The core objective of compensation authorities is to facilitate recovery and return to work, but a body of research suggests that claims processes themselves can significantly impact on these outcomes. This research helps compensation bodies understand and address the impact their processes can have on claimant recovery.

Comparative analyses

In Australia, there are ten major public compensation systems in operation, assisting more than 200,000 workers with their claims and return to work process on an annual basis. Return to work outcomes vary across different compensation systems, largely due to differences in system design. The ComPARE Project closely examined the differences in these systems to identify what factors are most effective in facilitating return to work.

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Workers’ compensation claims among nurses and ambulance officers in Australia, 2008–2014 Research Report

This study used the ComPARE dataset to compare the rates and types of compensable injuries in nurses and ambulance officers. The study identified that ambulance officers were 5-7 times more likely to be injured than all other workers. Musculoskeletal injury was the leading injury type. The study also highlighted a growing trend of claims related to occupational violence in both sectors.

Authors: Gray, S; Collie, A

Keywords: claims management; claim outcomes; musculoskeletal injury; occupational violence; workplace injury

Date published: May 2016

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Identifying strategies to reduce disputation in the Victorian workers’ compensation scheme Research Report

This research project set out to identify strategies to improve workers’ compensation claims management and reduce the number of claims requiring dispute resolution. A rapid review of the evidence base was conducted to identify best practice, and extensive stakeholder consultation, including a forum focused on the Victorian worker’s compensation scheme, took place. The forum identified four key areas to improve in the current system and several strategies were identified to improve these issues.

Authors: Bragge, P; Goodwin, D

Keywords: claims management; compensation system; decision-making; dispute resolution

Date published: March 2016

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VOTOR-TAC Linkage Report: Impact of the TAC Recovery Model Research Report

This project linked VOTOR and TAC administrative data to assess the impact of the TAC recovery model on patient outcomes, the association between fault and client outcomes, claim costs for clients who sustained pelvic ring fractures, and claim costs for those with tibial plafond fractures. At 12-months post-injury, there was evidence that the probability of reporting moderate to severe has decreased since the model was introduced, and physical health scores have improved. However, the introduction of the Recovery model was associated with increased claim costs at 12-months. The initiatives expected to impact client outcomes were implemented post 12-months, and client outcomes are expected to improve in future analyses.

Authors: Gabbe, B; Simpson, P

Keywords: orthopedic trauma; persistent pain; claim outcomes; compensation system

Date published: July 2015

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VOTOR-TAC linkage report: Association between fault status and patient reported outcomes in hospital orthopaedic cases.pdf Research Report

The ISCRR Victorian Orthopaedic Trauma Outcomes Registry (VOTOR) project plan includes deliverables related to linkage of VOTOR and TAC claims data at regular intervals. This report analysed client perception of fault in a road vehicle accident and TAC and client recovery outcomes. The study identified a relationship between the perceptions of fault and patient outcomes. Clients who were not at fault, or believed that they were not at fault, demonstrated much poorer patient-reported outcomes than VOTOR Recovery clients who were at fault. This highlights a potential psychological factor in client recovery.

Authors: Gabbe, B; Simpson, P

Keywords: rehabilitation; psychosocial factors; orthopedic trauma; claim outcomes; return to work; RTW

Date published: June 2015

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The cost of comorbidity to the Transport Accident Commission compensation scheme Research Report

This research looked at the cost of pre-injury factors on claims to determine if pre-existing conditions affected claims and if so, what conditions had an impact. The findings revealed that pre-injury factors have a relatively low impact on total TAC claims costs, with the exception of pre-injury mental health service use, which impacted costs significantly. The results also showed that pre-existing health conditions including diabetes, cardiovascular disease, recent surgery, and back pain influenced subsequent hospital, medical and paramedical expenses.

Authors: Hassani Mahmooei, B; Berecki-Gisolf, J; Hahn, Y; McClure, R

Keywords: claim outcomes; claims management

Date published: July 2014

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VOTOR Victorian orthopaedic trauma outcomes registry TAC linkage report Research Report

This project linked the Victorian Orthopaedic Trauma Outcomes Registry and TAC administrative data to assess the impact of the TAC recovery model on patient outcomes, the association between fault and client outcomes, claim costs for clients who sustained pelvic ring fractures, and claim costs for those with tibial plafond fractures. Analysis revealed that the TAC recovery model was associated with better outcomes in the treatment of pain.

Authors: Gabbe, B; Simpson, P

Keywords: claims management; claim outcomes

Date published: December 2013

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Healthcare provider interactions in workers’ compensation schemes - Implications for injured workers Poster

This review demonstrates that in many instances, injured workers with long-term complex injuries experience difficulties when receiving health services in the context of workers’ compensation systems.

