Track Recovery v43.0
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Summary
1.0 Identify change of client's circumstances
Recovery Assistant, Recovery Coordinator, Recovery
Partner
Objective
To ensure we are effectively tracking how a client’s recovery
a Receive information for changes in circumstances via
is progressing. The process identifies the steps to determine if
email, fax, inbound mail, digital, face to face or phone call
and what intervention is required to progress a client’s recovery
from the client, providers, vendors, general practitioner
when their circumstances change.
(GP), employer, family members, whanau, associates,
safe contact person, clinical staff member or advocate.
It allows us to be proactive in a client’s recovery, including iden-
NOTE What information can indicate a change in
tifying if a client is in a vulnerable situation, eg there is a poten-
circumstances?
tial threat to their safety, health, or wellbeing. If you're working
• recovery milestones are not met
on someone's claim and recognise the signs that they may be in
• updated or new supports required
a potentially vulnerable situation, you must immediately report
• change in diagnosis
your concerns to your manager so decisions can be made
• additional diagnosis
about reducing the chances they will come to harm.
• needs and level of support from ACC has in-
creased or decreased
• client is planning to return to work
Background
• change in employment circumstances
Track recovery identifies changes that occur during the different
• recovery complication, ie infection.
stages of recovery. Injury recovery can proceed through four
• a new ACC18 has been received post the client
key stages: acute, rehabilitation, adaption and stable. Healing
returning to work
can progress backward or forward depending on internal and
• client has been transitioned to a different
external factors.
Recovery Team
• new claim received
In many circumstances when the Recovery Plan is created,
NOTE What if the Client advises you they have re-
the client circumstances change, for example the client is not
signed, been terminated or received redun-
coping with job loss, is suffering pain, or there are concerns
dancy?
and/or requests for supports or information. Track recovery
If it is a work injury, and the client has now lost
identifies the triggers that will help us to proactively respond to
their job:
a client's needs and take the required action or interventions.
1) Add the same employer as a second employer
There are many different types of referrals and assessments
participant
and each one of these has an opportunity to proactively inform
2) Update them to previous
when intervention is required. Examples include treatment
This ensures the employer stops receiving inca-
reports, vocational rehabilitation and independence reports,
pacity updates via their MyACC4B account
social rehabilitation, inbound contact, eg regarding a change of
circumstances, such as not managing, job loss, pain, concerns
Add an Employer to a Claim
and/or requests for supports, or information received indicating
Client resigns, loses job / termination, is made
ACC or a client may be in breach of legislative compliance,
redundant
such as code complaints, review, fraud, etc.
NOTE What if the change of client circumstances is
While providing support to our clients, we may identify that
a new claim being received that requires
they are at risk. It is important to understand how to respond to
cover to be assessed?
vulnerable situations. Vulnerable situations for clients come in
Refer to the GUIDELINES Assessing claim for
many forms. Sometimes the potential for harm comes from the
cover in Recovery Team to identify the actions
addictions, mental health conditions, or aggressive or anti-social
you will need to complete on both claims.
behaviours the person exhibits. Sometimes it is the person’s
NOTE What if you receive information that confirms
poor health or medical conditions in combination with the condi-
a client is no longer entitled to receive a sup-
tions they’re living in. Sometimes the potential harm comes from
port or entitlement?
others the person is living with.
Go to Stop Supports.
Owner
[Out of Scope]
PROCESS Stop Supports
Expert
[Out of Scope]
GUIDELINES Assessing claim for cover in Recovery
Team
Procedure
PROCESS
Create or Update Recovery Plan
Recovery Assistant, Recovery Coor-
dinator, Recovery Partner
ACC > Claims Management > Manage Claims > On-Board Client and Manage Recovery > Track Recovery
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NOTE What if the client's claim is in Enabled Recov-
NOTE What if information indicates the claim needs
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ery?
to be transitioned to another Recovery
Clients streamed to Enabled Recovery do not re-
Team?
quire a Welcome Conversation and can self
Go to Transition Claim process to determine if
manage by either using MyACC or by calling us
the claim should be transitioned.
when they need support.
