blog

Stress Claims – How common are they and have they become more common?

November 28, 2016

Mental stress has accounted for an average of 95% of mental disorder claims over the past 10 years.

 

SafeWork Australia produced a report about this in April 2013.

 

Their findings were:

Mental stress claims are the most expensive form of workers’ compensation

claims because of the often lengthy periods of absence from work typical of

these claims.

>> Mental stress claims are predominantly made by women.

>> Men and women are more likely to make a claim for mental stress as they

get older but after they reach 54 years the likelihood that they made a claim

decreases.

>> More Professionals made claims for mental stress than other any other

occupation with over a third of their claims made for Work pressure.

>> There were more mental stress claims made for Work pressure than any

other sub-category.

>> The hazards that result in mental stress claims vary with worker age.

Younger workers are more likely to make claims as a result of Exposure to

workplace or occupational violence, whereas Work pressure is the main

cause of mental stress claims for older workers, peaking for those aged

45–49 years.

>> General clerks, School teachers and Police Officers accounted for the

majority of claims for Work pressure.

>> Women were around three times more likely than men to make a workers’

compensation claim due to Work-related harassment &/or workplace

bullying. Approximately one-third of all claims in this mental stress subcategory

were made by workers in the occupational categories of Advanced

clerical & service workers and General clerks.

>> For the industries with the highest number/rate of mental stress claims, the

majority of claims were for Work pressure. This was particularly true in the

Education sector. Claims for Exposure to workplace or occupational violence

were notable in the Retail trade industry, while the Transport & storage and

Health & community services industries dominated claims for Exposure to a

traumatic event.

 

WorkSafe Australia produced a further report in 2015 – Work-Related Mental Disorders profile

 

Their findings were that 6% of all workers compensation claims were for mental disorders .

 

The typical compensation payment for such a claim was $23,600 totalling $480 million for the 7820 Australian claimants. The average period of time spent off work was 14.8 weeks. 39% of these claims were for harassment/bullying/exposure to violence. 90% of all mental disorder claims were attributed to stress.

 

65% of all mental disorder claims were awarded to workers aged 40 or over.

 

For 1 million hours of work there were 0.5 mental disorder claims.

 

Occupations most at risk:

First responders-police, paramedics and firefighters comprising one in five of this group

welfare and community workers affirm one in 10 were compensated, prison officers, bus and rail drivers and teachers of whom one in five were compensated.

 

The more common conditions included reactions to stressors (41%), anxiety/stress disorders (28%) and post traumatic stress disorder (11%). Combined they accounted for, on average, about 4/5 mental disorder claims over the period.

 

The most up-to-date statistics are those provided by WorkSafe Western Australia in October 2016.

 

Their findings were that: Over four years, the number of stress-related claims increased by 25 per cent.  In 2015/16, there were 547 stress-related claims lodged,  representing

3.2 per cent of all workers’ compensation lost-time claims.

 

Although the number of stress-related claims increased, the frequency rate (claims per million hours worked) for stress-related claims is stable.

 

Females accounted for 59 per cent of stress-related claims compared with 41 per cent for males.

In terms of prevalence of stress claims, female workers tend to have a higher frequency rate.

The top three industries for stress-related claims were:

 

Health care and social assistance           25%

public administration and safety            24%

education and training                               16%

 

The causes of stress and later claims included:

 

Work pressure                                              39%

Harassment and bullying                           23%

exposure to a traumatic event                               19%

exposure to workplace violence            14%

other causes                                                  5%

 

There appears to be a significant drop in the number of stress-related claims in WA representing 3.2% of all workers compensation lost time claims, the WorkSafe Australia statistics were that 6% of all claims were stress-related. In Victoria in the late 1990s about 5.5% of all claims were stress-related. There appears to have been little real change in the incidence of stress-related disorders over the last 20 years.

Workers’ compensation guidelines for medical practitioners

November 24, 2016

I have downloaded all the permanent impairment guidelines I can find in Publications, look in Guidelines Workers Compensation

Read it and weep – WA fee schedule for Specialist WorkCover Panel

Examination and provision of report and certificate — psychiatric — complex assessment (eg. reviewing significant documented prior psychiatric history) $3554.35 or $3863.35 (minus fee for intrpreter.  Think about what you get paid.

