Who's involved in the claims process for employers
If you're a worker, find out who's involved in the claims process for workers.
The recovery and return to work journey for an injured worker can be a daunting one. If your worker is injured at work, you have an important role to play in assisting in their recovery and timely return to safe work. You will need to provide your worker with suitable and/or pre-injury employment (where possible) and consult with your worker, their support person or representative, the worker’s treating health practitioner (with the worker’s consent) and the occupational rehabilitation provider (if any). It’s important to stay in touch with your worker if they are away from work so that you can stay informed of their progress, treatment and any relevant issues/concerns/problems as they arise.
Your worker has an important role to play in their own recovery. No one knows how they are feeling better than they do, so it’s important that you encourage them to communicate this information to both you and their treating health practitioner(s).
It will help their recovery and return to work if you’re able to help them to stay positive; to concentrate on what they can do, not just what they can't do both at home and at work; and acknowledge and address their concerns as best you can. Knowing what they can do will also help you and their treating health practitioner(s) to find things they can safely do back at work.
The longer your worker is away from work the harder it will be for them to return, and the worse it’ll be for their health and wellbeing, so actively participating in their return to work is the best thing they can do.
Except for self-insurers, Victorian employers are required to choose a VWA Agent to manage their workers compensation claims from five agents authorised by VWA. Your VWA Agent will make decisions about your worker’s entitlement to compensation, e.g. weekly payments and medical and like services, etc. Agents also provide assistance to help you and your injured worker with return to work planning.
If you are unsure of your VWA Agent, please contact the VWA Advisory Service on freecall 1800 136 089.
An independent medical examiner’s role is to examine your worker and provide your VWA Agent with an opinion about their injury or illness, work capacity and treatment. They do not provide your worker with treatment.
An independent medical examination is conducted so that the examiner can provide information to the VWA Agent to support your worker’s recovery, rehabilitation and return to work. These reports may also be used to help the VWA Agent to make decisions about your worker’s entitlement to weekly payments and medical and like services.
Depending on your worker’s injury circumstances, the worker may be required to attend an independent medical examination conducted by a medical practitioner, physiotherapist, osteopath, chiropractor, psychologist or dentist, before the claim is accepted and at reasonable intervals.
Independent medical examiners are not employees or representatives of VWA, VWA Agents or self-insurers. However, they are paid by VWA Agents and self-insurers for the independent medical advice they provide.
After a work-related injury or illness, your worker may visit their treating medical practitioner who will assess their work capacity and may provide them with a VWA Certificate of Capacity. This could be their general practitioner or specialist.
Only a medical practitioner can issue your worker with their first VWA Certificate of Capacity.
Treating medical practitioners are responsible for the overall management of an injured worker’s injury or illness. This includes primary care of the injury or illness, making an appropriate diagnosis and referrals, monitoring progress and outcomes and facilitating their return to work. When your worker visits their treating medical practitioner they should provide them with information about their claim, employer, VWA Agent and their work duties.
Your worker may require treatment for their injury from an allied health professional. A referral/request is not required from the worker’s medical practitioner when seeking treatment from a physiotherapist, chiropractor, osteopath or podiatrist. However, a referral/request may be required from a medical practitioner for other types of allied health services approved by VWA.
Your worker can choose which allied healthcare professional they use providing they are registered with VWA. When your worker visits an allied healthcare professional, they should provide them with information about their claim, employer, VWA Agent and their work duties.
Occupational rehabilitation (OR) services are about preparing you, your worker and your workplace (where possible) for your worker’s safe return to work. OR services can be approved by your VWA Agent for your worker where reasonable and appropriate.
OR providers are independent of VWA and VWA Agents, though they are paid by VWA Agents to provide return to work assistance. Their purpose is to provide independent and impartial assistance and advice to help your worker to return to work safely.