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Work Capacity – an Insurer’s view. We continue on our journey with Work Capacity Understand Work Capacity Establish our approach Educate staff and stakeholders.

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Presentation on theme: "Work Capacity – an Insurer’s view. We continue on our journey with Work Capacity Understand Work Capacity Establish our approach Educate staff and stakeholders."— Presentation transcript:

1 Work Capacity – an Insurer’s view

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3 We continue on our journey with Work Capacity Understand Work Capacity Establish our approach Educate staff and stakeholders Apply Work Capacity Decisions Build competency and quality

4 The goal is to achieve a sustainable and successful return to work 1. Build a Functional Capacity 2. Identify Suitable Employment and support with return to work 3. Work Capacity Decisions4. Review process

5 First we determine what the worker CAN do We make a decision to either: 1 2 Medical and functional information Current certificates Current certificates What else have we discovered?  Early identification of the Return to Work goal is essential  Give weight to current, consistent and justified opinions  Recognise and respond to changes on certificates

6 There are key components to Suitable Employment Suitable Employment Functional capacity AgeEducation Skills and experience RTW Planning Rehab services Key components of Suitable employment There is demonstrated ability they can do the role NTD agrees the role is suitable Education and training has improved skills Rehab support tailored to the individual

7 It has been essential to keep our rehab providers informed Workshop key concepts and practical application Review de-identified case studies They support our workers obtain suitable employment. Rehab services to be tailored to an individual’s needs. Provide support to our Providers Match abilities to each role Contact ‘Real Employers’ to find out what is required Obtain information to a worker’s specific circumstances Doctors to approve requirements of the role – not the title Understand Suitable Employment Identify transferrable skills Support overcome unique challenges Tailor services and recommendations Support the worker be the best candidate Support best practice

8 Work Capacity Decisions occur throughout the life of a claim

9 1. Work Capacity Decisions: Continuous improvement through experience The Review Process supports continuous improvement 1. Work Capacity Decisions: Continuous improvement through experience 2. Internal Reviews: Quality Assurance; identify trends; staff development 1. Work Capacity Decisions: Continuous improvement through experience 2. Internal Reviews: Quality Assurance; identify trends; staff development 3. Merit Reviews: Practical application of work capacity; use of evidence 1. Work Capacity Decisions: Continuous improvement through experience 2. Internal Reviews: Quality Assurance; identify trends; staff development 3. Merit Reviews: Practical application of work capacity; use of evidence 4. Procedural Reviews: Letters; processes; procedural fairness and admin law

10 Work Capacity continues to evolve Continuous cycle of discovery – learning, applying and improving. Focus early on Return to Work. Be transparent COMMUNICATION AND ENGAGEMENT Learn more about concepts and their application. Support fair and sustainable outcomes ADAPT QUICKLY Improve and refine the shape of our approach. TAILOR SUPPORT TO THE INDIVIDUAL

11 “It is not the strongest of the species that survives, nor the most intelligent that survives. It is the one that is the most adaptable to change.” ~ Charles Darwin

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13 Simone Witschge Contract Account Liaison P: 02 8251 9031 E: S.Witschge@employersmutual.com.au Kathryn Horne Work Capacity Manager P: 02 8251 9078 E: K.Horne@employersmutual.com.au


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