Victorian ombudsman damning of work safe agents and some IMEs

September 20, 2016

The Victorian Ombudsman has released a report regarding an “Investigation into the management of complex workers compensation claims and WorkSafe oversight”

 

This report is very critical of practices of WorkCover agent’s particularly with regard to doctor shopping and is unsparing in its criticism of certain IMEs in particular with regard to their bias and poor quality reports. The report is a damning with regard to actions taken by work safe about IME reports that are inadequate. Based on the reports the following recommendations relevant to psychiatrist were made. A copy of the full report is available in publications and a summary is also available.

 

Recommendation 14

Implement changes to the current IME system to:

  1. prevent agents from selectively using ‘preferred IMEs’ or
  2. provide injured workers a choice of the IME with the appropriate speciality, by whom they are examined.

Recommendation  15

Amend its IME complaint handling policy to provide scope for examination of complaints where a worker does not provide consent for the complaint to be provided to the IME, which may include the referral of the matters raised to the IME quality assurance division for intelligence gathering purposes.

 

Recommendation 16

Amend the IME quality assurance process to:

  1. ensure IMEs subject to a high number of complaints are peer reviewed
  2. document the process by which WorkSafe will review an individual claim file where significant deficiencies are identified in relation to an IME’s report, to ensure a worker’s entitlements have not been unreasonably rejected or terminated based on the

Revalidation, new CPD requirements and Lewis Carroll

August 25, 2016

I have written a draft submission to the Medical Board of Australia expressing significant concerns about revalidation.  The one area I have not included is probably the most important: What is the problem? Where is the evidence this complicated process is required? Is it just more Nanny state bullshit because the profession cannot be trusted?

These are the recommendations of thew Medical Board Expert Advisory Group. They are also present in the revised CPD program of the RANZCP

The recommendations include:

  •  maintaining and enhancing the performance of all doctors practising in Australia through efficient, effective, contemporary, evidence-based continuing professional development (CPD) relevant to their scope of practice (‘ strengthened CPD’), and
  •  proactively identify doctors at-risk of poor performance and those who are already performing poorly, assessing their performance and when appropriate supporting the remediation of their practice.
  •  The Expert Advisory Group (EAG) proposes that medical practitioners in Australia should participate in three core types of CPD, with activities prioritised to strengthen individual performance. A summary is provided of the core types of CPD.
  1. Undertaking educational activities:
    1. lectures
    2. conferences
    3. Reading
    4. research
    5. supervision
    6. workshops
    7. grand rounds
    8. online learning

 Reviewing performance:

    • peer review of performance
    • peer-review of medical records
    • peer discussions of cases, critical incidents, safety and quality events
    • multisource feedback from peers, medical colleagues, co-workers, patients, other health practitioners.

 

  1. Measuring outcomes
  1. clinical audit
  2. review of medical records
  3. mortality and morbidity reviews
  4. clinical indicators
  5. comparison of individual data with local, institutional, regional datasets
  6. review of individual and comparative data from de-identified large datasets e.g. Medicare, PBS

The problem is that this is a generic list that does not fit some groups. The people who do medicolegal work measuring outcomes is meaningless. All of the third component has no relevance. Reviewing performances is also problematical particularly multisource feedback from peers, medical colleagues, co-workers, patient, other health practitioners. How on earth do we do that.

Similarly peer-reviewed medical records. We have no medical records we have reports. The reports are assessed by the various statutory schemes and by lawyers and ultimately attested in court. There is no recognition of that. Peer review is something that we do anyway but again there are no medical records so how can there be peer review of medical records other than peer review of reports. Most of us read many reports from our colleagues and sometimes give feedback with regard to these. We also have peer discussion of cases but we don’t have to deal with critical incidents.

I urge you to make your views known if you agree with this analysis.

The onerous provisions of the Victorian Transport Accident Act have been removed!

The Transport Accident Amendment Act 2016 was enacted in mid April 2016 (see effect of changes). The Act reverses the provisions enacted in the Transport Accident Amendment Act 2013 that limited the right of families of people who die or are severely injured in transport accidents to seek compensation for psychological injury.

The requirement that claimants with psychiatric injuries needed to seek treatment for three years before they can bring a serious injury claim has also been reversed. It did not recognise that many people suffering from mental illness find it difficult to reach out for assistance. Furthermore, it was especially difficult for claimants living in rural areas who may have limited access to mental health services.

This is a victory for common sense

Another flank attack!