PROCESS Transition Claim
If a client calls us to set up weekly compensation
NOTE What information should be reviewed if claim
or supports, you can set up these for them by
is transitioned from Assisted Recovery?
completing (only) the relevant sections of the
Go to Transitioned Client Claim Review to review
Welcome Conversation in Salesforce, however
the appropriate information when a claim is
please encourage them to continue to self-
transitioned into Supported Recovery or Part-
manage via MyACC.
nered Recovery
Transitioned Client Claim Review
If a client is having trouble with MyACC, go to
MyACC for Client process to support them.
b Review client information:
• Check if the client has an identified language need.
Task management
• Confirm who is the best person to speak with. If your
It is not mandatory to have an open task or
client has a complex injury, this may be family/whanau, a
Recovery Plan on Enabled claims. If you receive
clinical staff member or a safe contact person.
a task via Salesforce such as MyACC or Elec-
• Review recent contacts to minimise the client repeating
tronic Medical Certificate, you would action the
themselves.
request appropriately and then close the task in
c Review the medical certificate details:
Salesforce.
• Check if the client is employed, and whether they are off
work or currently working.
If you are unclear on whether the client should
• Review medical certificates and understand how their
be in Enabled or Assisted Recovery, refer to the
recovery is progressing.
transition guidelines in Transition Claim process.
• Understand the Expected Claim Outcome (ECO) for the
PROCESS Invite Client to MyACC
client’s injury.
NOTE What if you receive information from Integrity
Refer to the information below - Supporting Recovery at
Services?
work - to consider how to support your customer at work.
Integrity Services might pass on information they
NOTE What if the medical certificate indicates a
receive about a client that doesn’t warrant an
change to your client's ability to work, in-
investigation from them but may be useful for the
cluding a return to full-time work?
management of the client’s recovery.
In Eos, update the incapacity details to ensure
weekly compensation payments are correct. For
In these cases, you will receive a “Contact Party”
details about eligibility and steps to follow, go to
task from Integrity Services, requesting that you
the Maintain Weekly Compensation process.
contact them to discuss the information. After
PROCESS Maintain Weekly Compensation
discussing with Integrity Services, you can con-
tinue to follow the Track Recovery Process to
NOTE What if the client is planning to return to
determine how to proceed, as with any new
work part-time?
information received about a client.
In Eos, review and update the incapacity details
to adjust weekly compensation details. Review
It is crucial that you do make and maintain con-
income and weekly compensation details to
tact with Integrity Services when acting on infor-
adjust amount paid going forward. Go to the
mation that they have passed on. While it may
Manage Abatement in Eos process.
not be a matter as serious as fraud, there still
PROCESS Abate Weekly Compensation -
may be a delicate situation that Integrity Services
Simple requests
can advise you how to handle. For example, it is
important that you do not breach the anonymity
NOTE What if the medical certificate indicates this
of whoever has provided the information when in
is a subsequent incapacity?
contact with the client.
Refer to the Policy below to determine this is a
'Date of Subsequent incapacity.
Identify Claims for Rapidly Deteriorating Clients
If eligible, go to Conduct Recovery Check-in
Conversation process.
PROCESS Conduct Recovery Check-in
?
Is your client at risk?
Conversation
Recovery Assistant, Recovery Coordinator, Recovery
Partner
Subsequent Inability to Work (Subsequent Inca-
pacity)
YES....
PROCESS Respond to Clients in Vulnerable
Situations
NO....
Continue
2.0 Review claim information
Recovery Assistant, Recovery Coordinator, Recovery
Partner
a Decide if the client is being supported in the most appro-
priate way for their goals and needs.
ACC > Claims Management > Manage Claims > On-Board Client and Manage Recovery > Track Recovery
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NOTE What if the provider indicates on the medical
NOTE What if the provider indicates on the medical
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certificate ‘Support needed to stay at work/
certificate ‘ACC to contact me’?
return to work’? (Task ‘AUTO Alert: RTW Re-
• Contact the provider to understand their re-
quest - ACC18 Incapacity’ or ‘AUTO Alert:
quest
RTW Request - ACC18 No Incapacity)
• In Salesforce, create a contact action
• Contact provider to discuss request if it isn’t
• Record outcome of the conversation in the con-
clear what they are asking for
tact action
• Check the claim to see if vocational rehabil-
• What if you are unable to contact the provider?
