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Beware the case conference

Once a claim for workers' compensation is accepted, the insurer will appoint a rehabilitation provider to assist in your return to work.

The rehabilitation provider liaises with you, your treating doctor, the insurance company, and your employer to participate in injury management and to return you safely to work. Both you and your employer have responsibilities and rights in relation to the injury management and your return to work.

Whilst rehabilitation providers can be of assistance in finding you suitable work with your employer and assist in developing a return to work program, problems can arise when an employer is unable to provide suitable duties.

Whilst an employer has an obligation to provide suitable duties to the injured worker, it is not required by law. If no such suitable duties are available, then an injured worker cannot return to work.

The injured worker however continues to have a responsibility to look for work in accordance with the WorkCover Medical Certificate. This puts the injured worker in a difficult situation where they remained employed but have an obligation to look for work in accordance with their certificate, even where an employer failed to provide suitable work.

The Case Conference

The rehabilitation providers however have various “tactics” which they use to either return people to work or use the workers’ compensation legislation as a way of stopping a workers’ weekly payments.

This situation occurs when the rehabilitation provider arranges a case conference with you and your treating doctor. The purpose of the case conference is so the rehabilitation provider can understand your injuries and assist with your return to work. However, what usually happens is that the rehabilitation provider intimidates or pressures the doctor to change the restrictions and hours of work contained on the WorkCover Certificate of Capacity.

For example, the worker has a certificate that certifies them unfit for work, the rehabilitation provider will arrange a case conference with you and your treating doctor. At that case conference the rehabilitation provider will try any means possible to have the doctor change the WorkCover Certificate of Capacity from unfit to work to fit for suitable duties.

The rehabilitation provider will state that the sooner the injured worker returns to work, the better off they will be and there is some support for this proposition however the difficulty arises when a worker has been receiving weekly benefits for at least 130 weeks.

If you have been receiving weekly benefits for between 130 and 250 weeks (that is 2.5 to 5 years) and your WorkCover Certificate is changed from being totally unfit to fit for suitable duties (usually because of pressure from the rehabilitation provider at a case conference) then this can cause great difficulties in receiving ongoing payments of weekly compensation.

Weekly payments can be stopped following an increase in hours on your certificate

Pursuant to Section 38 of the Workers Compensation Act, an injured worker is only entitled to weekly benefits after 130 weeks if one of the following is satisfied:

  1. The worker is totally unfit for work; or
  2. If the worker is fit for suitable duties and working at least 15 hours per week.

Most workers who have been receiving compensation for at least 130 weeks have usually been terminated or the employer has refused to provide them with suitable work. As soon as the Certificate therefore is upgraded to suitable duties, if the worker cannot obtain such suitable duties on the open labour market with some other employer, then pursuant to Section 38 of the Act, weekly payments of compensation stop. The insurer is only required to provide 6 weeks notice that weekly benefits are to stop.

Once weekly benefits stop the worker is only entitled to receive medical expenses for 2 more years.

The above only applies to workers who have a 20% whole person impairment or less. If your whole person impairment is 21% or greater, you continue to receive weekly benefits until retirement age.

Therefore, the case conference is used as a tool by rehabilitation providers and insurers to put pressure on the nominated treating doctor to increase the hours of work particularly from a worker who is unfit to work to certify that the worker is fit for some suitable employment.

The consequences of such a change in capacity for work is significant when a worker has received benefits for at least 130 weeks. If an injured worker at that stage is not working at least 15 hours per week and receives a Certificate for suitable work, then weekly compensation will stop.

Refuse to attend a Case Conference

An injured worker has a right to refuse to attend a case conference.

We recommend that you refuse to attend a case conference if you believe the rehabilitation provider will pressure the Doctor to change the certificate. Or you can make sure you discuss these matters with your general practitioner prior to the case conference without the rehabilitation provider present.

The general practitioner should be made aware that the purpose of the case conference is that the rehabilitation provider is likely to pressure the doctor to increase the Certificate of Capacity so weekly compensation benefits can be stopped, then discuss this with the Doctor before allowing the rehabilitation provider into the room.

