENT FOR MORE THAN 5 WORKING DAYS
Where a worker receiving weekly payments at OES commencement has more than 5 working days off
work in the 13 week sustainable RTW period due to the compensable injury, a further 13 week sustainable
RTW period can be calculated from when the worker commences work again. If during this second 13 week
sustainable RTW period they are again absent for more than 5 working days due to the compensable injury
then no RTW Incentive is payable. In calculating the more than 5 working days during a 13 week
sustainable RTW period, a part day is counted as 1 day.
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10.5
OES SERVICES ‘INACTIVE’ DURING 13 WEEK SUSTAINABLE RTW PERIOD
Where a worker achieves PIH but during the 13 week sustainable RTW period the worker also returns to
PID or PD, RC715 OES services become ‘inactive’. During an ‘inactive’ period an OR provider may choose
to maintain a limited contact with the worker, the worker’s THP, the injury employer or the agent to
accomplish a sustainable RTW. There is no payment to be made for this contact and no Monthly Progress
Report is required to be submitted during an OES ’inactive’ period.
If the worker’s circumstances change, an OR provider should contact the agent immediately and discuss
whether RC715 OES services need to become ‘active’ again. A RTW Incentive is payable to the OR
provider at the completion of the 13 week sustainable period providing the conditions for paying an incentive
can be satisfied including the submission of an appropriate invoice.
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11. INJURY EMPLOYER’S OBLIGATIONS
11.1
INJURY EMPLOYER’S RT W OBLIGATIONS
When reviewing whether an injury employer’s RTW obligations have been satisfied, the agent must confirm
that other RTW opportunities at any workplace of the injury employer have also been fully exhausted. The
exhausting of RTW opportunities may include the provision of retraining courses to address competency or
skill gaps that may be limiting a worker’s suitability to perform a job at a workplace of the injury employer.
Redeployment in another job at a workplace of an injury employer may also be considered.
Changing a worker's RTW Goal to a new employer is a serious consideration for an agent. WorkSafe
expects the RTW Goal with the injury employer to remain the primary focus for the agent even where
information is received that may suggest the injury employer has difficulty identifying RTW solutions for the
worker or the worker is reluctant to engage in offers of pre-injury or suitable employment at an injury
workplace.
11.2
DETERMINING WHETHER RTW WITH THE INJURY EMPLOYER HAS BEEN EXHAUSTED
Sometimes, the agent will form the view that the injury employer’s RTW obligations have been satisfied
even when the worker has achieved some RTW at an injury workplace. The types of reasons that an agent
may rely on include but are not limited to:

There is medical evidence suggesting the worker cannot undertake or does not have a capacity for any
of the duties or jobs available at the injury workplace;

The worker has relocated and a RTW is no longer practicable at the injury workplace;

The worker has resigned from the pre-injury employment;

The employer no longer has pre-injury or suitable employment available at an injury workplace; or

The employer has terminated the worker’s pre-injury employment or ceased to trade.
The exhausting of RTW opportunities with the injury employer may also include providing a retraining
course to the worker to gain a new competency to satisfy the requirements of suitable employment that may
be available at an injury workplace.
The opinion and information included by an OR provider in the OES reports are important when the
agent is deciding whether a RTW with the injury employer has been fully exhausted for a worker.
AGENT SENIOR REVIEW REQUIRED TO CONSIDER NES BEFORE 52 WEEKS
If the agent forms the view that a RTW Goal of new employer may be appropriate prior to the worker
receiving 52 weeks of weekly payments, a Senior Review must be completed. The type of review
activities relied on by the agent may include but are not be limited to:

Collecting appropriate evidence to demonstrate the injury employer has satisfied their RTW
obligations under the legislation;
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
Inviting the worker to attend an interview;

Reviewing available information or medical reports or OES reports particularly a Cessation
Report if submitted;

Identifying and planning the actions that may be needed to return the worker to new employment;
and