August 16, 2016

The Victorian ombudsman has taken it upon herself to have an enquiry into the use of Independent medical examiners by WorkCover agents. We have had significant concerns about potential outcomes. In particular one of our members has been targeted by the ombudsman with the possibility of a recommendation that he no longer see WorkCover claimants. In an interesting denial of natural justice he has had no opportunity so far to respond to allegations made by a disgruntled claimant. In general however the focus of the investigation is on the agents rather than on Independent medical examiners. Nevertheless the Victorian Branch of the faculty of forensic psychiatry thought it would be useful to make a submission to the Ombudsman explaining our obligations including the College code of ethics, guidelines for medicolegal examinations, the WorkCover handbook for medicolegal assessment and legal requirements of expert witnesses. You can see a copy of the submission here

Independent medical examiners exert a negative influence on the therapeutic relationship between workers and healthcare providers (a recent study that is a blinding glimpse of the obvious)

July 28, 2016

This review funded by the ISCRR demonstrates that in many instances, injured workers with long-term complex injuries experience difficulties when receiving health services in the context of workers’ compensation systems. Independent medical examiners were a source of contention for both injured workers and healthcare providers (HCP), and likely exert a negative influence on the therapeutic relationship. Healthcare providers experience problematic interactions with insurers, and injured workers bear the brunt of healthcare providers’ frustration as some HCP’s offer poorer quality service or refuse to treat compensable clients as a result.

Supportive patient-centred interaction with HCP’s who have high job satisfaction is important for injured worker recovery. Reduction of organisational pressures and improving communication between insurers and service providers could result in increased job satisfaction for HCP’s and ensure that providers are more amenable to operating in compensation systems. Improved HCP participation and job satisfaction will more than likely have a corresponding positive influence on injured workers’ recovery and return to work.

List of participants First Mental Health Reform Stakeholder Group Meeting 22 February 2016

April 29, 2016

By my count there were:

2 psychiatrists

1 psychologist

1 GP

1 mental health nurse

1 carer rep

1 consumer rep

4 mental health bodies

6 bureaucrats

At the meeting, this diverse range of stakeholders raised a multitude of views and concerns, particularly the lack of mental health consumer and carer input into private health network.

Adjunct Assoc. Prof. Kim Ryan CEO, Australian College of Mental Health Nurses
Professor Malcolm Hopwood President, RANZCP
Professor Lyn Littlefield Executive Director, Australian Psychological Society
Professor Morton Rawlin Vice President, Royal Australian College of General Practitioners
Dr Bill Pring Private Mental Health Alliance (PMHA), AMA Observer
Mr Frank Quinlan CEO, Mental Health Australia
Ms Georgie Harman CEO, Beyondblue
Ms Sue Murray CEO, Suicide Prevention Australia
Ms Marita Cowie CEO, Australian College of Rural & Remote Medicine
Mr David Meldrum Executive Director, Mental Illness Fellowship of Australia
Mr David Butt CEO, National Mental Health Commission
Ms Janet Meagher Consumer representative
National Mental Health Consumer and Carer Forum
Ms Eileen McDonald Carer representative
National Mental Health Consumer and Carer Forum
Mr Stephen Brand Senior Manager, Policy & Advocacy
Australian Association of Social Workers
Professor Tom Calma Advisor
Australian Government Department of Health
Ms Natasha Cole (Chair) First Assistant Secretary, Health Services Division
Australian Government Department of Health
Ms Colleen Krestensen Assistant Secretary, Mental Health Reform Taskforce
Australian Government Department of Health
Dr Anthony Millgate Assistant Secretary, Mental Health Services Branch
Australian Government Department of Health
Ms Emma Gleeson Acting Assistant Secretary,
Mental Health Early Intervention Branch
Australian Government Department of Health

 

 

Familiar complaints about the health complaint bodies

AMA Psychiatry Newsletter April 2016; AMA Qld submission to the Office of the Health Ombudsman

The Office of the Health Ombudsman (OHO) was established by the Queensland Government in 2013 to strengthen the health complaints management system. It replaced the Health Quality and Complaints Commission (HQCC), an organisation that had been criticised for fundamental deficiencies in the way it handled complaints, as well as unjustified delays in dealing with complaints against medical practitioners. Plus ca change plus la meme chose!

