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Formal Complaint to WorkSafe Victoria

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21st May, WorkSafe’s Andrew calls

My long wait was over, or so I thought, when on 21st May I received a call from a Service Review Analyst working with WorkSafe’s Capability & Service Division.

Yes, it did seem that they had “escalated” my complaint, as promised, and I would at last be given some answers. But my hopes were soon dashed as the guy on the other end of the line tried to explain to me why it was taking so long to deal with my complaint. He told me that WorkSafe was having to seek further information as to whether I was making an additional complaint or was merely hoping for a response to my original one. I made it clear that I was still awaiting a definite response to my original complaint. Having then established that we were both on the same page, the caller said that he was in fact ringing to apologize to me for the delay. No reason for this was given.

When I inquired how he would feel if he was in my situation, he once again apologised to me.

As you might have gathered by now, I found this phone call to have been awkward, uncoordinated, empty and senseless.  It was patently obvious that he had not looked all that deeply (if at all) into my complaint.

Was he inexperienced and being thrown in at the deep end by his manager?  Or had he been told to play “dumb”? I wondered whether WorkSafe really does have a mechanism in place to investigate legitimate complaints! Perhaps their lack of response serves as a tactic to deter most people from pursuing answers to their complaints.

But once more I find myself waiting with “bated breath and whisp’ring humbleness” for some honest answers. Honest answers and compensation payments that I believe are fully justified.

20th May, Soula follows up:

Hi Liz,

Can you give me the ‘relevant person’s’ name and direct contact please? I’m beginning to think they don’t exist. It really shouldn’t take this long.

13th May, from WorkSafe’s, Lizabelle

Hi Soula,

Thanks for your further email.

Please be advised that I have referred your email to the relevant person looking into your complaint for his information and response.

Should you have any further queries…Blah blah

12th May, Soula follows up:

Hello Anthony,

Are you able to follow the ‘escalation’ of my enquiry. I feel it may have been lost on the way…

May I remind you the original enquiry was made on April 4th. Pretty poor on WorkSafe’s behalf I feel.

Soula Mantalvanos

24th April, Soula looks into WorkSafe’s complaint procedure

I was wondering who the Service Improvement Division were after my reply from WorkSafe. I found a WorkSafe Victoria Complaints Handling Policy pdf. I nearly threw up reading this as this is certainly NOT what I’ve experienced in my seven years as an injured worker (or self employer). In fact I can’t believe the words ‘caring’ and ’empathy’ are even used and ‘We live up to our promises’ isn’t true, WorkCover isn’t ‘Quality Income Protection’.

Grab yourselves a bucket injured workers, download the pdf or read my favorite worst bit:

Complaints handling at WorkSafe

WorkSafe Victoria (WorkSafe) is committed to actively seeking client and stakeholder feedback. Complaints about WorkSafe, our authorised Agents or service providers are an important aspect of client feedback. We value this feedback and see it as an opportunity to improve our service.

WorkSafe has developed complaints handling processes which comply with the Australian Standards and Australian Securities and Investments Commission (ASIC) policy statement and encourages anyone who has contact with WorkSafe to provide feedback. There is no fee associated with providing feedback or having a complaint investigated.

WorkSafe will consider all feedback in a manner that is fair both to the complainant and to the party being complained about and which equally values all views.

WorkSafe will manage complaints consistently with its corporate values of being constructive, accountable, transparent, effective and caring.
Constructive
We are constructive in the way we provide information, advice and service.
Accountable
We are accountable for what we do and what we say. We live up to our promises.
Transparent
We work in a transparent way in an environment which is open and honest.
Effective
We are effective by working collaboratively to deliver high quality services.
Caring
We demonstrate care by showing empathy in our dealings with everyone we work with.

7th April reply from WorkSafe’s Anthony:

Good afternoon Soula

Thank you for your email enquiry

Please note that the complaint has been escalated to our service improvement division to manage this query.  They will contact you in relation to this matter

Should you have any further queries or issues, feel free to contact the WorkSafe Advisory Service on 1800 136 089 or 03 9641 1444 or visit us on the web at http://www.worksafe.vic.gov.au.

Advisory Service information and advice is prepared in the context of the information you have provided in your email.  Whilst care has been taken to provide accurate information and advice, the Advisory Service has not endeavoured to advise on all possible contingencies and therefore not intended for other situations or circumstances, as this may affect this advice.

Prior to acting upon any information or advice offered by the Advisory Service, you will need to consider your individual circumstances to determine the application of the advice to any additional statutory obligation or duty relevant to your query.