Where gaps in information are identified, arranging for supplementary or new information to be
collected from sources such as the worker’s THP or an IME.
An OR provider providing RC715 OES services to the worker may be contacted during a Senior
Review to support and assist this review process.
NES APPROVAL
Once the agent is satisfied that the injury employer’s RTW obligations have been satisfied and have
medical evidence of the worker’s CWC, a Vocational Report should be approved to determine
whether suitable employment can be identified for the worker based on a labour market analysis
relevant to the worker and where they reside. The identification of suitable employment is an
important consideration for agent approval of a 26 Week NES.
OES & NES SERVICES AT THE SAME TIME
If the worker is receiving RC715 OES services at same time the agent approves a 26 Week NES
then the agent should discuss with the OR provider providing those services what further RC715
OES services may be needed to maintain the worker at work especially if the worker is not receiving
weekly payments. If the agent does approve further RC715 OES services then these services
would most usually be provided via telephone. The agent should also closely monitor the
arrangements agreed with the injury employer to maintain the worker at work. The worker, the injury
employer, the agent and the OR provider should have a common understanding of the expected
date when any maintenance at work arrangement may cease.
If the OR provider delivering a 26 Week NES to the worker is different to the OR provider delivering
RC715 OES services then the agent must ensure the worker understands the RTW Goal has
changed to a new employer. The OR provider delivering RC715 OES services should ensure that
the NES provider and the agent are immediately informed if they form the view that the worker has
no CWC or will have no CWC or there is a current barrier to the worker’s RTW preventing
them from being able to be maintained at work.
11.3
WORKER PRIVACY WHERE THEY ARE RECEIVING OES AND NES SERVICES AT THE SAME TIME
Where the worker is receiving OES and NES services at the same time, the OR provider delivering NES
services must not provide the injury employer with any NES reports or provide advice or updates about the
worker’s progress in NES.
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The agent or an OR provider requiring clarification about WorkSafe’s expectations when OES and NES
services are being provided at the same time should contact WorkSafe via
[email protected]. WorkSafe will provide a response within 48 working hours.
WorkSafe may seek further information during this period and any determination will then be made within 48
hours of this further advice being received by WorkSafe.
11.4
RTW INCENTIVE PAYABLE FOR A RTW TO INJURY EMPLOYER AFTER NES COMMENCED
A RTW incentive may be paid to an OR provider providing NES services when they negotiate a RTW with
the injury employer and the agent and the OR provider agree that the conditions for paying the incentive can
be satisfied including the submission of an appropriate invoice.
If an OR provider has previously commenced RC715 OES services with the worker, a RC750 RTW
incentive is payable. If the OR provider has not previously commenced RC715 OES services with the
worker, a RC891 RTW incentive is payable.
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12. GP RTW CASE CONFERENCE
A GP RTW Case Conference is a face to face meeting arranged by an OR provider with the worker and the
worker’s GP at the GP’s rooms. An OR provider can only arrange two GP RTW Case Conferences per
claim. The face-to-face component of a GP RTW Case Conference should take approximately 30 minutes
to complete. An OR provider may seek up to two hours in total for the time spent on arranging and attending
the GP RTW Case Conference and the sending of an Action Plan.
11.1
REASONS FOR ARRANGING A GP RTW CASE CONFERENCE
The types of reasons for arranging a GP RTW Case Conference may include but are not limited to:

An IME or worker self-reporting suggest the worker has a work capacity however, the GP continues to
provide medical certificates that the worker does not have a CWC;

The OR provider has identified suitable employment at the injury workplace however, the GP says the
worker does not have a CWC;

The GP and IME have a differing opinion about the worker’s degree or type of capacity or the suitability
of employment available at the injury workplace; and

There has been a RTW at the injury workplace with restrictions to PID or pre-injury hours PIH and the
GP will not vary their opinion about the worker’s capability to increase the duties or hours.
11.2
ADVISING THE AGENT
When an OR provider determines that a GP RTW Case Conference is needed they should telephone or
email the agent. A GP RTW Case Conference can proceed unless the agent advises them within two
working days of that contact that a GP RTW Case Conference is not approved.
A second GP RTW Case Conference requires agent approval and no arrangements should be made to
schedule a GP RTW Case Conference until that approval is received.
11.3
WORKER TO BE ADVISED IF OTHERS HAVE BEEN INVITED TO THE CONFERENCE
An OR provider may also invite the agent to attend a GP RTW Case Conference. Alternatively if the RTW
goal is with the injury employer they may also be invited to attend. The worker should be advised prior to
the GP RTW Case Conference where the agent or injury employer has indicated they will attend a
conference.
11.4
SCHEDULING A GP RTW CASE CONFERENCE
The worker, the GP and any other party are contacted and a mutually suitable time for the GP RTW Case
Conference is agreed. The worker must be advised prior to the GP RTW Case Conference when the
agent or pre-injury employer has agreed to attend the conference.
If the worker or GP decline to participate in a GP RTW Case Conference then the OR provider must
contact the agent immediately.
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At least one working day prior to the scheduled GP RTW Case Conference, an OR provider will confirm via
email or facsimile the date, time and location of the conference with all parties who have agreed to attend.
The GP RTW Case Conference Agenda letter is required to be sent to the worker (Attachment 1, page
22) and GP (Attachment 2, page 23). A GP Information Sheet must be included with the GP letter to
explain why a GP RTW Case Conference has been arranged. The Agenda letter and Information Sheet
also explains how the GP may seek payment for their involvement.
11.5
CONFIRMING THE AGREED ACTIONS FROM A GP RTW CASE CONFERENCE
An OR provider may complete a GP RTW Case Conference Action Plan and gain agreement from the
participants to the each action prior to the conference being concluded. An OR provider may give a copy of
the GP RTW Case Conference Action Plan to the worker, the GP and any other parties attending the
conference at the meeting’s conclusion or alternatively within five working days (Attachment 3, page 24).
An OR provider must also email or facsimile a copy of the GP RTW Case Conference Action Plan to the
agent within five working days of the date of the GP RTW Case Conference.
11.6
INFORMATION ABOUT GP RTW CASE CONFERENCE IN NEXT OR PROVIDER REPORT
Where the next Monthly Progress Report falls due within five working days of the date of the GP RTW
Case Conference then an OR provider should include information with that report. The GP RTW Case
Conference Action Plan can be attached or alternatively the following can be included under the section of
the report headed COMMENTS/ADDITIONAL INFORMATION:

The date of and who was present at the conference;

The key discussion points;

A summary of the agreed actions which may include but are not limited to the GP:

changing or issuing a medical certificate immediately for PIH or PID; or

increasing the hours being worked or agreeing to do so when the next medical certificate is due; or

agreeing to a RTW arrangement prepared by the injury employer.
11.7
EXPECTED OUTCOME FROM A GP RTW CASE CONFERENCE
Following a GP RTW Case Conference, all parties should have a better understanding of:

the OR provider’s role as an independent RTW expert;

the importance of the GP’s opinion and medical certificate when determining the suitability of
employment available at an injury workplace;

the types of duties and hours of work available at an injury workplace;
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
what the injury employer and worker need to do to meet their RTW obligations; and

what has been agreed and included in the Action Plan.
11.8
OR PROVIDER FEES FOR GP RTW CASE CONFERENCE PURPOSES
An OR provider may seek up to two hours in total for the time spent on arranging and attending the GP
RTW Case Conference and the sending of an Action Plan. The inclusion of the Action Plan details in an
OES report is payable as part of the fee for that particular report. An OR provider may not seek additional
payment under the GP RTW Case Conference fee for this activity.
An OR provider will submit an invoice for RC715 OES services for the time spent on arranging and
attending the GP RTW Case Conference and the sending of an Action Plan as well as Provider Travel for
the time spent in travelling to and from their nearest location to the GP’s rooms.
11.9
GP FEES FOR GP RTW CASE CONFERENCE PURPOSES
The GP submits an invoice including their patient’s name, the WorkSafe claim number and the date of the
conference to the agent. The agent will pay for the RTW Case Conference within 28 days of receiving the
GP’s invoice. A GP who also saw the worker on the same day for their regular consultation may seek
payment for that consultation on the same invoice.
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13. OES SERVICES AND FEES
In accordance with WorkSafe’s Agreement with OR providers for the provision of OR services, the OES fees
will be automatically indexed on 1 July each year.
WORK REPORT
Service Item Code & Description
Fee + GST
RC700 Work Report
Fixed amount $750.05 paid on receipt of a complete report and invoice
An agent approves a Work Report to determine what OES services may be needed to return a worker to pre-injury or suitable employment at an
injury workplace particularly where issues or barriers have been identified that may be delaying or impeding the worker’s RTW. Within 3 working
days of receiving the OR Referral form, an OR provider must telephone the agent, worker and injury employer.
In the agent discussion, the OR provider must confirm the agent’s understanding of the circumstances that led to the claim and confirm why a
Work Report was approved. The OR provider should also seek clarification about any matter that may be unclear or not fully explained in the OR
Referral form.
In the worker and injury employer discussions, the OR provider must confirm their understanding of the circumstances that led to the claim,
establish what issues or barriers the worker or injury employer may consider are delaying or impeding a RTW. The OR provider should also check
their availability so they can schedule workplace meetings with them both as soon as it is practicable. This information should also be used by the
OR provider to form a preliminary view prior to the first workplace meetings of the activities that may be needed or issues that need to be resolved
to facilitate a negotiated RTW for the worker.
After these discussions, an OR provider should have sufficient information to form a preliminary view prior to the first meeting with the worker and
the injury employer about what activities may be needed or what issues may need to be resolved to facilitate a negotiated RTW. They will have
also established or verified:
-
The worker’s pre-injury duties/tasks and hours of work;
-
Any other duties/tasks that may be available for the worker full or part time at an injury workplace;
-
Whether the injury employer has commenced RTW planning;
-
Whether the worker has returned to work with the injury employer or if they returned to work why this may or may not have continued;
-
The current medical evidence related to the worker’s capacity for work including any work restrictions; and
-
Whether a RTW date has been suggested by the agent or the worker, the worker’s THP or the injury employer.
An OR provider must attempt to engage the worker’s THP when completing this service.
A Work Report must clearly state the independent opinion formed by an OR provider and will summarise the information collected by them at the
time the report was completed. It will include a review of the medical evidence related to the worker’s CWC including any work restrictions, it will list
any identified actual or perceived barriers to RTW, the worker’s work status, confirm the worker’s pre-injury duties and tasks, recommend the duties
and tasks the worker may be able to perform, identify the pre-injury or suitable employment that may be available at the injury workplace, state
whether the injury employer has commenced RTW planning and nominate an expected RTW date.
Prior to a Work Report being submitted
An OR provider is required to contact the agent prior to the Work Report being submitted to discuss their recommendation. If the OR provider forms
the view that a RTW can be achieved immediately then this discussion should include seeking approval of RC717 RTW Assistance.
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Additional information to be obtained where the agent supports a training course consideration
To cover the cost of an OR provider investigating and including training course information as part of a Work Report, the agent should approve
additional funding (under the RC770 Retraining or Redeployment Report service code). The type of training course information to be included in
the Work Report is:
-
The name of at least two training courses available in locations suitable to where the worker resides;
-
