Policy Directive

14 Pages·2016·0.36 MB·English

Policy

P olicy Directive: compliance is
mandatory
Management of Work Related Injury/Illness (WHSIM)
Policy Directive

Objective file number: 2015 - 07171
Document classification: For Official Use Only – I2- A2
Document developed by: Workforce Health, People and Culture
Approved at Portfolio Executive: 23 December 2015
Next review due: 31 December 2018

Summary The Management of Work Related Injury/Illness (WHSIM) Policy
Directive provides guidance in the implementation of a systematic
and consistent approach to the management of work related
injury/illness, ensuring compliance with the Return to Work Act
2014 (SA) and its regulations.
Keywords Injury Management, WHSIM, Work Health and Safety, workers
compensation, claim, rehabilitation, return to work, Management of
Work Related Injury/Illness (WHSIM) Policy Directive
Policy history Is this a new policy? N
Does this policy amend or update an existing policy? Y
Does this policy replace an existing policy? Y
If so, which policies?
Management of Work Injured Employees (WHS) Policy Directive

Applies to All SA Health Portfolio

Staff impacted All Staff, Management, Admin, Students; Volunteers

EPAS compatible NA

Registered with Divisional Policy Yes
Contact Officer
Policy doc reference no. D0325

Version control and change history
Version Date from Date to Amendment
1.0 28/05/ 2013 31/08/2016 Original version
2.0 23/12/2015 current Reviewed to align with the new Return to
Work Act 2014 (SA)

© Department for Health and Ageing, Government of South Australia. All rights reserved.
Management of Work

Related Injury / Illness
(WHSIM)
Policy Directive
Document control information

Executive Director , People and Culture, Workforce, System Performance
Document owner
and Service Delivery, SA Health
Manager, Workforce Health
Contributors Injury Management Strategist, Workforce Health
Return to Work and Job seeking Consultant, Workforce Health
Document Classification For Official Use Only I2-A2
SA Health internet – ‘policies page’

Document location
SA Health intranet only – ‘policies page’ (only if publishing exemption
requested and approved by Portfolio Executive)
2015 – 07171
Reference
D0325
Valid from 23 December 2015
Anticipated Date of Review 31 December 2018

Document history

Date Version Who approved New/Revised Version Reason for Change
Reviewed to align with the new
23/12/2015 V.2 Portfolio Executive
Return to Work Act 2014 (SA)
21/08/2013 V.1 Portfolio Executive PE Approved version.

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Contents Page

1. Objective .............................................................................................................................. 4
2. Scope ................................................................................................................................... 4
3. Principles .............................................................................................................................. 4
4. Detail .................................................................................................................................... 5
5. Roles and Responsibilities ................................................................................................... 6
6. Reporting ............................................................................................................................ 11
7. EPAS .................................................................................................................................. 11
8. Exemption .......................................................................................................................... 12
9. National Safety and Quality Health Service Standards ..................................................... 12
10. Risk Management .............................................................................................................. 12
11. Evaluation .......................................................................................................................... 12
12. Definitions .......................................................................................................................... 13
13. Associated Policy Directives / Policy Guidelines ............................................................... 13
14. References, Resources and Related Documents.............................................................. 13

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Management of Work Related
Injury/Illness (WHSIM) Policy Directive

1. Objective

SA Health values its workforce and recognises the potential risks associated with workers’
compensation claims management and of protracted recovery from work related injury or
illness. SA Health is committed to meeting its requirements to comply with the Return to
Work Act 2014, SA, (RTW Act), its regulations, and the SA Public Sector Code of Practice
for Crown Self-Insured Employers and ensure a consistent approach with government
policy.

This policy directive supports the development, implementation and maintenance of an
effective Work Health Safety and Injury Management system that:
• ensures the continual improvement of injury management services, involving the
regular review and auditing of all systems and processes for effectiveness and
accountability;
• facilitates and enables the provision of consistent, equitable, effective, appropriate
and early injury management intervention which rehabilitates, compensates and
retains / returns injured workers to a safe workplace and community;
• recognises partnerships and shared responsibilities for injury management and
injury management outcomes through an inclusive and consultative approach with
the worker, management, Injury Management and treatment providers; and
• achieves the best practice levels of physical and mental recovery.

2. Scope

This policy applies to all SA Health workers, who are paid directly by SA Health, at any
work location. The Management of Work Related Injury/Illness (WHSIM) Policy Directive
must be read in conjunction with the Management of Work Related Injury/Illness (WHSIM)
Procedure.