Email Address WorksafeTo WorkSafe Victoria,

I’d like to formally report the lack of support, frustration, and stress I am experiencing with my claim with (enter WorkSafe Agent name) and within the WorkCover system. I have also been publicising my frustrations as I’m sure your social media management team are aware of but thought to give WorkSafe Vic the opportunity, once again, to handle my issue if I approached via your preferred methods. Having stated this, my previous complaints seem to have been lost to this address, I hope this one doesn’t have the same fate.

Here are my issues:

  • An injured worker should not have to be disadvantaged (such as held up payments) when a WorkSafe Agent employee is on leave,
  • I don’t appreciate having a valid point and being excluded from the Facebook page or having my posts deleted,
  • I have asked 6 times where it is stated in the regulations that my WorkSafe Agent (enter WorkSafe Agent name)  have 60 days to make a decision after a Medical Panels opinion has been delivered and have still not received an answer,
  • I have asked about the surveillance evidence that was provided to the Medical Panel ‘for completeness’. I had previously requested all my surveillance material and was allegedly provided with ‘all of it’. I want to know where the additional information provided to the Panels came from and why it was not provided to me when I asked?

And I want to express the following:

  • WorkSafe, from my experience, have no idea how to support an injured worker attempting to return to work,
  • my efforts to return to work should not be abused but rather encouraged
  • I should not have to endure $0 weekly assistance for 13 months (and still running) when I’m returning to work, not even when my hours are at 9 hours per week (and fall under the minimum requirement). This makes it all the more difficult to attempt return to work.
  • I have been using social media because writing to WorkSafe directly has been a huge failure from past experience and I expect that this latest attempt will also fall upon deaf ears
  • WorkSafe needs to take more responsibility for the WorkSafe Agents it employs, ostensibly to ‘help’ injured workers with their claims
  • WorkSafe is failing in its attempts to help injured workers find evidence-informed treatments, to help them recover and return to work
  • Your past responses to my letters of ‘noting my advocacy’ has made not the slightest difference to these governance issues

Once again, all this documentation will be noted and made public (without the WorkSafe Agent’s name) on my website www.pudendalnerve.com.au

Regards
Soula Mantalvanos

Feedback

41
  • John Quintner

    Soula, just for the record it is time to rate WorkCover’s performance in responding to your complaint according to its own standards. The VWA claims to be Constructive, Accountable, Transparent, Effective, and Caring. I would rate its performance on each of these parameters as 0%. Is this fair comment?

    • Soula

      Well actually if there was a negative value it would be more appropriate…

      • John Quintner

        But there is really nothing to rate unless they change the parameters to Obstructive, Unaccountable, Opaque, Ineffective and Uncaring. They would then score quite highly on each of these.

  • Soula

    In reply to your comment John:
    John Quintner on June 10th
    ‘Soula, the point to be made is that the Clinical Framework is an official document that provides a benchmark for best practice claims management. It would carry great weight in a Court of Law when a dispute reaches litigation stage and it can be shown that the principles contained within the document have not been followed by an Agent of WorkCover.’

    I’d have to say this would give me no courage if I was approaching court. My latest conciliation experience is showing me even more that the Agents seem to have a law of their own. If that Clinical Framework was in fact official, practitioners would be made to use it and so would the Medical Panels. I can tell you they don’t and it’s never been mentioned to me in 7 years. I sent that document in my defense when approaching conciliation and there was no reference made to it at all.

    Principles not being followed would not even make it into a court conversation… and if it has, I hope someone would inform us so. This system is never questioned for its poor service or treatment toward injured workers. Ever. Show me one case where it has been questioned and our Government has taken responsibility/action?

    • John Quintner

      The only example I can give you is when a barrister used a similar document when successfully arguing the case for a claimant before the Administrative Appeals Tribunal. This involved Telecom (as Telstra was then known) and it was a document authored by that organization in relation to “Repetitive Strain Injury” that torpedoed Telecom’s own argument that the condition did not exist.

      The “Clinical Guides” IS official and in fact is the only Guide available by which an independent person or body can assess the fairness or otherwise of the VWA”s system.

      • Soula

        Telstra / laymen injured workers… We can only dream of such attention and such representation! (And not to mention my self employer status).

  • John Quintner

    But it bears the imprimatur of WorkCover Victoria. Perhaps the document needs to be widely circulated amongst all stakeholders to ensure that they adhere to best practice claims management.