If you would like further information on Workers Compensation, please see our articles on our blog;

Garling & Co Lawyers

Matthew Garling

Matthew Garling is an Accredited Specialist in Personal Injury Law approved by New South Wales Law Society. He is admitted to practice in the Supreme Court of NSW and the High Court of Australia. Matthew is also a member of...
Kimberly B.
23:14 14 Feb 24
Mathew is very knowledgable and has been of great assistance to me. All the staff are friendly and helpful. I'm so happy I found this firm.Thank you Mathew and team for your great work in my case.... I am 100% happy with what you achieved for me.read more
Julie M.
10:16 16 Jan 24
My last stage of Workers compensation claim was managed by Emma Perkins, Natasha Stojanovic, Rebecca Dunshea and Kelli Robinson at Garling and Co. Lawyers who went the extra mile with their service... from the beginning to the end of 3 years of my case. I have become very anxious with almost everything after a workplace injury and a lot of times I probably ask more questions than I need to, but Emma Perkins always finds clear answers to my questions in a short time and explains to me patiently even using her mealtime or between her meeting and make me feel that I have been very well take care and supported. I am so grateful and extremely satisfied. The excellent service, attitude, and culture of Metthew Garling and his team are second to none with a very high success rate. If you going to battle with your workplace injury for a short or long period, you are better off with Garling and Co. lawyers who are able back you up every step of the way. I strongly recommend it to anybody who needs their service like me. Julieread more
patrick P.
01:46 19 Dec 23
I like to say that I had a very wonderful experience,And the support, and also understanding with all my requests,I could not ask for a better team!Thank you Emma and also her assistant Rebecca... thank youread more
Kazi H.
13:38 13 Dec 23
Work cover fund is GOVT’S money but insurer think that it is from their 14th generation. So only they can have it. Not only that, people from the work, IME doctor from insurer, back to work... coordinator from work, Rehab provider from any side push the worker as hard as possible that the worker (doesn’t matter how the workers mental or psychical condition) either go back to his pre injury duty or leave the job.More over on that very bumpy any difficult journey some of them only treat the worker as a MONEY MAKING MECHINE .in some point worker feels like, no rooms to breath. On that moment need someone to support legally, someone to care, someone to relive.On my case I believe that, somehow, I manage to make my God happy. That’s why God sends me to Matthew Gerling and his team Allison, Rebecca and Nathan, and all of GARLING & co Lawyers.I am not good enough in English, can’t express my gratitude.Matthew, Allison, Rebecca and Nathan, please accept my appreciation and pass it to others.read more
Carol L.
01:32 29 Nov 23
Professional, understanding and friendly
Sean G.
23:21 14 Nov 23
Matthew Garling and everyone I spoke to at Garling and Co were kind, caring and compassionate. They were sensitive to my psychological condition and were patient in explaining everything to me, so... that I clearly understood the legal process. I am exceptionally grateful for the settlement outcome that Garling and Co obtained for me. Many thanks.read more
waqas A.
08:33 13 Nov 23
Great Experience with Garling & Co. Matthew explained everything in detail during the first appointment. Allison, Nathan, Rebecca and the staff have been extremely helpful. Thank You to the team and... lawyers at Garling & Co. for making the long process easy for me and getting an excellent outcome for my compensation claim.I would highly recommend Garling & Co. Lawyersread more
Saskia L.
21:42 08 Nov 23
The world of workers compensation is long, hard and confusing, but Emma and Rebecca at Garling & Co always treated my case with kindness, respect and understanding. No question was ever silly and... they always had time to make sure I knew what would happen next and how we could best prepare. I am so thankful for their expertise and could not have chosen anyone better to represent me.read more
Antonio P.
08:46 06 Nov 23
Thank you Matthew and his team for taking care of my case couldn’t ask for a better results and couldn’t have better team to do that thank you
Julie M.
00:40 06 Nov 23
Garlic & Co Lawyers have been wonderful, supporting me through some difficult times. With their assistance, positive outcomes were achieved. Many thanks to the Team.Julie
READ ALL TESTIMONIALS

