WorkSafe guides medical professionals through new WorkCover scheme changes

Amendments took effect in March 2024

WorkSafe guides medical professionals through new WorkCover scheme changes

Insurance News

By Roxanne Libatique

Effective March 31, Victoria’s WorkCover scheme underwent significant changes, influencing how general practitioners (GPs) and other medical professionals assess patient eligibility for compensation.

WorkSafe Victoria, the state’s workplace health and safety regulator, has released a guide on the key changes to help medical professionals and their patients.

WorkCover scheme changes as of March 31

  • Redefinition of mental injury: Mental injury is now defined as significant behavioural, cognitive, or psychological dysfunction diagnosed according to the Diagnostic Statistical Manual of Mental Disorders (DSM).
  • Updated eligibility criteria: To qualify for compensation, mental injuries must meet the new criteria.
  • Employment as primary cause: For primary mental injury claims, employment must be the main contributing factor.
  • Exclusion for stress and burnout: Mental injuries caused primarily by stress or burnout from routine work events are excluded from compensation, except in cases involving bullying, harassment, or exposure to traumatic events.

These changes apply only to new mental injuries that occur on or after March 31, 2024.

Weekly payments beyond 130 weeks

Workers must now have a whole person impairment (WPI) of 21% or more and pass the existing work capacity test to continue receiving weekly payments beyond 130 weeks. This requirement is applicable to claims that reach 130 weeks on or after March 31.

Victorian workers remain entitled to up to 13 weeks of provisional payments for mental health treatment and support services to address barriers to returning to work. Workers no longer eligible for weekly payments after 130 weeks can still access support services, including occupational rehabilitation.

Importance of supporting medical practitioners

Commenting on the latest changes, WorkSafe CEO Joe Calafiore emphasised the organisation's role in supporting medical practitioners during this transition.

“WorkSafe is committed to ensuring that medical practitioners receive the support and resources they need to assist patients in navigating the evolving landscape of the WorkCover scheme,” he said. “This includes fostering a collaborative environment where practitioners can confidently guide patients through the necessary changes, ultimately ensuring their wellbeing remains at the forefront of our modernised approach.”

Meanwhile, Insurance and Care NSW (icare) recently announced an 8% increase of average workers’ compensation premium rates in New South Wales for the 2024-25 financial year. A spokesperson said the additional revenue will help the Nominal Insurer scheme return to a break-even funding level.

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