The management of non-work related disability or medical incapacity of SA Health
workers is not covered by this policy directive.

3. Principles

SA Health will establish and maintain an Injury Management program compliant with
legislative and self-insurer standard requirements, addressing the following principles of
injury management:
• Provision of a respectful, timely and fair Injury Management service delivered with
integrity and courtesy to workers who have suffered an injury or illness in the
course of their employment with SA Health
• A focus on retention at work, or early safe, sustainable return to work to a
worker’s substantive position and roster, or to the contracted position the worker
was occupying at the time of injury as a primary goal
• Active identification and resolution to workplace barriers preventing recovery and
return to work that is swift, effective and without prejudice
• Confidentiality and privacy is integral to the injury management process
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• Managers and supervisors fulfil their obligations in the provision of a coordinated,
timely and safe return to work of injured workers which benefits the workers
recovery process
• Active assistance and participation of the worker and all senior managers and line
managers in the resolution of workers compensation claims with the focus on
maintaining relationships
• Injured workers are aware of identified avenues for feedback or complaints
• A multi-disciplinary approach to management of work injuries, utilising the
expertise of all key persons involved to assist in the identification and resolution of
issues during the return to work process through the provision of clear, accurate
and complete information
• Best practice through continuous improvement of systems using performance
indicators, benchmarking and auditing as evaluation tools.

4. Detail

SA Health will, as far as reasonably practicable:
4.1 Effectively risk assess and plan for Injury Management with defined goals,
objectives and planned outcomes that are measured through the establishment of
performance indicators and provide a means for systems review and
improvement.
4.2 Establish targeted strategies aimed to reduce workers compensation costs,
increase safe, sustainable return to work and reduce rates of injury / illness
4.3 Develop and maintain related procedures ensuring that responsibilities and
accountabilities are clearly defined.
4.4 Establish and maintain appropriate governance mechanisms to ensure active
executive and senior management review, including:
• undertaking and utilising analysed injury management data and identified
trends / high risk areas to strategize and plan appropriate action,
• facilitating improvements in workplace safety and injury management
outcomes.
4.5 Establish, promote and maintain effective mechanisms for early reporting and
notification of a work injury to initiate a rapid and appropriate response and the
assessment for the need for recovery and return to work services.
4.6 Ensure all work related injuries are reported in accordance with SA Health and
local procedures.
4.7 Provide prompt action and early intervention following notification of any work
injury, including the early development of Recovery/Return to Work plans for
injured workers through consultation with relevant parties.
4.8 If a claim determination (i.e. acceptance or rejection) cannot be made within 10
business days of receipt of the claim for compensation form by Injury
Management, interim benefits are to be offered whilst the claim is being assessed.
4.9 Promptly determine the return to work goal post injury, and establish a process for
retraining where applicable, and job seeking for injured workers who are not able
to return to their substantive position, where necessary.
4.10 Deliver injury management services with integrity and transparency of process,
and in a confidential manner.
4.11 Ensure the active assistance and participation of all senior managers, line
managers and affected workers in the resolution of workers compensation claims,
the recovery and return to work process and the provision of suitable work duties/
employment.
4.12 Ensure the equitable management of workers compensation claims, in accordance
with the Return to Work Act, 2014 (SA) and the Regulations, undertaking prompt
investigation and determination of claims.
4.13 Maintain effective processes for consultation and dispute/complaints resolution in
injury management matters.
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4.14 Ensure confidentiality is understood and maintained by all parties through limiting
information flow in accordance with legislation and by effective safe and secure
handling and storage of injury management files, including electronic data.
4.15 Provide information, training and instruction to managers and supervisors and
those with key Injury Management responsibilities about the injury management
process and the rights and responsibilities of all staff in the management of a work
injury.
4.16 Provide information and instruction to injured workers in the injury management
process that includes their rights and responsibilities with regard to a workers
compensation claim, and the right to be supported by another person and to be
represented by a union, advocate or lawyer.
4.17 Ensure financial accountability is imbedded into injury management activities and
processes, such as appropriate use of financial delegations, reconciliation
activities and cost effective recovery and return to work and claims management.

