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User Guide - Office for the Public Sector

1. Salary Class y Payroll Code y Pay Frequency y Step 4 Enter the Worker s Earnings details including the Date Effective and Status Commercial in Confidence SBC IT South Australia Department of Premier and Cabinet Page 175 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 Date Effective B Status Active Current v status Date Date Entered 6 11 2014 Entered By SBC System Admin The Date Entered Status Date and Entered By fields are read only and will be automatically populated when the Workers Earnings screen is added to the claim The Date Entered and Status Date fields default to the current system date the Workers Earnings for the claim is entered and Entered By is the name of the person entering the Workers Earnings information for the claim Note Multiple Earning can be added to the Claim using this one screen however only one record can have a Status of Active Current for each claim Step 5 Add the Worker s Earnings for This Employment and any Other Employment if applicable including the Base Weekly Earnings Overtime and Non Pecuniary Benefits Step 6 Record the Normal Weekly Hours Normal Days Per Week and Normal Weekly Overtime Hours for This Employment and any Other Employment if applicable Normal Weekly Hours l Normal Days per Week x Step 7 Check that the Current Notional Weekly Earnings is displ
2. 131 28 HOW DO I ENTER A PERMANENT IMPAIRMENT ASSESSMENT 0 cceseeeeeee 132 28 1 PERMANENT IMPAIRMENT ASSESSMENT ccc0scccecccescececeeecetenceseeceeuceteueeseeteaeeseueesseesaneess 132 28 2 PERMANENT IMPAIRMENT ASSESSMENT STEP BY STEP sscccceececeeeeeceeeeceeeeseeeeesaueesaaeeesaes 132 28 2 1 How do I Add a Permanent Impairment Assessment to the Claim ccccceeeee 133 28 2 2 How do Upload a DOCUMENT sretisnies enk 134 28 2 3 How do I Modify the Permanent Impairment Assessment screen after it has been saved 135 28 2 4 How do I Add Multiple Permanent Impairment Assessment screens to a claim 136 28 2 5 How do I Delete the Permanent Impairment Assessment SCre n cccceeeeeeeeeees 136 28 3 PERMANENT IMPAIRMENT ASSESSMENT ADDITIONAL INFORMATION 0 ccceeceeseeeeeeneeeeeeeeees 137 ZO Sl Mandatory FieldSurssrsnia a a a A 137 POO TEECNO E a ee 137 29 PERMANENT IMPAIRMENT SUMMARY ccccsceseeceseeeneeenseseaseeeneseeeeseneeenesons 140 29 1 PERMANENT IMPAIRMENT SUMMARY STEP BY STEP c 0cccceeececeeceteecesceeeeceueesseeeesaueesseeesaes 140 29 1 1 How do I View the Permanent Impairment Summary ccccceeeeceeeeeeeeseeeeeeeeeaeeess 140 29 1 2 How do I use the Permanent Impairment Summary Search ccccseeeeeeeeeeeeeeeeees 140 29 1 3 How do Open a Permanent Impairment from the Permanent Impairment Summary screen 141
3. Item Number Payment Category Jurisdiction South Australia Payment Type C Exclude if Injured Worker is Payee Claims Manager Date Entered Invoice Date Date From E Date To E Date From E Date To Search Clear cancel Approve Selected Items Select All 35 2 2 How dol Approve one or more Payments Open the Unauthorised Payment Search by selecting Administration gt Unauthorised Payment from the Menu Once the Unauthorised Payment Search screen opens in the Screen window select the Criteria associated with the desired Unauthorised Payment Step 3 Press the 4 Search button The Unauthorised Payments matching the selected criteria will appear in the Search Results list box Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 171 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 Step 4 Select the Approve checkbox to the right of each of the Payments in the Search Results Claim Number n Payment Category Payment Type Item Number Service Date Amount exc G Medical Other Goods and Services 00001 1 06 2015 164 00 0 00 164 00 Vv Chemist expenses all 15000001 01 John Gilmore 12545 Invest Step 5 Confirm you have selected all Payments which are to be Authorised and select the Approve Selected Items bution located at the bottom of the screen Provid
4. screen Step 1 To view the Permanent Impairment Summary for the claim click on the Permanent Impairment Summary folder in the Claim Tree Control gohe Permanent Impairment Summar bes _ Permanent Impairment No 2 a a Permanent Impairment No 1 Step 2 Review the list of Permanent Impairments listed in the Summary until you have located the Permanent Impairment you wish to open Step 3 Click on the Date Received hyperlink The Permanent Impairments will open in the Screen window Permanent Impairment Summary Impairment Summary Date From Date To Impairment Code y Search Clear Date of Assessment Act Reference Impairment Code Impairment 16 10 2014 Section 24 1101 Loss of thumb Commercial in Confidence SBC IT South Australia Department of Premier and Cabinet Page 142 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 30 HOW DO ENTER SURGERY RELATED INCAPACITY The Surgery Related Incapacity screen records the details of surgery undergone by the worker in relation to the claim injury The Surgery Related Incapacity screen may be added for a Claim from the floating menu Only one Surgery Related Incapacity screen may be recorded for a claim The Surgery Related Incapacity screen will be displayed in the tree window above the Estimates SA node The screen will consist of a single tab e Surgery Related In
5. 8 3 1 How do I Modify the Return to Work File Note lt N Step 1 Open the claim record you wish to modify and click on an existing Return to AJ Work File Note screen in the tree control See How do I search for a Claim to locate a specific claim for modification Step 2 Click on the MODIFY icon The fields will become active and you will be able to select different values Step 3 Make the desired changes to the Return to Work File Note Screen Step 4 Click on the SAVE amp icon and the fields will become inactive and your changes will be saved If you Modify a Return to Work File Note Screen and do not wish to save your changes click on the MODIFY J icon for a second time Your changes will not be saved and the claim will stay open If you wish to discard you changes and close the claim click on the CLOSE RECORD gt icon from the toolbar 53 1 6 How do I Add more than one Return to Work File Note Step 1 Open the Claim record you wish to add a New Return to Work File Note to and click on an existing Return to Work File Note in the tree control Step 2 Select the ADD NEW E icon from the toolbar Add the details of a new Rehabilitation Note Step 3 Click on the SAVE 4 icon and the fields will become inactive and your changes will be saved Commercial in Confidence SBC IT South Australia Department of Premier and Cabinet Page 269 of 309 Claims Management System Self Insurance SA Version 1
6. Note You may only select one Employee profile when you are searching from within the Injured Worker screen 8 3 Employee Search Additional Information The following sections contain additional information about the Employee screen functionality and validation e Employee Search Using the Search e Employee Search Search Warning Messages 8 3 1 Using the Search Where multiple criteria are entered the SIMS will search for records that meet the criteria For example if the user selects both the Family Name and Given Name s only Employee s matching both criteria will be displayed in the Search Results lf you search and no results are returned but you are confident that the record exists you should either Check spelling accuracy of input details Reduce your criteria i e if you entered two 2 or more criteria remove one of them Use Like searching use the symbol as a wildcard i e sm th to locate both smith and Smyth or Use alternative or broader criteria If you have entered both a Given Name and Family Name try removing one criteria to broaden your search Employees cannot be deleted from the SIMS as they are imported from the Human Resources Interface Contact your System Administrator or IT Department if you discover a duplicate Employee record Commercial in Confidence SBC IT South Australia Department of Premier and Cabinet Page 50 of 309 Claims Management System
7. Redemption Commutation of Income Support Rehabilitation Total Recoveries Net Totals The Estimate screen appears as a default for each Claim when a payment is added and saved to the claim The screen will not need to be added to the Claim 31 2 Estimate Step by Step The following topics are available to assist you in the management of Estimates on a Claim e How do Modify the Estimate screen The following sections are related to the management of estimates are available in other sections of this User Guide e How dol View the Estimate History 31 2 1 How do Modify the Estimate screen P Step 1 Open the Claim you wish to modify the Estimates for we Step 2 Select the Estimates screen from the Tree Control Step 3 Modify the Estimate screen by clicking on the MODIFY A icon in the toolbar Step 4 Click on the Outstanding column for the Estimate Category you wish to update Commercial in Confidence SBC IT South Australia Department of Premier and Cabinet Page 149 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 Pending Payments Outstanding Incurred Reason for Change Deed of Release Hospital Inpatient Hospital Outpatient Lump Sum Economic Loss Lump Sum Non economic Loss edical Allied Health Medical Other Goods and Services Medic
8. Step 2 Click on the MODIFY A icon The fields will become active and then select the Add button to add the Time of Work details for the Injured Worker Selecting the Add button will create a row in the Time of Work Details table Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 95 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 Time Off Work Details Date Ceased Time Ceased Estimated Date Fit Date Fit Return Date Return Time Date Entered f f 10 06 2015 p Add Remove Work Duties Work Duties Indicator y Date Effective Changed By Date Changed Work Status History Work Duties Indicator Date Effective Date Status Changed Changed By here is no Return To Work Status History for this claim Step 3 Enter the Date Ceased and the Time Ceased along with an Estimated Date Fit if known which may be a future date When the Date Fit is entered the Estimated Date Fit field disappears from the screen When the Date Fit is entered the Return to Work Status is enabled for the user to record how the Injured Worker is returning to work e g Partial RTW Note The Date Entered field is read only field and will be populated with the system date that the record in the Incapacity Table was entered and saved Step 4 Record t
9. cccccececcececcccececccceccccceceaceneaeeceeaceneaeeneaesueceaueneaeeneas 281 58 HOW DO I ENTER CORRESPONDENCE IN ccccececececcececececncnececececeeueneeeneceeeeuenenenenss 282 58 1 CORRESPONDENCE IN er a a 282 58 2 CORRESPONDENCE N STEP BY STEP wcicud pectieincddekt echeenddnh ace wed h decide ct actee ees 282 58 2 1 How do I Create a New Correspondence IN Sereen ccccceeceeeeeceeeeseeeteneeseetaneess 283 58 2 2 How do Upload a Document cc cccccccceeeeceeeeeeeeceeeeseeeseeeseeeeseeeseueeseeeseueeseeesaeeess 284 58 2 3 How do I Add More than one Correspondence IN screen cscceseeeeeeeeeeeeeseeeeaeeens 285 58 2 4 How do I Delete the Correspondence IN Screen cccccceeccceeeeeeeeceeeeeeeteneesseeeaeeess 285 58 3 CORRESPONDENCE IN ADDITIONAL INFORMATION cccecececececcecececececcccecececececucauaenenerscacanars 285 58 31 Mandatory FICIOS ie8 sect 2cc3 aa a aaad ee e a a aa A Rane eastaanuiee tae 286 58 3 2 Tree Control ctatarascusasarricassscaeeacisescoananonbesccnunoncganabsaalamusaautachesaitennsaanmeaaueuecenaienens 286 5833 Privileged and Confidential 2s2 c7 cease sccatenict catedeceeate tect en E TE 286 59 HOW DO I VIEW THE CORRESPONDENCE IN SUMMARY SCREEN cscececeeeees 287 59 1 CORRESPONDENCE IN SUMMARY STEP BY STEP ccccecececececcececececuceeaeaecececucueaeaeaeeeeneneeeass 287 Commercial in Confidence SBCIT South Australia Department of Premier a
10. Reversal Details Reversal Type Full Reversal Reversal Date 17 06 2015 Reversal Amount 500 00 Step 6 Add the Reversal Method and Reversal Reason If you select Vendor Cheque or EFT you must enter the Cheque EFT Number as well Reversal Method O Vendor Cheque EFT No Payment Made Cheque EFT Number Reversal Reason Step 7 When you save the Reversal and click on Refresh the Payment Reversal will display under the Income Support Payment that has been reversed 42 2 3 How dol Add Multiple Payment Reversal Screens to a Claim Step 1 Open the Claim you wish to add the Payment Reversal to Highlight the Authorised Payment that you wish to reverse Step 2 See Section 41 2 1 above to create the Payment Reversal for each Payment that requires one How do I Delete the Payment Reversal Screen Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 207 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 43 HOW DO I ADD PAYMENT RESTRICTIONS This screen allows the user to record payment restrictions The payment restrictions stop payments from being entered for a claim for a nominated category or all categories The screen will be available from the floating menu allowing the user to select New Payment Restrictions A claim will have only one Payment Restrictions screen in the tree window The tree window will display as
