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Case conferences

For: Claimants Employers and managers Service providers Advocates

At a case conference meeting, participants discuss an employee’s claim, rehabilitation or return to work.


Case conferences explained

A case conference is a planned meeting which brings interested people together.

There are different types of case conferences. Each type of case conference has a different purpose and different people attend.

  1. Return to work case conferences
  2. Claims manager and employer case conferences
  3. Bulk case conferences.

Reasons for a case conference

A case conference is an opportunity to:

  • ensure all interested people are working towards the same goal
  • coordinate roles, establish goals and activities, and identify responsibilities
  • share information early in a claim
  • discuss complex cases
  • work together on cases where return to work has stalled.

Principles for effective case conferences

Collaborative

Actively involve all interested people to improve outcomes.

Bring participants and interested people together for a discussion, where information is shared openly, the conversation is respectful, and opportunities are provided for all to contribute to mutually agreed solutions.

Empowered

Empower the employee to be at the centre of their recovery at work.

Empower the employee to be an active participant in their recovery at work. This includes rehabilitation and self-management.

Purposeful

Focus on outcomes to optimise an employee’s function, recovery and participation.

Have a clear purpose and set realistic goals that address the main risk factors, barriers and supports.

Informed

Ensure rehabilitation and recovery at work is based on the best available information.

Make decisions based on the best available evidence and experience from the employee, the employer, the general medical practitioner and other treatment providers.

Holistic

Adopt a biopsychosocial model.

In this model, the biological, psychological and social risk factors to recover at work are identified and addressed. This is done to optimise function, support recovery and maximise independence.

Who attends a case conference

The people who attend a case conference depends on the type of case conference and its purpose.

Employees are only involved in return to work case conferences.

Other people who may be involved in a case conference meeting are:

  • supervisor
  • rehabilitation case manager
  • medical practitioner, such as general practitioner (GP), psychologist, physiotherapist or specialist
  • workplace rehabilitation provider
  • claims manager
  • injury management adviser.

Return to work case conferences

Return to work case conferences are one type of case conference. They bring interested people together to support recovery at and return to work outcomes.

Purpose of a return to work case conference

Those taking part in a return to work case conference can:

  • discuss the benefits of return to work
  • set goals that are specific, measured, achievable, relevant and timely (SMART)
  • consider the employee's capacity for work
  • identify barriers that may be impacting an employee’s return to work
  • agree on the support an employee needs to recover at, or return to, work. This can include flexible work arrangements, adjusting the workplace or workplace equipment, or alternative duties
  • decide who is responsible for actions.

Roles and responsibilities

Table 1: Roles and responsibilities in a return to work case conference - employers and rehabilitation case managers, medical practitioners, and workplace rehabilitation providers.
Roles and responsibilities Employer and rehabilitation case manager Medical practitioner Workplace rehabilitation provider
Request a return to work case conference X X X
Organise the case conference X   X
Provide advice on capacity for work   X X
Certify capacity for work   X  
Provide advice on treatment and how treatment supports the return to work goal   X X
Provide advice on restrictions, alternative duties and modifying the workplace X X X
Identify barriers and strategies to employee returning to work X X X
Identify potential suitable duties X X X
Provide inputs to the return to work plan X X X

Summarise the actions and outcomes and distribute to all participants

X   
Implement actions X X X
Monitor progress towards goals and review as requested X X X
Provide ongoing support to employee X X X
Make decisions about liability for treatment    
Table 2: Roles and responsibilities in a return to work case conference - employees, carers and family members, and claims managers.
Roles and responsibilitiesEmployee Carer and family member Claims manager
Request a return to work case conference X X X
Organise the case conference    X
Provide advice on capacity for work X   
Certify capacity for work    
Provide advice on treatment and how treatment supports the return to work goal    
Provide advice on restrictions, alternative duties and modifying the workplace X X  
Identify barriers and strategies to employee returning to work X X X
Identify potential suitable duties X   
Provide inputs to the return to work plan X   X
Summarise the actions and outcomes and distribute to all participants    X
Implement actions X X X
Monitor progress towards goals and review as requested X   X
Provide ongoing support to the employee   X X
Make decisions about liability for treatment    X

Guides and checklists

We have developed resources to assist with return to work case conferences.

