The WorkCover return to work obligations
The WorkCover return to work obligations are a list of requirements you need to reasonably follow to ensure your weekly payments are not suspended or terminated.
If you are off work because of an injury and you have an accepted WorkCover claim, the ‘return to work obligations’ apply to you.
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The return to work obligations for an injured worker are:
Both injured workers and employers have obligations with regard to returning an injured person to work.
Your obligations, as the injured worker with regard to returning to work are outlined by the insurer as follows:
Our suggestions in relation to the return to work obligations
Here are our suggestions in relation to the return to work obligations referred to above.
You can have input into your return to work
Some people might feel like they’re being forced to return to work before they’re ready, perhaps to do work that isn’t appropriate given their injury, or retrain in a role that they have no interest or experience in.
You are able to have your input into any potential return to work – either with your injury employer or a new employer.
This applies also to any proposed retraining.
Don’t feel as though you have no say in relation to the return to work process.
Yes, there are obligations you need to meet when it comes to the return to work process.
But if you don’t feel comfortable with something that is being suggested, or you feel like you’re being pushed around by the occupational rehabilitation provider for example, you can have input into the process. If you need assistance, engage a WorkCover lawyer.
If you’re unfit for all duties
If you have no capacity at all (your doctor is certifying you as unfit for all duties), there is still a requirement that you meet the above obligations.
This doesn’t mean that you’ll be forced to go back to work or apply for jobs before you’re ready.
But there’s still a requirement, for example, that you participate in assessments of your capacity.
So even if you’re not able to return to work at a particular time, you should ensure to keep the return to work obligations in mind because they continue to apply to you.
That leads to the next suggestion:
Work with your doctor
When it comes to the return to work obligations and a return to work, your treating doctor/s (and health practitioners) are important.
It’s important your the people that are providing medical treating to you understand the work you do. This means that they need to understand your work duties and tasks.
They need to understand what’s required of you at work.
And if a return to work plan is proposed, your doctor should understand what it is you’re being asked to do.
And what impact the return to work may have on your injuries.
Any return to work plan should be signed off by one of your treating doctors, so it’s important that they understand what they’re signing off on.
If you think modifications need to be made to a return to work plan for example, ensure to discuss these modifications with your doctor.
Your certificates should reflect your work capacity
This is critical when you’re under the WorkCover system.
Your WorkCover certificates should reflect what your work capacity actually is.
As mentioned above, your doctor needs to understand the nature of the work you do and your work duties so they can accurately certify you.
If you don’t agree with what your doctor is certifying you, discuss this with the doctor. Explain to them what your concerns are.
Don’t aggravate your injury
If you return to work and feel as though the work you’re being asked to do is or could aggravate your injury, you should speak to your doctor.
In some cases, they’ll provide an injured worker with an amended certificate of capacity, and they can correspond with the insurer for you.
Or if you have a lawyer speak to them about the issue and ask them to assist.
You’ll notice that the word reasonable is referred to a number of times.
For example, you need to make ‘reasonable efforts’ to return to work.
What is reasonable depends upon the circumstances of each matter.
Just remember, you can say no to things when it comes to the return to work obligations. You don’t have to go along with everything that the occupational rehabilitation provider, insurer or employer say.
If you’re not sure where you stand or what to do, speak to your WorkCover lawyer.
What happens if you don’t meet your return to work obligations?
If the insurer feels as though you aren’t meeting your return to work obligations, in that you are not making reasonable efforts to get back to work for example, typically what they do is this:
Remind you that you have return to work obligations to meet and if you don’t meet those obligations they may terminate your entitlement to weekly payments.
You should receive a written notice that outlines why they feel you’re not complying with your return to work obligations and what you need to do.
If you disagree with what they say, you can ask them to perform an internal review or you can lodge a request for conciliation.
If you don’t have a WorkCover lawyer at this point, given the importance of weekly payments it might be a good idea to consider engaging one.
If after this the insurer still feels you aren’t meeting your return to work obligations they can pause your weekly payments for a period of time.
If you don’t address what they believe the breach is within the time frame that is specified in their notice, they may terminate your entitlement to payments.
What if you disagree with the insurer’s notice/s and decision/s?
You can contest the insurers decision to pause or terminate your entitlement to weekly payments.
Given the importance of weekly payments, we’d recommend initiating an internal review and at the same time, initiating conciliation.
Conciliation can take several weeks before the matter is reached so we’d recommend lodgement of a conciliation request as soon as possible.
It’s not a bad idea to initiate a conciliation request initially when you receive the warning from the insurer that you’re not complying. Even if you withdraw the conciliation at a later time, it’s a good idea to lodge early and get time ticking to avoid any possible delay.
You’ll read elsewhere that you only have 60 days to initiate a conciliation.
While it is preferable to do so, you can initiate a conciliation well outside 60 days. You will just need to provide reasons as to the delay. Sometimes that reason might be “I wasn’t sure what to do.”
The WorkCover return to work obligations are a set of guidelines that outline what you need to do as an injured worker with regard to returning to work – either with the employer you suffered injury with or a new employer.
If the insurer feels as though you’re not meeting your obligations to return to work, they should let you know. If they feel as though you continue to not meet your return to work obligations, they can pause and then terminate your entitlement to weekly payments.