11. A Related Claims a View Specialties ALQRTW Assessments a Maintain FTE Numbers oi Manage Teams Delete Claim saa Employer Reassignment Step 3 Select Reverse Payment from the menu A new tree branch and screen window will automatically appear This process is creating a new screen against a claim meee iNew Reversal Step 4 The Reversal screen will appear with the Details of the source Income Support Payment such as Compensation From Date Compensation To Date Days Lost in Period Hours Lost in Period Date Entered Date Authorised and Total Amount fields automatically populated from the Payment selected These fields are read only and cannot be changed Payment Details Compensation From Date 2 01 2015 Compensation To Date g 01 2015 Days Lost In Period 3 Hours Lost In Period 15 Date Entered 29 05 2015 Date Authorised 29 05 2015 Total Amount 500 00 Commercial in Confidence SBC IT South Australia Department of Premier and Cabinet Page 206 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 If you need to change the Payment Details section then you may have selected the wrong Payment to begin with Check to ensure you have selected the correct payment for Reversal Step 5 The Reversal Type Reversal Date and Reversal Amount will also be automatically populated in the Reversal Details section
12. a Related Claims New File Note HEQ RTW Assessme New Other Injuries or Diseases New Correspondence In New Correspondence Out a New Medical Referral _ New Investigation Referral New Motor Vehicle a New Nominated Treating Doctor New Claim Provider New Legal Representative amp New Dependant 2 New Witness Pd hl P a New RTW Assessment z New RTW Plan Step 3 Select New Permanent Impairment Assessment from the floating menu A new tree branch and screen window will automatically appear This process is creating a new screen against a claim To add further details to the claim you must select the option from the FLOATING MENU and create a screen Step 4 The Permanent Impairment Assessment screen will appear in the screen window Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 134 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 Step 5 Enter the Assessment Date and select the Assessment Type and Injury Type Permenant Impairment Assessment Date ay Assessment Type N Injury Type y Degree of Whole Person Impairment Examination B Z U ae gt 2 3 Format Font Family Font Size Diagnosis B Z U ae gt 2 Format Font Family Font Size Step 6 Select the Body Part or System and enter the WPI applicable to the Permanent Impairment claim The user can ad
13. payment Status Invoice Date 2 11 2014 i Invoice Number 12345 Date Entered 4 11 2014 Entered By SBC System Admin Approved A Payment has been Authorised by an Advisor but not yet Transferred or Paid if the Payment has a Date Authorised The Payment Status is set to Authorised as seen below nvoice Detalls Date Received 31 10 2014 Payment Status Authorised Invoice Date 31 10 2014 Invoice Number 12345 Date Entered Entered By SBC System Admin Payment Details Date Authorised 31 10 2014 Authorised By Nicole Howard Transferred A Payment has been Transferred to the Finance System to be Paid but may not yet be Paid if the Payment has a Date Transferred but no Date Paid or a Cheque Number EFT Receipt Number recorded as seen below Date Transferred oOo O Payment manually processed Commercial in Confidence SBC IT South Australia Department of Premier and Cabinet Page 163 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 Paid A Payment has been fully Paid by the Finance System if a Date Paid and a Cheque Number EFT Receipt Number is recorded as seen above Declined A payment has been declined by and has not been paid 33 3 7 How dol Upload a Document nes Step 1 Select a Payment screen you wish to attach the invoice file to WE b Step2 To attach a Document Invoice File click on the Upload button and use the Windows File Browser to loca
14. 12 2 Injured Worker Step by Step The following topics are available to assist you in the use of the Injured Worker screen e How do l Enter an Injured Worker to a Claim Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 64 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 How do Add a New Injured Worker to the Claim How do Modify the Injured Worker screen How do Add Multiple Injured Worker screens How do Delete the Injured Worker screen The following sections are related to the Injured Worker screen are available in other sections of this User Guide e How do I Use the Employee Search 12 2 1 How do I Enter an Injured Worker to a Claim J Step 1 we Step 2 Step 3 Step 4 Step 5 Step 3 To add an Injured Worker to a new claim follow the Instructions on creating a New Claim Once the Claim Details have been Saved the user will be taken to the Injured Worker screen Click on the Select Employee button on the Injured Worker screen The Employee Search screen will open Follow the Instructions in Employee Search and locate the Employee you wish to associate to the Claim Once you have selected the OK 4 button and imported the Existing Employee Details into the Injured Worker screen you may enter additional details as required Once all of the mandatory fields are completed click on the SAVE al icon
15. 30 HOW DO I ENTER SURGERY RELATED INCAPACITY 2 0cecececscsceececscsceeenescseeeees 142 30 1 SURGERY RELATED INCAPACITY cccccececcccccececececcccececececcacacacuceneaeacaceteneauauseeueeatansesneneaeas 142 30 2 SURGERY RELATED INCAPACITY STEP BY STEP ivsscesacecasdsacensatcansnachcaensaacseaasaadeeeseaseceaaramenacds 142 Commercial in Confidence SBC IT South Australia Department of Premier and Cabinet Page 9 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 30 2 1 How do I Add Surgery Related Incapacity to the Claim ccceceseeceseeeeseeeseeeeeeeens 142 30 2 2 How do I Modify the Surgery Related Incapacity screen after it has been saved 144 30 2 3 How do I Add Multiple Surgery Related Incapacity records for a claim 00008 144 30 2 4 How do I Delete a Surgery Related Incapacity record cccccceecceseeeesaeeeeeeeeeseeeeees 144 30 3 SURGERY RELATED INCAPACITY ADDITIONAL INFORMATION 0sccsceceseeceeeeenceteeeseeesaneess 146 BO 051s Mandaio NP IOIOS sintncticcediinecsnad oni eredeineaialant ieedantuuatnedsuudanpeiainnd uu ynanialan vamcunanianany 146 W WESC COMM Ol ea AN 146 31 HOW DO I ENTER CLAIM ESTIMATES 2 2 cccescccnsecsnscennseenseecnseensseenseesseenseeensees 147 Ma ESTATE E E tons E cepene tas ata ease Aetna E Me ti Be Ri ee aaa Bal ree dee 147 312 ESTIMATE STEP BY OTEP cerminan E aAa SDN 148 31 2 1
16. Click on the SAVE lal icon and the fields will become inactive and your changes will be saved When you add further Permanent Impairment Assessment screens to the claim the system will automatically check that the details you have entered into the previous screen are valid before creating a new screen For example the User created a Permanent Impairment Assessment screen but forgot to fill in a mandatory field This system would not let the user use the ADD NEW 4 function as the previous screen is invalid 28 2 5 How do Delete the Permanent Impairment Assessment screen Step 1 Step 2 Step 3 To remove the Permanent Impairment Assessment screen from the claim firstly select the claim you wish to remove the Permanent Impairment Assessment from Once you have the claim open select the Permanent Impairment Assessment branch under the Permanent Impairment Assessment Summary folder from the tree control which is to be removed If the Permanent Impairment Assessment is selected the background behind the text will appear blue Click on the DELETE amp icon from the toolbar When the confirmation message appears click on OK The Permanent Impairment Assessment screen will be removed from the claim Message from webpage 2 Are you sure you wish to delete this screen Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 137 of 309 Claims Management System Self Insurance SA V
17. SBC IT South Australia Department of Premier and Cabinet Page 108 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 E fetta tiles lest 62015 10 06 2015 13 06 2015 10 06 2015 11 06 2015 22 2 2 How do Iuse the Certificate Summary Search To use the Certificate Summary for the claim click on the Certificates folder in the Claim Tree Control and this will display the Certificate Summary screen wif 10 06 2015 13 06 2015 mt 10 06 2015 11 06 2015 Step 2 Enter criteria in to the fields at the top of the Summary Screen to locate a specific Work Capacity Certificate For example select a Date Range and the Capacity to refine the Search Results Date From Date To Capacity y 4 Search Clear Provider Type y Provider The Date From and Date To range will pick up all Certificates which cover the same days selected even if the Work Capacity Certificate entire period is longer than the date range selected as criteria For instance if the user enters 01 05 2014 5 05 2014 all Work Capacity Certificates with a Date Range which covers this date i e a Work Capacity Certificate with a Date From Date To range of 04 05 2014 09 05 2014 will appear in the results Step 3 Once you have selected one or more criteria select the Search button The Certificate Summary screen will refresh and the Work Capacity Certificates matching the
18. Service Plans The Treatment Service Plans screen will be displayed as follows Treatment Service Plans Plans Treatment Approvals Date Entered Date Authorised Payment Category Provider Number Limit Remaining Remainin Treatment Service Plan No Add M Remove Recommendation By Doctor Service Provider Date Recommendation Approved Date Entered 17 06 2015 Entered By SAPS Test From Date B To Date jp _ No Expiry Document Date Document Type Name View Add There are no Treatment Documents MRemove Payment Category y Payment Type y GL Code Provider Additional Notes Number of Services Requested Treatment Service Amount Limit Requested Number of Services Authorised Treatment Service Amount Limit Authorised Number of Services Used Treatment Service Amount Paid Number of Services Remaining Treatment Service Amount Limit Remaining LC Create Associated Purchase Order Purchase Order Status Awaiting Authorisation y Authorised By Date Authorised 46 2 Treatment Service Plans Step by Step The following topics are available to assist you in entering and maintaining Treatment Service Plans details on a claim Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 225 of 309 Claims Managemen
19. pama pana Date From a Date To i Document Source v search Clear Document Category y Document Type y Document Summary Document Date Document Source Document Category and Type Related To Registered By 27 05 2015 Correspondence Out General Correspondence Out SAPS Test 27 05 2015 Correspondence Out General Correspondence Out SAPS Test 27 05 2015 Correspondence In General Correspondence In SAPS Test 27 05 2015 Correspondence In General Correspondence In SAPS Test 25 05 2015 Motor Vehicle Motor Vehicle abc123 SAPS Test 25 05 2015 vendor Payment Vendor Payment see es aa bee SAPS Test 25 05 2015 Investigation Referral Investigation Referral Surveillance 25 05 2015 SAPS Test 25 05 2015 Correspondence In Forms SAPS Test 25 05 2015 Correspondence Out Rejection Leo Jones SAPS Test 25 05 2015 Correspondence Out Liability Accepted Injury Injured Worker SAPS Test 25 05 2015 Correspondence In General Correspondence In SAPS Test 25 05 2015 Correspondence In Incident Form Barry Henderson SAPS Test Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 275 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 55 2 Step by Step 55 2 1 How dol View the Document Summary Step 1 To view the Document Summary screen for the claim click on the Document Summary folder in the Claim Tree Control me Document Summary Step 2
20. 1 0 User Guide Printed 18 06 2015 14 HOW DO I ENTER DETAILS OF OTHER EXTERNAL CURRENT EMPLOYMENT The Other External Current Employment screen allows the user to record the details of any other employment that the Injured Worker has This screen will only be available when the user selects Yes in response to the Does the Injured Worker have any other Employment On the Employment Details screen The Other External Current Employment screen consists of a single tab e Other External Current Employment 14 1 Other External Current Employment The Other External Current Employment screen is displayed as follows Other External Current Employment External Current Employment Other External Current Employment Details Name of Employer Address Average Weekly Earnings Hours Telephone gt Name of Employer OOOO O Star ate st be stemave Address End Date ey Average Weekly Earnings Ll Normal Hours per Week state J Postcode normal Days per week C International Address Country Telephone 14 2 Other External Current Employment Step by Step The following topics are available to assist you in the use of the Other External Current Employment screen How do Enter the Other External Current Employment How do Modify the Other External Current Employment screen How do Add Multiple Other External Current Employment screens How do Delete the Other External Current Employme