If you are have engaged or are working with a workplace rehabilitation provider, they may use their own similar tools.

Steps to organising a return to work case conference

Usually, the rehabilitation case manager or workplace rehabilitation provider, if one has been engaged, organise the return to work case conference. However, any interested person can initiate a case conference.

Following these steps provides a consistent way to organise and manage a case conference.

Step 1 – Identify need for a case conference

A return to work case conference can be triggered when:

  • an employee has been having, or is expected by their medical practitioner to need, significant time off work due to their injury
  • numerous providers are involved in a complex claim
  • the employee’s return to work process is stalling
  • an unexpected change in the employee’s condition affects their recovery and return to work
  • a medical practitioner or employee makes a request to discuss recovery and return to work
  • medical information changes the recovery or return to work goal and this needs to be discussed with external people
  • barriers to return to work cannot be overcome through traditional methods
  • conflicting advice is received about the employee’s capacity for work.

Step 2 – Prepare for the case conference

Preparing well is key to getting the best outcomes from a return to work case conference.

Preparing and planning includes to:

  • confirm who will chair the discussion. This is usually the rehabilitation case manager or the workplace rehabilitation provider, if one has been engaged.
  • schedule the case conference
  • invite participants
  • develop a draft plan
  • compile relevant supporting information

Participants should be given enough time to contribute to the draft plan before it is finalised and circulated.

It is important to ensure that everyone agrees on the purpose and desired outcome.

Step 3 – Hold the case conference

A return to work case conference is usually held at the medical practitioner’s rooms.

Effective chairing of the conference involves:

  1. Introduce the participants, explain the chair’s role and the role of other participants.
  2. Discuss the points outlined in the plan, as well as other issues that emerge.
  3. Ensure all participants have an opportunity to contribute to the discussion.
  4. Focus on setting realistic and achievable goals.
  5. Summarise the agreed outcomes and actions, including who is responsible for actions and when they are due to be delivered.

Step 4 – Actions after the case conference

After the conference, the rehabilitation case manager or workplace rehabilitation provider:

  • distributes the completed case conference plan to participants with agreed actions and timeframes
  • engages with interested people who did not attend the meeting, to make sure they are aware of the outcomes
  • incorporates any required changes into the rehabilitation program and provides a copy to participants and interested people.

Step 5 – Review outcomes

Following the return to work case conference, participants and interested people should:

  • actively monitor the activities and goals against agreed timeframes
  • keep medical practitioners updated on progress and any changes
  • consider if a future case conference is needed.

Steps to organising a return to work case conference

Training

We provide e-guidance training for rehabilitation case managers to help build capability in organising and conducting return to work case conferences. Training is provided through our learning management system called Comcare LMS.

For more information about the courses we offer, see Training and learning.

Claims manager and employer case conferences

This type of case conference is a meeting between the claims manager and an employer to discuss liability or rehabilitation matters for a particular claim.

The purpose of this type of case conference can include:

  • developing a plan to manage the claim
  • developing a plan to progress and ensure safe and successful recovery at, and return to, work
  • providing mentoring or support from rehabilitation experts
  • ensuring the claims manager and the employer are meeting their responsibilities under the Safety, Rehabilitation and Compensation Act 1988 and any service level agreements that are in place.

A premium paying employer can request a case conference with our claims management team to discuss liability or to ask for help from an injury management adviser to identify return to work strategies.

To request a case conference please contact your Account Manager, send an email to eam@comcare.gov.au or call us on 1300 366 979.

Bulk case conferences

A bulk case conference is a type of case conference between Comcare and an employer to discuss multiple claims.

Some reasons premium paying employers request a bulk case conference are:

  • the lifetime cost estimates of the claims exceed an identified figure
  • costs to date of the claims exceed an identified figure
  • absence from work exceed an expected timeframe.

To request a bulk case conference please contact your Account Manager, send an email to eam@comcare.gov.au or call us on 1300 366 979.


More information

If you have an enquiry about claims manager and employer case conferences, email Comcare's Employer Account Management team at eam@comcare.gov.au.

Page last reviewed: 23 August 2024

Comcare
GPO Box 9905, Canberra, ACT 2601
1300 366 979 | www.comcare.gov.au

Date printed 21 Nov 2024

https://www.comcare.gov.au/claims/getting-you-back-to-work/case-conferences