Behind the Claims Podcast

Say you receive a letter on your kitchen table saying your employer or insurer has arranged a specialist appointment to assess your ability to work. There’s a doctor’s name, a date, and a time.Most people just show up. They assume it’s legitimate. They assume everything was done by the book. And most of the time, nobody tells them otherwise.But here’s the thing. In many cases, that letter does not meet the legal requirements under workers compensation guidelines. And the insurer is counting on you not knowing that.A real government audit of QBE looked at 50 workers compensation claims over just five working days and found zero compliance on one key obligation insurers must follow before sending this type of letter.Dr. Danny Tang joins us again to explain what an Independent Medical Examination (IME) letter must legally include, what insurers are actually doing, and what it means for your claim when the process is not followed correctly. He also explains how IMC referrals fit into the process and why knowing your rights matters.If you’ve received one of these letters, or know someone who has, watch this before taking the next step.⏱️ Timestamps 0:00 – Introduction 1:02 – Dr. Tang is back 1:35 – What an IME letter is and legal requirements 2:36 – Workers compensation guidelines explained 4:40 – Why IME letters often look identical 5:49 – Compliance issues and what it means for injured workers 6:54 – Requirement to contact the treating doctor 8:23 – How claims can be impacted by this process 9:22 – IMC referrals and compliance issues 11:29 – Audit findings and insurer obligations 12:06 – Why understanding your rights matters 12:36 – Closing thoughts 📲 Need help with your workplace injury? Call us on 1300 391 947 or visit 👉 https://www.ausrehab.com/🔗 Reach out to Dr. Danny Tang: https://www.patrickmedical.com.au/🔗 Listen & Connect Catch every episode early! Subscribe free on Spotify: https://sptfy.bio/behindtheclaims and Apple: https://apple.co/48Etptt📲 Need help with your workplace injury recovery? Call us on 1300 391 947 or visit our website 👉 https://www.ausrehab.com/📣 Follow us for more Instagram: https://www.instagram.com/ausrehab/ Facebook: https://www.facebook.com/AusRehab LinkedIn: https://www.linkedin.com/company/ausrehab/ Website: https://www.ausrehab.com/ Email: [email protected] Podcast Playlist: https://www.youtube.com/playlist?list=PLWSvHJb6Zuk43NnqhjwVNsjLysoZRQx6y#WorkersCompensation #IME #IndependentMedicalExamination #WorkCoverNSW #InjuredWorker #KnowYourRights #WorkplaceInjury #ReturnToWork

“Stress is not a diagnosis. And if there’s no diagnosis, there’s no injury. And if there’s no injury, there’s no claim.”In this episode of Behind the Claim, Dr Danny Tang returns to break down one of the most important documents in a workers compensation claim: the Certificate of Capacity.Most injured workers sign it without reading it closely. Many treating doctors complete it without fully understanding what the legislation requires. And when mistakes are made, claims can be delayed, disputed, or payments can stop.Dr Tang speaks from both sides of the process, as a treating doctor and as an Independent Medical Consultant (IMC). He explains what insurers look for, where doctors commonly get it wrong, and why small compliance issues can create major problems for injured workers.This episode covers:• Why the Certificate of Capacity matters so much in a workers comp claim• Why terms like “stress,” “anxiety,” and “neck pain” are not valid diagnoses on their own• How the date of injury can affect treatment access and referrals• What the capacity for activities section is for, and why it should not be left blank• Why “one month” is not the same as 28 days under the NSW workers compensation rules• Why older WorkCover NSW certificates are no longer valid• How better compliance could improve claim outcomes for injured workersIf you are injured at work, supporting a family member, or involved in managing workers compensation claims, this episode gives a practical look at what the paperwork actually requires and why it matters.⏱️ Timestamps 0:00 – Intro 1:02 – Dr Tang returns2:11 – Initial vs subsequent Certificate of Capacity3:39 – Why employer name and occupation matter4:07 – Consent and privacy rules6:07 – Why “stress” and “anxiety” are not valid diagnoses on their own 7:40 – DSM-5 and psychiatric diagnosis8:09 – No diagnosis means no claim9:30 – Why the date of injury matters12:20 – The 12-week referral rule15:31 – Treatment plans and capacity for activities19:48 – No current work capacity and missing timeframes24:24 – Why 28 days is not “one month”29:07 – Why WorkCover NSW certificates are invalid33:22 – Why “neck pain” is a symptom, not a diagnosis43:32 – Closing thoughts on compliance and better claims🔗 Listen & ConnectCatch every episode early! Subscribe free on Spotify: https://sptfy.bio/behindtheclaims and Apple: https://apple.co/48Etptt📲 Need help with your workplace injury recovery? Call us on 1300 391 947 or visit our website👉 https://www.ausrehab.com/📣 Follow us for more Instagram: https://www.instagram.com/ausrehab/ Facebook: https://www.facebook.com/AusRehab LinkedIn: https://www.linkedin.com/company/ausrehab/ Website: https://www.ausrehab.com/ Email: [email protected] Playlist https://www.youtube.com/playlist?list=PLWSvHJb6Zuk43NnqhjwVNsjLysoZRQx6y#CertificateOfCapacity #WorkersComp #WorkCoverNSW #SIRA #MedicalCertificate #ReturnToWork #BehindTheClaim #AusRehab

