Independent review into the management of complex claims

What is the independent review into complex claims?

In 2020 the Victorian Government commenced an independent review into the management of complex claims in the workers compensation scheme.

The review was a response to a recommendation by the Victorian Ombudsman.

The review has made 22 recommendations to support those who face additional challenges in recovering and returning to work after suffering a workplace injury.

The Government has accepted five recommendations, with a further 14 accepted in principle. Two require further consideration and one is noted.

The Government's media release contains links to the independent review and the Government's response.

How will the way claims are managed change?

WorkSafe will take over the direct care of about 1500 additional long-term complex claims, to be supported directly by a dedicated complex claims unit – the WorkSafe Claims and Recovery Support Team.

This transition will occur in 2022.

Which claims are being transferred to WorkSafe?

Workers who still receive weekly compensation payments after 130 weeks, but whose employers have ceased to operate, will have their claims transferred to be directly managed by WorkSafe.

Who will manage these claims at WorkSafe?

WorkSafe's Claims and Recovery Support team already supports some similar claims and will be expanded to accommodate the new claims. Everyone whose claim transfers will be assigned a WorkSafe case manager.

How will I know if my claim is being transferred?

If you are impacted, you will be contacted before your claim is transferred.

Can I opt in or out of the transfer?

All claims that meet the criteria will be transferred, and agents will no longer be managing any of these types of claims. Your claim cannot be transferred to WorkSafe unless it meets the criteria.

Will entitlements be different for claims managed by WorkSafe?

Claims being supported directly by WorkSafe will be eligible for the exact same entitlements as they would have when managed by agents.

I'm expecting my claim to meet the criteria for transfer soon. Will it be transferred?

A process to identify claims as they become eligible and initiate the transfer process will be established.

Will workers with claims managed by WorkSafe still have access to dispute management options?

Yes. Workers with claims to be supported directly by WorkSafe will still have access to all existing dispute management options.

I am an employer. Will the transfer of these claims impact me?

No, only claims where the employer has ceased to operate are transferring to WorkSafe.

Will premiums rise to cover this change?

No.

Will any other recommendations impact me as an employer?

There are other recommendations that may impact employers, including a requirement for training for return to work coordinators.

More information about these changes will be made available before they are implemented.

I provide services to injured workers. Will this change impact me?

If an injured worker’s claim transfers to WorkSafe, individual billing arrangements will also need to change. Further details about this will be provided as claims transfer.

My claim is complex, but doesn't meet the criteria. Why?

The Independent review made some recommendations that would change the way claims are accepted and triaged to allow more complex claims to be managed by WorkSafe.

These recommendations are accepted in principle, but WorkSafe needs to consult further with stakeholders before any further changes are made.