    • Soula

      WorkCover Victoria / Victorian WorkCover Authority print many things John but they have a dictionary that seems to vary from the one you or I refer to. I have always stated ‘independent’ and ‘binding’ are two words that certainly have a different meaning in this system and now I can add a third, ‘conciliation’.
      The system is far from what it states to be judging from my 7 year experience within it.

      • John Quintner

        George Orwell coined a term for this type of intellectual,behaviour – Doublethink!

        • soula

          Yes, that’s great. A conversation between the Victorian Workcover Authority (VWA), George Orwell and Franz Kafka would be incredibly beneficial for injured workers. Even for the VWA but their sights are too hard set on immediate funds instead of long term benefits for all.

          • John Quintner

            Soula, the point to be made is that the Clinical Framework is an official document that provides a benchmark for best practice claims management. It would carry great weight in a Court of Law when a dispute reaches litigation stage and it can be shown that the principles contained within the document have not been followed by an Agent of WorkCover.

  • John Quintner

    Soula, I can see why WorkCover (previously WorkSafe) has not as yet replied to your complaint. That organization would be hard put to explain why it and its agents had not taken on board any or all of the five principles that are embodied in its “Clinical Framework for the Delivery of Health Services”.

    • Soula

      Well apparently my contact was sick since last Thursday and he is now back on the case. I informed him of the current (and so far unresolved) conciliation process taking place so he has all the information he needs. Let’s see what he comes back with. The “Clinical Framework for the Delivery of Health Services” makes no sense to me, was there any point of producing that document? Certainly not a resource within the system from what I’ve seen.

  • John Quintner

    Still no response to your complaint? This could be seen by some uncharitable observers as little more than a blatant attempt by WorkCover to knock off some of its “low hanging fruit” (i.e you and your employer). But to pursue the analogy, there is also an odour of rotting fruit emanating from somewhere high up in the tree. As your case makes abundantly clear, legitimate complaints of employers and their injured employees are being studiously ignored or trashed. Could it be that a culture of inhumane treatment of long-term claimants is now embedded within the organization and is being perpetuated within the rebadged Victorian WorkCover Authority? I have seen no evidence to suggest that this is not the case.

    • soula

      That’s exactly what it is John. That’s what I’ve experienced. The system is money driven and that’s all it is. It is not concerned with working with an injured worker or the employee. This is greedy insurance at it’s dirtiest and it has nothing to do with support, empathy, return to work, quality income protection, or anything described within the agreement we (in VIC) pay premiums for. Where there is a way out of supporting an injured worker or employer, the Agents will find it and the WorkCover Authority (regardless what they chose to call themselves yesterday or today) is in full support of it swinging against the injured worker. The system is completely setup to avoid support for an injured worker and now especially focused on knocking off the ‘low hanging fruit’. The systems are in place so for an injured worker to get the treatment and support they need is almost impossible. win win for the WorkCover Authority, kick them when they’re down. No long term plan here, no faith that the injured worker can get back to tax paying status. That’s way too long to wait for their dollars, they want $$$$ NOW.

      Putrid and for everyone working within the system justifying this treatment as ‘it’s a system’ is, in my eyes supporting it and milking it for what it’s worth. I’d love to see any of these system employees cope without pay for 1.5 years. I bet they’d be wearing the fake neck brace instead unlike stupid me, being positive and believing that honesty is the best policy. idiot, looks like I will live to regret it.

  • John Quintner

    Soula, I can come up with three possible explanations for WorkSafe’s failure to address your complaint.

    1. The personnel in the complaints section are incompetent. But this is highly unlikely!

    2. You are being punished for having the audacity to make a complaint about the way you have been and are being treated. There may be some truth in this explanation but it would be difficult to prove.

    3. Having out-sourced the responsibility for claims management to the commercial sector, WorkSafe has signed away its power to ensure that its published guidelines for best-practice are being observed by your Agent. But without access to the terms of the agreement between WorkSafe and its authorised agents, one cannot draw this conclusion, even though it appears to be the most likely one.

    With Comcare Australia also moving to outsource its Workers’ Compensation claims management to the same commercial sector, warning bells are ringing but who is within ear-shot of them?

    • soula

      I like your 3 possible explanations. I actually thought of drafting a guess response to myself. I bet I’d get it right. They are probably thinking I’m going to go away with conciliation coming up… I’m not. There are many people following this post and they need to read the response.

