Hand therapy services policy

Background

Hand therapists are occupational therapists or physiotherapists with specific experience in treating hand and upper limb injury or illness.

This policy outlines guidelines for the provision of hand therapy services under the Victorian workers compensation scheme (WorkCover).

This policy must be read together with the following:

Guidelines

What WorkSafe will pay for

WorkSafe (either directly or through one of its authorised agents) can pay the reasonable costs of hand therapy services that are:

• required as a result of a work-related injury or illness
• performed by a clinician registered by WorkSafe to provide hand therapy services
• clinically justifiable, safe, and effective
• for a clear rehabilitative purpose, and are not for non-work-related injury rehabilitative purposes
• likely to achieve or maintain a measurable functional improvement
• likely to achieve progress towards functional independence, participation, and self-management

The agent will periodically review an injured worker's entitlement to hand therapy services to ensure treatment and services are reasonably applicable to the work-related injury and/or illness, and payable under the WorkCover scheme.

What WorkSafe will not pay for

WorkSafe or an agent will not pay for:

• treatment or services for a person other than the injured worker
• treatment or services provided by a treating healthcare provider (THP) not registered and approved to provide hand therapy services under the WorkCover scheme
• more than one initial consultation by the same provider or clinic unless exceptional circumstances apply (e.g. hospital admission, or significant time has passed since the injured worker last received treatment)
• more than one consultation per day for the same injured worker
• multiple or concurrent physical treatments unless exceptional circumstances apply (e.g. where a worker requires hand therapy in addition to physiotherapy, osteopathy, chiropractic services, or acupuncture for treatment of a compensable non- upper limb injury)
• consumable prostheses, aides, and appliances used in the course of the consultation
• pharmacy items such as creams and gels supplied by THPs
• fees associated with cancellation or non-attendance
• treatment or services provided outside the Australia without prior written approval from the agent
• treatment, services, prostheses, or equipment where there is no National Health and Medical Research Council level 1, or level 2 evidence of safety and efficacy

Hand therapist eligibility criteria

To be eligible to register as a hand therapist with WorkSafe, applicants must:

• be registered with the Occupational Therapy Board of Australia or Physiotherapy Board of Australia without any current restrictions on practice
• have the credential of Accredited Hand Therapist from the Australian Hand Therapy Association Credentialing Council
• be registered with WorkSafe to provide services as an occupational therapist or physiotherapist
• have signed a declaration committing to provide hand therapy services in line with the Clinical Framework and related Service Standards

Hand therapists who do not hold full Australian Hand Therapy Association (AHTA) accreditation, but show appropriate skills in this field, should refer to the applicable occupational therapy or physiotherapy policy and fee schedule for relevant service provision information.

Service standards

These Service Standards must be read together with the Hand therapy services declaration. Hand therapists who do not comply with the service standards may have their WorkSafe registration withdrawn.

The role of a hand therapist

A hand therapist’s role is to provide client-centred, goal orientated treatment to injured workers. Treatment must be consistent with the Clinical Framework, with a focus on return to health, achieving independence and return to work.

A hand therapist’s treatment must adopt the following principles:

• measure of and/or show the effectiveness of treatment
• adopt a biopsychosocial approach
• empower the injured worker to manage their injury
• implement goals focused on optimising function, participation, and return to work
• base treatment on the best available research and evidence

Reporting and communication

After treatment has commenced, the hand therapist must submit an Allied Health Recovery Management Plan (AHRMP) to the agent by the fifth consultation.

The hand therapist must work with WorkSafe and its Clinical Panel to ensure treatment adheres to the Clinical Framework, Service Standards and Declaration.

WorkSafe registered hand therapy practitioners are also expected to communicate and collaborate with other parties involved in the worker's support team to facilitate continuity of care and return to work.

Return to Work Case Conferences (RTWCC) bring together the worker, referring medical practitioner, employer, WorkSafe agent, occupational rehabilitation provider, and other relevant parties. They can be used to discuss the worker’s capacity, any barriers affecting recovery, set goals, and agree on timeframes for recovery at/return to work.

Typically, a RTW case conference will be requested by an agent or the occupational rehabilitation consultant however, a treating health practitioner can request a case conference by contacting the agent or the occupational rehabilitation consultant directly. RTWCCs will be remunerated as outlined in the relevant fee schedule.

Service delivery expectations

Services must:

• achieve the best clinical, functional and vocational outcomes for injured workers
• be provided in accordance with the Clinical Framework
• be provided in consultation and collaboration with other THPs, community and support services and vocational service providers involved in the management and treatment of an injured worker
• be provided under reasonable directions and instructions provided by WorkSafe

Facilities and equipment

Hand therapists must ensure facilities and equipment used to conduct examination and treatment are clean, safe and fit for purpose.

Quality management

The hand therapist must take part in quality improvement and performance management processes as required.

Required information for agents

Referral requirements

WorkSafe considers occupational therapy a referred service. Hand therapy services provided by an occupational therapist must be referred by a medical practitioner and approved by the agent before treatment commences.

Referral from a medical practitioner is not required for hand therapy services provided by a physiotherapist.

Invoicing requirements

All services must be invoiced per WorkSafe's Occupational therapy services, Physiotherapy services or EIPF fee schedule and Hand therapy services declaration.

For further information, refer to instructions for invoicing WorkSafe.

Concerns about unpaid or returned invoices should be directed to the agent case manager. Unresolved queries can be escalated by submitting an online complaint.

Agent processing times

The agent will advise the outcome of a request for payment within 10 working days, or they may request extra information before making a decision.

If extra information is requested, the agent will confirm the request outcome within 10 working days of receiving the extra information.