S16. Case conferencing

Commencement date: 21 October 2019

Case conferences bring together the worker, the nominated treating doctor and other parties such as the insurer, the employer and workplace rehabilitation providers to discuss how to deliver the best possible return to work outcomes for the worker.

Principle

Case conferences will be conducted in a manner that promotes return to work and respects the worker’s right to confidential medical consultations.

ExpectationsBenchmarks
S16.1

When seeking to arrange a case conference, the insurer is to:

  • advise the worker of the insurer's intention to seek a case conference and the reasons for doing so
  • provide a statement of the purpose and agenda for the case conference to all parties involved, and
  • schedule the case conference at a time separate to the worker’s medical consultation, unless otherwise agreed by the worker and the nominated treating doctor.

Evidence on claim file

Effective injury management is a coordinated effort involving the worker, employer, nominated treating doctor and others, such as a workplace rehabilitation provider. Communication between these stakeholders should be transparent and collaborative.

A worker’s scheduled medical review with their nominated treating doctor is confidential and does not involve other stakeholders. However, the involvement of other parties in the recovery process can assist and promote the worker’s recovery to good health and to work.

A case conference is a meeting (either in-person or over the phone) with the worker, the nominated treating doctor and either some, or all, of the other members of the support team such as the insurer, employer and a workplace rehabilitation provider.

A case conference can be used to set goals, ensure roles and responsibilities are understood, and to agree on timeframes for recovery at/return to work.

A case conference is separate to the worker’s scheduled medical review. If a stakeholder requests the insurer arrange a case conference, a separate appointment should be made for it This is usually adjacent to the worker’s scheduled medical review but also may be at another time and/or date.

There may be limited circumstances where this is not possible, for instance, rural or remote locations with limited availability. The insurer should liaise with the worker to identify an appropriate alternative, which may include conducting the case conference via video or conference call, or obtaining the worker’s agreement to attend their scheduled consultation.

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