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SISA Claims Management Course Expression of Interest

A

Tuesday 2 April 2024

SISA is currently assessing the level of need for a Claims Management Certificate for Members and Associates.  It is noted that there has been no specific industry standard Claims Management Certificate in South Australia for some time, which means Members hold the responsibility to train staff and leaders on all aspects of workers compensation.

SISA is considering a Claims Management Certificate that will take approximately 10-12 months to complete (1 module per month) with modules to include (but not limited to):

 

Modules

Compensability of Claims

  • Physical injuries
  • Psychological injuries
  • Application (e.g. WFH, journey etc.)
  • Interim benefits
  • AWE calculations
  • Investigations

Permanent Impairment

  • When to consider for a PIA
  • Preparing for a PIA
  • Reviewing a PIA report
  • Determination & close out

 

Noise Induced Hearing Loss

  • Assessing a new NIHL claim
  • Medical investigations
  • Employment investigations
  • Determining liability
  • Dispute management
  • Prevention of NIHL claims

 

Claim Benefits

  • Income support
  • Medical expenses
  • Pre-approval requests
  • Therapeutic appliances
  • Property damage / transport
  • Discontinuing / reducing income support
  • Supplementary income
  • Income support reviews

 

Dispute resolution

  • SAET processes (e.g. IDH, Conciliation, JSC)
  • IMA’s & how to use them
  • Strategic use of SAET
  • Discovery & evidence use
  • Preparing for & attending Trial

 

Injury Management Programs

  • Early intervention programs
  • Managing psychosocial factors
  • Record management
  • Managing confidentiality
  • Claims management system considerations
  • RTWSA IM Standards
  • Preparing for and excelling at an IM evaluation

Suitable Employment & RRTW Plans

  • Section 18
  • Host employer arrangements
  • New/other employment requirements
  • What is reasonably practicable
  • RRTW Plans
  • SAET considerations
  • Service Standards

 

Gathering & Analysing Medical Data

  • Writing great medical report requests
  • When to refer for an IME, FCE, WSA, ICE, ADL, clinical notes etc. & who
  • Interpreting medical advice
  • Medical terminology

 

Serious / Complex Case Management

  • Seriously injured workers
  • Recoveries
  • Excess of loss notifications
  • Death claims
  • Redemptions

It would be appreciated if all Members could complete a short Expression of Interest to inform SISA as to whether a Claims Management Certificate is needed for the sector.  We ask that the below 2 minute survey is completed and submitted at your earliest convenience.

Link to survey:

https://qualtricsxmf3bbgxv5s.qualtrics.com/jfe/form/SV_3dRVDjXwCzc5cai