Modification History
Not applicable.
Unit Descriptor
Unit descriptor |
This unit describes the performance outcomes, skills and knowledge required to process and analyse both workers compensation and sick leave claims. It also covers the establishment of rehabilitation needs and return to work programs, and their monitoring, ongoing review and evaluation. No licensing, legislative, regulatory or certification requirements apply to this unit at the time of endorsement. |
Application of the Unit
Application of the unit |
This unit applies to human resources managers or specialists who manage claims and ensure that the organisation provides appropriate support for the worker. Note that the unit does not in any way address the process of curing the worker of their injury or illness as this is the task of the health professional. Instead the unit focuses on the process of dealing with claims and ensuring that the organisation supports the worker through return to work programs. In large organisations this work may be a full time role for some people, in smaller organisations it would typically be a part of a broader role with a human resources focus. |
Licensing/Regulatory Information
Not applicable.
Pre-Requisites
Prerequisite units |
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Employability Skills Information
Employability skills |
This unit contains employability skills. |
Elements and Performance Criteria Pre-Content
Elements describe the essential outcomes of a unit of competency. |
Performance criteria describe the performance needed to demonstrate achievement of the element. Where bold italicised text is used, further information is detailed in the required skills and knowledge section and the range statement. Assessment of performance is to be consistent with the evidence guide. |
Elements and Performance Criteria
ELEMENT |
PERFORMANCE CRITERIA |
1. Analyse claims |
1.1. Ensure that the organisation has and maintains a current Workers' Compensation insurance policy (or equivalent) as required by the applicable legislation 1.2. Process claims in accordance with organisational policies, and legal and insurance requirements 1.3. Dispute claims where insurer or organisational requirements are not met 1.4. Notify rehabilitation provider in accordance with organisational procedures 1.5. Advise claimants as to whether their claim has been accepted 1.6. Analyse claims to identify the nature of the illness/injury and prepare report/s 1.7. Identify projected period of absence and where rehabilitation assistance is required, and ensure arrangements are made in the work team to deal with absence |
2. Establish rehabilitation/return to work program |
2.1. Ensure consultation occurs between rehabilitation provider and treating doctor 2.2. Ensure consultation occurs between rehabilitation provider, relevant managers and employee 2.3. Consider job redesign, reduced hours and alternative duties in the light of medical advice 2.4. Design a rehabilitation/return-to-work program to achieve a successful return-to-work 2.5. Obtain approval for return-to-work program by relevant managers 2.6. Establish rehabilitation program with employee 2.7. Undertake risk analysis in relation to proposed program and mitigate risk where appropriate 2.8. Commence program as close to the time of the accident/illness as possible |
3. Monitor/evaluate rehabilitation/ return to work program |
3.1. Encourage regular feedback/communication between provider, supervising manager and employee 3.2. Organise regular contact and support between provider and employee 3.3. Identify breaches of the return-to-work program and take remedial action promptly 3.4. Refer return-to-work program to workers compensation authorities where breaches occur 3.5. Modify return-to-work program where appropriate if it is not delivering the required outcomes 3.6. Evaluate each rehabilitation/return-to-work program at its conclusion and implement recommendations for system improvement where appropriate |
Required Skills and Knowledge
REQUIRED SKILLS AND KNOWLEDGE |
This section describes the skills and knowledge required for this unit. |
Required skills |
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Required knowledge |
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Evidence Guide
EVIDENCE GUIDE |
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The Evidence Guide provides advice on assessment and must be read in conjunction with the performance criteria, required skills and knowledge, range statement and the Assessment Guidelines for the Training Package. |
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Overview of assessment |
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Critical aspects for assessment and evidence required to demonstrate competency in this unit |
Evidence of the following is essential:
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Context of and specific resources for assessment |
Assessment must ensure:
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Method of assessment |
A range of assessment methods should be used to assess practical skills and knowledge. The following examples are appropriate for this unit:
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Guidance information for assessment |
Holistic assessment with other units relevant to the industry sector, workplace and job role is recommended, for example:
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Range Statement
RANGE STATEMENT |
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The range statement relates to the unit of competency as a whole. It allows for different work environments and situations that may affect performance. Bold italicised wording, if used in the performance criteria, is detailed below. Essential operating conditions that may be present with training and assessment (depending on the work situation, needs of the candidate, accessibility of the item, and local industry and regional contexts) may also be included. |
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Claims may include: |
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Rehabilitation provider may be any authorised health professional including: |
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Alternative duties may include: |
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Risk analysis means: |
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Mitigation means: |
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Workers compensation authorities means: |
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Evaluation means: |
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Unit Sector(s)
Unit sector |
Competency field
Competency field |
Workforce Development - Human Resource Management |
Co-requisite units
Co-requisite units |
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