Both Sides of the Fence #12 22 October 2010 The WorkCover Ombudsman: Who Complains and Why? Presented by Wayne Lines WorkCover 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 can complain? 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 % 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, Grenfell Street, Adelaide Freecall: Mail: GPO Box 1719, Adelaide SA Web: Fax: (08)

Questions? The End