itation support is already in place and that client
- In Salesforce, create a future contact action
is
- Record the provider name and reason for the
eligible.
contact, ie ‘ACC18 indicated ACC to contact
• If the client already has vocational support in
(insert
place then you do not need to do anything else
provider name), unable to contact provider,
with
follow up contact with provider required
this request and the task can be closed with no
- Set due date for 5 working days.
further action.
d Review or confirm existing cover decision(s). Cover must
be reviewed whenever you receive new information or a
Consider the following actions and decide which
request for an additional entitlement. This can occur at
is most appropriate for your client:
any stage during the life of a claim.
• If there is no support in place and the client and
employer are managing a return to work be-
NOTE What do you need to consider?
tween
• Understand what the injury is and how it hap-
themselves, consider checking in on how this is
pened.
going and whether they need further support.
• Has there been a change in diagnosis?
• If this is a change in incapacity for the client; if
• Is there an additional injury on an existing
they have moved from ‘fully unfit’ to ‘fit for selec-
claim?
tive
work’ then this could suggest vocational rehabil-
For more information on the 'Confirm existing
itation is ready to begin. Consider whether they
cover decision', refer to the web link below.
need our support to do this.
• If the client has the functional capacity to
Confirming Existing Cover Decision
engage in return to work activities. Do the client
and
employer need support to explore this?
3.0 Review Recovery Plan
• Consider whether your client still holds employ-
Recovery Assistant, Recovery Coordinator, Recovery
ment. This will determine what type of vocational
Partner
support we put in place if any is needed.
a In Salesforce, review the Recovery Plan details and
• Ensure to close the loop with the certifying
where the client is in their recovery, eg the client's goals,
treatment provider via email if you haven’t had
Recovery status life area details including their current
contact
treatment plan, supports, work status, medical certificates
yet to say what you’ve done following their med
and any potential recovery obstacles that you will need to
cert
check on.
If Stay at Work support is required:
b Identify any obstacles. During the client’s rehabilitation
PROCESS Set Up Stay At Work Support
journey, there may be flags or barriers that can potentially
impact on their recovery pathway. When we identify
NOTE What if the provider indicates on the medical
these, they are known as obstacles. These should be
certificate ‘Clinical Review of Patient’s fitness
noted in the Life Areas in Salesforce.
for work needed’? (Task ‘AUTO Alert: RTW
Request - ACC18 Incapacity’ or ‘AUTO Alert:
NOTE How do you identify flags and barriers?
RTW Request - ACC18 No Incapacity’)
Refer to the 'Identifying obstacles to recovery'
• Review the cover on the claim and whether we
section of the Recovery Management Guide for
are clear on the reason for the clients ongoing
details.
incapacity.
NG GUIDELINES Recovery Management
• Contact the certifying treatment provider to
understand what their concerns are and what
NOTE Is the client in the correct team?
they
Go to Transition Claim process for further infor-
feel needs to be addressed.
mation.
• Once the concerns/barriers are clear, consider
PROCESS Transition Claim
what ACC interventions might overcome these
c
barriers.
Review open tasks.
NOTE What are the Task Management Principles?
Refer to the Recovery Management Guide for
these principles.
NG GUIDELINES Recovery Management
4.0 Contact key participants in the client's recovery
Recovery Assistant, Recovery Coordinator, Recovery
Partner
a Receive tasks.
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NOTE What to consider for outgoing call interac-
NOTE What if you can't establish contact?
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tions?
• Attempt a maximum of 2 contacts over 2 full
Almost all our outgoing call interactions are
working days before leaving a voicemail or send-
planned, and we are reminded to have these
ing a notification to request client contact.
interactions through tasks. These are often sche-
• If you are unable to reach the client, extend the
duled contact tasks, with information to support
task for additional 2 working days and note in the
the interaction.
task description that this is the 2nd attempt to
b
contact the client.
Prepare for interaction.
