Articles tagged under ‘Claims Management’

Articles 1 - 94 of 94

• Comcare’s management of IMEs — the Commonwealth Ombudsman takes a look

  The Commonwealth Ombudsman’s investigation into Comcare’s management of IMEs addresses reports of unreasonable and unethical behaviour and offers up suggestions for improvement.

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• Claims intake at WorkCover Queensland — Insights from the introduction of a biopsychosocial framework

  A partnership between researchers and a workers compensation insurer (WorkCover Queensland) is an example of what can be done when evidence informs practice.

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• Big ideas for mental health in small businesses

  In this Q&A with Tim Hoopmann, small business owner and Beyond Blue speaker, we learn how to better support small business through work injury claims and mental health struggles.

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• Getting the workplace onside

  A guide to help insurance case managers, RTW Coordinators and rehabilitation providers motivate immediate supervisors and senior managers to better manage work injury.

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• Case management opportunity alert

  Get to know an untapped resource: Australia’s committed, highly experienced cohort of RTW case managers.

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• Webinar recording: Two highly experienced and effective case managers share their experience of what works

  Dr Wyatt interviews two case managers involved in an extremely effective evidenced based proactive and early intervention approach.

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• Webinar recording: The elephant in the room - a rehabbers journey to the other side

  Dr Mary Wyatt interviews Rhea Mercado, author and rehabilitation professional, about the connection she sees between performance targets, process-driven systems and worker wellbeing.

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• Webinar recording: My top strategies for rehabilitation case management

  In this webinar psychologist, Tatjana Jokic shares top strategies for effective case management.

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• Ten things injury insurers do that plaintiff lawyers love

  An ex-compensation lawyer spills the dirt on how injury insurers can be their own worst enemies, pushing claimants towards seeking legal representation and increasing the likelihood of a win if the case goes to court.

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• A new focus on case management

  Dr Wyatt describes the current state of case management in Australia, and asks for your help in identifying a positive path that benefits injured workers and improves conditions for case managers too.

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• Legal disputes, workers' compensation and COVID

  A Brave New World: a workers compensation perspective on resolving legal disputes via technology in a COVID-19 world.

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• icare laid bare

  icare engaged with the evidence-base around best practice injury management, and tried to reform NSW workers' comp accordingly. What can we learn from the resulting mess?

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• Mirror, mirror

  “Who’s the fairest?” matters to compensation recipients. Researchers find associations between reduced adversarialism, greater perceived fairness and better health.

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• New insurer approach reduces delays in decisions about healthcare

  Delays and disputes are stressful and can have a negative impact on recovery and return to work. The Medical Support Panel in NSW gives speedy, evidence-based answers to questions around work causation and medical treatment.

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• Jurisdictional comparison: Claim lodgement

  Early intervention is only possible when injuries are promptly reported. How do different Australian jurisdictions manage claim lodgement?

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• Webinar recording:Taking control of Workers' Compensation

  Understanding risk management when it comes to Workers’ Compensation premiums is valuable knowledge for Return to Work Coordinators and Employers in managing both health outcomes and in reducing costs.

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• Webinar recording: Life Insurance - What to do when you don't have a big stick - Make carrot soup.

  Meredith Taylor, Trina Moyes and Josh Agar from MLC Life Insurance discuss innovative ways to motivate and engage claimants.

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• "Termis" and tragedy

  When injured workers are seen as numbers and claims terminations are rewarded at the expense of good claims management, the human cost is high.

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• What injured workers want

  The bad news: according to workers, positive interactions with insurers are few and far between. The good news: what workers actually want from insurers can be boiled down to three simple requests…

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• Consequences of bad juju between workers and insurers

  When interactions with insurers are negative, workers’ compensation claimants describe serious consequences for mental health, financial stability, family relationships and recovery.

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• Top five insurer fails: Injured workers talk

  In workers’ compensation systems across the world, injured workers describe predominantly negative interactions with insurers. We share the low-down from an Australian review of the research.

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• How to support psychological claimants

  When psychological claimants feel supported by their employer the RTW outlook is bright. Here we distil the advice of experts into a brief how-to guide to help you capitalise on the support advantage.

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• New data shows employer support crucial for psychological claimants

  In Australia, only one third of psychological claimants feel supported by their employer: those who do are substantially more likely to return to work.

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• How-to guide: Calling psychological injury claimants

  Delaying contact with workers who’ve claimed for psychological injury can delay return to work. This article outlines why, how and when to make *that* call.

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• WorkSafe Victoria failing the most vulnerable: insurers profiting

  We summarise the Victorian Ombudsman's investigation into WorkSafe's handling of complex claims, which paints a picture of opportunistic insurers and systemic failings. Is WorkSafe ready to listen?