21. 213 4AT RECOVERIES scpnctancctenctscuasenascnaactesagnetaet dulactusgaceas E E A a 213 442 RECOVERIES OTEP BY OTEP svonsenen n E 213 44 2 1 How do I Add Recoveries to the Claim ccccccccccceececeeeceececeeteeeceeeeseeetenseneeetaeees 214 44 2 2 How do I Modify the Recoveries screen after it has been Saved ccccseeeeeeeeeees 215 44 2 3 How do I Add Multiple Recoveries to a claim ccccecccseeeeceeeeeeeeeeseeeeseaeeeseeeeseeeeess 215 44 2 4 How do I Upload a Document to the Recoveries screen ccccceceeeeeeeeeeeeeeeeesaeeess 216 44 2 5 How do I Delete a Recoveries record nnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnrnnrnnrnnrnnrnnrnnrnnnnne 217 44 3 RECOVERIES ADDITIONAL INFORMATION cc 0scccsccceececeeeeccetenceceeeeeuceteueesseeteeeteueesseetaeess 218 Acak Mandatory Fields scesero hace a hoes agora eee 218 aA 2 ES CONTO A 218 45 HOW DO I ENTER A MEDICAL REFERRAL 0 cccccescceeeeeeneeeeneeenseceneseeseseneeeenesens 219 45k MEDICAL REFCRRA Da a a 219 45 2 MEDICAL REFERRAL STEP BY STEP ssccessocsccaneixctandeverdsahounctanbeseriandsucwtanhsvaatanasvncanaseeetans que 219 Commercial in Confidence SBC IT South Australia Department of Premier and Cabinet Page 12 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 45 2 1 How do I Add a Medical Referral to the Claim 0 0 0 ceccccccceccseceeeeeeeeeeeeeeeeeseeeaeeeaees 219 45 2 2
22. 64 2 1 e Task List Interpreting Task List Search Results Interpreting Task List Search Results When results are returned from a Task List search a variety of useful information is presented in a number of columns including Claim Number Task Description Type Due Date Start Date and Worker Name The value returned in the Claim Number column is the Claim Number for the Claim the task is for You can click on this number to open the desired Claim Record The description in the Task Description column is the name or description of the task depending on the type of task For example if the task was a File Note the value returned in the Event column is the value entered in the File Note Subject field of the File Note screen Commercial in Confidence SBCIT
23. Cancel hyperlink When the CANCEL Cancel hyperlink is selected the Document Search screen will close and the search will not be conducted When the CLEAR Clear hyperlink is selected will clear the results from the selection criteria fields as well as the results grid 56 3 Document Search Additional Information 56 3 1 No Records Match the Criteria Entered If the user selects the SEARCH 4 Search hyperlink and no matches are returned in SIMS the following message will appear in the Search Results grid No records matched the supplied criteria The following are a list of reasons why the SIMS may not locate the document you are searching for e The Document Details are incorrect Check the Document details you entered as criteria It might be that the criteria you are entering will not match the details entered when the Document was registered into the SIMS e You are using too many Search Criteria Simplifying your search by entering fewer search criteria e Incorrect Spelling Use the Like Search See Like Search for further details Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 279 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 e The Document does not exist in the SIMS The Document may not have been entered into the SIMS 56 3 2 Like Search The SIMS has the ability to perform Like searches with the use of a
24. GST incl GST Claim No Payee Payment Type o records matched the supplied criteria The following is a list of reasons why SIMS may not locate the Payment you are searching for e The Criteria entered are incorrect Check the Payment details you entered in the criteria It might be that the criteria you are entering will not match the details entered when the Payment was recorded e You are using too many Search Criteria Simplifying your search by entering fewer search criteria or Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 53 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 e The Payment does not exist in the SIMS The Payment may not have been entered into SIMS Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 54 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 10 HOW DO I CREATE A NEW CLAIM IN SIMS When creating a New Claim screens are displayed requiring the details indicated in the Claim Form You must complete all of the mandatory screens and fields before your Claim can be saved and a Claim Number can be allocated to the Claim The screens required are as follows Claim Injured Worker Employment Details Incident Details Injury Details The system will display the following when one of the options is selected Opti
25. Has requested a copy of their recovery and return to work plan Communication C Case Manager to contact Doctor on receipt of Certificate Preferred Method of Contact y C Employer to contact Doctor on receipt of Certificate Commercial in Confidence SBC IT South Australia Department of Premier and Cabinet Page 99 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 21 2 Work Capacity Certificate Step by Step The following topics are available to assist you in the use of the Work Capacity Certificate screen How do Add a Work Capacity Certificate to a Claim How do Modify the Work Capacity Certificate Screen after its been Saved How do Add Multiple Work Capacity Certificate Screens to a Claim How do Delete a Work Capacity Certificate How to upload a document to the Work Capacity Certificate The following sections are related to the Work Capacity Certificate screen are available in other sections of this User Guide e How do I View the Work Capacity Certificate Summary e How do use the Work Capacity Certificate Summary Search e How do Open a Work Capacity Certificate from the Work Capacity Certificate Summary screen e How do Use the Provider Search 21 2 1 How dol Add a Work Capacity Certificate to a Claim MS Step 1 Open the claim you wish to add the New Certificate of Capacity to MCS we Step 2 Go to the Claim Summary branch of the tree contro
26. How do Add Multiple Payment Reversal screens to a Claim How do Delete a Payment Reversal Screen The following sections are related to Payment Reversal are available in other sections of this User Guide Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 205 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 e Howdol Enter a Payment 42 2 1 How dol Add a Payment Reversal for Income Support Payments to the Claim Step 1 Open the Claim you wish to add the Payment Reversal to Highlight the AJ Authorised Compensation Payment that you wish to reverse Step 2 Select the Administration gt Reverse Payment menu item as shown below task list Claim 15000001 01 Gilmore Jot ai Claim Summary Claim Details 4 Unauthorised Payments 4 Unauthorised Compensation Payments amp Injured Worker Paneg d wid Employment Details niy i TA Incident Details AIT r _m Injury Codes gt S Time Off Work Change Password _ Notional Weekly Earnings 4 Audit Trail a Permanent Impairment EAE a Payments Service Rate Payment Item Search e 1 06 2015 12545 SA Licences amp Estimate y Transfer Claims Owner itt Estimate History amp Set Authorisation Levels m File Note Summary 4 Claims to be Coded mO Correspondence In Summ Modify Claim Number lj Document Summary t Upload Lump Sum Return
27. Payment Restrictions The screen will consist of a single tab e Payment Restrictions 43 1 Payment Restrictions The screen will be displayed as follows Payment Restrictions Restrictions Payment Restrictions Payment Category Payment Type Date Form Date To Reason There are no Payments Restrictions to show insertt MRemove Date From Date To Date Entered Entered By Payment Category Payment Type Reason Notes 43 2 Payment Restrictions Step by Step The following topics are available to assist you in the use of the Compensation Restrictions screen e How do I Add a Payment Restriction to the Claim e How do I Modify the Payment Restrictions Screen after it has been saved e How do I Add Multiple Payment Restrictions to a Claim e How do I Delete Payment Restrictions The following sections are related to the Payment Restrictions screen are available in other sections of this User Guide How do Add an Income Support Payment How do Enter Multiple Income Support Payments How do Authorise Income Support Payments How do add Recurring Payments How do Authorise Recurring Payments Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 208 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 e How do search for a Party How do I Add a Payme
28. SBC IT South Australia Department of Premier and Cabinet Page 239 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 Step 4 Click on the SAVE lal icon and the fields will become inactive and your changes will be saved When you add further Witness screens to the claim the system will automatically check that the details you have entered into the previous screen are valid before creating a new screen For example the User created one Witness screen but forgot to fill in a Mandatory field This system would not let the user use the ADD NEW a function as the previous screen is invalid 48 2 5 How dol Delete the Witness Screen XS Step 1 To remove the Witness screen from the claim firstly select the claim you WG wish to remove the Witness screen from Step 2 Once you have the claim open select the Witness branch from the tree control which is to be removed If the Witness is selected the background behind the text will appear blue Step 3 Click on the DELETE amp icon from the toolbar When the confirmation message appears click on OK L _J The Witness will be removed from the claim Message from webpage Are you sure you wish to delete this screen Canca If you are unable to DELETE the Witness screen selected you may not have access to complete this function Check with the SIMS System Administrator that you have the correct access level 48 3
29. Step 2 Commercial in Confidence Open the Claim you wish to add the New RTW Assessment to Go to the Claim Summary branch of the tree control and click on the FLOATING MENU icon A list of options will appear to the right of the icon as shown below SBCIT South Australia Department of Premier and Cabinet Page 111 of 309 Version 1 0 Claims Management System Self Insurance SA User Guide Printed 18 06 2015 E ds BEET eta T Claim Details New Injury Details a Injured Worker New Notional Weekly Earnings dig Employment D New Certificate of Capacity amp Incident Detail gt New Surgery Related Incapacity E Ci Injury _ New Permanent Impairment Assessment e OTime Off Work yew Vendor Payment i s New Income Support Payment 1 aad 6 2015 y New kerpvenes New File Note Lu 10 06 20152 cence SS Estimate New Other Injuries or Diseases P K Estimate Histol New Correspondence In m Related Claims 2 New Correspondence Out a New Medical Referral _ New Investigation Referral New Motor Vehicle a New Nominated Treating Doctor New Claim Provider New Legal Representative amp New Dependant 2 New Witness New RTW Assessment New RTW Plan Step 3 Select New RTW Assessment from the floating menu A new tree branch and screen window will automatically appear This process is creating a new screen against a claim To add further details to the claim you must select the option from t
30. WORK GAPACITY CERTIFICATE ciupassrsiesui ea a a a E eee 97 21 2 WORK CAPACITY CERTIFICATE STEP BY STEP cccscccscccecccecececececececccacecaeecseeceeeceeecenseeeseass 99 21 2 1 How do Add a Work Capacity Certificate to a Claim eeccceeceeeeeeeeeeeeeeeeeeeeeeeeaeeees 99 21 2 2 How do Modify the Work Capacity Certificate Screen after it s been Saved 102 21 2 3 How do I Add Multiple Work Capacity Certificate Screens to a Claim 0c0e 103 21 2 4 How do I Delete a Work Capacity Certificate ccecccccecceceeeeseeeeeseeeeseeeeeseeeeeeeeeas 103 21 2 5 How do Upload a DOCUMENH neien a E E eE 104 21 3 WORK CAPACITY CERTIFICATE ADDITIONAL INFORMATION 00ccceecececeeseeceeeeeneeeeneenseesaneess 104 2ko Mandalory Fiola Sorsa a dd eoeeeemn ia eral mani ea ant eae 105 PRE E EE S EE E E E A E A E E A A 105 21 3 3 Work Capacity Certificate Periods cccccccsssceccsseeeceeeeeseeeecseeeessaseeeseeeeesseneessaees 105 22 HOW DO I VIEW THE CERTIFICATE SUMMARY 0 ccccceseceesesenseeeneeenseeeneeeenenees 107 22 4 SGERTIFICATIE CUMMAR Yain camucassnansiustiannoniiconune anu ans nana pacteen na saan nasteanaaieioanee 107 22 2 CERTIFICATE SUMMARY STEP BY STEP 5 00c secccecccecsceccceccoeeccecsoncccecsoueccecsoeesceesouesceesoeees 107 22 2 1 Howdo View the Certificate SUMMATLY cccccceeccceececeeeeeceeeseeeeeseeeesseeeeseeeeseeeess 107 22 2 2 Howdoluse the Cer