• On the task due date and if there is been no re-
NOTE Why do we need to prepare before holding an
sponse from the client to the voicemail or notifi-
interaction?
cation, send the CM04 - Advise client that you
Before we speak with a key participant it is
were unable to reach then by phone letter.
important to ensure we have authority from the
• Extend the task date as appropriate to take into
client and have checked the safe contact, this
account postal delivery and note in the task
helps us to start thinking about:
description this is the 3rd attempt to contact the
1) the information we want to share
client and the CM04 letter has been sent.
2) the information we need to collect
• On the task due date and if there is no contact
3) what we might want to ask during the call
from the client and they are continuing to receive
4) what support the client might need at this
support, seek internal guidance to determine
stage in their recovery
next steps.
5) check if there is an alternative or a safe con-
• If you're in Partnered and no contact is made
tact.
with the client after three attempts, you must
contact the provider, GP or other verified contact
If you need to gather further information, refer to
on the claim.
the web link below.
What to say in a voicemail message
Gather Additional Information or Advice
Decline Entitlement When Client is Non-compliant
c Determine if a face-to-face meeting is required.
Policy
NOTE What are the guidelines if the conversation is
CM04 Advise claimant that you were unable to reach
to be a face-to-face conversation?
them by phone
Assess the suitability of having a face to face
NOTE How can you confirm client contact details?
meeting. Go to the process below, and refer to
Consider the following options:
Client Face to Face Meetings guidelines to
• check details on the ACC45
determine if a meeting is required.
• check the latest ACC18
PROCESS Arrange Face to Face Client
• contact the client's treating provider
Meeting
• contact the client's employer.
d In Salesforce, if you have identified that you will be col-
f Identify any obstacles.
lecting medical or other information, confirm that the
client has provided authority.
Obstacles may be identified during a conversation with a
View Client Consent
client, provider or employer or via correspondence re-
ceived, such as medical reports, provider assessment re-
NOTE What if the client has not granted ACC au-
ports or emails. We can also identify psychosocial ob-
thority to collect medical and other records?
stacles through asking the ‘How are you coping gauge’
You will need to obtain the client's authority to
questions.
collect medical and other records. Go to the
process below.
NOTE Identifying obstacles during interactions
PROCESS Obtain Client Authority to Col-
Client – Each communication with our client,
lect Information
either verbal or written, is an opportunity to iden-
tify any obstacles that have arisen during the
e Contact the participant and initiate the interaction. If con-
client’s journey. Our interactions with our clients
tacting a participant or a person with Authority to Act
need to be proactive and outcome focused, not
(ATA) for them, perform the relevant identity check to
process driven, so that we can build a valuable
confirm you are speaking to the right person.
relationship with our clients. This results in them
Identity Check Policy
getting the right support from us at the right time
to address any obstacle.
NOTE What if the participant advises they are
unable to have the conversation now, or
Provider – Providers play an essential role in a
during the conversation they are unable to
client’s recovery. We empower the provider and
continue?
give them a clear understanding of the client’s
Agree a date to continue, and update the due
treatment and support. Providers, as part of their
date in the task to this date. Add a note in the
role, are continually assessing and treating
description field of the task advising the conver-
clients. They gather valuable information by
sation was paused and needs to be completed.
identifying obstacles. From time to time we will
refer to providers to help us address the ob-
NOTE What if the client's employer is a Third Party
stacle.
Administrator or an accredited employer?
Go to the process below.
Employer – Employers play an essential role in
PROCESS Identify and Transfer Work-
being the gatekeeper to re-entering the place of
Related Injury Claim to Accre-
employment. By encouraging the employer to
dited Employer (AE)
become involved in the rehabilitation planning,
they can communicate with us any past and/or
present examples of obstacles they have
encountered.
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NOTE What if your client requires an assessment to
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5.0 Print Recovery Plan
allow more information to be gathered about
Recovery Assistant, Recovery Coordinator, Recovery
their injury or recovery needs?
Partner
Go to Arrange Medical Single Discipline Assess-
a If your client has requested a copy of their Recovery
ment process.
Plan, confirm how they want to receive this.
PROCESS Arrange Medical Single Discip-
line Assessment
Ensure that the client has agreed to each specific inter-
c Consider if your client needs to be transitioned to another
vention in the Recovery Plan. Agreement to interventions
team as your client is either tracking ahead or behind
must be evidenced in contact notes either following
their Recovery Plan.
discussions with the client/ATA or email. This means that
the client’s signature is not required on the printed Plan.