 Highlights: 

  1. The absence of medical practitioner leadership and guidance
  2. Suspension of natural justice and procedural fairness in Investigations ; the approach of the OHO is unnecessarily antagonistic
  3. Unreasonably prolonged complaints resolution time (, even where the matter is trivial or vexatious); mandated time frames not followed with no explanation.
  4. Health Ombudsman weakening the national system
  5. The OHO, as it currently operates, creates differing standards and thresholds between itself and the Medical Board of Australia. Thus less consistency of decisions, poor data comparability, reduced confidence of medical practitioners and patients in the decisions of both bodies.

Medical Board of Australia Newsletter April 2016 – Improving the Notification Process?

April 28, 2016

I have written previously about the problems forensic psychiatrists have had with vexatious notifications to the Medical Board. Two of our colleagues had had four notifications each, three of them had been shown to have no merit but it appeared that four notifications required action and so the two psychiatrist had a practice visit from two other psychiatrist over a period of a day. I thought this was questionable with regard to ethical practice in particular the psychiatrist roared through all the medical records not just those to do with the notifications and apparently sat in on one or two interviews.

Complaints were made to the Medical Board of Victoria by our representatives and as you will see there has been dialogue with the AMA. Some information about this was provided in the April newsletter of the Medical Board of Australia. (See below)

Improving the notification process

Continuing our work on a fair and timely process

Senior leaders from the Board, AHPRA and the AMA met in February 2016 to look at ways in which doctors’ experience can be improved when a notification is made about them. This was the second workshop with the AMA about this. The first workshop was held 12 months ago.

There was positive feedback about changes we have made in the last 12 months to improve the experience of doctors involved in the regulatory process. Improvements include:

  • significantly reduced time frames for assessing matters. This means that low risk notifications can be resolved and high risk notifications can be investigated more quickly
  • development of a decision matrix with the health complaints entities (HCEs) we work with in each state and territory to better steer complaints and notifications to the most appropriate pathway
  • improved communication with practitioners. We have reviewed and revised the templates we use as the starting point for our correspondence with doctors and we are now providing more information to practitioners, particularly when we expect our inquiries to take longer than first thought, and
  • senior staff and Board members are reviewing notifications at specific times, to make sure regulatory work is on track.

The workshop also explored what we are doing to support good regulatory decision-making including:

  • establishing a Risk-based Regulation Unit in AHPRA, to analyse our data to help identify risk of harm. As this work progresses, we will be publishing the results of our analysis to help inform and educate practitioners
  • setting up a National Restrictions Library. This is a collection of conditions and other restrictions that decision-makers can use to ensure that any restrictions they impose on practitioners’ registration to manage risks to patients, are consistent, enforceable and able to be monitored, and
  • asking notifiers what they are looking for from the regulatory process and providing more information up front about what it can achieve. This helps to better align notifier expectations with possible outcomes. As well, AHPRA is usually providing practitioners with all the information provided by the notifier, but specifying within this the issues that the Board is investigating.

The Board and AHPRA agreed to explore how we can most usefully ask practitioners for feedback about their experience of the regulatory process when a notification has been made about them, so we can improve our processes.

There was also good discussion about how the experience of the National Scheme1 can better support the profession to deal with practitioners whose performance is not satisfactory.

The Board and AHPRA appreciate the AMA’s commitment to continuing to work constructively with us to improve the process for practitioners, in a fair way, with clear information.

The AMA has also published information about the workshop at A refined way to complain.

For more information about notifications, AHPRA has published guides for practitioners on the notifications process (performance assessments).

 

WA – Changes to WorkCover

Western Australia is pressing ahead with its 2013 plan to replace the State Workers’ Compensation and Injury Management Act 1981 with a new statute, WorkCover WA has confirmed.

“The drafting of the Bill is a significant undertaking and is at a preliminary drafting stage with Parliamentary Counsel’s Office,” a spokesperson said yesterday.

The State Government has been quiet on the proposed laws since approving the drafting process in October 2014 .

The spokesperson confirmed that the new statute will be based on recommendations from WorkCover’s June 2014 report on the old Act, and the Government will consult broadly on the Bill before introducing it to Parliament.

“I cannot confirm when it will be introduced to Parliament at this stage,” he said.