31. amp xs O iy 3 gt Libraries gt l 4 ig Search Libraries p 4 Organize v fil wr Favorites Libraries MB Desktop Open a library to see your files and arrange them by folder date and other properties Bb Downloads E Recent Places Documents a Music lt Pictures s iy Library Library wy Library d OneDrive mF i lt gt Vid l a Documents ae a Music i t Pictures Videos jM Computer hi Network File name All Files Open Cancel Once the desired file is selected click on the OPEN button in the File Browser Step 2 If successfully attached the filename will be visible in the File Name field Once a document is uploaded to a RIW Assessment screen it cannot be modified If you have selected the wrong document you can select the Clear button to delete the uploaded file and start again attach File view Step 3 Once all the details have been entered onto the screen the user would save the details by pressing the SAVE la icon 23 2 3 How dol Modify the RTW Assessment Screen after it has been saved NS Step 1 Open the claim record you wish to modify and click on an existing RTW Assessment screen in the tree control See How do I search for a Claim to locate a specific claim for modification Step 2 Click on the MODIFY A icon The fields will become active and you will be able to select different values Step 3 Make the desired changes to the RTW Assessment screen C
32. capacity for work types to ensure duplicate entries do not exist The following message will be provided if a match is found Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 106 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 Medical Certificate A Medical Certificate for the same period exists are you sure you would like to save this Certificate By selecting YES to continue or NO to prevent the new work capacity certificate from being saved A selection of one or more of the impairment types must be recorded by the user Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 107 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 22 HOW DO I VIEW THE CERTIFICATE SUMMARY The Certificate Summary appears when the Certificates folder is selected from the Claim Tree Control The Summary displays a listing of all Work Capacity Certificates for the Claim ordered by Date To ascending earliest date first The user may select the Date To hyperlink to open the desired Work Capacity Certificate in the Screen window if required The user may select Criteria in order to refine the list of Certificates which appear in the Certificate Summary A combination of Date From Date To Capacity Provider Type and or Provider may be used to refine the list The Certifica
33. e How do I Use the Payment Summary Search e How do Open a Payment from the Payment Summary screen The following sections are related to the Payment Summary screen are available in other sections of this User Guide How do Add a Payment How do Enter an Employee Reimbursement Payment How do Enter Payment Items How do Enter Multiple Payment Items for a Payment How do Authorise Payment Items How do Determine the Status of a Payment Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 167 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 e How do Upload a Document 34 2 1 How dol View the Payment Summary Step 1 To view the Payment Summary for the claim click on the Payment Summary folder in the Claim Tree Control Omir on 31 10 2014 12345 380 00 Lil 30 10 2014 8789 45 00 on j29 10 2014 23165 22 00 Ln 20 10 2014 26326 50 00 Lu 29 10 2014 23165 198 00 om j29 10 2014 789 200 00 we 34 2 2 How dol use the Payment Summary Search Step 1 To use the Payment Summary for the claim click on the Payment Summary folder in the Claim Tree Control and this will display the Payment Summary screen ORE 31 10 2014 12345 380 00 Li 30 10 2014 8789 45 00 mi 29 10 2014 23165 22 00 b 29 10 2014 26326 50 00 g 29 10 2014 23165 198 00 gA 29 1
34. modify details the user must open the Provider Profile For more information refer to How do Modify the Provider Screen You do not need to modify and re add the Provider each time the Provider details are changed in the Provider Profile The link between the Provider Profile and Claim is dynamic and any updated to the Profile will automatically come across to any linked Claims How do I Add Multiple Nominated Treating Doctor Screens to a Claim Step 1 Step 3 Step 4 Open the claim record you wish to add a New Nominated Treating Doctor to and click on an existing Nominated Treating Doctor in the Tree control Select the ADD NEW al icon from the toolbar alternatively you can go to the Floating Menu and select New Nominated Treating Doctor Add the details of anew Nominated Treating Doctor Click on the SAVE lal icon and the fields will become inactive and your changes will be saved When you add further Nominated Treating Doctor screens to the claim the system will automatically check that the details you have entered into the previous screen are valid before creating a new screen For example the User created one Nominated Treating Doctor screen but forgot to fill in a Mandatory field This system would not let the user use the ADD NEW a function as the previous screen is invalid How do I Delete the Nominated Treating Doctor Screen Step 1 Step 2 Step 3 To remove the Nominated Treating Doctor screen
35. selected claim is indicated by the character to the right of the Search Result Claim Number Injury Date Claim Type Injured Worker Claim Status Determination Date of Birth Disabili g 15000001 01 21 05 2015 Self Insured Claim John Gilmore Claim Reopened Accepted 18 09 1974 Department of Planning Phi Transport and Infrastructure gt 15000001 02 4 05 2015 Self Insured Claim John Gilmore Claim Open Accepted 18 09 1974 Families SA Phi Step 4 Click on the New Claim button tew claim to create a new Claim for the Injured Worker The Injured Worker will be pre populated on the New Claim record Complete the Claim entry following the instructions in How do create a New Claim in SIMS starting from step 2 6 1 3 Alternative Quick Search Step 1 Enter the Claim Number directly in the field to the right of the Activity List field on the toolbar Step 2 To perform the selection press Enter or Tab 6 2 Claim Search Additional Information The following sections contain additional information about the Claim Search screen functionality and validation e Claim Search Search Warning Messages 6 2 1 Search Warning Messages 6 2 1 1 No RECORDS MATCH THE CRITERIA ENTERED If you click on the SEARCH i hyperlink and the SIMS returns the following message the SIMS has been unable to locate the claim you are searching for Injury Date Claim Type Injured Worker No records matched the supplied criteria The following is a list of
36. you will need to select Clear to remove the attached document and upload the correct document File Name lrest docx View Step 4 Once all the details have been entered onto the screen the user would save the details by pressing the SAVE la icon 48 2 3 How dol Modify the Witness Screen after it s been saved Step 1 Open the Claim record you wish to modify and click on an existing Witness screen in the tree control See How do search for a Claim to locate a specific claim for modification Step 2 Click on the MODIFY amp icon The fields will become active and you will be able to select different values Step 3 Make the desired changes to the Witness screen Step 4 Click on the SAVE icon and the fields will become inactive and your changes will be saved If you Modify a Witness screen and do not wish to save your changes click on the MODIFY 4 icon for a second time Your changes will not be saved and the claim will stay open If you wish to discard you changes and close the claim click on the CLOSE RECORD gt icon from the toolbar 48 2 4 How do I Add Multiple Witness screens to a Claim Step 1 Open the claim record you wish to add a New Witness to and click on an existing Witness in the Tree control Step 3 Select the ADD NEW w icon from the toolbar alternatively you can go to the Floating Menu and select New Witness Add the details of a new Nominated Treating Doctor Commercial in Confidence
37. 00 0 00 5 000 00 0 00 SBC System Adjusted Permanent Admin Impairment Assessment Hospital 4 000 00 0 00 4 000 00 0 00 pe System Change in Condition min Household services 250 00 0 00 250 00 0 00 SBC System Change in Condition attendant care Admin Legal Costs 1 000 00 0 00 1 000 00 0 00 SBC System Adjusted Permanent Admin Impairment Assessment On this screen a row is displayed for each Estimate adjustment and Payment transaction Payment transactions are only displayed when they are authorised The following information is displayed on this screen e Current Incurred The current expected Total Cost of the Claim after the transaction has been processed for the Category e Current Payments The current total amount Paid for the Claim after the transaction has been processed for the Category e Incurred Variation The change in the expected Total Cost of the Claim after the transaction has been processed for the Category e Payment Variation The change in the total amount Paid for the Claim after the transaction has been processed for the Category e User The name of the User who processed the transaction e Reason The reason for the Estimate adjustment Reasons are only displayed for Estimate adjustments Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 152 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06
38. 2 1 How do I Add a Payment Reversal for Income Support Payments to the Claim 205 42 2 2 How do I Modify the Payment Reversal Screen after it s been Saved 00c00 206 42 2 3 How do I Add Multiple Payment Reversal Screens to a Claim cccseceeseeeeeeeeeees 206 42 2 4 How do I Delete the Payment Reversal Screen ccccccseecseeeeeeeeseeeeseeeseeeeseeesaeeens 206 43 HOW DOI ADD PAYMENT RESTRICTIONS 1 ceceeteeeeeeneeeeeeeeeeneeeenseseeneeeeaeeseeneenens 207 A331 PAYMENT RESTRICTIONS vcccassossdsncaceseuasoutinbiacginguainettatsscgiapeatnuniahiscgianbetentabatagiaeerteotianiasy 207 43 2 PAYMENT RESI RIGHONS STER BY 91 EP cacao vt sacs ests woes set tae a aseeeeae 207 43 2 1 How do I Add a Payment Restriction to the Claim 0 ecccecceeccsecceeeeeeeeeeeeseeeaeeeaaes 208 43 2 2 How do I Modify the Payment Restrictions screen after it has been saved 209 43 2 3 How do I Add Multiple Payment Restrictions to a claim ec ccceeccceeeeseeeeeeeeeeeeaeeees 210 43 2 4 How do I Delete a Payment Restriction record cccccccceeecseeeeeeeeceeeseeeseeeeseeeeaeeens 210 43 3 PAYMENT RESTRICTIONS ADDITIONAL INFORMATION 0 ccseccceeeeceeeeeeeeeeeeeseeeeaeeeseueeseeesaeens 211 ASST Mandatory FIEldS eee ne eee ee eee ee eee 212 43 92 VCS CONU Ol aona AEAEE E E EE 212 44 HOW DO I ADD RECOVERIES wesiissccicntstansccenveotnnesiuntsntesaniewintuntentawantinvsisalstusamsewstennen
39. 2015 33 HOW DO I ENTER A PAYMENT The Vendor Payments screen allows the user to enter or view the details of a Payment made to a Vendor Provider for the Claim for example a Payment for a Medical Consultation or Surgery Multiple Vendor Payments may be recorded for each Claim and these will be displayed ina Folder titled Payments A Payment that is not yet Authorised may be deleted if the User has the relevant Security Privilege however Authorised Payments may not be deleted Authorised Payments can be reversed by creating a Payment Reversal See Section Error Reference source not found Error Reference source not found for more information Payments will display in the Payments folder with a Description in the following format lt Invoice Date gt lt Invoice Number gt lt Total Invoice Amount incl GST gt For example 01 01 2014 ABC123 19 95 Payments in the Payments folder will be grouped into Sub Folders for the Financial Year of the Payment s Invoice Date as well as a subfolder titled Lump Sum All payments of payment type lump sum will appear in the sub folder Payments with an Invoice Date that is in the Current Financial Year will not be displayed in a Sub Folder These Payments will be displayed above the Sub Folders Payments will be ordered in the Folders by their Invoice Date in descending order with the most recent Payment displaying first Selecting the Payments folder itself will display the
40. 55 First Road Address 55 First Road Suburb MELBOURNE State Postcode 3000 MELBOURNE State vic Postcode 3000 International Address Country International Address Country Contact Details Telephone Fax Number Mobile Email Contact Name Step 6 The user may add any additional notes to the Nominated Treating Doctor screen if required Paragraph FontFamily FontSize Step 7 Once you are satisfied with the Nominated Treating Doctor details entered into the fields on the screen click on the SAVE al icon and the fields will become inactive and your changes will be saved against the claim If you have multiple screens in MODIFY mode A when saving the screen SIMS will check to see if any other screens are in modify mode If there are any screens which meet this criteria the system will open the screen which needs saving and you will need to click on the SAVE al icon again Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 233 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 47 2 2 How dol Modify the Nominated Treating Doctor Screen after it s been saved When a Nominated Treating Doctor provider is added to a Claim Address and Contact details for the Provider may not be modified from this screen To