NOTE What if your client needs to be transitioned to
another team?
An employer must be given an opportunity to participate
Remember to align the due date for Recovery
in the preparation of the Recovery Plan, however it does
Check-in conversations with key milestones.
not mean they need to see a copy of the plan. Ensure
Go to Transition Claim process.
you do not show any sensitive client information to the
PROCESS Transition Claim
employer. Check all auto-populated fields and remove
data as necessary. Where there is a sensitive claim we
d Determine the type of support required to help your client
must follow directions by the client and not involve the
to achieve their recovery goal(s) and confirm their eligi-
employer.
bility. Consider our Decision-making principles in the
Recovery Management Guide.
b Generate a copy of the Recovery Plan for the client.
NOTE How do you generate a copy of the Recovery
To find details about how to create tasks for other types
Plan?
of financial supports, search for the support type in Pro-
Click Send PDF to Eos on the Salesforce Recov-
mapp (eg lump sum, independence allowance, HCSS
ery Plan.
payments).
Result: This will generate ACC7979 form.
NG GUIDELINES Recovery Management
c Arrange to send your client a copy of their Recovery
NOTE What if you need to set up supports for the
Plan.
client?
NOTE What if the client wants the Recovery Plan
If you need to:
sent to them by email?
• set up social supports for the client, go to
Follow the Emailing from Eos – System Steps.
Manage Social Interventions / Supports web link.
• set up vocational supports for the client, go to
NGCM - FINAL Emailing from Eos - System Steps
Manage Vocational Interventions / Supports web
NOTE What if the client wants the Recovery Plan
link.
sent to them by mail?
• respond to a treatment request, go to Manage
Treatment Interventions / Supports web link.
Refer to 'Send letters from Client Recovery and
Claims Assessment'.
Manage Social Interventions / Supports
Send letters from Client Recovery and Claims
Manage Vocational Interventions / Supports
Assessment
Manage Treatment Interventions / Supports
NOTE What if you need to set up weekly compen-
6.0 Determine next steps
sation for the client?
Recovery Assistant, Recovery Coordinator, Recovery
Go to the Request Set Up of Weekly Compen-
Partner
sation Payments process.
a
PROCESS Request Set Up of Weekly
In Salesforce, update the plan with the new information
Compensation Payments
or outcome of the interaction.
NOTE What if you need to reinstate Weekly
NOTE How do you update the Recovery Plan?
Compensation?
Go to Create or Update Recovery Plan process.
In Eos, at ACC45 level, complete the reins-
PROCESS Create or Update Recovery
tatement information in the Non Standard WC
Plan
Setup Eform, (documents tab, stand alone eform
b Assess the information in the Recovery Plan and deter-
category). Then create a Setup weekly comp
mine if the next step is clear and obvious.
Entitlement task (the eform is linked automat-
ically). The task auto routes to the Centralised
Vocational Services Roadmap
Weekly Compensation queue.
NOTE What if you need help to determine next
e Determine if your client is unlikely to be able to return to
steps of the client's recovery?
their pre-injury occupation due to their injury, or if they are
Talk to your Team Leader first, then use the
vocationally independent.
Recovery Support Decision Tree to help with
next steps.
NOTE How do you arrange an IOA to identify the
types of work that may be appropriate for the
Recovery Support Decision Tree
client?
NOTE What if you need clinical information to help
Go to Arrange Initial Occupational Assessment
complete the client's recovery plan?
process.
Go to Request Clinical Records process.
PROCESS Arrange Initial Occupational
PROCESS Request Clinical Records
Assessment (IOA)
f Determine if your client no longer needs support.
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NOTE What if the client has confirmed they don’t re-
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quire any supports?
Go to Stop Supports.
PROCESS Stop Supports
g Respond to a notification that the client has passed away.
You may be notified that the client has passed from con-
tact with either a family member, provider or via death no-
tices.
NOTE What if you are advised the client has passed
away?
Refer to the Record Date of Death process
below.
PROCESS Record Date of Death
NOTE What if you are advised that the client has
passed away due to (or possibly) as a result
of their injury?
