Rehabilitation and return to work guidelines for insurers

The guidelines were developed in response to the 2021 Safe Work Australia National Return to Work Survey results, declining scheme return to work data performance (PDF, 0.49 MB), and scheme intelligence gathered through complaints management and claims and rehabilitation compliance audits.

The guidelines have been informed by extensive consultation with all scheme stakeholders, including insurers, and employer, worker, legal and allied health representatives.

While the new guidelines are targeted at insurers, they also establish insurer, employer and worker responsibilities for RRTW planning, how these interact, and why it’s important to work together to achieve positive outcomes for an injured worker.

Employers play a key role in return to work planning, and an employer’s attitude towards a returning worker can have a critical influence on return to work outcomes.

An injured worker’s tailored RRTW plan, which is coordinated by an insurer, is an important tool for an employer to influence return to work outcomes and to work collaboratively with a worker, their insurer, and a worker’s treating health providers towards a shared goal.

If possible, employers should offer alternative work duties to support recovery at work. The suitable duties program an employer develops for an injured worker details how to do this and is a key component of a worker’s RRTW plan.

By supporting an injured worker to return to work quickly and safely, employers will improve return to work outcomes for a worker, as well as improve productivity and reduce costs for their business.

Workers’ Compensation Regulatory Services (WCRS) performed a targeted audit of all Queensland workers’ compensation insurers focussed on rehabilitation and return to work plans, between 1 March and 13 September 2024.

We conducted the audit to:

• assess how well Queensland workers’ compensation insurers were meeting their obligations in relation to rehabilitation and return to work plans
• identify areas of better practice and opportunities for improvement
• assist in evaluating and reviewing the Rehabilitation and return to work guidelines for insurers to ensure they are effective in positively impacting worker experience and rehabilitation and return to work outcomes, remain evidence-based and provide practical guidance for insurers.

Key results

The audit revealed opportunities to improve. The audit identified that across all files audited, five out of 29 audits met minimum requirements for rehabilitation and return to work plans, which were:

• The insurer developed the rehabilitation and return to work plan in consultation with the worker and the worker’s employer and treating medical provider.
• The rehabilitation and return to work plan included the objective/s and steps to reach the objective/s.
• The insurer maintained the rehabilitation and return to work plan.
• The insurer shared a copy of the worker’s rehabilitation and return to work plan with the worker and the worker’s employer and treating medical provider.

Across all claims audited, 24 out of 29 audits did not meet minimum requirements.

Read the full report (PDF, 2.48 MB) detailing audit findings and WCRS’ response to ensure the scheme is supporting all scheme stakeholders.

Note: The audit did not audit to the standard of the new laws made by the Workers’ Compensation and Rehabilitation and Other Legislation Amendment Act 2024 that commenced on 23 August 2024. These new laws require an insurer to have a written rehabilitation and return to work plan in place within 10 business days of a claim being accepted.

Next steps

Insurers are implementing the findings arising from their own individual audit reports. Actions being taken to improve outcomes include insurers:

• reviewing their systems and processes and ensure they are complying with legislative requirements and the rehabilitation and return to work guidelines for insurers
• looking for ways to implement remediation plans to continuously improve, monitor and review quality assurance, and employ a person-centred approach to the rehabilitation and return to work journey
• consulting with workers to identify opportunities to improve their approach to rehabilitation and return to work planning.

WCRS is continuing to monitor and report on performance relating to rehabilitation and return to work plans, including monitoring improvement action plans required as a result of this audit.