41. 56 1 Document Search The Document Search screen displays as seen below and contains the following fields Document Search Document Search Document Details Content Searching Examples Document Number Here are some examples of common content search expressions Each ae search operator has a shorthand symbol Each example shows the full Jurisdiction South Australia operator example on the left and symbolic version on the right Document Source ats AND dogs cats amp dogs Document Category Returns documents containing both the words cats and dogs Document Type Content ats OR dogs cats dogs Registered By Returns documents containing either word File Name ats AND NOT dogs cats amp dogs a Returns documents containing the word cats but not dogs Date From BEY Date To Claim Details Claim Number 4 Search _j clear Cancel 56 2 Document Search Step by Step 56 2 1 How dol Use the Document Search Step 1 Open the Document Search screen by selecting the Document gt Document Search menu item Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 277 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 Search Generate Fina 1 Provider Search i Claim Search Payment Search Bi Document Search Step 2 Select the Search Criteria the user w
42. 7 The user may elect to Assign a Person Responsible to the File Note if an action is required by clicking on the Assign checkbox When the checkbox is selected the Due Date Reminder Date Date Completed and Name Email Address fields are displayed and active for the user to enter the required information Multiple people may be assigned and removed to from the File Note by selecting the INSERT and REMOVE icons Assign Due Date _ E Reminder Date Date Completed Name Email Address insert Remove Person Responsible Type Nicole Howard User You may select to send the File Note to an Employee and assign a Due Date and Reminder Date for the Task Refer to How do Notify an Employee of my File Note Step 8 Once you are satisfied with the File Note details entered into the fields on the screen click on the SAVE amp icon and the fields will become inactive and your changes will be saved against the claim 51 2 2 How dol Upload a Document Step 1 To attach a Document click on the Upload button and use the Windows File Browser to locate and select the desired file Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 256 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 i Choose File to Upload _ B xs G a via gt Libraries gt l v 4 n Search Libraries p y Organize v 0 Ft Favorit
43. Assessments oe 10 06 2015 Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 116 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 24 2 2 How dol Open a RTW Assessment from the RTW Assessment Summary screen a A Step 1 To view the RTW Assessments Summary for the claim click on the RTW AJ Assessment Summary folder in the Claim Tree Control CORME Ae wf bee ll y 10 06 2015 Step 2 Review the list of RTW Assessments listed in the Summary until you have located the RTW Assessment you wish to open Step 3 Click on the Start Date hyperlink The RTW Assessment will open in the Screen window IRTW Assessments Summary Assessments Summary RTW Assessments Start Date Completion Date Status RTW Consultant Assessment Type Assessment Outcome 10 06 2015 Open SAPS Test Internal Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 117 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 25 HOW DO I ENTER A RTW PLAN This screen allows users to enter details of an Injured Workers RTW Plan such as rehabilitation plans goals and any restrictions on the Injured Workers path to regaining full productivity Multiple RTW Plans screens may be associated to the Claim The RTW Plan screen consists of one tab RTW Plan 25 1 RTW Plan The RTW Plan
44. Clear amp Search for File Note entered by SBC System Admin 29 10 2014 1 04 PM Category General Subject Telephone call checking on Injured Worker Worker seems to be in good spirits File Note entered by SBC System Admin 30 10 2014 3 40 PM Category Alert Note Subject Injured Worker displaying Verbal Abuse over phone Injured Worker displaying Verbal Abuse over phone File Note entered by SBC System Admin 30 10 2014 3 44 PM Category General Subject File Audit File Audit completed Confidential 52 1 File Note Summary Step by Step The following topics are available to assist you in the use of the File Note Summary screen e How do I View the File Note Summary e How do I Use the File Note Summary Search e How do I Open a File Note screen from the File Note Summary screen The following sections are related to the File Note screen are available in other sections of this User Guide How do Add a File Note to a Claim How do Modify the File Notes Screen after it has been saved How do Add more than one File Note How do Delete a File Note Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 261 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 52 1 1 How dol View the File Note Summary Ns Step 1 To view the File Note Summary for the claim click on the File Note Summary WG folder in the Claim Tree
45. Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 118 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 25 2 RTW Plan Step by Step The following topics are available to assist you in the use of the Rehabilitation Plan screen How do Add a RTW Plan to the Claim How do Upload a Document How do Modify the RTW Plan Screen after it has been saved How do Add Multiple RIW Plan screens to a Claim How do Delete the RTW Plan screen The following sections are related to the RIW Summary screen are available in other sections of this User Guide How do View the RIW Summary How do use the RTW Summary Search How do Open a RTW Plan from the RTW Summary screen How do Use the Provider Search How do I Add a RTW Plan and its Outcomes to the Claim Step 1 Open the Claim you wish to add the New RTW Plan to 25 2 1 S i Step 2 Go to the Claim Summary branch of the tree control and click on the FLOATING MENU icon A list of options will appear to the right of the icon as shown below g Claim Summary _ Claim Details New Injury Details S amp Injured Worker New Notional Weekly Earnings dg Employment Dj New Certificate of Capacity oom Incident Detail New Surgery Related Incapacity E Injury P New Permanent Impairment Assessment o DT VA Time Off Work New Vendor Payment O Certificates New Income
46. Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 191 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 Recipient a Selection of the SEARCH aa icon will open the Party Search dialog Refer to How do Search for a Party For more information Selection of a Party from the Party Search dialog will auto populate the Recipient Contact Name Telephone Fax Number Email and Postal and Residential Addresses Step 7 Enter either the per Payment or Amount per Payment per Payment Amount per Payment Max Amount per Payment Max Amount per Claim Total Paid to Date Step 8 Enter any Notes if applicable Notes Step 9 The Compensation Recipients screen can be saved once all mandatory details have been entered by selecting the SAVE a icon 38 2 2 How dol Modify the Compensation Recipients screen after it has been saved Step 1 Open the claim record you wish to modify and click on the Compensation Recipients screen in the tree control cipients _ TIE eee Step 2 Click on the MODIFY A icon The fields will become active and you will be able to select different values Step 3 Make the desired changes to the Compensation Recipients screen Step 4 Click on the SAVE icon and the fields will become inactive and your changes will be saved lf you modify the Compensation Recipients screen an
47. Date From BF Date From grl Date From ma Date To H Date To i Date To H Date To EEH Date To Total Claims io Step 2 The user can search for Claims a number of ways using just one group of fields in the Claim Search screen or many In the Claim Details group of fields the user can enter criteria such as the specific Claim Number if known or select the Claim Status Claims Manager or Classification for example Claim Details Claim Number Jurisdiction South Australia Claim Type Claim Status y Claims Manager y Classification Registration Status y Rehab Manager iv Rehab Status Determination y Alternatively the user can enter search criteria to find the desired Injured Worker For example the Workers Family Name Smith is entered as search criteria The SIMS will search for all Claims where the Injured Commercial in Confidence SBC IT South Australia Department of Premier and Cabinet Page 42 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 Worker s Family Name is Smith The SIMS will only return results which match the criteria entered The user may also search for Claims using the Employment at DOI group of fields In order to populate these fields the user must first select the Portfol
48. Date To RTW Period Date From Fe Date To p H Review Date Date Prepared 10 06 2015 i Prepared By Step 7 Enter the Objective and Goals If applicable enter any Additional Goal s Objective B The worker s return to different employment with the pre injury employer y Goals Maintain Suitable duties Other Goal s _ Pre injury duties with the pre injury employe Return to independence within the Community Suitable duties in another workplace Upgrade from unfit to fit for suitable duties Upgrade in both hours and capacity Upgrade in capacity _ Upgrade in hours Additional Goal s Step 8 Select the Add button to add an Action or Service to the RTW Plan Actions Services Responsible Person Due Date j sae hadd Remove Step 9 Compete the Actions Services description and enter the name of the Responsible Person and the Due Date of the action or service Step 10 Select the person s that have signed the RTW Plan Note The Signed By section will only be enabled and mandatory when a RTW Plan has been uploaded Step 11 Select the Upload button to search for and upload a file attachment to the plan if applicable please refer to How do Upload a Document for further details Once a file is selected and uploaded the file name will appear in the File Name field To clear the uploaded generated file select th
49. ENTER INCOME SUPPORT PAYMENTS ccccsscceseeceseeeseceneeeeneseneees 178 37 1 INGOME SUPPORT PAYMENT stseccssctez lt cercun2cdiwanne cease snnedauseadsteneesamajauneaeeuaiatumabqunendsuacenunabaueennets 178 37 2 INCOME SUPPORT PAYMENT STEP BY O TEP egos ge r tage pean R E 179 37 2 1 How do I Add an Income Support PayMent cccccccccseececeeeeeeeeeeseeeeseeeeeseeeesseeees 179 37 2 2 How do I Enter Multiple Income Support Payments cccccccseeeeseeeeeeeeeeseeeeeeeeeens 183 37 2 3 How do I Authorise Income Support Payments cccceccecseeeeeeeeeeeeeseeeeeseeeeeeeeens 183 37 2 4 How do I Add Recurring Payments ccccccscecsececeeeeceeeseueeseeeceeeseueeeeeeseueeseeesseeens 184 37 2 5 Howdo Authorise Recurring Payments epiros a E 185 37 3 INCOME SUPPORT PAYMENT ADDITIONAL INFORMATION 2sccceeceteeeeeceseeceneeeseeeeteeeteneeenens 186 37 31 MANGALONY FieldS ssepe ee EER En 186 Iko TEC CGONUO roa a E O S eee ee 187 38 HOW DO I ADD COMPENSATION RECIPIENTS 2 ccccccesecceseeeneeceneeenseseneeenseseneees 188 S64 COMPENSA ON R O E N cicisceressanaiiatenereiaicnanaasineausene caeaeasaneaiiete uae eae aoe 188 38 2 COMPENSATION RECIPIENTS STEP BY STEP cccccccccececeeecceceseeeeceeesoesessaeeceaesoeeeseeesoeeess 189 38 2 1 How do I Add a Compensation Recipient to the Claim ccccceccccseeeseeeeeeeeeeeeeeeens 189 38 2 2 How do I Modify the Compensation
50. ENTER TIME OFF WORK DETAILS The Time Off Work screen allows the user to enter the period where the employee ceases work and resumes work as a result of an incident The Time Off Work screen consists of one tab e Time of Work 20 1 Time off Work The Time Off Work screen will display as follows Time Off work _ Time Off Work Details Date Ceased Time Ceased Estimated Date Fit Date Fit Return Date Return Time Date Entered azl Bey pea jarl 10 06 2015 p Add Remove Work Duties Work Duties Indicator y Date Effective Changed By Date Changed Work Status History Work Duties Indicator Date Effective Date Status Changed Changed By here is no Return To Work Status History for this claim 20 2 Time off Work Step by Step The following topics are available to assist you in the use of the Time Off Work screen How do Add Time Off Work Details to a Claim How do Modify the Time Off Work screen after it s been saved How do Add multiple Time Off Work for the Injured Worker How do Delete a Time Off Work screen 20 2 1 How do I Add Time Off Work to a Claim Note The Time Off Work screen gets automatically added to every Claim as soon as a Claim is saved amp Step 1 Navigate to the Time Off Work screen which was added automatically upon Wh saving the Claim This screen is titled Time Off Work in the tree node