5. Roles and Responsibilities

In accordance with SA Health Policy Directive – Roles, Responsibilities and Governance
(WHS), the following outlines the respective roles of relevant parties in the context of this
Policy Directive:

5.1 Chief Executive

Will take reasonably practicable steps to:
• Exercise due diligence to ensure compliance with the intent of this Policy
Directive
• Support the implementation of the SA Health WHSIM system
• Be accountable for the SA Health WHSIM System
• Provide direction to ensure that work injured job seekers are supported and
placed in suitable funded roles, wherever possible
• Establish awareness and accountability for the implementation of this policy
• Provide resources for the SA Health WHSIM system
• Delegate responsibility for the day to day running of the SA Health WHSIM
system

5.2 Deputy Chief Executive

Will take reasonably practicable steps to:
• Exercise due diligence to ensure compliance with the intent of this Policy
Directive
• Support the implementation of the SA Health WHSIM system
• Provide direction to ensure that work injured job seekers are supported and
placed in suitable funded roles, wherever possible
• Establish awareness and accountability for the implementation of this policy
• Provide resources for the SA Health WHSIM system

5.3 Chief Executive Officers / Chief Operating Officers / Executive Directors

Will take reasonably practicable steps to:
• Exercise due diligence to ensure compliance with the intent of this Policy
Directive
• Support the implementation of the SA Health WHSIM system
• Provide direction to ensure that work injured job seekers are supported and
placed in suitable funded roles, wherever possible
• Ensure line management accountability for roles and responsibilities concerning
the management of a worker who suffers an injury at work and address
performance concerns
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• Assess and analyse injury management data to identify areas of concerns within
the LHN / HS / BU
• Actively promote injury management throughout the LHN / HS / BU.

5.4 Directors (Clinical, Medical, Nursing, Allied Health and Other) and
General Managers / Site Managers

Will take reasonably practicable steps to:
• Where relevant, exercise due diligence to ensure compliance with the intent of
this Policy Directive
• Ensure line management accountability for roles and responsibilities concerning
the management of a worker who suffers an injury at work
• Provide direction to ensure that work injured job seekers are supported and
placed in suitable funded roles, wherever possible
• Fulfil the role responsibility of Line Managers, where required.

5.5 Line Managers

Will take reasonable care to:
• Where relevant, exercise due diligence to ensure compliance with the intent of this
Policy Directive
• Ensure the safety of the workers following reports of work related injury, including
requirement for first aid and addressing a safe work environment / practice
• Ensure any work injury is recorded and managed through the SA Health 1800 or
SAAS 1300 Notification of Work Injury phone number in accordance with the SA
Health / SAAS Notification of Work Injury process
• Ensure any work incidents are recorded using the SA Health Work Health and
Safety Learning System (WHS SLS), or for SAAS who are required to report in
accordance with their designated WHS system using the Incident Report and
Quick Assessment (IRQA) Form.
• Ensure mandatory training requirements are met in their area
• Proactively identify and resolve barriers within the workplace to accomplish safe,
sustainable return to work for workers who have suffered an injury at work,
including the identification and provision of suitable modified and/or alternate
duties when requested
• Support workers who have sustained a work injury through the injury management
process, including early return to work and maintenance of normal rosters and
hours
• Support retraining and skill development opportunities for work injured job seekers
to assist in gaining suitable funded roles
• Actively participate in all return to work meetings and report any issues with return
to work to the assigned Return to Work Consultant as soon as possible.

5.6 Injured Workers

Will take reasonable care to:
• Report work injuries to their line manager / supervisor as soon as they become
aware of the injury / illness, and where reasonably practicable on the same day /
same shift that the injury occurs, following the process for Notification of Work
Injury (refer to WHSIM procedure – Reporting and Investigation WHS Hazards and
Incidents)
• Report any work incidents using the SA Health Work Health and Safety Learning
System (WHS SLS), or for SAAS who are required to report in accordance with
their designated WHS system using the Incident Report and Quick Assessment
(IRQA) Form
• Seek medical treatment as soon as practicable, where required
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• If the injured worker makes a claim for compensation, they must provide a Work
Capacity Certificate relevant to the injury claimed and for the period of incapacity,
and complete the ReturnToWorkSA Claim form
• Comply with all reasonable instructions from Managers and Injury Management
personnel pertaining to a return to work following a work injury in accordance with
the RTW Act 2014, SA.
• Report any issues or concerns as soon as possible to the line managers and
Return to Work Consultant or WHSIM Manager.

