Key results: Targeted audit campaign of insurer rehabilitation and return to work plans

WCRS conducted the audit to:

• assess how well Queensland workers’ compensation insurers are 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.

The audit identified opportunities to improve across all files audited with five out of 29 audits meeting 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.

It is important to note because evidence shows that return to work planning improves return to work outcomes. Better outcomes are achieved by a supportive, tailored, person-centred approach. The injured worker should be at the centre of, and consulted in, return to work planning with their insurer, employer and treating health providers working collaboratively towards a shared goal.

A rehabilitation and return to work plan is a claims management tool that helps insurers develop a tailored person-centred approach to recovery and return to work. It takes into account a worker’s and their workplace’s individual needs and circumstances. A rehabilitation and return to work plan is also a planning tool that sets out the various steps involved in a worker’s rehabilitation and a communication tool that supports successful outcomes.

Workers' compensation laws state that insurers must develop and maintain a rehabilitation and return to work plan for every accepted claim.

Note: The audit did not meet 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

• Read the full report (PDF, 2.48 MB) detailing audit findings and WCRS’ response to support scheme stakeholders.
• Employers can review their practices and talk with their insurer about how to best contribute to a workers’ rehabilitation and return to work plan. Employers must still provide rehabilitation opportunities for injured workers by identifying suitable duties and developing a suitable duties program.
• Insurers are implementing the findings arising from their own individual audit reports. Actions being taken to improve outcomes include:
  • 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.

More information

Rehabilitation and return to work guidelines for insurers