Authors: Kilgour, E; Kosny, A; McKenzie, D; Collie, A

Date published: October 2013

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The health effects of compensation systems study: Summary of findings Research Summary

Summary of a longitudinal study of a cohort of hospitalised injury patients who claimed compensation in Victoria, New South Wales and South Australia, combined with a questionnaire about participants’ experiences of the claims process.

Authors: Grant, G; O’Donnell, M; Spittal, M; Studdert, D

Keywords: claims management; compensation system; claim outcomes

Date published: September 2013

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Understanding independent medical assessments - a multi-jurisdictional analysis Environmental Scan

This review examined how compensation bodies use medical assessments including their processes and policy, procurement models and quality assurance. The medical assessment process varies widely among jurisdictions and each approach has its merits and drawbacks. The review identified a number of practices that may improve aspects of the medical assessment process. The review recommended future research directions with the intention to improve medical assessments for compensation bodies, clients and healthcare professionals.

Authors: Kosny, A; Allen, A; Collie, A

Keywords: claims management; compensation system; claim outcomes; rehabilitation; return to work; RTW

Date published: June 2013

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The individual, family and societal impacts of injury Presentation

In general much is known about the function, activity and participation of the injured individuals. Indeed, estimates of the burden of injury are based almost entirely on knowledge of the impact on the injured person. However very little is known about the impact of injury beyond the injured person, such as family members, carers, compensation systems, healthcare providers. A presentation at ACHRF 2012.

Authors: Collie, A

Keywords: claim outcomes; claims management; social factors; compensation system

Date published: October 2012

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Identification of sources of injury outcomes data in Australia Research Report

Information about injury outcomes is necessary to guide the public health response to injury, identify and inform priorities, assist with policy setting and strategic health services planning, and to monitor the impact of changes in care and interventions. A coordinated approach to identifying sources of injury outcome data has significant benefits for injury stakeholders. The benefits include reduced duplication of effort in collecting data and a greater understanding of data that may be used for organizational performance monitoring.

Authors: Jennings, P; Gabbe, B; Collie, A

Keywords: Jennings P, Gabbe B, Collie A. Identification of sources of injury outcomes data

Date published: July 2011

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Information based interventions for injury recovery: A rapid review Evidence Review

Compensation authorities are well positioned to promote information and education based interventions to facilitate the recovery of injured persons following transport accidents. This review examined the academic and grey literature regarding effective information and education based interventions for promoting recovery from injury to determine approaches that may be applicable in the Australian injury compensation setting. Although the review identified a range of applicable studies, the vast majority did not report details of the personal injury compensation or health insurance system for the jurisdiction(s) in which the study took place. As such it is difficult to draw generalisable conclusions about effective interventions for promoting recovery from traumatic injury, and very difficult to interpret the results of the review in terms of their applicability to the Australian compensation environment. Despite the methodological quality of the literature reviewed, this study identified types of information and education based interventions that may be effectively implemented in the Australian compensation system.

Authors: Clay, F; Collie, A; McClure, R; Palagyi, A

Keywords: compensation system; evidence base; rehabilitation

Date published: July 2011

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To strike a balance: A history of Victoria’s workers’ compensation scheme, 1985–2010 Research Report

This history outlines the evolution of WorkSafe from its first incarnation as WorkCare through to the development of WorkCover, and then into its current form. It highlights the significant influence that state politics and corporate management styles have had on the scheme, and it also details the organisation’s success in shifting Victorians’ cultural attitudes on workplace safety and occupational accidents and their aftermath. The ‘compo’ culture of the mid‐1980s has been replaced by a safety culture, whereby the community expects that employers provide safe workplaces for their employees and that injured workers will use the system fairly.

Authors: Stylianou, M

Keywords: Stylianou M.

Date published: June 2011

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Management of noise-induced hearing loss

Noise-induced hearing loss at work is a significant safety issue. These projects assess current policy and practice to improve the way that existing cases are managed.

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The relationship between compensation and recovery following a motor vehicle accident: A systematic review Research Report

This review provides a systematic evaluation of the literature investigating the relationship between compensation and recovery from a motor vehicle accident. Despite the objective of compensation to aid recovery from injury, this systematic review confirmed findings from previous systematic reviews that compensation does not facilitate recovery following a motor vehicle accident, with respect to physical health, psychological health and chronic pain. Furthermore, being involved in a Tort compensation scheme, as opposed to a No Fault compensation scheme, was associated with poorer recovery from a motor vehicle accident. However, although previous studies have shown that those who receive compensation have worse injuries than those who do not, such factors were not controlled for in the majority of studies included.

Authors: Giummarra, M; Ioannou, L; Gibson, S; Ponsford, J; Fielding, J; Cameron, P; Jennings, P; Georgiou-Karistianis, N

Keywords: compensation system; claims management; rehabilitation

Date published: March 2013

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