51. First Incapacity SWSA Advisory Date i es 52 Week End Date 104 Week End Date Step 7 The Degree of Whole Person Impairment is read only and is populated as follows Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 60 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 e If one Permanent Impairment Assessment with an Assessment Type of Assessed Injury has been recorded for the Claim the Degree of Whole Person Impairment will be populated from the corresponding field on this Assessment e If multiple Permanent Impairment Assessment with an Assessment Type of Assessed Injury have been recorded for the Claim the Degree of Whole Person Impairment will be populated from the Assessment with the greater Degree of Whole Person Impairment e f no Permanent Impairment Assessment with an Assessment Type of Assessed Injury has been recorded for the Claim but a Permanent Impairment Assessment with an Assessment Type of Interim Decision has been recorded the Degree of Whole Person Impairment will be populated from the corresponding field on this Assessment e f no Permanent Impairment Assessment with an Assessment Type of Assessed Injury has been recorded for the Claim and multiple Permanent Impairment Assessments with an Assessment Type of Interim Decision have been recorded the Degree of W
52. Go to the Claim branch of the tree control and click on the FLOATING MENU icon A list of options will appear to the right of the icon as shown below atii Claim Summary Claim Details New Injury Details E amp Injured Worker New Certificate of Capacity ssn 4j Employment D New Surgery Related Incapacity Incident Detail New Permanent Impairment Assessment Injury New Vendor Payment TLYTi OTime Off Work New Income Support Payment Ss Notional Weekl m Certificates i m New File Note m Permanent Imjo aa m Payments New Other Injuries or Diseases m Income Suppoil2 New Correspondence In uw amp Estimate New Correspondence Out a SY Estimate Histol New Medical Referral QMotor Vehicles TEATA G EEE ow P Ee oe New Motor Vehicle o Nominated Tre New Nominat o Witness i New Witness z A Related Claims amp New Dependant _BEQ RTW Assessme iit New Witness cr zn New RTW Assessment Se z New RTW Plan tS New Recoveries a New Nominated Treating Doctor New Claim Provider Ei New Legal Representative Step 3 Select New Investigation Referral from the floating menu A new tree branch and screen window will automatically appear This process creates a new screen against a claim To add further details to the claim you must select the option from the FLOATING MENU and create a screen Step 4 Select an Investigation Type and Investigator by selecting a va
53. How dol Delete a Compensation Recipient record Once a Compensation Recipients screen has been added to a Claim the screen cannot be deleted The user must select a row and then select the REMOVE Remove hyperlink Removal of all rows will result in the Compensation Recipient Details table displaying as follows Compensation Recipient Details Priority Date From Date To Recipient Type Amount per Payment per Payment There are no Compensation Recipients Step To remove a Compensation Recipient record from the claim firstly select the NG claim you wish to remove the record from Step 2 Once you have the claim open select the Compensation Recipients folder from the tree control If the Compensation Recipients folder is selected the background behind the text will appear blue ee iCompensation Recipi Step 3 Select the MODIFY amp icon The fields will become active Step 4 Select the row in which you wish to delete the Compensation Recipient details of Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 193 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 Compensation Recipient Details To select the row click on the grey column to the left of the Priority field Before Priority 1 After Priority P 1 d A right arrow will display in the grey column when the row is selected Please note that only one
54. IT South Australia Department of Premier and Cabinet Page 68 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 Employer DOI Current Employer Employer Current Employer Portfolio y Region y Agency v Service v Division y Cost Centre y Organisation Unit y Current Workplace Address Current Workplace Details Address Employer Contact Telephone Email Suburb State Postcode Industry Current Occupation Occupation Job Title Tasks Duties 13 3 Employment Details Step by Step The following topics are available to assist you in the use of the Employment Details screen How do Enter the Employer DOI and Current Details How do Modify the Employment Details screen How do Add Multiple Employment Details screens How do I Delete the Employment Details screen The following sections are related to the Employment Details screen are available in other sections of the User Guide e How do Enter Details of Other External Current Employment 13 3 1 How do I Enter the Employer DOI and Current Employer Details Step 1 Enter the details of the Employer DOI by selecting any values in the WMI hierarchy If the worker s current employer is not the same as the employer at the time of the incident
55. Investigation R 2 New Appeal a Motor Vehicles aE Witness _ New Court Details Ga claim Provider _ New Permanent Impairment Legal Represer New Medical Certificate a Nominated Tre _ New Rehabilitation Assessment F 9 Reconsideration gt New Rehahilitation Details lf a Return to Work File Note already exists for the Claim you will need to use a different method to add the new Return to Work File Note Refer to How do Add More than One Return to Work Note Step 3 Select New Return to Work File Note from the floating menu A new tree branch and screen window will automatically appear o RTW File Note Summary eeeciNew RTW File Note Oo m Step 4 Add a Subject for the File Note If required select the Privileged and Confidential checkbox Category _ Privileged and Confidential AN Note The Category will be pre populated with a category of RTW and will be read only Step 5 Enter a Description of the Return to Work File Note Commercial in Confidence SBC IT South Australia Department of Premier and Cabinet Page 266 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 Description B Z U age Format Font Family Font Size X Tip You may use the toolbar in the Description text box menu to format the Return to Work File Note Description Step 6 Upload a document to the Return to Work File Note if required See the section be
56. Item tab Step 3 If you are viewing an existing Payment ensure that the screen is in MODIFY mode by selecting the MODIFY icon on the toolbar Step 4 Select the Authorise All hyperlink below the Payment Items table to authorise all Payment Items The Status of the Payments will immediately change to Approved and the Payment Item screen will be read only Service Date Supplier Reference Status Description Item Amount GST Amount incl GST Bi gt 24 10 2014 Approved PROFESSIONAL ATTENDANCE being ana 380 00 0 00 380 00 Alternatively each individual Payment Item s Status to Approved Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 162 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 Status M Declined Entered Hold Paid Step 5 Once you are satisfied with the changes made click on the SAVE lal icon in the toolbar 33 3 6 How do I determine the Status of a Payment Step1 Navigate to the Claim and the Payment in the Payment folder in the Claim Tree AJ Control Step 2 Examine the fields on the Payment tab as demonstrated below to determine a Payment s Status Entered A Payment has been Entered by an Advisor but not yet Authorised or Paid if the Payment has a Date Entered but no Date Authorised The Payment Status is set to Entered as seen below Invoice Details Date Received 2 11 2014
57. NSW 2580 BRISBANE MARKET QLD 4106 BRISBANE ADELAIDE STREET QLD 4000 Once a valid suburb has been selected the State and Postcode fields will automatically populate with the corresponding State and Postcode for the Suburb selected The user is unable to modify the State and Postcode fields The user may have misspelt the Suburb or it may not exist To check the spelling a Like Search may be done A Like Search involves replacing one or more letters in the word with the percent character 4 3 4 How do I Search for a Postcode Step 1 If the user enters a Suburb where there are multiple Suburbs that match the value entered the screen will be displayed with all matches so that the user can select the appropriate Suburb and its corresponding Postcode Scroll down the list of Suburb s to find your desired selection and click once on the Suburb value to populate the State and Postcode into the fields on the screen you were completing Pn Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 38 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 Brig BRISBANE QLD 4001 BRISBANE QLD 9000 i BRISBANE QLD 9001 BRISBANE QLD 9002 BRISBANE QLD 9003 BRISBANE QLD 9005 BRISBANE QLD 900 BRISBANE QLD 9008 BRISBANE QLD 9009 BRISBANE QLD 9010 BRISBANE QLD 9013 BRISBANE QLD 9015 BRISBANE QLD 9020 BRISK BAY QLD 4805 BRISBANE GPO QLD 4
58. New Investigation Referral amp New Motor Vehicle New Nominated Treating Doctor 7 New Claim Provider New Legal Representative A New Dependant 83 New Witness lill New File Tracking New RTW Assessment New RTW Plan AN ASS lf a Correspondence In screen already exists for the Claim you will need to use a different method to add the new Correspondence In Refer to How do Add More than One Correspondence In screen Step 6 Select a Document Type and Letter Type as applicable to the Correspondence In Correspondence In Privileged and Confidential Document Type y Letter Type When a New Correspondence In screen is created the Privileged and Confidential checkbox will not be selected This checkbox is linked to Security and User Access in the Administration Tools Only users with access to Privileged and Confidential Correspondence will see these appear in the Claim Tree Control If you believe that you require Privileged and Confidential Correspondence In access contact your system administrator Refer to Correspondence In Privileged and Confidential for more information Privileged and Confidential Step 7 Enter a Date Received Document Date Receipt Method and Received From information as applicable Date Received HAY Document Date le Receipt Method oy Received From i o o E 7 File Name Upload SBC IT Commercial i
59. Payment Summary screen When a Payment is first entered each of the Payment s Items will have a Status of Entered A User may the Authorise this Payment via this screen by selecting the Authorise All hyperlink or changing the Payments Status to Authorised or by using the Unauthorised Payments screen The User who entered the Payment cannot change the Payment s Status under any circumstances due to the System s Separation of Duties features The Payment screen will consist of two tabs e Payment e Payment Item 33 1 Payment The Payment tab will be displayed as follows Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 153 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 Payment Item Invoice Details Date Received ee Payment Status Entered Total Amount excl GST Invoice Date EEH Invoice Number eal Total GST Date Entered 10 06 2015 Entered By SAPS Test Total Amount Incl GST Invoice File _upload Clear Payment Details Date Authorised Authorised By Total Amount excl GST Date Transferred _ Payment manually processed Total GST LS Date Paid Cheque No EFT Recipient No Total Amount incl GST Date Presented C Decline Total Payment Declined By Date Declined Payee Name A amp Reimbursement To Worker Provider Type E Payment Partic
60. Recipients screen after it has been saved 191 38 2 3 How do Add Multiple Compensation Recipient s Details to a claim cc0e 191 38 2 4 How do I Delete a Compensation Recipient record cccccecccseeeceeeeseeeseeeeseeesaeeess 192 38 3 COMPENSATION RECIPIENTS ADDITIONAL INFORMATION 0 cccesceceeceeceseeceeeeeeeeeteneetaeeeeens 193 3093k Mandatory Fields eciecestee es eee sare E cnet sacle 8 ocala ares cate 193 BOrs e JCe COMM EAE A A E A sitet to E A pet celal eae T 193 39 HOW DO I VIEW THE INCOME SUPPORT PAYMENT SUMMARY cccsseeeeeee 195 39 1 INCOME SUPPORT PAYMENT SUMMARY STEP BY STEP ccssscccceeceeeeceeceeeeceecesseeeeseneeeseeeeees 195 39 1 1 How do I View the Income Support Payment Summary 2 eee ceeeeeeeeeeeeeeeeeeeeeeeaees 195 39 1 2 How do I use the Income Support Payment Summary Search cccceceeeeeeeeeeeeees 195 39 1 3 How do Open an Income Support Payment from the Income Support Payment SUMMA SC EO ea te Sens cates at caius R 196 40 HOW DO I SEARCH FOR UNATHORISED COMPENSATION PAYMENTS 197 40 1 UNAUTHORISED COMPENSATION PAYMENTS cccseccecececeeececeeceeeeeeeeeeeeseeeeeseeeeseeeesseeesaes 197 40 2 UNAUTHORISED COMPENSATION PAYMENTS STEP BY STEP ccescceeeeeeeeeceeeeeeeeseeeseeesaeeens 197 Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 11 of 309 Claims Management Sys
61. Remove ay Recovery Amount Date Entered 17 06 2015 Entered By SAPS Test v Payment Category y Ei State Postcode Country y Cheque Number Date Finalised Finalised Amount Finalised By avy Upload Clear Enter the Date From Date To and Payment Category and any other details following instructions provided in How do add a Recovery to the Claim Click on the SAVE lal icon and the fields will become inactive and your changes will be saved 44 2 4 How dol Upload a Document to the Recoveries screen Step 1 Step 3 To attach a Document to the Recoveries record click on the Upload hyperlink and use the Windows File Browser to locate and select the desired file i Choose File to Upload _s ey xs G lt DUE gt Libraries gt X 4 Search Libraries P i Organize v iv Ol r Favorites Libraries E Desktop Open a library to see your files and arrange them by folder date and other properties i i Downloads E Recent Places amp Documents a Music Pictures i usi 5 rary brary brary amp OneDrive Y Librar Pd Library SJ Librar File name All Files Once the desired file is selected click on the OPEN button in the File Browser If successful the filename will be visible in the File Name field If you have selected the wr
