Penny Markham, A/Registrar & Amanda Le Poidevin, Managing Solicitor

Operation of Medical Panels

SA 17 April 2009

Overview

Key Features of Medical Panels Benefits Operations Selection of Doctors Facility How to refer to a medical Convenor’s directions – consultation and

concepts Opinions and reasons Contact us

Key Features

An independent body separate to WorkCover & WCT

An important part of the dispute resolution process Medical experts making final and binding decisions

on medical questions Pool of medical practitioners appointed by the

Governor in Council on the recommendation of the Minister

Doctors are experienced and from a range of specialty groups

From the pool medical panels will be convened to determine particular medical questions referred to it

Expected number of referrals annually = 1500

Why change?

Disputes arise from disagreement over medical information

No avenue for a definitive ruling on medical matters Judges hear competing and often substantially different

medical opinions Decisions may not be entirely consistent with medical

opinion Medical practitioners often have an actual or perceived

bias toward the party they represent Disputes can become protracted and subject to significant

delays Significant scope for improving the efficiency of resolution

of disputes relating to medical information

Benefits

Timely and accurate decisions on medical issues

Support a focus on return to work and a return to the community

Increase efficiency in resolution of disputes Increase consistency of decision making Remove the actual or perceived bias in

decision making Increase quality of decision making according

to best practice and the current evidence base

Operations

Model based on Medical Panels Victoria Convenor and Registrar oversee operations

with supporting legal and administrative staff Medical questions are referred from a number

of sources (Corporation, SI’s, WCT, EML) Up to five member multi-speciality medical

panels will be constituted to hear a matter Constitution of the panel will be tailored to the

question and medical condition being considered

Other consultants may be co-opted as considered necessary by the panel in each case

Operations

Appoint presiding member Consider all documentation referred and examine the

injured worker Enable the injured worker to tell them their story Discuss the relevant information, results of the

examination and each member’s perspective The Presiding Member will also confer with legal staff as

necessary Issue a certificate of opinion and reasons for that

opinion to the referrer and injured worker A Medical Panel must form its opinion on a medical

question within 60 days The decisions of the medical panel are final and binding

on all parties (judicial review available on grounds of procedural fairness/breach of natural justice)

Selection of doctors

MPSA Selection Committee formed by the Minister for Industrial Relations

Prof. Paddy Phillips, Chief MO appointed as Chair of the Selection Committee by the Minister

Stakeholder driven selection process comprising:Medical Board of South AustraliaSpecialty CollegesAustralian Medical AssociationEmployer representativeEmployee representative

Doctors Appointed by the Governor

85 doctors from 21 specialties were nominated by the Committee to the Minister for Industrial Relations and were appointed by the Governor on 12 March 2009

Approximately 18 doctors from 13 other specialties and 14 health professionals from 8 health disciplines are also required

Recruitment is currently underway for the above

Medical PractitionersNominated by Selection Committee

Cardiology (1) Dermatology (3) Endocrinology (1) Gastroenterology (2) General Medicine (1) General Practice (21) General Surgery (1) Infectious Diseases (1) Neurology (2) Neurosurgery (3) Obstetrics and Gynaecology (3)

Occupational Medicine (9) Ophthalmology (1) Orthopaedic Surgery (10) ENT surgery (3) Pain Medicine (2) Psychiatry (11) Rehabilitation Medicine (4) Rheumatology (4) Thoracic Medicine (1) Urology (1) Vascular Surgery (1)

Medical PractitionersRound 2 Doctors Allergy Cardiology Endocrinology Gastroenterology General surgery Infectious diseases Oncology Ophthalmology Oro-maxillofacial surgery Plastic & reconstructive surgery Public health medicine Respiratory medicine Urology Vascular surgery

Other health professionals Chiropractic Dentistry Neuropsychology Occupational therapy Orthotist Physiotherapy Prosthodontist Psychology

~ closes 5th June 2009 ~

Use of doctors in Medical Panels Victoria

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Facility

Based at Level 1/ 44 Currie St Specially designed Now operational

Consultation processes

Completed consultation on MPSA referrals process

Consulted on Convenor’s Directions with stakeholders

Consulted with employee and injured worker groups about frequently asked questions

s98G requires that MPSA be provided with a document specifying medical issues that have been agreed and those in dispute

Referral is accompanied by medical reports, notes, surveillance film, photographs of scars and so on

Working party has endorsed referral form – available on website

How to refer

Procedures affecting the day to day management of the panels are contained in the Convenor’s Directions

The Minister may issue Ministerial Guidelines

Working party discussion Final draft for Convenor and Minister

endorsement

Convenor’s Directions

Opinions and Reasons The wording of each medical question is scrutinised to ensure it fits within the parameters of the definitions of a “medical question” If any question is unclear or is not (even broadly) within the definitions of a “medical question”, the Convenor may decide not to put the question to the Panel. The answer to any medical question contained in a Certificate of Opinion and must be accepted as final and conclusive by any body /person. A Certificate of Opinion can only be clarified if it is considered to be non-responsive by the referring person/body and the Medical Panel agrees. Detailed reasons for the opinion will be distributed to the referrer and the worker

Contact us

 

 

www.medicalpanels.sa.gov.au

Ph: 8204 1530

Fax: 8204 1550