Faster treatment times achieved for injured workers
The time it takes for an injured worker to receive treatment has been reduced by icare’s Medical Support Panel (MSP).
The panel was first introduced 12 months ago with the aim of cutting down treatment and medical causation decision time frames where an injury has occurred at work.
Following the success of an initial pilot, the panel is now a permanent feature of the insurer’s customer-centric claims services model. More than 2000 cases have been referred to the MSP, with average medical causation and treatment recommendation time frames reducing from six weeks before the trial, to five days post-trial.
The panel, composed of medical specialists with expertise in work injuries, provides case managers with medical case support to fast-track decision-making.
“icare is transforming the NSW workers compensation system by reducing the waiting time for a treatment decision upon the claim. This means injured workers can access treatment much more quickly,” said icare’s Interim Chief Executive Officer, John Nagle.
“We know that faster treatment times can improve the long-term injury outcomes for people and lower the risk of secondary associated injuries.”
Chief Medical Officer Dr Chris Colquhoun said the panel supports not only the injured worker, but also their employer.
“Feedback on the panel has been positive. Injured workers and treating doctors appreciate how quickly they are contacted by the specialists on the panel and how easy and straightforward their conversations have been,” Dr Colquhoun said.
The Medical Support Panel is not intended to replace independent medical examinations (IME).
“IMEs play a valuable role in the scheme, mainly in cases where medical information is incomplete or a physical examination is required. In most cases the panel’s recommendation is to support the proposed treatment. Around one-quarter of cases reviewed by the panel are referred for an IME for further assessment regarding medical causation or treatment,” said Dr Colquhoun.
icare’s claims services partners have also been integral to the panel’s success and are committed to adopting the new framework and implementing the panel’s recommendations.
Panel members support case managers and treating clinicians in various ways, like opening up communication lines between workers and their healthcare providers, assisting with case strategies, and discussing possible alternate best practice treatment options.
"We are achieving positive recovery outcomes and will continue to improve the panel process by adopting the feedback from our customers and claims services partners. Our end goal is to ensure injured workers get the most appropriate and timely treatment possible to allow early recovery,” Dr Colquhoun said.
One such worker was Jim Turner, who was working on a narrow balcony when he fell over the railing onto the footpath below. As well as fracturing his collarbone, ribs and pelvis, he also received a head injury.
A year after the fall, Turner was still living with intense pain in his shoulder, which was thought to be neuropathic but remained undiagnosed, and conservative treatment was failing him. His doctor recommended surgery, but Turner’s injury management advisor at GIO was concerned about his mental health and wellbeing, given the extent of the injuries and the length of time he had been out of the workplace.
The injury management advisor consulted icare’s Medical Support Panel to determine whether surgery was the best option. The panel reviewed his case and, within only 24 hours, concluded that the diagnostic arthroscopy was necessary and appropriate.
“I was very happy with the speed of the decisions and approval for surgery,” said Turner.
icare’s panel enabled the team supporting Turner — his claims advisor, health professionals and industry specialists — to work together in a holistic way and find the most appropriate solution at the right time.
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