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• Disputes: at what cost?

  If an employee is suspected of 'gaming the system,' is it worth investigating the matter further and entering into a dispute? We take a look at the costs involved.

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• Dispute Resolutions: How does your jurisdiction stack up?

  The CPM report provides information on disputation rates and dispute resolution rates across Australia and New Zealand schemes. The 2015 report is the 17th report analysing year on year workers compensation data.

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• Claims Process: the stress of making a claim

  When a worker is injured, there might be fears for their job stability, financial burdens, or concern that they will never be able to regain their previous lifestyle.

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• Dr Melita Giummarra: Injury, Compensation and Perceptions of Injustice

  Monash University in association with the Transport Accident Commission conducted a study into perceptions of injustice, chronic pain and pain-related disability.

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• Vic Ombudsman: inquiry into workers' compensation

  The Victorian Ombudsman, Deborah Glass, has begun an investigation into the handling of workers’ compensation claims.

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• Webinar Recording: Adjusting to change

  Adjusting to change is difficult for all of us, but it can be particularly difficult after a work injury.

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• Influence: Creating an environment of success

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• Influence: Language - a goldmine of potential

  What do you think of when you think of the words: injured worker, claimant, client, worker? Are your thoughts different? How does that impact return to work?

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• Influence: Six tips to reduce resistance and overcome objections

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• Influence: The gentle art of disagreeing

  Real influence is when you build from agreement, not from conflict; to align and lead rather than to try and overcome resistance.

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• Want better answers? Ask better questions

  Well-chosen questions can give injured workers - and frustrated RTW professionals - renewed positivity and momentum.

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• Influence: Stop talking! Four keys to listening

  To be heard is a powerful experience, and for your claimant it will make them feel safer, more secure and begin to trust.

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• Webinar Recording: How Jetstar reduced the impact of workplace injuries by implementing a novel early intervention model

  How an innovative phone medical service helped Jetstar to support their employees with early streamlined care

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• Can we change workplace culture by the way we talk?

  What if we change the language in the workplace?

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• Psychological claims: Part 4

  Getting ready for psychological claims - change the story

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• Psychological claims: Part 3

  The history is not just a formality

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• Psychological claims: Part 2

  Finding a model that makes sense of it all

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• Psychological claims: Part 1

  Are you standing in your own way?

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• Tension before and after an injury

  A cost analysis of workplace culture and its impact on return to work

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• Using telephonic case management for health interventions

  Evidence shows that picking up the phone improves RTW outcomes

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• Can job descriptions for case managers give us insights into state systems?

  We compare two jurisdictions

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• Use of telephonic case management as a cost effective approach to improve RTW outcomes

  The features of telephonic case management that can improve RTW

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• Using telephonic case management for assessment and triage

  Telephonic methods can be used to assess the clinical and work participation needs of people with common health problems.

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• What is telephonic case management?

  The evidence and benefits

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• The case of the "lying" handyman

  How can Return to Work professionals prevent suspicion and mistrust from derailing a claim?

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• After the injury, there's more pain to come

  Injured workers are being further harmed by Australian compensation systems, according to an article by Robert Guthrie and Stephen Monterosso

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• Why we are pro best practice case management

  Dr Wyatt reflects on research she conducted, highlighting that the worker-centred approach substantially reduces costs.

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• Michael Simpson - a discussion about case management

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• Doctor, patient, insurer: The impossible triangle

  An interview with psychiatrist Dr Joe Dunn on improving relationships with doctors, and some of the other complexities of the patient, doctor, insurer interaction.

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• Give a little bit of 'tough' and you'll probably get some back

  We all know what happens to that which goes around (it comes around), so why do we sometimes forget that to get respect in the workplace, we have to give it too?

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• The Value of Questions and Early Answers

  Gather round, I've got a story to tell - and it starts with a question...

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• SuperDoc: Serve up a good attitude

  Want positive results from your clients? Check your 'tude.

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• Consider the alternative: Part 2 - Dispute resolution systems

  Dispute Resolution system expert Nerida Wallace explains the important characteristics of a workers' compensation dispute resolution system

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• Leading the pack or dragging it down?

  When one part of the system underperforms, the others follow suit.

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• Decision-making justice: Part three

  What works and what does not work in the decision making process. A must read for claims / case managers.

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• Decision-making justice: Part two

  Another must read for claims / case managers: how you cannot afford to get it wrong, and how you can get it right.

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• Decision-making justice Part 1.

  A good decision making process is worth its weight in platinum, making this a key read for claims staff and decision makers.

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• Saying no to compensation

  Lara (not her real name) recovers from brain trauma but eventually quits her job and abandons her claim. Why?

