WHAT IS REHAB FOCUSED COMPENSATION & WHY DOES IT BENEFIT YOUR COMPENSATION CLAIM?

WHAT IS ‘REHAB FOCUSED COMPENSATION’?

‘Rehab Focused Compensation’ means that following an accident, an injured person prioritises their recovery, working in conjunction with their treatment providers, the insurance company and their lawyer to achieve optimal health and return to work outcomes in addition to their compensation entitlements.

Specifically, it involves ensuring that medical, allied health and rehabilitation providers in a compensation claim:

• Are familiar with the requirements of the NSW Workers Compensation and CTP schemes and know how to navigate the complex scheme framework.

• Have a genuine interest in your recovery and return to work outcomes and do not simply adopt a ‘tick a box’ style approach to your rehabilitation.

• Know how to complete all documentation properly to provide the insurer with accurate information to make timely decisions about treatment and care requests.

• Clearly identify all pre-existing, degenerative and accident related injuries in the relevant medical certificates and treatment reports sent to the insurer to facilitate accurate claim management.

• Are willing to include your lawyer on treatment updates and reports sent to the insurer, in real time, to encourage transparent communication between everyone involved in your claim, for the prevention of disputes.

WILL YOUR GENERAL PRACTITIONER TREAT YOUR WORKERS COMPENSATION OR MOTOR ACCIDENT INJURY?

Imagine being treated by your trusted GP for 10, 15 or even 20 years, only to find out that they are unwilling to assist you with a compensation claim. Seems unimaginable, yet this exact scenario happens regularly to people injured in workplace and motor vehicle accidents in NSW.

If this happens to you, before nominating a new GP it is essential that you consider a few important factors:

• Experience – Does the GP have experience in completing the NSW compensation scheme medical certificates and reports? Getting this correct impacts both your treatment, weekly wages and also compensation rights.

• Communication – Is the GP prepared to correspond with the insurer, your rehabilitation provider and your lawyer openly and transparently to achieve your recovery and return to work goals? Ideal health and compensation outcomes rarely occur when all parties to a claim are not communicating.

• Understanding Your Injuries – Is the GP prepared to spend time with you each month to understand how your injury is recovering, plateauing or deteriorating and to ensure that prompt treatment is obtained? If not, important details may be omitted from your claim, resulting in unnecessary disputes with the insurer.

• Ease of Access – Is the GP located near your home or work? Alternatively will they undertake telehealth consultations? You’ll need to visit them monthly, and sometimes with short notice when things go wrong.

If the answer is ‘No’ to any of the above, then in our experience, achieving ideal health and maximum compensation outcomes are unlikely.

DID YOU KNOW THAT YOU CAN CHOOSE YOUR OWN REHABILITATION PROVIDER?

In the majority of cases involving serious injuries resulting from workplace or motor accidents, the insurance company will assign a rehabilitation provider to assist with the claim. The rehabilitation provider is responsible for coordinating appropriate treatment and facilitating a prompt return to work. Since the rehabilitation provider is appointed by the insurer, injured people often express concerns about potential bias or conflict in favour of the insurer.  This perception bias can have a devasting effect on rehabilitation outcomes as an injured person will commonly call into question every action or recommendation made, resulting in lack of genuine engagement, frustration or even anger.

What people fail to realise however is that it is possible to nominate your own rehabilitation provider for your claim. Much like choosing a new GP, it is essential that you do your research before making the switch.  Some factors to consider, based on our experience with NSW workers compensation and CTP claims include:

• Experience – Does the rehabilitation provider have experience in the compensation scheme you are going through? The workers compensation and CTP schemes in NSW operate quite differently despite being similar in design. You should look for a rehabilitation provider who has at least 2 years’ experience in the compensation scheme you are in to ensure your rehabilitation and return to work outcomes are being met. In the NSW Workers Compensation scheme, it is also important that they are accredited by the State Insurance Regulatory Authority (SIRA) or the insurer will not agree to them being involved in your claim.
  
  
• Communication – Much like a GP, your rehabilitation provider should be willing to communicate with all parties involved in your claim. This includes you, your treatment providers, the insurer and your legal representative. When selecting a rehabilitation provider, it is important that they are open to discussing the claim and treatment objectives, and agree to share their rehabilitation reports in real time with everyone involved in the claim.

• Access to a Manager – Things don’t always happen smoothly in a compensation claim setting. Understanding whether you have access to the rehabilitation provider’s manager to sort out any issues, or to even change rehabilitation providers within a company will give you confidence in the organisation and the recommendations they make.

• Understanding Your Injuries – Not all injuries are the same, and the path to recovery differs from person to person. Your rehabilitation provider needs to have a thorough understanding of your injuries and treatment needs to develop a personalised plan which aims to achieve an ideal recovery, as well as safe return to work and return to activities of daily living.

• Accurate Reporting – Insurance companies require accurate and timely reporting to approve treatment and return to work objectives in accordance with statutory timeframes. Where mistakes are made, or reporting is inaccurate it can lead to treatment requests being denied, incorrect wage payments  being made and even delays in compensation claim payouts.

DO ALL LAW FIRMS PRACTICE ‘REHAB FOCUSED COMPENSATION’?

In short, no. The reality is that most personal injury law firms have never heard of ‘Rehab Focused Compensation’, let alone practiced it, as it is a concept pioneered by Advantage Legal.

In our experience, other personal injury law firms have a tendency to:

• Be reactive in their approach to claim management, only involving themselves in disputes or compensation payouts. This leaves injured people to worry about treatment, rehabilitation and return to work outcomes themselves without sufficient oversight or guidance. A strategic plan incorporating rehabilitation should always be included in a claim

• Adopt a purely litigious approach to claim management, which results in unnecessary disputes with insurers and ultimately longer claim durations.

• Incorrectly assume that if you return to work, you do not have a compensation claim worth pursuing. That assumption can ultimately be very costly if you forgo compensation as a result.

ADVANTAGE LEGAL – PIONEERS IN ‘REHAB FOCUSED COMPENSATION’

Advantage Legal are in pioneers in ‘Rehab Focused Compensation’ and intend on bringing about positive change to personal injury compensation schemes in NSW.

Our Principal Solicitors:                        

• Are Accredited Specialists in Personal Injury Law and have worked in insurance companies, plaintiff law firms, defendant law firms and also as decision makers in a NSW tribunal. This experience gives them a 360 degree view of the personal injury compensation claim process.

• Intentionally hold a smaller portfolio of claims compared to other law firms, allowing more time to be dedicated to understanding injured people, their treatment needs and issues associated with their return to work.

• Adopt a collaborative approach to compensation claims with careful and considered case strategies tailored to each and every client, only adopting a litigious mindset and approach when it is actually required.

• Always focus on assisting injured people to achieve ideal health and safe return to work outcomes in addition to maximising compensation entitlements.

• Recognise that if injured people stay at home and fail to make any attempt to rehabilitate or return to work that an insurance company is unlikely to offer a substantial compensation settlement. Post-accident rehabilitation, ongoing attempts to return to work and clear communication with the insurer are essential.

• Are dedicated to helping cyclists with their ‘return to cycling’ journey. Due to our affiliation with the Bicycle NSW and the cycling community at large, we’ve developed unique strategies to ensure that our cycling client’s get ‘back on their bike’ as soon as possible. We appreciate that a return to cycling for cyclists is critical for both physical and mental health and needs to be included as part of any post-accident rehabilitation plan.