A treating doctor has a clear role in the injury management process, which includes:

• diagnosis, primary care and coordination of medical treatment;
• establishing, in their opinion, whether the diagnosis does/does not correlate with the disability as described by the patient;
• reviewing the injured worker’s medical condition;
• liaising with the employer or employer’s representative to facilitate an injured worker’s maintenance in or return to work;
• referring for vocational rehabilitation assistance where required; and
• reporting specified industrial diseases to WorkSafe on 9327 8777 or toll free 1800 678 198. This notification must be carried out within 14 days of the first consultation with the injured worker.

It is not the treating doctor’s role to determine whether a worker has a valid claim under the Workers’ Compensation and Injury Management Act 1981 or not. Medical opinion should be restricted to whether the medical condition could have resulted from the incident reported by the worker and the consequential degree of incapacity (i.e. totally unfit, partially unfit).

The claim form and First Medical Certificate contain a consent authority clause to be signed by the worker (signing is optional). If signed, this allows the treating doctor (whether named on the form or not) to discuss the worker’s medical condition in relation to the claim for workers’ compensation and return-to-work options with the worker’s employer and insurer. If the worker fails to sign the consent authority, it may delay the decision on determining liability on the claim by the insurer.

Should you wish to contact the employer or insurer, you must obtain the worker’s consent prior to initiating contact with these parties.

The Privacy Amendment (Private Sector) Act 2000 may also have implications for medical practitioners, and you may wish to obtain advice to how the Privacy Act affects your operations.

Fees and rates: In a workers’ compensation claim, the invoices should be forwarded to the employer for payment, even when the claim is in dispute. If the claim is denied, your patient is responsible for prior and future treatment costs and should forward such accounts to Medicare, and where appropriate their private health fund, for a rebate.