Ordered to attend occupational rehabilitation despite hallucinations

Summary

Lee injured his back at work and was receiving weekly workers compensation payments. An Independent Medical Examiner said they were unable to properly examine Lee’s back injury. This was because Lee was experiencing psychotic hallucinations.

Despite this, Lee’s WorkCover agent required him to attend occupational rehabilitation. Lee missed several appointments so the agent terminated his payments. When we raised this case with WorkSafe, they told the agent to reinstate Lee's weekly payments. He was back-paid about $40,000.

What was the case?

Lee was working in a factory when in 2010 he injured his back. He ceased work and made a WorkCover claim. This was accepted. Lee also had an unrelated pre-existing psychiatric condition.

In 2017, Lee’s WorkCover agent, EML, referred him to occupational rehabilitation. Lee was also seen by an Independent Medical Examiner (IME). The IME said they were unable to properly examine Lee’s back injury because he was experiencing psychotic hallucinations. They said Lee could not return to work or take part in occupational rehabilitation because of his psychiatric issues.

Despite the IME’s opinion, EML continued to require Lee to take part in rehabilitation. In mid to late 2017, Lee missed several scheduled appointments.

He told the rehabilitation provider that he was not able to take part. This was due to his back injury and psychological state. EML told the provider to continue scheduling appointments.

EML issued Lee a few warning notices for the missed appointments. Then they suspended and terminated his payments.

Lee’s lawyer requested conciliation. EML’s dispute resolution team recommended withdrawal of the termination notice. But at conciliation, EML did not agree to withdraw the termination.

Our enquiries

We raised Lee's case with WorkSafe, as part of a wider investigation.

WorkSafe said EML's decision to require Lee to take part in occupational rehabilitation was not appropriate. They said this decision did not take into account the available medical evidence.

Outcome

WorkSafe requested EML withdraw the termination notice and reinstate Lee's weekly payments. They said he should be back-paid for the period since his payments ended. He was back-paid close to $40,000.

System failures WorkSafe