WorkCover’s 171 recommendations included: replacing the “complex and highly prescriptive” 1981 Act with a new Act; redefining “worker” as “an ’employee’ for the purpose of assessment for Pay As You Go (PAYG) withholding” under Commonwealth taxation laws; enforcing whole person impairment thresholds for common law claims; and significantly increasing death benefits

 

The Victorian Workplace Injury Rehabilitation and Compensation Act compared to the Accident Compensation Act

April 6, 2016

The Workplace Injury Rehabilitation and Compensation Act (the WIRC Act) recasts the Accident Compensation Act 1985 ( the ACA Act) and the Accident Compensation (WorkCover Insurance) Act 1983 (ACWI Act) into a single Act that is simpler and easier to use.

This link gives you a table that indicates where the provisions of the Accident Compensation Act 1985 can be found in the Workplace Injury Rehabilitation and Compensation Act 2013 that became operational on 1 July 2014.

Of particular significance is section 91 (6) in the ACA Act that has been replaced with Section 64 (a) and (b) with regard to psychiatric impairment assessment.

 

More action regarding complaints against medical practitioners

March 23, 2016

There has been action on two fronts with regard to reviewing the current system of medical complaints. The Senate has established a wide ranging review (see below) and AHPRA has provided some insights into a KPMG independent review of that system and processes for managing notifications in Victoria. I reckon I could have written this in my coffee break. It includes such mind-boggling new ideas such as:
better risk assessment
Management of high-risk matters
greater transparency
culture
performance
You will notice that the item to do with “culture” refers to ” address perceptions of being pro-practitioner”. That has certainly not been our experience. Our experiences that you are guilty until proven innocent.
These are astonishing glimpses of the obvious. Go to the section below to read the full document.

On 2 February 2016, the Senate referred the following matter to the Senate Community Affairs References Committee for inquiry and report:

The medical complaints process in Australia.

The terms of reference are:

  1. the prevalence of bullying and harassment in Australia’s medical profession;
  2. any barriers, whether real or perceived, to medical practitioners reporting bullying and harassment;
  3. the roles of the Medical Board of Australia, the Australian Health Practitioners Regulation Agency and other relevant organisations in managing investigations into the professional conduct (including allegations of bullying and harassment), performance or health of a registered medical practitioner or student;
  4. the operation of the Health Practitioners Regulation National Law Act 2009 (the National Law), particularly as it relates to the complaints handling process;
  5. whether the National Registration and Accreditation Scheme, established under the National Law, results in better health outcomes for patients, and supports a world-class standard of medical care in Australia;
  6. the benefits of ‘benchmarking’ complaints about complication rates of particular medical practitioners against complication rates for the same procedure against other similarly qualified and experienced medical practitioners when assessing complaints;
  7. the desirability of requiring complainants to sign a declaration that their complaint is being made in good faith; and
  8. any related matters.

Submissions should be received by 13 May 2016. The reporting date is 23 June 2016.

Committee Secretariat contact:

Committee Secretary
Senate Standing Committees on Community Affairs
PO Box 6100
Parliament House
Canberra ACT 2600

Phone: +61 2 6277 3515
Fax: +61 2 6277 5829
community.affairs.sen@aph.gov.au

AHPRA has provided some insights into the findings of a KPMG independent review of its system and processes for managing notifications in Victoria.

The report recommends actions in five main areas, including a more systematic, data informed approach to risk assessing notifications:

  1. Better risk assessment: need to embed a more systematic, data informed approach to risk assessing notifications not only taking account of the information which is outlined in the notification, but also factors such as a practitioner’s history of notifications, their practice context and who made the notification.
  2. Management of high risk matters: more intensively apply resources to higher-risk notifications, so these cases are investigated thoroughly but quickly.
  3. Greater transparency: interpret and use the National Law flexibly, not narrowly, to support information sharing in the public interest and promote greater understanding and transparency of what we do.
  4. Culture: address perceptions of being pro-practitioner and shift this perception through cultural change, with a greater emphasis on service. We need to drive an open and transparent organisational culture with a clear balance between the interest of patients, public safety and the practitioner to ensure our service culture balances the rights and needs of all stakeholders.
  5. Performance: continue to critically evaluate the causes of delays, especially for high risk and complex cases.

 

 

Bits n’ Pieces

March 3, 2016

I thought you might be interested to see 4 recently written papers

 

 

Victorian Wrongs Act Amendments from 2 December 2015

January 21, 2016

There have been a number of amendments to the Victorian Wrongs Act 1958 (Wrongs Act Amendment Act) that took effect on 2 December 2015. The major issue for us is with regard to psychiatric assessment. The threshold wording has been changed from “impairment of more than 10%” to “10% or more”. This applies to any climate to have been assessed before that date where the matter has not yet been finalised. Victorian forensic psychiatrists will be asked to submit a new certificate incorporating the changed wording. There are 5 changes in all of which the above is the only one relevant to us.

