NSW Health psychological injury claim handling draws ire

Questions have been raised over the way NSW Health handles psychological injury claims among its employees, with internal documents showing the claims are sent to the department's lawyers before they can be assessed by a medical officer.

Critics - including some employees who have lodged claims - say the department's new pre-liability early intervention process for psychological injury suggests claims are treated with suspicion and seen as potentially fertile ground for fraud.

NSW Health has firmly rejected the assertion the claims are intended to discredit workers, saying the process enables employees to fast access treatment and removes barriers for claimants.

From February 1 psychological injury claims where liability is a concern are sent to the local health district's legal team before an independent medical officer (IMO), according to the guidelines. This fast-tracking process allows workers to access "reasonably necessary treatment" while their claim is investigated.

"Delays in liability decisions can have a negative impact on the worker if they are unable to access the necessary treatment to facilitate their recovery," the document read.

"Immediate treatment which is reasonably necessary, can be sought by the worker even though the claim is reasonably excused."

But the guidelines also stipulate that solicitors help tailor questions for an IMO to ask employees who have lodged a psychological claim.

"[Solicitors'] advice will also include the most suitable and appropriate questions for Independent Medical Investigations (IMEs) to ensure relevant information is obtained," the process document reads.

The NSW Greens MP David Shoebridge said subjecting psychological injuries to this kind of scrutiny sent a clear signal to employees that they treat them as less medically serious than physical injuries and potentially fraudulent.

"If an employer's first response is to send their claim to a lawyer before a doctor then alarm bells are definitely ringing," he said.

"When, from the outset, a lawyer for the employer is helping to craft the questions, how can we expect a fair outcome?

"Independent medical officers are no more independent than the assumptions of the questions being asked," Mr Shoebridge said.

"This is a process designed to put barriers in the way of proper compensation for those workers who suffer psychological injury," Mr Shoebridge said.

According to the document, one of the reasons solicitors are called in early is to help "minimise the ongoing exposure for the LHD" as well as determine liability, advise on investigations and management strategies.

A benefit of the process was to "reduce the average cost of psychological claims", in addition to improving effectiveness and reducing the duration rate of the claims.

That health authorities were enacting the guidelines was "especially distressing", Mr Shoebridge said.

He called on the Minister of Health to intervene and have the guidelines withdrawn.

A spokesperson for NSW Health said the department prided itself on supporting employees dealing with both physical and psychological injuries.

"Claims the new guidelines are intended to discredit our staff are completely wrong," the spokesperson said in a statement.

"These early intervention processes are focused on removing barriers for people lodging claims for any type of injury, including psychological."

The spokesperson said the policy was based on modern research around the treatment of post-traumatic stress disorder and enabled employees to access treatment immediately when a claim is lodged, irrespective of the liability decision.

Maurice Blackburn injuries and compensation lawyer Josh Clarke said psychological claims are inherently complex.

"It's not like if you break an ankle at work, you can point to a scan and see the broken bone," he said.

"Bullying and harassment [common sources of psychological injury] can involve multiple people over a long period of time.

"It is fair to send out an investigator but to get lawyers involved with an aim to minimise the exposure is a bit concerning to say the very least," Mr Clarke said.

A spokesperson for iCare said "Neither the guidelines nor the workers compensation schemes are designed to save on cost".

They said the role of lawyers was to provide advice "having regard to the provision of the relevant legislation".

A claims manager or scheme agent would then make a decision on liability based on an objective review of the facts, the spokesperson said.

An injured worker who is concerned about their claim not being accepted by their employer also has the right to seek legal advice, the spokesperson said.

Health Minister Brad Hazzard said "NSW Health have assured me that caring for staff who may be suffering from work-related health issues is a priority and it is proactive in supporting its workers."

Mr Hazzard said he understood from the department that referring cases to solicitors at an early phase expedited an informed liability decision so claims could be resolved quickly.

The story NSW Health psychological injury claim handling draws ire first appeared on The Sydney Morning Herald.

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