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Kimberly B.
23:14 14 Feb 24
Mathew is very knowledgable and has been of great assistance to me. All the staff are friendly and helpful. I'm so happy I found this firm.Thank you Mathew and team for your great work in my case.... I am 100% happy with what you achieved for me.read more
Julie M.
10:16 16 Jan 24
My last stage of Workers compensation claim was managed by Emma Perkins, Natasha Stojanovic, Rebecca Dunshea and Kelli Robinson at Garling and Co. Lawyers who went the extra mile with their service... from the beginning to the end of 3 years of my case. I have become very anxious with almost everything after a workplace injury and a lot of times I probably ask more questions than I need to, but Emma Perkins always finds clear answers to my questions in a short time and explains to me patiently even using her mealtime or between her meeting and make me feel that I have been very well take care and supported. I am so grateful and extremely satisfied. The excellent service, attitude, and culture of Metthew Garling and his team are second to none with a very high success rate. If you going to battle with your workplace injury for a short or long period, you are better off with Garling and Co. lawyers who are able back you up every step of the way. I strongly recommend it to anybody who needs their service like me. Julieread more
patrick P.
01:46 19 Dec 23
I like to say that I had a very wonderful experience,And the support, and also understanding with all my requests,I could not ask for a better team!Thank you Emma and also her assistant Rebecca... thank youread more
Kazi H.
13:38 13 Dec 23
Work cover fund is GOVT’S money but insurer think that it is from their 14th generation. So only they can have it. Not only that, people from the work, IME doctor from insurer, back to work... coordinator from work, Rehab provider from any side push the worker as hard as possible that the worker (doesn’t matter how the workers mental or psychical condition) either go back to his pre injury duty or leave the job.More over on that very bumpy any difficult journey some of them only treat the worker as a MONEY MAKING MECHINE .in some point worker feels like, no rooms to breath. On that moment need someone to support legally, someone to care, someone to relive.On my case I believe that, somehow, I manage to make my God happy. That’s why God sends me to Matthew Gerling and his team Allison, Rebecca and Nathan, and all of GARLING & co Lawyers.I am not good enough in English, can’t express my gratitude.Matthew, Allison, Rebecca and Nathan, please accept my appreciation and pass it to others.read more
Carol L.
01:32 29 Nov 23
Professional, understanding and friendly
Sean G.
23:21 14 Nov 23
Matthew Garling and everyone I spoke to at Garling and Co were kind, caring and compassionate. They were sensitive to my psychological condition and were patient in explaining everything to me, so... that I clearly understood the legal process. I am exceptionally grateful for the settlement outcome that Garling and Co obtained for me. Many thanks.read more
waqas A.
08:33 13 Nov 23
Great Experience with Garling & Co. Matthew explained everything in detail during the first appointment. Allison, Nathan, Rebecca and the staff have been extremely helpful. Thank You to the team and... lawyers at Garling & Co. for making the long process easy for me and getting an excellent outcome for my compensation claim.I would highly recommend Garling & Co. Lawyersread more
Saskia L.
21:42 08 Nov 23
The world of workers compensation is long, hard and confusing, but Emma and Rebecca at Garling & Co always treated my case with kindness, respect and understanding. No question was ever silly and... they always had time to make sure I knew what would happen next and how we could best prepare. I am so thankful for their expertise and could not have chosen anyone better to represent me.read more
Antonio P.
08:46 06 Nov 23
Thank you Matthew and his team for taking care of my case couldn’t ask for a better results and couldn’t have better team to do that thank you
Julie M.
00:40 06 Nov 23
Garlic & Co Lawyers have been wonderful, supporting me through some difficult times. With their assistance, positive outcomes were achieved. Many thanks to the Team.Julie
University of Technology, Sydney
Member of Law Society of New South Wales
Law Society of NSW Specialist Accreditation
University of Sydney
Legal Profession Admission Board of New South Wales
The law society of nsw professional standards scheme logo.
University of Technology, Sydney
Member of Law Society of New South Wales
Law Society of NSW Specialist Accreditation
University of Sydney
Legal Profession Admission Board of New South Wales
The law society of nsw professional standards scheme logo.
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