The cost, duration, the name and location of the retraining provider offering those training courses;
-
Any pre-requisites for the training courses i.e. an expectation of prior learning; and
-
The type of competency that would be obtained by the worker completing these training courses e.g. a Certificate VI in Workplace Training
No RC715 OES services to commence
An OR provider must be able to substantiate why they formed a view the worker should not commence a RC715 OES services at this point of time.
The types of reasons may include but not limited to:
-
A worker has no CWC or is unlikely to have a CWC within a 3 month period;
-
There is a current barrier to RTW preventing them from actively participating in RC715 OES services.
Work Report submitted
Within 15 working days of the OR Referral form being received, the report is submitted with an invoice reflecting the outcome of the discussion with
the agent:
-
RC715 OES services to commence, an invoice for RC700 and a Funding Request for RC715 OES services;
-
No RC715 OES services to commence, an invoice for RC700;
-
Consideration of a training course, an invoice for RC700 and RC770;
-
RTW achieved immediately, an invoice for RC700 and RC717.
There should be no reference to NES in the report unless this has been discussed and approved by the agent. In this instance the report may
include a reference that the agent is considering this possibility.
Commencing RC715 OES services
An OR provider may commence RC715 OES services as soon as the first meeting can be arranged with the worker.
Possibility of training course approval
An OR provider must ensure that the worker understands that a training course approval relies on the agent determining that a course is a
reasonable and necessary to enhance the worker’s employability. An agent may agree to consider a training course as part of a Work Report but a
separate approval is required to approve a specific training course.
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MONTHLY PROGRESS REPORTS
Service Item Code & Description
Fee + GST
RC701 Monthly Progress Reports
Fixed amount of $96.54 paid on receipt of a complete report and invoice
A Monthly Progress Report is submitted with an invoice for RC701 for every month of OES RC715 services completed except for when a 6
Month or 12 Month Progress Report is due. A Monthly Progress Report is submitted on the same date one month after the date the Work Report
was submitted. An Additional Funding Request may also be included with the report and invoice if additional RC715 OES services is required.
A Monthly Progress Report must clearly state the independent opinion formed by an OR provider and will summarise the information collected by
them at the time the report was completed. It will include a review of the medical evidence related to the worker’s CWC including any work
restrictions, an update on the pre-injury or suitable employment options, the progress made toward the achievement of those options, the progress
made to resolve any identified actual or perceived barriers to RTW as part of the agreed activities, whether the injury employer is carrying out any
RTW planning, the date and who attended any facilitated meetings held between the worker and the injury employer and the proposed RTW date if
the worker has not achieved a RTW during the month. The report should contain sufficient information to substantiate any recommendation being
made by an OR provider and any further funding being sought for RC715 OES services.
There should be no reference to NES in the report unless this has been discussed and approved by the agent. In this instance the report may
include a reference that the agent is considering this possibility.
An OR provider may also recommend that the worker needs to improve their work fitness because they have formed the view that the worker’s
CWC does not match the requirements needed to perform pre-injury or suitable employment. In this circumstance, an OR provider should
contact the agent immediately. The discussion should include whether additional RC715 OES services should be approved for this ‘work fitness’
service. An OR provider may only provide this type of ‘work fitness’ service where the worker is not receiving treatment from a medical or allied
health provider such as a physiotherapist or an occupational therapist or an occupational physician. See also RC715 OES services.
Prior to a Monthly Progress Report being submitted
After RC715 OES services are commenced an OR provider may contact an agent to discuss whether RC715 OES services should continue, be
suspended or ceased or a training course be considered to obtain a competency. If this has not occurred then prior to a Monthly Progress Report
being completed, they should contact the agent to discuss what they propose to recommend in that report. A Monthly Progress Report should
not make a recommendation that has not been previously discussed with the agent.
Additional information to be obtained where the agent supports a training course consideration
To cover the cost of an OR provider investigating and including training course information as part of a Monthly Progress Report, the agent should
approve additional funding (under the RC770 Retraining or Redeployment Report service code). The type of training course information to be
included in the report is:
-
The name of at least two training courses available in locations suitable to where the worker resides;
-
The cost, duration, the name and location of the retraining provider offering those training courses;
-
Any pre-requisites for the training courses i.e. an expectation of prior learning; and
-
The type of competency that would be obtained by the worker completing these training courses e.g. a Certificate VI in Workplace Training
RC715 OES services not continuing
An OR provider must be able to substantiate why they formed a view that RC715 OES services should be suspended or ceased at this point of
time. The types of reasons may include but not limited to:
-
A worker has no CWC or is unlikely to have a CWC within a 3 month period;
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-
There is a current barrier to RTW preventing them from actively participating in RC715 OES services.
If 100%PIH is achieved during the month, a RC730 Placement Report is submitted and no Monthly Progress Report is required.
