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

Workers’ Compensation Regulatory Services 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.

Overall, the audit identified opportunities for improvement.

What you need to know

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.

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.

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.

Why this is important

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 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 say that insurers must develop and maintain a rehabilitation and return to work plan for every accepted claim.

What actions can I take now?

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

You can review your practices and talk with your insurer about how you can best contribute to your workers’ rehabilitation and return to work plans.

You must still provide rehabilitation opportunities for your workers by identifying suitable duties and developing a suitable duties program.

Your toolkit

• Understand rehabilitation and return to work terms, roles and responsibilities (PDF, 1.08 MB) specific to the Queensland workers’ compensation scheme.
• Understand the difference between a rehabilitation and return to work plan and a suitable duties program.
  • A rehabilitation and return to work plan is developed by an insurer. It is a tailored, written plan that outlines the worker’s overall rehabilitation objectives and the steps required to achieve them. It is also a communication tool between the different stakeholders involved in a worker’s rehabilitation and return to work. It is developed in consultation between an insurer, employer and a worker’s treating health provider, with the worker at the centre.
  • A suitable duties program is developed by an employer. It is tailored to the needs of an individual worker and sets out graduated progressions in hours, days or duties to help a worker return to normal. Best practice is a suitable duties program developed in collaboration with your worker and shared with your insurer. Download the injury information pack for employers and workers (DOCX, 0.61 MB) for help on how to develop a suitable duties program together.

• Understand the critical influence you have as an employer on return to work outcomes.
  • Workers have better return to work outcomes when workplaces engage with them early and provide support immediately following an injury.
  • Having a rehabilitation and return to work coordinator or dedicated resource to manage the return to work process at the workplace improves return to work outcomes.
• Read more about your legal obligations and how to meet them in the Guidelines for Standard for Rehabilitation (PDF, 0.4 MB). To understand the key system and tool that insurers use to manage rehabilitation and return to work, review the
  • Accredited return to work program guideline – for insurers (PDF, 1.03 MB)
  • Rehabilitation and return to work plan guideline – for insurers (PDF, 1.65 MB).
• Subscribe to this e-bulletin to stay informed on rehabilitation and return to work matters.