This will require investigation by Cover Assess-
ment. You will need to:
- Add a contact in Eos recording the details of
the notification (ie date of death, who advised of
the death and their relationship to the client, who
the key family contact would be (and their con-
tact details) and what you have been notified as
being the cause of death).
- Go to Stop Supports process to stop any sup-
ports.
- RTM to provide ACDIS01 and ACC21 to the
clients' family or representative and provide the
contact number for the representative to call
when they are ready 0800 222 075. Internal hun-
tline 87917 or V_CAS_FATALS in Genesys if
they wish to speak to someone now
PROCESS Stop Supports
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Page 6 of 6
Limits on using and disclosing information Policy v10.0 GOV-032739
Summary
3.0 Disclosing information to employers
a There are limits to what information we can disclose
Objective
about a client to their employer. In general, we may only
We must have very good reasons to release information about
disclose information about work-related injuries to em-
a client to any other person or organisation. Principles 10 and
ployers.
11 of the Privacy Act 2020 (Privacy Act) set out how we can use
and disclose the client information that we've collected.
• You may only disclose client information to their em-
ployer if it’s about a specific work-related injury
Owner
[Out of Scope]
• Do not disclose information about a non-work injury to
Expert
[Out of Scope]
an employer, unless you have the client’s consent to do
so
Policy
• Encourage the client to provide any relevant information
1.0 Rules
to the employer themselves.
a We may only use or disclose information for the purposes
that we collected it for. Once we’ve obtained personal
Please see "Disclosure of clients' health information to
information for one purpose we cannot use or disclose it
employers Policy" for more information.
for another purpose.
Disclosure of clients' health information to employers
Policy
Personal information should not be used or disclosed
https://go.promapp.com/accnz/Process/9841edd8-7ca
outside of the normal purpose (i.e. claims management),
without consulting with the Privacy team.
Privacy Hub - What information can we give an em-
ployer
We are able to disclose client health information to par-
https://accnz.sharepoint.com/sites/PrivacyHub/SitePa
ents or guardians of clients under the age of 16 where a
duty of care exists. Once a client is over the age of 16 we
must not disclose information to their parents or guar-
4.0 ACC45 Injury claim form
dians unless an Authority to Act is obtained. Please see
a
"Disclosure may be contrary to the interest of a person
You must take particular care when the employer infor-
under 16 Policy" for more information.
mation provided on an ACC45 is incomplete or confusing.
If you are unsure, contact the client to confirm their em-
Screen captures of Eos information or from other internal
ployer.
systems, taken with the Snipping Tool, are useful for pur-
poses such as training material or raising queries to
If the employer is a 'franchise' employer’, you must make
Helpdesk; however you must take care to remove/black
sure you have the correct employer location. If needed,
out any personal information (e.g. names, DOB, contact
seek further clarification from the client.
details, accident description, employment). Use the Snip-
ping Tool to grab only the information you need to copy,
NOTE Example
then paste it into a new document or email. If possible
McDonald's Wellington could mean any McDo-
use Sandpit or a training environment rather than the live
nald's outlet in the Wellington city area, not just
environment.
the central city location.
For further advice, particularly if you wish to send infor-
mation externally, please consult with the Privacy team.
Disclosure may be contrary to the interest of a
5.0 Work-related injury notifications
person under 16 Policy
a If we send a work-related injury notification to an incor-
https://au.promapp.com/accnz/Process/626edb08-ce2
rect address this is still a breach of the client's privacy,
even if we’ve taken reasonable care to locate the correct
employer.
2.0 Exceptions
a Under the Privacy Act, Section 22, Information Privacy
Where an employer denies that a claim is work-related,
Principles 10 and 11, we may use or disclose information
there is no breach if we’ve notified the correct employer.
for a different purpose if we reasonably believe that it's
necessary. These situations include:
• to assist legal proceedings and investigations
• to avoid a serious and imminent threat to public health
or safety, or the life or health of the individual concerned.
If you are unsure whether an exception applies, please
contact the Privacy Team.
For details see Complete information privacy principles.
Complete information privacy principles
ACC > Claims Management > Manage Client Information > Operational Policies > Communication > Information disclosure and request > Limits on using and disclosing
information Policy
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Page 1 of 1
Document Outline
