both sides of the fence #12 22 october 2010 the workcover ombudsman: who complains and why?...
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Both Sides of the Fence #1222 October 2010
The WorkCover Ombudsman:Who Complains and Why?
Presented by
Wayne LinesWorkCover Ombudsman
Slide 222 Oct 2010
The WorkCover Ombudsman:Who Complains and
Why? Who can complain?
Who complains?
Types of complaints
Examples
Why do they complain?
Slide 322 Oct 2010
Who cancomplain?
Complaints may be received from anyone affected by the operation of the South Australian workers compensation scheme
● workers
● employers
● service providers
● individuals, organizations (public and private sectors)
Slide 422 Oct 2010
Who complains?
200 formal complaints lodged in the 2 year period 2008-2010
90% lodged by or on behalf of injured workers
9% lodged by or on behalf of employers
1% lodged by or on behalf of service providers
Slide 522 Oct 2010
Types of Complaints
The WorkCover Ombudsman may receive complaints about:
“Administrative acts” under the Act
Failures to comply with Sections 58B or 58C
Other matters relating to rehabilitation and return to work
Slide 622 Oct 2010
Examples of Complaints
Administrative acts under the Act● Complaints by workers
– Refusal of provisional weekly payments
– Inappropriate referral to IME or MPSA
– Delay in complying with S107B or S109
– Pressured by case manager to accept a redemption
Slide 722 Oct 2010
Examples of Complaints
Administrative acts under the Act● Complaints by employers
– Delay in reimbursement of wages paid to injured worker
– Inadequate investigation of claim by case manager
– Failure by case manager to respond to request to review worker’s entitlements
(continued)
Slide 822 Oct 2010
Examples of Complaints
S58B/C and Rehabilitation● Complaints by workers
– Employer failed to ensure injured worker performed duties in accordance with RRTW Plan
– Worker’s requests for retraining ignored
– Worker not consulted with preparation of RRTW Plan
– Employer refused to offer suitable employment
(continued)
Slide 922 Oct 2010
Examples of Complaints
S58B/C and Rehabilitation● Complaints by employers
– Inadequate investigation by WorkCoverSA as to whether reasonably practicable to offer suitable employment
– Delay in arranging worker’s return to work
(continued)
Slide 1022 Oct 2010
Why do they complain ?
Frustration
● Cannot sort it out with the case manager. Desperation
● Time is running out. Need action quickly. Distrust
● Lost faith in the people or the system. Comfort
● Want an independent person involved. Hope
● Perhaps the Ombudsman can help?
Slide 1122 Oct 2010
Contact Details
Office: Level 6, 91-97 Grenfell Street, Adelaide Freecall: 1800 195 202 Mail: GPO Box 1719, Adelaide SA 5001 Email: owo@sa.gov.au Web: www.wcombudsmansa.com.au Fax: (08) 8204 2169
Questions?
The End
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