Taking the initiative: A modern approach to workplace mental injuries

Major changes are occurring to WorkCover schemes across Australia with WorkSafe Victoria the latest to modernise theirs, bringing in new eligibility requirements for mental injury claims.

Jason Lardelli, Executive Director of Return to Work Victoria, told hello leaders that mental injury is becoming more prevalent in the workplace and it’s time that their WorkSafe scheme – developed in 1985 – reflected a modern understanding of mental well-being and mental health. 

“There’s one thing widely agreed across all parties and that is the Victorian WorkCover scheme must be viable and here to support Victorian workers both now and into the future,” Mr Lardelli said.

“The 31st of March was when the government introduced the new legislation which has seen the creation of Return to Work Victoria as Worksafe’s specialised return to work business unit.

“It was on the back mental health claims rising and also the fact that injured workers were staying on the scheme longer. So we had more claims coming in and more staying on and that’s made the scheme unsustainable.”

Key points:

• Two key changes modernised Victoria’s WorkCover scheme this year: new eligibility requirements for mental injury claims and an additional whole person impairment requirement for weekly payments
• Recent growth in the number of mental injury claims means that a third of all claims received by WorkSafe Victoria in 2030 are expected to be for mental injury
• Meanwhile, to continue receiving weekly payments after 130 weeks, workers must have a whole person impairment (WPI) of 21% or more and meet the existing capacity test requirement

With a scheme that’s more fit for purpose, mental injury claims now have more defined eligibility criteria. This is crucial for sectors such as aged care and healthcare, as well as frontline services, where traumatic incidents are more likely to occur.

This has resulted in a new mental injury definition where a mental injury must:

• Cause significant behavioural, cognitive or psychological dysfunction; and
• Have been diagnosed by a medical practitioner in accordance with the Diagnostic Statistical Manual of Mental Disorders (DSM)

Additionally, “A mental injury must have predominantly arisen out of the course of employment to be compensable, so work must be the strongest link or largest contributing cause of a worker’s mental injury”. 

The DSM requirement gives general practitioners and psychiatrists a clear set of guidelines to work off when determining eligibility. Mr Lardelli said the new definition will ensure people seeking support and compensation are more clearly determined as eligible under WorkCover. 

“There’s a focus where employment must be the single greatest cause for compensation eligibility and primary mental injury claims. Compensation is not granted for mental injuries primarily caused by stress or burnout from usual work events except in cases of exposure to traumatic events,” he added. 

“That’s a significant point of clarity these reforms have brought about. Our commitment is to support those whose mental health has been directly impacted by their work environment but also acknowledge that everyday stress and burnout, while challenging, may not qualify for compensation under these revised laws.”

Aged care is one sector where exceptions are likely, however. Employees might be regularly exposed to traumatic events as part of their normal work, such as physical abuse the threat of physical harm or something that is emotionally shocking, and they will experience stress or burnout as a result. If they are ‘mainly’ caused by a traumatic event, they will remain eligible for compensation. 

Mental injuries caused by workplace bullying or harassment will also continue to be eligible for compensation. Mr Lardelli said WorkSafe Victoria will continue to work with providers in higher risk industries to ensure support and safety mechanisms are in place to help minimise the risk of mental injury.

This includes early intervention, with applications eligible for up to 13 weeks of payments while their mental injury claim is being assessed. 

“Studies show that when contact is made with an injured worker within the first three days post-injury, the return to work outcome improves by 63% for psychological injuries. That’s significant,” he added.

“In the hospital they have the golden hour and in these schemes, I’d say it’d be the golden three days for us with regards to psychological injuries. We are putting a lot of research into understanding more about where we can shave the timeframes so that we can get the best outcomes for injured workers, without delay.

“Work is good for our health which brings about financial independence and improves self-esteem and ultimately mental health.”

Helping with the return to work

At the other end of the WorkCover scheme is the whole person impairment requirement. Under the changes, those covered must pass an additional assessment to continue to receive weekly payments after the 130-week second entitlement period.

“The Scheme was built in 1985 and this is probably the biggest financial challenge we’ve had in our history; more claims coming in primarily with mental injury and staying on for greater periods of time. The underlying factor for us is the research has been clear that the longer injured workers are on these schemes the more successful outcomes will diminish,” Mr Lardelli explained.

“It’s not about taking people off the scheme, it’s about making sure people get the help they need as quickly as possible. The sooner we can help to address and rehabilitate them and then return them to work earlier the greater likelihood of a more durable outcome for them.”

For individuals who don’t meet the whole person impairment threshold of 21% or more, they will have a notice period of 13 weeks before payments stop. They will still have ample time for their injury to stabilise, two and a half years, with the second assessment designed to help prepare for a return to work where possible.

“If a person doesn’t meet that threshold then we have programs in place to help support them back into a workplace, to help employers make sure they have the workplace ready to help with a more sustainable return to work outcome,” Mr Lardelli added.

Extra support such as psychosocial supports, training and occupational rehabilitation are made available by WorkSafe to help. 

But it is Mr Lardelli’s hope that more treatment and support occurs sooner, rather than later. Just like aged care, where early intervention and preventative methods slow decline, he wants to see employers and employees being proactive in their approach to managing workplace physical and mental injuries. 

More information about the changes made to Victoria’s WorkCover scheme are on the WorkSafe Victoria website.