5.7 Executive Director, People and Culture

Will take reasonably practicable steps to:
• Exercise due diligence to ensure compliance with the intent of this Policy Directive
• Represent the interest of SA Health WHSIM system both within SA Health, the
wider SA Government and to relevant external parties
• Monitor the WHSIM system performance for SA Health
• Review and where appropriate approve lump sum payments as submitted through
the Injury Management Strategist and the Manager Workforce Health, SA Health,
in accordance with approved financial delegations.

5.8 LHN / HS Directors of Workforce / Manager Workforce Operations

Will take reasonably practicable steps to:
• Exercise due diligence to ensure compliance with the intent of this Policy Directive
• Establish and maintain effective business partnerships within the LHN / HS / BU to
support Injury Management Governance and Consultation and to facilitate
effective injury management practice and improved performance.
• Ensure Injury Management performance indicators and audit report outcomes are
included in LHN / HS / BU WHSIM Due Diligence reports.
• Ensure the requirements and objectives of the WHSIM system are communicated
and understood within the LHN / HS / BU
• Ensure the provision of multi-disciplinary professional expertise to facilitate prompt
and effective injury management (recovery and return to work and claims
management) service as required
• Ensure the implementation of the SA Health WHSIM system, strategies and
monitoring functions for reporting purposes at the LHN / HS / BU
• Ensure Injury Management staff are provided with and informed of appropriate
financial delegation to undertake their duties
• Ensure that the practice of workers compensation reconciliation is occurring at
each LHN / HS / BU
• Assist in the development of financial and other injury management targets for the
LHN / HS.

5.9 Manager, Workforce Health

Will take reasonably practicable steps to:
• Exercise due diligence, where relevant to ensure compliance with the intent of this
Policy Directive
• Through a consultative process across SA Health, ensure the establishment,
review, monitoring and improvement of the SA Health WHSIM system and ensure
the system framework and associated documentation is communicated to the LHN
/ HS / BU
• Through a consultative process across SA Health, ensure the establishment of the
strategic Workforce Health plan for SA Health
• Ensure the establishment of the SA Health level WHSIM monitoring functions for
reporting purposes
• Ensure provision of timely analysed reports to LHN / HS / BU
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• Gather data and conduct practice improvement to refine and improve the SA
Health WHSIM system
• Ensure the SA Health WHSIM system complies with Building Safety Excellence in
the Public Sector 2015-2020, SA Government, SA Health and ReturnToWork SA
requirements.
• Coordinate consistent financial delegations across SA Health for Injury
Management
• Ensure that the practice of workers compensation reconciliation for lump sum
payments is undertaken monthly
• Review and where appropriate approve lump sum payments as submitted through
the Injury Management Strategist, in accordance with approved financial
delegations.

5.10 Injury Management Strategist

Will take reasonable care to:
• Provide a strategic review of the injury management components of the WHSIM
system and other management related projects
• Build effective partnerships with the LHN / HS / BU and liaise with all interested
parties to promote awareness and accountability of the WHSIM system
• Receive and forward any injury management issues to appropriate parties for
resolution
• Provide support and guidance for Injury Management personnel, where required
• Gather data and conduct practice improvement to refine and improve the SA
Health WHSIM system
• Establish and maintain data integrity standards within WHSIM
• Review and where appropriate approve / recommend approval of lump sum
payments as submitted through by LHN / HS based Claims personnel, in
accordance with approved financial delegations.
• Facilitate reconciliation of lump sum payments through provision of activity reports
to LHN / HS based finance personnel via DHA financial accounting on a monthly
basis.
5.11 The Return to Work and Job Seeking Consultant

Will take reasonable care to:
• Provide a prompt, comprehensive and efficient return to work and job seeking
advisory service to SA Health which meets legislative requirements
• Monitor job seeking cases and works in partnership with Return to Work
Consultants to achieve job seeking intervention
• Assist the Injury Management Strategist to develop professional support and
training sessions aimed at building capability of the Return to Work workforce and
contribute to the planning, policy and procedure development and review.

5.12 LHN / HS / BU WHSIM Manager

Will take reasonable care to:
• Ensure the delivery and monitoring of the recovery and return to work and claim
management service to the LHN / HS / BU
• Review and provision of analytical reports to LHN / HS
• Establish and maintain care pathways and implement early return to work
strategies including job seeking for injured workers, as required
• Promote the strategies and outcomes of the WHSIM system within the LHN / HS /
BU by attendance at LHN / HS / BU guided meetings and committees.
• Review and report on injury management trends and analysis, performance
against key performance indicators and cost saving strategies for each LHN / HS /
BU
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