The role of a GP in your WorkCover claim
It’s likely that your GP will play an important role in your WorkCover matter if you have been obtaining treatment from them for your work related injury, illness or condition.
Unfortunately, the role of a GP in the Victorian WorkCover process can be confusing for injured workers and for the GP’s themselves.
This page hopefully helps to clarify the role of the GP in WorkCover matters.
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Sometimes medical material is sought from your GP when your initial WorkCover claim is being determined.
The GP may be asked to provide a medical report, and/or a copy of their clinical notes.
Their comments in relation to your injury can be very important in determining whether your claim is accepted or rejected.
Keep in mind that a GP cannot initiate a WorkCover claim on behalf of a person. That needs to be done by the injured person themselves.
Help around the home
If you are unable to perform duties around the home (home help) – such as mowing the lawns or doing the washing – because of a work related injury, in some instances the WorkCover insurer can pay for someone to come to your home and perform those tasks for you.
Typically, however, you will need medical material to support the need and this support often comes from your GP.
The GP can be asked to provide a short letter confirming that you need support around the home, the nature of the support required and to what extent it is required.
Certificates of capacity
If because of the work related injury you can no longer work to the extent that you did prior to the injury, then you may be entitled to claim weekly payments of compensation from the WorkCover insurer.
And in order to claim weekly payments of compensation you’ll need to obtain and submit certificates of capacity to the WorkCover insurer.
In our experience, certificates of capacity are usually completed by a person’s GP.
Certificates of capacity are very important in WorkCover matters.
When a GP (or someone else) completes a certificate of capacity, they need to indicate on the certificate what your work capacity is.
That is, whether you have a capacity for full unrestricted duties, a capacity for modified duties or no capacity for any work.
In order to do this accurately, they need to have an understanding of the nature of your work and how your injury impacts your ability to work.
Whatever they certify you on the certificate will dictate the nature of the work that you will be doing (if at all) for the relevant certification period.
Return to work
If you have been off work for a period of time because of an injury, it’s common for a return to work plan to be drawn up by the occupational rehab provider engaged by the WorkCover insurer.
Your GP may be asked for their opinion and input in relation to the return to work plan.
Again, this is why it is important that your general practitioner has an understanding of the nature of your work and the duties that you are required to perform on a day to day basis.
Your GP will likely be asked to sign off on the return to work plan if it is suitable.
If they wish to suggest changes to the return to work plan they can do so and you should work with your GP in this regard to ensure that any return to work plan is suitable taking into account the nature of your injury and current work restrictions.
Medical material to be used in lump sum claims
Under the WorkCover scheme there are two potential lump sum claims open to a person to pursue.
In relation to obtaining lump sum compensation, the medical opinion of your GP will likely be very important – particularly in relation to common law claims.
Your doctor may be asked to provide a medical report commenting on the the diagnosis of your injury, the prognosis of your injury, and the impact that the injury may have on your work capacity moving forward.
Your doctors opinion in relation to your injury and work capacity moving forward will likely have a bearing on the amount of compensation that you are entitled to by way of loss of earnings.
It could also be important in determining whether you are entitled to claim compensation for loss of earnings at all.
Being someone to talk to
Having a WorkCover claim on foot can be difficult for many people.
There’s the stress of having to deal with the WorkCover insurer, perhaps not being able to work, concerns regarding income, and the uncertainties regarding how an injury may impact things moving forward.
Having a GP that you can talk to who is understanding and who has an understanding of the WorkCover system can assist by simply being someone you’re able to talk to.
Can I choose my own GP if I have a WorkCover claim?
Yes, you can.
And this is the case not only for your GP – but all medical and health providers when you have a WorkCover claim.
Keep in mind however that the experience some doctors have had varies in comparison to others. And some doctors don’t look after patients who have WorkCover matters (unfortunately).
A person’s GP will often play a crucial role in their WorkCover matter.
They are often the first person that a person speaks to regarding a WorkCover claim and the GP will usually have an ongoing involvement in a persons claim.
The GP will be responsible in many cases for providing certificates of capacity and assisting a person to return to work and stay at work.
Their opinion in relation to the diagnosis, prognosis and the impact of an injury on your work capacity will likely be important when it comes to claiming lump sum compensation.
The GP is also able to assist in a number of other ways such as assisting with requests for home help and gardening services, prescribing medication, and simply being someone that an injured worker is able to talk to from time to time.