      No one will give workers’ compensation much thought until they need it sadly. I think employers should really be the ones to stand up and demand their premiums return better quality income protection. No wonder they all want to escape their injured workers, I woudn’t want to fork out payments for an injured staff member so they can go to the useless IME’s and appointments the system sent me to. None of them were able to diagnose, assess or treat me. We’re heading for doom!

    • John Quintner

      Soula, looking at what happened in New Zealand in 2012 where their Accident and Compensation Corporation knocked off the “low hanging fruit” in the system, it seems that WorkSafe Victoria is employing the same tactics against you. If so, I would not be at all surprised to learn that your agent is being instructed by WorkSafe officials to make it extremely difficult for you to obtain your compensation payments. I know this is a horrifying scenario but it would at least explain why WorkSafe Victoria has not responded to your complaint.

      • Soula

        Yes, it feels that way. If I’d known I would not have attempted to get back to work. If anyone ever asked me if they should attempt return to work, I’d have to say ‘no’ now. This is truly ugly, and becoming uglier by the day. I’m entitled to my part payments and that is all that’s left to finalise. The Agent is only giving me more amunition to bag this system and I won’t stop until I get what’s rightfully mine. Injuries like mine don’t get better with time. The Agent and WorkSafe know that which is why they’d love to use my positive attitude and Theo’s neverending support against us by trying to wipe us off the system all together. That won’t happen.

  • John Quintner

    Soula, your complaint resonates with a Conclusion reached by the Victorian Auditor-General’s report of June 2009 – “Claims Management by the Victorian WorkCover Authority.”

    When commenting on the scheme’s favourable financial performance, the Auditor-General finds that “These achievements, however, have not translated into a substantial improvement in RTW over the same period, indicating that they are mainly due to a focus by agents on the liabilities management aspects of claims management driven by incentives in the VWA’s remuneration model.” [p.51]

    Yes indeed, you have grounds for your complaint. The humanitarian objectives professed by WorkSafe in its Conciliation process appear to be incompatible with those of the business model employed by your Agent. This would not come as a surprise to you and to many other injured workers with personal experience of being enmeshed in the very same system.

    • John Quintner

      Soula, I wonder whether your complaint has yet reached the Board of WorkSafe. This is where the buck should stop as the Board discharges WorkSafe’s responsibilities to Government, stakeholders and society. Is Anthony keeping you informed about the progress being made to address your complaint?

      • Soula

        About 36 days now John. I could have reached the moon sooner! I have not heard a single thing since Anthony’s last email. I’ll contact the ombudsman next. They helped me get a response last time.

        • John Quintner

          Soula, could there be another “complaints” section that specifically deals with complaints about the way WorkSafe handles complaints made about its complaints section?

          • Soula

            The Ombudsman is next as far as I know. It worked last time and suddenly someone remembered to email:
            “Dear Ms Matalvanos – please accept my apologies for this oversight. My subsequent reply to you was not sent correctly, and I failed to check my assumption it was provided on 30/7/13. The original delay resulted from time taken to seek a further comment regarding the progress of the National Guides from SafeWork Australia. The intended email follows.
            My apologies again”

            Read more:
            http://www.pudendalnerve.com.au/2013/07/07/reply-to-my-fair-assessment-for-compensation-letter/

  • John Quintner

    Soula, have you heard back from Anthony? Attending to your complaint is taking somewhat longer than the 21 days cut-off time, by which WorkSafe states it has reviewed 80% of complaints).

    • Soula

      I’ve not heard from anyone John. I know if I ask, I’ll probably get the ’21 working days’ excuse…

  • Soula

    Let’s have that again, it’s worth it: “The WorkCover systems are, sooner rather than later, likely to implode under the sheer weight of their regulatory red tape”

  • John Quintner

    Soula, as I understand your situation, and I may be wrong, WorkSafe and it’s appointed Agent are acting on your behalf as an employer and seemingly acting against you as an injured employee. Hence the impasse? Having your complaint “escalated” to the service improvement team could well be a major breakthrough for you, and others who find themselves in your situation, but whether “escalate” also implies “expedite” is a moot point.

    • Soula

      I don’t think the word ‘breakthrough’ could ever be used for any reference to the WorkCover system John. I’m not holding my breath, as mentioned in my letter WorkSafe have lost emails before and merely noted my complaints as ‘advocacy’. I have asked for Conciliation forms from the WorkSafe Agent today and beginning the process towards conciliation (which might take another 6-8 weeks!!!) and this is the time the insurer knows they can use to hold on to my money and in the process try and break me down. No damn insurer is going to deter me. The more they play ugly, the more I have to say about the WorkCover system. And I won’t stop until I get my rightful compensation. Thank you for being optimistic but I don’t believe WorkSafe represent anyone other than our Government and their greedy bank accounts.