NSW workers compensation guidelines for the evaluation of permanent impairment (4th edition) released

December 3, 2015

The NSW workers compensation guidelines for the evaluation of permanent impairment (4th edition) 1 April 2016 has just been released.  It has been re-written to conform with the Safe Work Australia template. However there is no agreement by states using the GEPIC to use the PIRS and considering the disdain with which the PIRS and AMA6 are held together with the cost of training any such change is unlikely. The changes to the PIRS are as follows:

Psychiatric and Psychological disorders

Paragraph 11.4 from the 3rd edition, on the development of the PIRS has been removed to align to the Safe Work Australia national template guideline. The numbering therefore changes from 11.4 onwards (in comparison to the 3rd edition).

Clause Change

  1. 3

Introduction

Removed 3rd and 4th sentences that referenced s67 pain and suffering.

Removing the reference to s67 in this clause does not affect an exempt worker’s entitlement to claim for pain and suffering compensation. The reference to s67 in this clause was a case management tool which is now considered inappropriate in a medical guideline.

  1. 9

Co-morbidity

Removed the Alzheimer’s disease example. Replaced with a bi-polar disorder example.

11.10

Pre-existing impairment Minor change to second half of the paragraph for improved clarity, and to align with the wording in 1.28 in the Guidelines: Rephrased to:

The injured worker’s current level of WPI% is then assessed, and the pre-existing WPI% is subtracted from their current level, to obtain the percentage of permanent impairment directly attributable to the work-related injury. If the percentage of pre-existing impairment cannot be assessed, the deduction is 1/10th of the assessed WPI.

NSW MOTOR ACCIDENTS COMPENSATION REGULATION (114) 2 March 2015 – Expert Witnesses

July 9, 2015

The recent NSW regulations, in particular 11(1)a has had an effect on the amount of work in NSW and increases the fee schedule for expert witnesses.  I have included a commentary from McInnes Wilson Lawyers

Section 11 Limit on costs for expert witnesses

(1) Costs are not to be included in an assessment or award of damages in respect of any expert witness giving evidence, or providing a report, on behalf of the claimant in relation to a claims assessment or in court proceedings under the Act, except for costs in respect of:

(a) one medical expert in any specialty (my emphasis) unless there is a substantial issue as to a matter referred to in section 58 (1) (d) of the Act

Section 58 Application

(1) This Part applies to a disagreement between a claimant and an insurer about any of the following matters (referred to in this Part as
“medical assessment matters” ):

(d) whether the degree of permanent impairment of the injured person as a result of the injury caused by the motor accident is greater than 10%.

McInnes Wilson Lawyers

The Regulations retain the existing fee structure with respect to medical treatment and medico-legal services however, provide an increase on the maximum allowable fees.

With respect to medical treatment, Clause 19 states that an insurer is not required to pay beyond what is specified in the Australian Medical Association (‘AMA ’) List of Medical Services,

The maximum fees recoverable for medico-legal services are set out in Schedule 2. These are based on the Schedule of Suggested Fees for Medical xaminations and Reports which is determined by the Law society of NSW and the AMA. There is an increase in medico-legal fees to reflect current market rates. For example, a medico-legal report obtained from a specialist who has not previously treated the claimant and requires an examination has increased from $720 to $1,200. There is also an incentive for parties to obtain joint medico-legal reports by providing a higher recoverable fee (up to $1,600) in an attempt to reduce appointments for an injured claimant.

A further amendment contained within the Regulations is the inclusion of Clause 10(3) which states that the costs of obtaining an initial treating medical report cannot be claimed by an injured claimant’s practitioner if the insurer has already obtained a report and provided a copy to them. If, however, a request has been put in writing for a copy of the report, and the insurer has failed to provide same within a reasonable time, the cost of a second report can be claimed. This restriction does not extend to updated treating reports subsequent to the initial report.

Investigation Reports and Expert Witnesses

Clause 11 of the Regulations maintains the restriction on claiming costs related to expert witnesses and reports.

There is a presumption that only one medical expert in any specialty and two experts of any other kind can be included in an assessment or award of damages.