Movement is key to getting better. Don’t sit around and do nothing.”Most injured workers are told to rest and wait for the pain to settle. But for many people, that approach can delay recovery and keep them away from work longer than necessary.In this episode of Behind the Claim, Stephen sits down with John Beshay, an exercise physiologist and chiropractor, to explain why some workplace injuries don’t improve and what actually helps people recover.John shares his journey into rehabilitation after seeing a close family member struggle with recovery, and how that experience shaped the way he now approaches treatment.Today, John works across workplace rehabilitation, combining exercise physiology and chiropractic care, and supporting injured workers, employers, and organisations including the Australian Defence Force.This episode covers:• Why movement plays a key role in injury recovery • The difference between exercise physiologists, chiropractors, osteopaths, and physiotherapists • Why staying off work too long can delay recovery • What happens during case conferences in workplace rehabilitation • How return-to-work planning supports long-term health outcomes • Real-world insights into workplace testing and rehabilitation systemsIf you’ve been injured at work, or supporting someone through recovery, this episode gives a practical view of how rehabilitation works and what can slow progress.Timestamps0:00 – Introduction2:21 – Who is John Beshay8:56 – EP vs chiropractor vs osteopath vs physiotherapist11:05 – How qualifications influence treatment18:55 – Early challenges in occupational rehab 20:14 – Return to life before return to work29:49 – Why movement is critical for recovery40:47 – When recovery takes longer than expected47:30 – Workplace testing and real-world examples1:08:26 – Working with the Australian Defence Force1:16:07 – Challenges in veteran rehabilitation🔗 Listen & Connect Catch every episode early! Subscribe free on Spotify: https://sptfy.bio/behindtheclaims and Apple: https://apple.co/48EtpttConnect with our guest, John Beshay, to learn more about rehabilitation and return-to-work strategies: https://www.linkedin.com/in/john-beshay-7a7b404b/ 📲 Need help with your workplace injury recovery? Call us on 1300 391 947 or visit our website 👉 https://www.ausrehab.com/📣 Follow us for more Instagram: https://www.instagram.com/ausrehab/ Facebook: https://www.facebook.com/AusRehab LinkedIn: https://www.linkedin.com/company/ausrehab/ Website: https://www.ausrehab.com/ Email: [email protected] Podcast Playlist: https://www.youtube.com/playlist?list=PLWSvHJb6Zuk43NnqhjwVNsjLysoZRQx6y#WorkplaceInjury #InjuryRecovery #ReturnToWork #ExercisePhysiologist #Chiropractor #WorkplaceRehabilitation #WorkersComp #AusRehab