62. Return to Work Note screen are available in other sections of this User Guide How do Add a Return to Work Note to a Claim How do Modify the Return to Work Notes Screen after it has been saved How do Add more than one Return to Work Note How do Delete a Return to Work Note 54 1 1 How do I View the Return to Work File Note Summary Step 1 To view the Return to Work Note Summary for the claim click on the Return to Work File Note Summary folder in the Claim Tree Control go ee Rehabilitation File Note Summary 5 01 2015 Rehabilitation le 20 11 2014 Rehabilitation lit 20 11 2014 Rehabilitation 54 1 2 How dol use the Return to Work Note Summary Search Step 1 To use the Return to Work Note Summary for the claim click on the Return to Work File Note Summary folder in the Claim Tree Control and this will display the Return to Work Note Summary screen OO EE a File Note Summary 5 01 2015 Rehabilitation nt 20 11 2014 Rehabilitation null 20 11 2014 Rehabilitation Step 2 Enter criteria in to the fields at the top of the Summary Screen to locate a specific File Note For example select a Date Range and Category to refine the Search Results Rehabilitation File Note Summary File Note Summary amp Search for From le To E Category y 4 Search O Clear Note The Date From and Date To range will pick up all Return to Work Notes with a Date Entered range cove
63. SIMS e Claim Provider Mandatory Fields e Claim Provider Tree Control 62 2 1 Mandatory Fields The following fields must be completed in order to successfully save the Claim Provider Details into the SIMS database It is mandatory to search for a Provider using the Provider Search button 62 2 2 Tree Control When the Claim Provider screen is saved the system will display the following detail in the Tree Control as a reference to the screen contents Claim Provider lt Provider Name gt The Tree Control will display all Providers for the Claim in order of Date Entered ascending earliest date entered first An example is displayed below Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Claims Management System Self Insurance SA User Guide E Claim Provider Details bbe Claim Provider Jane s Physio E Bf Claim Provider Jerry Wallace Commercial in Confidence Page Version Printed 300 of 309 1 0 18 06 2015 SBC IT South Australia Department of Premier and Cabinet Page 301 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 63 HOW DO I LINK LEGAL REPRESENTATIVES This screen is used to associate the Worker s or Employer s legal representation for an individual claim One or many legal representatives can be recorded for a claim Address and contact details for the Provider may not be modified
64. Search Results you may export the results to an Excel document by selecting the EXPORT button 9 3 Payment Search Additional Information The following sections contain additional information about the Payment Search screen functionality and validation e Payment Search Using the Search e Payment Search Search Warning Messages 9 3 1 Using the Search Where multiple criteria are entered the SIMS will search for records that meet all of the criteria entered For example if you select both the Invoice Number and Payment Type only Payments matching both criteria will be displayed in the Search results lf you search and no results are returned but you are confident that the record exists you should either e Check spelling accuracy of input details Reduce your criteria i e if you entered two 2 or more criteria remove one of them Use Like searching use the symbol as a wildcard i e Centre to locate all Payments with the name which ends with Centre or Use alternative or broader criteria If you cannot locate a payment by Type try using the Date Entered range This screen can be used to search for a particular vendors invoice 9 3 2 Search Warning Messages 9 3 2 1 No RECORDS MATCH CRITERIA ENTERED If you click on the 4Search button and the SIMS returns the following message the SIMS has been unable to locate the Payment you are searching for Date Amount GST Amount Authorised excl
65. Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 8 3 2 Search Warning Messages 8 3 2 1 No RECORDS MATCH CRITERIA ENTERED If you click on the OK ahyperlink and the SIMS returns the following message the SIMS has been unable to locate the Employee you are searching for Employee No Address No records matched the supplied criteria The following is a list of reasons why the SIMS may not locate the Employee you are searching for e The Employee criteria entered are incorrect Check the Employee details you entered in the criteria e You are using too many Search Criteria Simplifying your search by entering fewer search criteria or e Incorrect Spelling Use the Like Search to broaden your Search A Like Search involves replacing one or more letters in the word with the percentage character For example instead of the Employee s Given Name s the user may enter J to view all Employee s with the first initial J i e John Jack Jeffrey Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 51 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 9 HOW DO I SEARCH FOR A PAYMENT The Payment Search screen allows the user to search for a Payment This Search may be accessed by selecting Search gt Payment Search from the menu alternatively the Toolbar icon can be selected 9 1 Payment Search The P
66. The Document Summary screen will be displayed in the window Note The Document Summary screen displays the details of documents that have been received or generated for the Claim Note Selecting the Document No hyperlink will navigate to the selected Document Details screen The Document Summary screen is automatically created when a New Document has been generated or attached against the Claim The user may need to click on the REFRESH icon from the toolbar menu before the Document Summary screen will be displayed with recent updates Step 3 The user is able to filter the Document Summary screen by using the Document Details fields Document Details Date From ey Date To E Document Source iv Search L Clear Document Category y Document Type 55 2 2 How do I Modify the Document Summary Commercial in Confidence SBC IT South Australia Department of Premier and Cabinet Page 276 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 56 HOW DO SEARCH FOR A DOCUMENT The Document Search screen displays a summary of all Documents registered for all Claims in the System This includes all Correspondence In Correspondence Out Medical Certificates File Notes and many more This screen is accessible from the Search gt Document Search option in the Main Menu The Document Search screen contains one tab e Document Search
67. Vendor Payment F B New Compensation Recipients E ai at New Income mile Payment tom 10 06 2015 o PO eee ae Estimate ae New File Note wi Estimate Histou New Rehabilitation File Note Dependant New Other Injuries or Diseases ow New Depend 7 New Correspondence In A Related Claims New Correspondence Out a New Medical Referral _ New Investigation Referral amp New Motor Vehicle amp New Nominated Treating Doctor New Claim Provider Ei New Legal Representative amp New Dependant 2 New Witness 5 New Purchase Order New Treatment Service Plans New RTW Assessment za New RTW Plan sa New Compensation Recipients Step 3 Select New Compensation Recipients from the floating menu A new tree branch and screen window will automatically appear This process is creating a new screen against a claim To add further details to the claim you must select the option from the FLOATING MENU and create a screen Step 4 The Compensation Recipients screen will appear in the screen window Step 5 Enter the Priority Date Effective From and Type Priority Date Effective From E Date Effective To E The Priority field allows the user to indicate the priority of the Recipient The Income Support Payment amount will be apportioned to the Compensation Recipients in order of priority The value entered into this field must be a unique number Step 6 Select the Recipient by selecting the SEARCH icon
68. a Claim How do I Delete the Claim Provider Screen The following sections are related to the management of Claim Provider Profiles are available in other sections of this User Guide e How do I Use the Provider Search Commercial in Confidence SBC IT South Australia Department of Premier and Cabinet Page 297 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 e How do l Enter Maintain Provider Profiles 62 1 1 How dol Add a Claim Provider to the Claim Step 1 Open the Claim you wish to add the New Claim Provider to Step 2 Go to the Claim Summary branch of the tree control and click on the FLOATING MENU i icon A list of options will appear to the right of the icon as shown below f Y Td Claim aay New Injury Details B Injured Workei New Certificate of Capacity Employment D New Surgery Related Incapacity A Incident Detail _ New Permanent Impairment Assessment Injury New Vendor Payment OTime Off Work New Income Support Payment Certificates U New Recoveries aa Payments eee New File Note Estimate alle Estimate Histo New Other Injuries or Diseases Claim Provider F New Correspondence In Related Claims New Correspondence Out RTW Assessme New Medical Referral _ New Investigation Referral New Motor Vehicle New Nominated Treating Doctor 7 New Legal Representative amp New Dependant 2 New Witness lll New File Tr
69. a previous injury that has re occurred When this checkbox is selected the Date of Recurrence field will be enabled and mandatory Step 5 The Nature of Injury Description field allows the user to enter a description of the nature of injury recorded The Code field allows the user to enter the Nature of Injury code which will then populate the Nature of Injury Level 1 and 2 fields Nature of Injury Description Nature of Injury 1 Nature of Injury 2 Note lt is not mandatory to populate the Nature of Injury using the Code field The Nature of Injury Level 1 and 2 fields may be manually selected from the drop down lists provided The Nature of Injury 1 is populated with the TOOCS Version 3 1 Level 1 Injury Classifications Codes Upon selecting a value in the first level the corresponding associated values are populated into the Nature of Injury Level 2 field Step 6 The Bodily Location of Injury Description field allows the user to enter a description of the bodily location of the injury recorded The Code field allows the user to enter the Bodily Location of the Injury code which will then populate the Bodily Location of Injury Level 1 2 and 3 fields Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 82 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 Bodily Location of Injury Description Bodily
70. before creating a new screen For example the User created a RTW Assessment screen but forgot to fill in a mandatory field This system would not let the user use the ADD NEW af function as the previous screen is invalid 23 2 5 How dol Delete the RTW Assessment Screen 2 Step 1 To remove the RIW Assessment screen from the claim firstly select the UPN RI claim you wish to remove the RTW Assessment from KI Step 2 Once you have the claim open select the RTW Assessment branch under the RTW Assessment Summary folder from the tree control which is to be removed If the RIW Assessment is selected the background behind the text will appear blue Step 3 Click on the MODIFY A icon to enable the DELETE X icon and select this from the toolbar When the confirmation message appears click on OK _o _ The RTW Assessment screen will be removed from the claim Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 114 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 Message from webpage Are you sure you wish to delete this screen tance If you are unable to DELETE X the RTW Assessment screen selected you may not have access to complete this function Check with the SIMS System Administrator that you have the correct access level 23 6 RTW Assessment Additional Information The following sections contain additional information about th
