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SIRA targets return-to-work rate turnaround with 10-point plan

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The NSW State Insurance Regulatory Authority (SIRA) has released a 10-point action plan to address declining return-to-work rates in the state's workers’ compensation scheme - measures that include reviewing all participating insurers’ practices in the first-half of next year.

SIRA also says all insurers participating in the scheme must resubmit their business plans with detail on how they will improve the 4-week return to work performance. The resubmitted business plans must be lodged by February 28 next year.

According to SIRA, return-to-work rates across all insurers have deteriorated 12 percentage points since 2015/16.

In 2015/16 the four-week return-to-work rate stood at 77%, it was 76% in 2016/17, 70% in 2017/18, 66% in 2018/19, 69% in 2019/20 and 65% in 2020/21.

SIRA says in 2015 almost nine out of 10 injured workers were back at work within 13 weeks. Today less than eight out of 10 have resumed working in 13 weeks after an injury.

SIRA CEO Adam Dent says the “priority” action plan is designed to address factors that are contributing to the poor performance with the goal of returning the rates to “acceptable levels”.

“The core role of the workers’ compensation scheme is to help people recover and return to work,” Mr Dent said. “We know that staying at work or early return to work after an injury leads to the best possible health and social outcomes.

“Delayed return to work has serious implications for injured people as the evidence shows that the longer a person is away from work, the less likely they are ever to return.”

Mr Dent says weak return-to-work rates not only mean poorer outcomes for workers, they also significantly impact the financial performance of the workers’ compensation scheme.

“While the deterioration is more pronounced with some insurers, it is a pattern that is evident across the system as well as in some other jurisdictions,” he said.

He says driving improved return to work outcomes is his top priority next year.

“SIRA is committed to undertaking 10 actions aimed at reversing the trend of poor return-to-work performance and pushing insurers and employers to do better,” Mr Dent said.

“We’re targeting a range of measures that promote compliance with the practices that we know underpin positive return to work outcomes.”

Here is the 10-point action plan:

1 - SIRA has required all workers' compensation insurers to resubmit their business plans with detail on how they will improve four-week return-to-work performance. Resubmitted business plans are due to SIRA by February 28 2022

2 - SIRA will review all insurers’ return-to-work practices in the first half of 2022. The review will include an assessment of insurers’ injury management program, file reviews, interviews with customers and claims staff, and a review of the systems and controls in place to identify workers at risk of not returning to work

3 - SIRA is introducing a return-to-work and early intervention Standard of Practice. The standard articulates SIRA’s expectations when it comes to return-to-work and provides a checklist to help identify the risk factors for delayed recovery. SIRA is publicly consulting on the standard until February 28

4 - SIRA will commence publishing the return-to-work performance of all insurers in 2022. SIRA is committed to improving transparency in the workers' compensation scheme and holding insurers accountable for their performance

5 - SIRA is establishing a dedicated return-to-work inspectorate. The inspectorate will seek to improve workers’ recovery and return to work outcomes through education initiatives and, when necessary, enforcement action targeted at employers

6 - SIRA is funding a research fellowship at the Black Dog Institute for two years to focus on return-to-work for people with a psychological injury. This initiative will help SIRA understand barriers to recovery and help workplaces manage successful return-to-work for people with a psychological injury

7 - SIRA has expanded the scope of its review into the compliance and performance of Treasury Managed Fund (TMF) government agencies to audit return-to-work performance. The review will support the public sector to implement improvements where they are needed and ensure that it has best practice systems in place

8 - SIRA will use predictive modelling to identify and target employers with workers that may be at higher risk of delayed return-to-work. SIRA will seek to support and educate the employers through outbound calls, site-visits and the provision of information to improve workers’ return-to-work outcomes

9 - SIRA is trialling its successful CTP Assist program in the workers' compensation scheme for 12 months. As part of the program, SIRA will make outbound calls to workers at risk of delayed recovery as early as possible in the claims process. This contact will equip workers with the information they need to improve their understanding of the health benefits of good work and drive their recovery

10 - SIRA has partnered with the Australian Rehabilitation Providers Association (ARPA) to further explore the benefits of workplace rehabilitation providers on positive return-to-work outcomes. Recent research shows that the timely engagement of workplace rehabilitation providers improves return-to-work outcomes by up to 5% for physical injuries and 20% for psychological injuries. SIRA and ARPA will seek to expand on this research base to understand the circumstances and implement initiatives that allow workplace rehabilitation providers to have the greatest impact.