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• What does research say about Early Intervention?

  In response to a subscriber's question, we find that the early bird gets results.

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• RTW conflict Q & A

  Unresolved workplace conflict can prevent RTW, so RTW professionals need to know how to recognise the signs and tame the beast!

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• Compensation: More painful than surgery?

  There is a correlation between compensation and poorer surgical outcomes. What can be done?

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• Don't keep doctors dancing in the dark

  Assisting difficult RTW is even harder when the treating practitioner doesn't have all the facts.

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• Riding the see-saw of workers' comp costs

  During recession, claim numbers go down but claim duration goes up. What happens to costs?

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• Workers' comp and recession: Expect a decline in rate of claims

  Unless plant closures and mass lay-offs are planned, workers' comp claim rates tend to decline during recessions, while claim duration increases.

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• Back injuries and communicating with GPs

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• The three Rs of recovery

  The impact of Resilience, Responsibility and Readiness

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• Demystifying emotional intelligence

  EI and its practical application for RTW outcomes

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• Employee engagement

  This month we focus on employee/ claimant engagement.

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• 8 steps for tackling long-term cases - Part 1

  Picking up a long-term case for the first time can seem daunting. Here are a series of steps to help you structure your approach.

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• Litigation in workers' compensation disputes: how we can avoid it

  In the second part of our two-part series on the limitations of litigation in workers' compensation disuputes, we look at what employers can do to avoid it.

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• Litigation in workers' compensation disputes: why we should avoid it

  In the first of our two-part series on the risks and limitations of litigation in workers' compensation disputes, we look at why it should be avoided, and reasons why employees turn to the lawyers.

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• Case discussion - the difficult case that requires integration with claims management

  A case discussion with Andrew Paice of Nabenet and Lucia Tsui of Allianz.

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• The 'what' and 'how' of your workers' comp dispute: Part 2 - the 'how'

  In the second part of a two-part series on preparing for a workers' compensation dispute we look at 'how' you can best put your prepartion into practice

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• The 'what' and 'how' of a workers' comp dispute: Part 1 - the 'what'

  In the first of two articles on how to get the most out of your workers' comp dispute resolution process we take a look at the importance of understanding the 'what'/content of a dispute.

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• The patient's mouth

  Getting the information you need to facilitate RTW shouldn't be as painful as pulling teeth - you just need to ask the right questions...

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• Q&A CONFIDENTIALITY

  Shh! The low-down on confidentiality, return to work and workers' comp.

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• 8 tips for a great relationship - working with the claims manager

  We respond to a Return to Work Coordinator's query about resolving problems between employers and insurers.

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• Discrimination, harassment and RTW

  How can employers avoid real (or perceived) discrimination and harassment during the RTW process?

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• Quick guide: Avoiding litigation

  Don't send yourself--or your worker--to the dogs! Fair in-house systems can keep claims out of court.

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• Juggling RTW and performance issues?

  These practical industry insights will save you from having to grow an extra pair of arms...

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• "Getting back is the best"

  Aged care worker, Donna Taylor, remains positive by taking on an admin role following an injury at work.

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• How to tip the balance AWAY from claims for strains and sprains

  Practical tips for reducing musculoskeletal claims

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• KPI vs care - which is winning?

  A process-driven acrimonious workers' compensation system is a dark place - let's shed some light to turn things around.

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• The Stress Series - Part 4

  Managing a stress claim

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• The Stress Series - Part 2

  Stress claims commonly build up over time, until the person reaches a point where they can't continue to ignore the issues.

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• Quality control in RTW: Spend less, achieve more

  In the case of Mr S, a well managed return to work system saves an employer $$ and provides good outcomes for a worker with anxiety.

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• Burned by poor RTW management

  A badly managed case of staff burnout highlights the importance of an integrated approach to return to work

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• RTW Matters follows the journey of a young secretary forced out of her job by a common health condition.

  In this and subsequent articles on Deanne's case, we learn about her WorkCover journey and hear why both she and her employer is so distressed by the process.

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• Employers can sort out liability issues simply by seeking sensible medical advice

  An admin officer developed acute back pain after several weeks of 'niggling' soreness. Questioning the work relatedness of the back pain doubled the costs.

Archived Articles 1 - 16 of 16

• Webinar Recording: Living in parallel universes.

  Physiotherapists and claims manager's beliefs about treatment for injured workers.

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• What's the opposite of employee-centred case management?

  Rehab is about supporting the employee, leading them in a positive direction, setting goals, engaging, and return to work. Not billable hours.