      • John Quintner

        Soula, in my opinion some of the problems you are encountering are those imposed by a patriachal system in which injured workers are not encouraged to be involved in making decisions that involve them. Because they do not have “a place at the table” they are neither heard nor valued. Instead of coordinated health care designed to meet individual needs, the compensation system appears to deliver fragmented care which is always subject to the whim of WorkSafe’s Agents.

        • Soula

          John, an injured worker loses their voice and ‘citizenship’, from my experience, the second they have an accident in the workplace. They are then treated as a criminal which obviously aligns with the lost ‘place at the table’ you mention. I’ve said this before, there is only one thing left for this system to strip from an injured worker, and that is their right to vote. The treatment is completely unfair, primitive in its approach, in fact I’m just looking into the Equal Opportunity Act 2010 and Human Rights Commission to see if there’s any help I can get there. I’m stronger and have support to fight this but for those who are unwell and can’t, it’s definitely discriminatory treatment. The insurers seem to have authority to take advantage of the injured worker’s unhealthy situation, and that simply is unacceptable behaviour. Behaviour I would expect an organisation such as WorkSafe to pick up on and rectify, how can they not be interested in this? It can only make you wonder what is stopping WorkSafe, why they keep watching Agents frustrate injured workers, intimidating them, detering them from their rightful compensation with lengthy battles and their low grade services.

          • John Quintner

            Soula, they are good questions. The bottom line is that the relevant legislation and its intent severely constrains the role of WorkSafe in this “stormy world” of workers’ compensation. All politicians know that there are no votes to be gained by their attempting to improve the system. However, they spring into action when employers start to complain about the rising costs of their insurance premiums. My April 1 quote taken from Frank Sullivan’s book is “spot on” in its overview of the systems that we have inherited from our 19th century forebears. I have said this before but it bears repeating. The WorkCover systems are, sooner rather than later, likely to implode under the sheer weight of their regulatory red tape.

  • John Quintner

    Soula, I offer you and your readers the following insights, which have helped me to identify the principal drivers of our current WC systems: “Every jurisdiction draws a precarious line between needs-based justice and the preservation of work-driven distribution of prosperity … stormy world of workers’ compensation – a historic policy innovation that combines fairness, insurance, tort principles, realpolitik, and medicine in one large, complex, articulated, and evolving administrative mechanism.”

    Sullivan T, Frank J. Restating disability or disabling the state: four challenges. In: Sullivan T, ed. Injury and the New World of Work. Vancouver: UBC Press, 2000: 3-24.

  • John Quintner

    Soula, it has taken many centuries for us to understand the symbolism of the Sphinx. How long will it take for a WorkSafe and its Agent to provide answers to your straight-forward question – where is my money? If you are not entitled to receive it, here endeth the story. If the opposite case is the case, the willful act of withholding it from you comes under the category of theft, pure and simple. This has been part of the Law since Biblical times. Leaving you with uncertainty in such an important matter is unforgivable, at least in my opinion.

    • soula

      That is the main question at hand. And the other questions associated; why is it so difficult to address issues, respond in time, deliver what ‘WorkCover’ states it is meant to/what employers pay for? And why should an injured worker have to seek legal advice, why are legal companies advertising on day time television claiming to ‘help’ injured workers? Why is this necessary when you are faced with ill health, possibly never returning to work, bills continuing to flow in, a complete change of life… oh and hang on, I’ll need to get legal proceedings going for to receive ‘fair’ treatment? The legal service is not in anyway even for a legal battle, it’s the only way to get a fair say, how can this be right?

  • John Quintner

    Soula, WorkSafe’s Sphinx-like stance in this matter is completely unacceptable.

    • soula

      Sphinx is a great description. I seem to have no choice but to sit in front of the sphinx, even to the point where I may get hungry, and wait for the Sphinx to show some understanding for my position. So far the Sphinx has not budged oher than to read my post (Sphinx’s alerts are more efficient than their service).
      There is one point I forgot to make, and that is that I followed all their ‘procedures’ in my application and still, a huge hold up on release of my funds.
      I never believed this could be possible in Australia, such filthy behaviour from an organisation put in place to help injured workers.
      Another sleepness night ahead, more angst, higher pain levels, and more regret that I ever opened my mouth and attempted return to work.
      Thanks John

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