RC705 6 Month Progress Report
Fixed amount of $134.02 paid on receipt of a complete report and invoice
A 6 Month Progress Report is submitted with an invoice for RC705 and replaces the Monthly Progress Report that would have been due at 6
months of RC715 OES services. A 6 Month Progress Report is submitted on the same date six months after the date the Work Report was
submitted. An Additional Funding Request may also be included with the report and invoice if additional RC715 OES services is required.
The agent and the OR provider will adopt the same service requirements, processes and timelines for the submission of a 6 Month Progress
Report as for a Monthly Progress Report.
If 100%PIH is achieved during Month 6, a RC730 Placement Report is submitted and no Monthly Progress Report is required.
RC710 12 Month Progress Report
Fixed amount of $134.02 paid on receipt of a complete report and invoice
A 12 Month Progress Report is submitted with an invoice for RC710 and replaces the Monthly Progress Report that would have been due at
12 months of RC715 OES services. A 12 Month Progress Report is submitted on the same date twelve months after the date the Work Report
was submitted. An Additional Funding Request may also be included with the report and invoice if additional RC715 OES services is required.
The agent and the OR provider will adopt the same service requirements, processes and timelines for the submission of a 12 Month Progress
Report as for a Monthly Progress Report.
If 100%PIH is achieved during Month 12, a RC730 Placement Report is submitted and no Monthly Progress Report is required.
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OES SERVICES
OES services can include OR provider fees for Work Fitness and GP RTW Case Conference
Service Item Code & Description
Fee + GST
RC715 OES services
Agent approved hours @ $151.22 hourly rate paid on receipt of a
complete report and invoice
An OR provider will determine what activities may be appropriate to achieve a RTW to pre-injury or suitable employment at the injury workplace.
The activities should be amended as required and will include a review of the medical evidence related to the worker’s CWC including any work
restrictions, an update on the pre-injury or suitable employment options, the progress made toward the achievement of those options, the progress
made to resolve any identified actual or perceived barriers to RTW as part of the agreed activities, whether the injury employer is carrying out any
RTW planning, the date and who attended any facilitated meetings held between the worker and the injury employer and the proposed RTW date if
the worker has not achieved a RTW during the month. The OR provider must attempt to engage the worker’s THP when completing this service.
Work Fitness
After RC715 OES services commence, an OR provider may form the view that the worker would benefit from having their work fitness improved to
enable them to perform their pre-injury or other suitable employment. An OR provider should contact the agent to seek their approval to complete
objective and relevant tests to verify where the worker’s physical and mental capacity as well as their confidence may be improved. Following these
tests, an agent may approve work fitness activities be provided as part of RC715 OES services. Where the worker is receiving treatment from a
medical or allied health provider such as a physiotherapist or an occupational therapist or an occupational physician or a psychologist
then the agent should request that any work fitness activities be part of the treatment service offered to the worker.
GP RTW Case Conference
An OR provider may also seek up to two hours in total of RC715 OES services for the time spent on arranging and attending a GP RTW Case
Conference and the sending of an Action Plan. The inclusion of the Action Plan in a Monthly Progress Report including a 6 or 12 Month
Progress Report is payable as part of the fee for that report. An OR provider may not seek additional payment under RC715 OES services for
that activity.
A Monthly Progress Report including a 6 or 12 Month Progress Report should contain sufficient information to substantiate any
recommendations made by an OR provider within those reports to continue RC715 OES services.
RC717 RTW Assistance
Agent approved up to 1.5 hours capped at $226.78
If an OR provider forms the view while completing a Work Report that a RTW in pre-injury or suitable employment can be achieved without RC715
OES services then they contact the agent to seek approval of RC717 RTW Assistance.
However if agent contact cannot be established then an OR provider may proceed to provide this service on the understanding that the RTW will be
achieved at the same time that the report is completed although the actual date of the RTW may be later than the report date.
An OR provider should include in the Work Report sufficient information to substantiate how an OR provider resolved any identified actual or
perceived barriers to RTW and achieved a RTW. When RC717 RTW Assistance is used, a Work Report is submitted with an invoice for RC700
and RC717.
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RTW INCENTIVES
Service Item Code & Description
Fee + GST
RC720 Incentive
Fixed amount of $80.38 paid on receipt of a complete report and invoice
An OR provider submits an invoice for RC720 when at OES commencement the worker was not at work but achieves any RTW less than 100%
PIH. There is no report required when a RC720 RTW is achieved.
RC730 Placement Report 100% PIH achieved
Fixed amount of $257.32 paid on receipt of a complete report and invoice
A Placement Report is submitted with an invoice for RC730 within 10 working days of the worker achieving 100% PIH. A worker may initially
commence at less than 100% PIH but must be at PIH for at least 5 working days for an OR provider to seek payment of RC730. Day 1 of
100% PIH becomes Day 1 of the 13 week sustainability period.
A Placement Report replaces the Monthly Progress Report including a 6 or 12 Month Progress Report that would have been due that month.
The report should contain sufficient information to inform the agent about the 100% RTW in PIH to pre-injury or suitable employment.
Prior to a Placement Report being submitted
An OR provider is required to contact the agent prior to the Placement Report being submitted to advise whether they will be recommending