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• Consider the alternative: Part 9 - South Australia

  In our final article on the use of Alternative Dispute Resolution in Workers' Compensation disputes we take a look at South Australia

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• Consider the alternative: Part 3 - Victoria

  In the latest of our ongoing series on the use of dispute resolution in the context of worker's compensation disputes we take a look at Victoria, and the significant changes that took place last year.

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• Consider the alternative: Part 8 - Northern Territory

  In our ongoing series on the use of dispute resolution processes in the context of workers' compensation disputes, we hear from NT WorkSafe about how things are handled in the top end.

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• Change of name, change of outlook

  WorkCover employee Teegan Jordan explains that the authority's 'rebranding' of its case managers title reflects an improved RTW focus.

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• WorkCover QLD: a new era?

  In the past, the workers' compensation industry has suffered from a lacklustre reputation. Kerri Melkersson of WorkCover QLD convinces us a new era has begun.

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• Consider the alternative: Part 7 - Tasmania

  We speak with Stephen Carey, Chief Commissioner of the Tasmanian Workers Rehabilitation and Compensation Tribunal about the State's recent legislative changes.

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• Consider the alternative: Part 6 - Western Australia

  We speak with WorkCover WA about the current system and big changes on the horizon.

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• Consider the alternative: Part 5 - Queensland

  Q-COMP CEO Elizabeth Woods discusses Queensland's unique 'short-tail' workers' compensation system.

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• Consider the alternative: Part 4 - New South Wales

  We speak with the Registrar of the NSW Workers Compensation Commission Sian Leathem about how the Commission is working, and how it is looking to improve outcomes

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• News drop: Australia Post

  Who said what to the Senate inquiry into Australia Post's injury management practices? And what can be learnt from these grievances aired in public?

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• Inquiry goes postal

  The Senate inquiry into Australia Post should provide important lessons in OHS, HR, RTW and LTIFR

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• RTW Matters summer reading package

  We bring you a collection of our best tips for even better RTW in 2012.

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• Investigating an occupational stress claim? Say goodbye early intervention and hello long term claim!

  All too often, the Process Steamroller pushes stressed employees into the Chasm of Long Term Claims. We talk - seriously - with Dr Rod Gutierrez about the slapstick of occupational stress.

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• Claimants rate Australian insurers' customer service

  What do injured workers want from their insurers? According to the 11th RTW Monitor, a good attitude goes a long way - and Queensland shows us just how far.

Research 1 - 13 of 13

• Victorian Injured Worker Outcomes Study Part 4 — suggestions for improvement to the workers’ compensation system

  It’s the people who have first-hand experience of a service or system that can give the most valuable feedback about what works and what doesn’t. Participants in the Victorian injured worker outcome study tell us what they think.

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• The Victorian Injured Worker Outcomes Study: Part 1 — the impact of IMEs on workers’ recovery

  A Victorian study into the factors that influence longer term workers’ compensation claims found that some ‘events’ in workers’ compensation systems can lead to lengthy claims. One of those key events are independent medical examinations.

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• Case management survey: caseloads, commitment and self-training

  We share results from the 2021 Return to Work Matters Case Management Survey, completed by more than 60 insurance case managers, RTW Coordinators and rehabilitation professionals.

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• You didn't tell me that: Unfair communication and mental health

  More Australian research supports the link between mental health struggles amongst workers' compensation claimants and perceptions that the system is unfair - and suggests that unfairness around the provision of information is reasonably common.

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• Are we taking care of psychiatric nurses?

  Psychiatric nurses who report the most mental health symptoms see more barriers to seeking help than those whose mental health is good. How can organisations better support recovery?

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• Perspective check: Claims leaders versus frontline claims professionals

  Nine takeaways from US research comparing the perspectives of claims leaders to those on the front line.

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• Mirror, mirror

  “Who’s the fairest?” matters to compensation recipients. Researchers find associations between reduced adversarialism, greater perceived fairness and better health.

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• The emotional demands of case management

  Researchers take us to the struggling heart of case management, via focus groups with Australian case managers.

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• For injured workers, are insurers the rock and treaters the hard place?

  Workers view insurer / healthcare provider relationships as adversarial and hamstrung – but they also have clear ideas for improvement…

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• Questioning the impact of compensation stress on health

  What aspects of compensation systems cause stress? How common is it? Does compensation-related stress negatively impact health status? Does predisposition to stress matter?

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• Physical activity at work and low back pain

  Back problems are commonly attributed to work and many in the community believe that heavy lifting contributes to back problems.

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• She'll be right: Under-reporting injury in the workplace

  According to one study, only 52% of work related injury and illness gets reported

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• Predicting and preventing long-term disability

  Recognising the risk factors for long term disability can help employers reduce the compensation burden