Work Capacity Assessment

An insurer is required to conduct work capacity assessments of an injured worker at the intervals recommended in the SIRA Guidelines for claiming compensation (Part B1.2).

An assessment may be conducted at any time during the currency of a claim, but an assessment must be conducted after the worker has received 78 weeks of compensation payments, and at least once every 2 years thereafter (if the worker remains entitled to compensation).

This requirement for regular work capacity assessments does not apply to workers with highest needs (more than 30% WPI).

A worker with highest needs is not to undergo work capacity assessment unless the insurer thinks it is appropriate and the worker requests it.

Weekly payments can be suspended if a worker refuses to attend, or to properly participate in, a work capacity assessment.

An insurer may take into account all available information when conducting an assessment, including:

• Certificates of capacity issued by the nominated treating doctor
• Medical reports from treating doctors
• Independent medical assessments arranged by the insurer
• Reports from injury management and rehabilitation consultants
• The injured worker’s statements regarding his or her capacity and transferable skills
• The employer’s statements regarding the availability of suitable employment.