RC715 OES services to continue to support and assist the worker achieve PID, this report should also include a list of proposed activities and
expected timeframe for achieving PID. A Funding Request for RC715 OES services may be submitted with the report.
An OR provider continues RC715 OES services if the agent does not advise within 3 working days of the report being submitted that services are
not approved. If services continue, the agent may decide that a Monthly Progress Report including a 6 or 12 Month Progress Report is not
required and may negotiate with an OR provider for reports to be submitted at different times.
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NON-MENTAL INJURY CLAIMS
13 Week Sustainability Incentives 100% PIH & worker receiving weekly payments at OES commencement
Service Item Code & Description
Fee + GST
RC740 13 Week Sustainability Incentive where OES commenced
< 50 calendar days after the Agent Received Date
Fixed amount of $553.26 paid on receipt of a complete report and invoice
A Sustainability Report is submitted with an invoice for RC740 within 10 working days of the 13 week sustainability date being achieved when
the date of the OR Referral form is less than 50 calendar days after the ‘Agent Received Date’ for the claim and the worker was receiving weekly
payments at OES commencement and has remained at work on 100% PIH with no more than 5 working days off work5 in the 13 week sustainable
RTW period. See also RC750 below.
RC741 13 Week Sustainability Incentive where OES commenced
≥ 50 calendar days after the Agent Received Date
Fixed amount of $737.68 paid on receipt of a complete report and invoice
A Sustainability Report is submitted with an invoice for RC741 within 10 working days of the 13 week sustainability date being achieved when
the date of the OR Referral form is equal to or more than 50 calendar days after the ‘Agent Received Date’ for the claim and the worker was
receiving weekly payments at OES commencement and has remained at work on 100% PIH with no more than 5 working days5 off work in the 13
week sustainable RTW period. See also RC750 below.
MENTAL INJURY CLAIMS
Service Item Code & Description
Fee + GST
RC742 13 Week Sustainability Incentive
Fixed amount of $976.35 paid on receipt of a complete report and invoice
A Sustainability Report is submitted with an invoice for RC742 within 10 working days of the 13 week sustainability date being achieved when
the OR Referral form identifies the claim as a primary mental injury claim, the worker was receiving weekly payments at OES commencement and
has remained at work on 100% PIH with no more than 5 working days5 off work in the 13 week sustainable RTW period. See also RC750 below.
5
In calculating the 5 working days where the worker may be absent from work due to their compensable injury, a part day is counted as 1 day.
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12 WEEK SUSTAINABILITY INCENTIVES 100% PIH & PID OR PD AT 13 WEEK SUSTAINABLE RTW DATE
Service Item Code & Description
Fee + GST
RC750 Incentive Pre-injury Duties (PID) or Productive Duties
(PD) Achieved
Fixed amount of $160.76 paid on receipt of a complete report and invoice
Worker receiving weekly payments at OES commencement
The invoice for RC740 or RC741 or RC742 may also include RC750 when a worker has remained at work on 100% PIH with no more than 5
working days5 off work in the 13 week sustainable RTW period and at the 13 week sustainable RTW date the worker is working in PID or PD.
Worker at work PIH at OES commencement
Alternatively a Sustainability Report is submitted with an invoice for RC750 within 10 working days of the 13 week sustainability date being
achieved when a worker has remained at work on 100% PIH and subsequently returned to PID or PD for at least 4 weeks in the 13 week
sustainable RTW period. No other incentive is payable in this circumstance.
SUBSEQUENT WORK REPORT
Service Item Code & Description
Fee + GST
RC755 Subsequent Work Report
Amount negotiated up to $750.05 paid on receipt of a complete report
and invoice
The agent may approve a Subsequent Work Report to determine whether RC715 OES services should be approved or recommenced.
The agent and an OR provider will adopt the same service requirements, processes and timelines for the approval and submission of a
Subsequent Work Report as for the Work Report. WorkSafe expects the report will not require the same level of engagement or time as the Work
Report as this is an update or review of work previously completed by an OR provider.
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SUSPENSION AND CESSATION OF RC715 OES SERVICES
Service Item Code & Description
Fee + GST
RC764 Suspension Report
Fixed amount of $96.54 paid on receipt of a complete report and invoice
If the OR provider forms the view while preparing to complete a Monthly Progress Report including a 6 or 12 Month Progress Report that the
worker will have no CWC for more than 4 weeks but is expected to have a CWC within 13 weeks then the agent must be contacted immediately
to discuss suspending RC715 OES services.
Within 10 working days and the agent agreeing RC715 OES services should be suspended, a report is submitted with an invoice for RC764. The
report is a brief summary of the information collected by the OR provider to date and must contain sufficient information to substantiate why RC715
OES services are being suspended.
This report replaces the Monthly Progress Report including a 6 or 12 Month Progress Report that would have been due that month if RC715
OES services had not been suspended.
RC765 Cessation Report
Fixed amount of $134.02 paid on receipt of a complete report and invoice
If the OR provider forms the view while preparing to complete a Monthly Progress Report including a 6 or 12 Month Progress Report that the
worker does not have a CWC or will have no CWC for more than 13 weeks or there is a RTW barrier preventing them from actively participating in
OES then the agent must be contacted immediately to discuss ceasing RC715 OES services.
Within 10 working days and the agent agreeing RC715 OES services should be ceased, a report is submitted with an invoice for RC765.
The report is a summary of the information collected to date and should include but is not limited to:

A summary of all RC715 OES services and any other OES services provided to date;

Reasons why the OR provider has formed the view that the RTW Goal of RTW with a new employer may be more appropriate for the worker;

A summary of any RTW achieved in pre-injury or suitable employment at the injury workplace including the specific duties and tasks, the
number of hours worked per week and the number of weeks worked

If no RTW achieved or the worker is not at work at the time that cessation of RC715 OES services is being considered, a summary of the
agreed activities specific to RTW such as proposed duties or tasks, the number of proposed hours or weeks completed by the OR provider

A summary of any employer RTW planning while the OR provider was providing RC715 OES services to the worker;

Any current actual or perceived barriers to RTW that may be impacting on the worker participating in NES services or achieving suitable
employment at a new employer;

Any current issues about the worker’s recovery from the injury that may impact on the worker participating in NES services or achieving
suitable employment at a new employer; and

Any transferable skills or abilities identified during RC715 OES services that may be relevant to the identification of suitable employment at a
new employer.
The report replaces the Monthly Progress including a 6 or 12 Month Progress Report that would have been due that month if RC715 OES
services had not been ceased.
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IDENTIFYING AN APPROPRIATE RETRAINING COURSE OR REDEPLOYMENT
Service Item Code & Description
Fee + GST
RC770 Retraining or Redeployment Report
Agent approved up to $750.05 paid on receipt of a complete report and
invoice
When completing a Work Report or Subsequent Work Report or RC715 OES services, an OR provider may form the view that the worker’s
employability with the injury employer would be enhanced by a particular or different competency being obtained. In these circumstances, an OR
provider should contact the agent immediately. The discussion should consider whether the worker can actively participate in RC715 OES
services as well as complete a training course.
Alternatively, on receiving an OR Referral form from the agent approving this service, an OR provider must arrange this service with the worker
within 2 working days.
The OR provider must attempt to engage the worker’s THP when completing this service.
Agent agrees to training course consideration
When the agent agrees that a training course should be considered, they approve a Retraining or Redeployment Report to identify suitable
training courses based on the worker’s existing transferable skills and abilities and identified suitable employment. The report must include:
-
The name of at least two training courses available in locations suitable to where the worker resides;
-
The cost, duration, the name and location of the retraining provider offering those training courses;
-
Any pre-requisites for each training course i.e. an expectation of prior learning; and
-
The type of competency that would be obtained by the worker completing these training courses e.g. a Certificate VI in Workplace Training.
The type of redeployment information to be included in the Retraining or Redeployment Report is confirmation of the worker’s capacity to work in
that redeployment as well as verification that the worker’s transferable skills and abilities match the skills and abilities needed for the redeployment.
Retraining or Redeployment Report submitted
Within 15 working days of the agent approving this service, the report is submitted with an invoice for RC770. An OR provider may determine the
format of the report as there is no WorkSafe approved report template.
An OR provider may determine the format of the report as there is no WorkSafe approved report. Within 3 working days of this service being
completed an OR provider must submit the report plus an invoice for RC770.
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PROVIDER TRAVEL
Service Item Code & Description
Fee + GST
RC799 Provider Travel
Agent approved hours @ $151.22 hourly rate paid on receipt of a
complete report and invoice
The need for Provider Travel is considered when:
-
OES services will be provided at the worker’s injury workplace;
-
The OR provider is attending a GP RTW Case Conference.
The cost of Provider Travel is calculated as the OR provider’s travel costs from and to their location nearest to the worker’s pre-injury or any other
workplace of the injury employer where the OES services are to be provided or the GP’s rooms to attend a GP RTW Case Conference. An OR