 

Work Stress 2013 – Statistics from Safe Work Australia

July 8, 2015

This is the executive summary from this, the first document of its type I have seen (click here to see the complete document).  You can see why all governments put obstacles in the way of claimants, with specific wording eg the specific injury rather than a specific injury (Queensland and South Australia), different thresholds for psychiatric as opposed to physical injury (all states) and exclusions, in South Australia no compensation for non economic loss. Note that general clerks, police officers and school teachers accounted for the majority of ‘work pressure’ claims.  i have also included sub-categories of ‘work stress’ for your information.

Executive Summary

  • Mental stress claims are the most expensive form of workers’ compensation claims because of the often lengthy periods of absence from work typical of these claims.
  • Mental stress claims are predominantly made by women.
  • Men and women are more likely to make a claim for mental stress as they get older but after they reach 54 years the likelihood that they made a claim decreases.
  • More Professionals made claims for mental stress than other any other occupation with over a third of their claims made for Work pressure.
  • There were more mental stress claims made for Work pressure than any other sub-category.
  • The hazards that result in mental stress claims vary with worker age. Younger workers are more likely to make claims as a result of Exposure to workplace or occupational violence, whereas Work pressure is the main cause of mental stress claims for older workers, peaking for those aged 45–49 years.
  • General clerks, School teachers and Police Officers accounted for the majority of claims for Work pressure.
  • Women were around three times more likely than men to make a workers’ compensation claim due to Work-related harassment &/or workplace bullying. Approximately one-third of all claims in this mental stress sub-category were made by workers in the occupational categories of Advanced clerical & service workers and General clerks.
  • For the industries with the highest number/rate of mental stress claims, the majority of claims were for Work pressure. This was particularly true in the Education sector. Claims for Exposure to workplace or occupational violence were notable in the Retail trade industry, while the Transport & storage and Health & community services industries dominated claims for Exposure to a traumatic event.

Sub-Categories of Work Stress

The mechanism of Mental stress is assigned to claims where an employee has experienced an injury or disease because of mental stress in the course of their employment. Mental stress includes sub-categories distinguished by the nature of the actions, exposures and events that might lead to disorders as specified. The sub categories are:

  • Work pressure—mental stress disorders arising from work responsibilities and workloads, deadlines, organisational restructure, workplace interpersonal conflicts and workplace performance or promotion issues.
  • Exposure to workplace or occupational violence—includes being the victim of assault by a person or persons who may or may not be work colleagues; and being a victim of or witnessing bank robberies, hold-ups and other violent events.
  • Exposure to traumatic event—disorders arising from witnessing a fatal or other incident.
  • Suicide or attempted suicide—includes all suicides regardless of circumstances of death and all attempted suicides.
  • Other mental stress factors—includes dietary or deficiency diseases (Bulimia, Anorexia).
  • Work-related harassment &/or workplace bullying—repetitive assault and/or threatened assault by a work colleague or colleagues; and repetitive verbal harassment, threats, and abuse from a work colleague or colleagues.
  • Other harassment—being the victim of sexual or racial harassment by a person or persons including work colleague/s.

ComCare changes concerns

July 7, 2015

Concerns are still being expressed about this bill. The most recent from the Law Council of Australia in May 2015. The Council had a number of specific concerns to do with various matters. The matters most relevant to us are:

  1. “The Bill expands the notion of “reasonable administrative action” to virtually any management action by an Whilst it may be accepted that an expansion of the exclusion to the definition of injury is a matter for Parliament, the absence of a limitation or qualification of what is meant by the phrase “management action” is likely to lead to uncertainty and complex litigation, such as in Commonwealth Bank of Australia v Reeve (2012) 199 FCR 463, in order to determine the distinction between an employee’s usual duties and “management action”.

and

 

  1. The explanatory memorandum states that the Bill aims to “distinguish more clearly between work and non-work related injuries by requiring certain matters be taken into account in determining whether an ailment or aggravation was contributed to, to a significant degree, by an employee‘s employment” (page ii).
  2. Some of the amendments appear to require a decision-maker to apply value judgments at a level of abstraction that is not necessarily attainable without the assistance of expert evidence. For example, requiring a decision-maker to consider the probability that an employee would have been more or less likely to sustain a similar injury at a certain stage in their life is a matter that ought not to be left to the lay opinion of a decision-maker.
  3. Further, it is noted that this approach appears to involve a departure from the “eggshell-skull” principle – that the employer must take an employee as they find them, with or without existing ailments or propensity toward particular types of injury.