provider can commence Provider Travel, if the agent does not advise an OR provider within 2 working days that Provider Travel is not approved.
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ATTACHMENT 1 - GP RTW CASE CONFERENCE: WORKER LETTER
OR provider letterhead
Date
Worker Name & Address
Dear Worker,
GP Return to Work Case Conference
Name: Mary Worker
Claim number: 12345
Thank you for agreeing to participate in a GP Return to Work (RTW) Case Conference at your general practitioner’s clinic.
The purpose of the GP RTW Case Conference is to have a face to face discussion to ensure that any proposed return to work
activity is safe, sustainable and appropriate to your stage of recovery.
Conference support
You can be supported, assisted and represented in the return to work process by a family member, friend, colleague or union
representative if you would also like to invite a support person to attend with you. Please advise if you require an interpreter.
Conference details
Date and time:
Address:
Participants:
Conference topics
During the GP RTW Case Conference you and your general practitioner will be able to:

Provide an update on the progress of injury recovery

Discuss return to work goals

Discuss potential return to work time frames and suitable duties available at the workplace

Identify any workplace issues, barriers or concerns

Agree on actions to be taken to support the return to work goals and overcome any workplace issues, barriers or concerns to
help with to return to work
Other topics may also be raised by conference participants.
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After the GP RTW Case Conference, a letter will be sent to you and your general practitioner confirming the agreed actions from
the conference.
Getting more information
If you have any questions about this letter you can call me on 9999 9999.
Yours sincerely
OR Consultant Name
Service provided: Occupational Rehabilitation
Professional Background – [insert qualification]
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ATTACHMENT 2 - GP RTW CASE CONFERENCE: GP LETTER
OR provider letterhead
Date
GP Name & Address
Dear Dr,
GP Return to Work Case Conference
Name: Mary Worker
Claim number: 12345
Date of birth:
Thank you for agreeing to participate in a GP Return to Work (RTW) Case Conference with your patient.
The purpose of the GP RTW Case Conference is to have a face to face discussion to ensure that any proposed return to work
activity is safe, sustainable and appropriate to your patient’s stage of recovery.
Conference details
Date and time:
Address:
Participants:
Conference topics
During a GP RTW Case Conference you and your patient will be able to:

Provide an update on the progress of injury recovery

Discuss return to work goals

Discuss potential return to work time frames and suitable duties available at the injury workplace

Identify and agree actions to overcome any issues, barriers or concerns about return to work at the injury workplace

Agree actions to support and assist your patient to return to work
Other topics may also be raised at a conference by the participants. After the GP RTW Case Conference a letter will be sent to
you and your patient confirming the next steps and agreed actions from the conference.
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Conference invoicing
You should invoice the WorkSafe Agent for your participation in a GP RTW Case Conference using Item Code RTWCC. The fee is
$122.80 for a maximum of 30 minutes.
Getting more information
If you have any questions about this letter you can call me on 9999 9999.
Yours sincerely
OR Consultant Name
Service provided: Occupational Rehabilitation
Professional Background – [insert qualification]
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ATTACHMENT 3 - GP RTW CASE CONFERENCE ACTION PLAN
OR provider letterhead
Date
Dear
Name
[Client Full Name]
Claim number
[Claim Number]
Date of birth
Thank you for attending the Return to Work Case Conference on [insert date].
Outcome of the conference
The following actions were agreed to at the conference:
Activity6
6
By whom
When
Additional activities can be added into table by adding a row
2013.2 Schedule 2 OES effective 1 July 2013 released 1 February 2014
Page 45 of 46
Getting more information
If you have any questions about this letter you can call me on 9999 9999.
Yours sincerely
OR Consultant Name
Service provided: Occupational Rehabilitation
Professional Background – [insert qualification]
2013.2 Schedule 2 OES effective 1 July 2013 released 1 February 2014
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