71. both at the date of injury and the current employer as well as general details about the injured person s occupation with the Employer at the Date of Injury The Employment Details screen is made up of the following tabs e Employer DOI e Current Employer 13 1 Employer DOI The Employer DOI tab will be displayed as follows tS ue amp Current Employer Employer at DOI Portfolio Region Agency Service Division costcentre SSS Employer Details at DOI are the Current Employer Details Organisation Unit A Workplace at DOI Address address SSS Workplace at DOI Details Employer Contact Telephone Email Industry Occupation at DOI Occupation _ Apprentice Job Title Tasks Duties Employment Type Employment Classification Does the Injured Worker have any other Employment OYes ONo Unknown Return To Work SA Licence _N _ Registration TT RTWSA Location OOOO Y O 13 2 Current Employer The Current Employer tab allows the user to associate the Current Employer to the claim if it is different to the Employer at the time of the incident also known as the Employer at Date of Injury Employer DOI The values are only required if the user deselects the Employer at DOI is the Current Employer checkbox on the Employer DOI screen The Current Employer screen will be displayed as follows Commercial in Confidence SBC
72. changes click on the MODIFY A icon for a second time Your changes will not be saved and the claim will stay displayed in the tree window If you wish to discard you changes and close the claim click on the CLOSE RECORD icon from the toolbar 14 2 3 How do Add Multiple Other External Current Employment screens Note The SIMS will not allow multiple Other External Current Employment screens to be added to the Claim However you may add multiple Employers into the one screen 14 2 4 How dol Delete the Other External Current Employment screen Step 1 Open the desired Claim Step 2 select the Other External Current Employment Screen Step 3 Press the DELETE A toolbar button A warning message will be prompted to the user and selecting OK will remove and delete the injury screen Message from webpage Are you sure you wish to delete this screen Cancel 14 3 Other External Current Employment Additional Information The following sections contain additional information about the Other External Current Employment screen functionality and validation e Other External Current Employment Mandatory Fields e Other External Current Employment Tree Control Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 75 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 14 3 1 Mandatory Fields The following fields must be completed
73. claim A number of SIMS screens require that a valid Certificate is recorded for the claim Multiple Work Capacity Certificate screens may be recorded for each Claim The Work Capacity Certificate screen consists of one tab e Work Capacity Certificate 21 1 Work Capacity Certificate The Work Capacity Certificate tab will be displayed as follows Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 98 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 Work Capacity Certificate Capacity Certificate Worker Details Certificate Details Full Name Michaels wiam o Date examined SS stage SCO Date of Birth 8 03 1974 Date Entered 10 06 2015 Entered By SAPS Test Injury Details and Assessment The stated cause of the injury condition s C Injury condition consistent with the stated cause Stated Date injury condition s occurred developed sd Occurrence of Condition New Condition Recurrence of pre existing condition Clinical Diagnosis based on examination and other information Other comments clinical findings Certification C Have recovered from injury condition s and are fit to return to normal duties and hours Date From ss C Some further treatment may be required C Are fit to perform suitable duties that accommodate functional abilities Date From _s Date To ee C Are medically unfit to undertake sui
74. criteria entered will appear in the Summary list of Work Capacity Certificates for the claim select the Clear button Q Tip Once you have finished with the Search Results and want to return to the full 22 2 3 How dol Open a Work Capacity Certificate from the Certificate Summary screen Step 1 To view the Certificate Summary for the claim click on the Certificates wip folder in the Claim Tree Control E Certificates 2015 wtf 10 06 2015 13 06 2015 nE 10 06 2015 11 06 2015 Step 2 Review the list of Work Capacity Certificates listed in the Summary until you ve locate the Work Capacity Certificate you wish to open Step 3 Click on the Work Capacity Certificates Date From hyperlink The Work Capacity Certificate will open in the Screen window Commercial in Confidence SBCIT Page 109 of 309 Version 1 0 Printed 18 06 2015 South Australia Department of Premier and Cabinet Claims Management System Self Insurance SA User Guide Date To Date Examined Stage Capacity Diagnosis Provider Name 13 06 2015 10 06 2015 Initial Are fit to perform suitable duties that accommodate functional abilities 11 06 2015 10 06 2015 Follow Up Are medically unfit to trest undertake suitable duties Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 110 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 23 HOW DO I
75. displayed as follows Correspondence Out Out Correspondence Out Document Category y C Privileged and Confidential Document Type Date Sent HE Sent To File Name Entered By Employee Name y Position Description v Font Family Font Size 60 2 Correspondence Out Step by Step The following topics are available to assist you in the use of Correspondence Out How do Create a New Correspondence Out Screen How do Upload a Document How do Add More than one Correspondence Out screen How do Upload a Document How do View the Correspondence Out Document after its been Uploaded How do Delete the Correspondence Out Screen Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 290 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 60 2 1 How do I Create a New Correspondence Out Screen Step 1 f no previous Correspondence Out has been recorded for the claim the user Me can create a new Correspondence Out screen by clicking on the FLOATING WG MENU icon next to the Claim Summary screen in the Tree Control and selecting New Correspondence Out 4 GERESiitels Claim Details New Injury Details 6 Injured Worker 2 New Certificate of Capacity Employment D New Surgery Related Incapacity Incident Detail New Permanent Impai
76. e Ly an SS Videos Libraries Ep Library Documents iia a Music f Pictures Ew Videos jm Computer tu Network File name All Files Open Cancel Once the desired file is selected click on the OPEN button in the File Browser Step 3 If successfully attached the filename will be visible in the File Name field Once a document is uploaded to a Correspondence Out screen it cannot be modified lf you have selected the wrong document you will need to delete the Correspondence Out Screen and start again File Name Test docx l l l l l l l l l l l l l l View Step 4 Once all the details have been entered onto the screen the user would save the details by pressing the SAVE la icon Step 5 To view the document entered in the File Name field the user can select the View hyperlink The View hyperlink will not be enabled until the screen is saved and a document has been uploaded Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 292 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 Step 6 Once all the details have been entered onto the screen save the screen by selecting the SAVE alicon from the Toolbar 60 2 3 How do Add More than one Correspondence Out screen Step 1 If Correspondence Out already exists for the Claim the user can add a new Correspondence Out record
77. entered and by whom and if the payment has been authorised when and by whom Authorisation Date Entered 10 06 2015 Entered By SAPS Test Step 7 The Recurring Payments section is read only When the Recurring Payment checkbox is enabled and is selected the user is able to set up recurring payments for the claim See How do Add Recurring Payments for more information Recurring Payments a ed Date of First l Number of fie E aa Payment Recurring Weeks C Week of Authorised Pre Authorise Recurring Payments Date Authorised ss Authorised By Step 8 The Payment Details section will automatically populate nearly all fields contained within it via either information entered on the Worker s Earnings screen or by calculations being performed by the system Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 182 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 Payment Details Week of Payment s Injury Whole Person Impairment Surgery Supplementary Income Support Payment From Date Notional Weekly Earnings 100 wice State AWE Maximum Applied to NWE 2 x State AWE Capped Notional Weekly Earnings Earnings in Period This Employer Earnings in Period Other Employer Designated Earnings in Period Compensation Rate Calculated Compensation Amount Payable Part Time Ratio asd Federal Minimum Wage Applied to Payment Minimum Wage N
78. from this screen To modify details the user must open the Provider Profile The Organisation will define the access required to the Provider Profiles The Legal Representative Screen consists of one tab Legal Representative The Legal Representative screen will be displayed as follows Legal Representative Representative Claim Provider Provider Type 4 Provider Search Representative of Provider Name ABN Provider Numbers Street Address Postal Address Suburb State Postcode State Postcode Country Country Contact Details Telephone Fax Number Mobile Contact Name v Font Family Font Size h 63 1 Legal Representative Step by Step The following topics are available to assist you in the management of Legal Representatives on a Claim in the SIMS How do Add a Legal Representative to the Claim How do Modify the Legal Representative Screen after it has been saved How do Add Multiple Legal Representative Screens to a Claim How do Delete the Legal Representative Screen The following sections are related to the management of Legal Provider Profiles are available in other sections of this User Guide Commercial in Confidence SBC IT South Australia Department of Premier and Cabinet P
79. hours checkbox and enter a Date From If the worker is fit to perform suitable duties select the Are fit to perform suitable duties that accommodate functional abilities checkbox and enter a Date From and Date To lf the worker is unfit for suitable duties select the Are medically unfit to undertake suitable duties checkbox and enter a Date From and Date To Otherwise continue to the next step Certification v Have recovered from injury condition s and are fit to return to normal duties and hours Date From Some further treatment may be required v Are fit to perform suitable duties that accommodate functional abilities Date From Date To ey v Are medically unfit to undertake suitable duties Date From Date To ay Reason Estimated functional capacity to return to work in e Days Weeks uncertain at this stage Progressive Review Date at next medical consultation Step 7 lf a Treatment Plan is required enter the details Selection of any of the Treatment Plan checkboxes will enable the adjacent name field to allow the user to enter the name of the medical specialist psychologist physiotherapist or other specialist Treatment plan aimed at assisting recovery and return to work Medical Specialist Psychologist C Physiotherapist Other Specialist Step 8 Name of Specialist Name of Psychologist Name of Physiotherapist Name of Specialist Se
80. in the toolbar The SIMS will transport you to the next incomplete screen if all Mandatory fields have been completed The SIMS will require that each employee has a unique employee number If the employee number entered already exists the user will not be permitted to continue until the employee number is altered You must always search for an Injured Worker by selecting the 4 Select Employee hyperlink If the search returns with no results the system will automatically enable the 4F New Employee hyperlink Ensure you select the Cancel hyperlink to exit the Employee Search Search for an Injured Worker by selecting Search Employee hyperlink Refer to How do I search for an Employee for more information If you cannot locate the Employee after you have completed a search from the Employee Search screen select the Cancel button This will close the Employee Search screen and enable the New Employee button on the Injured Worker screen When the user selects the button the Employee Number Family Name Given Name s and Date of Birth fields will be enabled and are mandatory for the user to complete Commercial in Confidence SBC IT South Australia Department of Premier and Cabinet Page 65 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 Step 4 When a blank Injured Worker form is created complete all of the mandatory fields and click on the SAVE ad icon in the toolba
81. in order to successfully save the Other External Current Employment into the SIMS database e It is Mandatory to add at least one Other External Current Employer by selecting the Insert button when the screen appears in the Tree Control Name of Employer Address Line 1 Suburb State and Postcode Average Weekly Earnings Normal Hours per Week Normal Days per Week 14 3 2 Tree Control Only one Other External Current Employment screen may exist for each claim The screen will appear in the Claim Tree Control in the following format Other External Current Employment g s Claim Summary 2 E A Claim Injured Worker dg Employment Details ow Incident Details m Injury non SS Estimate wii Estimate History m Payments oo P New Other External Current Empl Commercial in Confidence SBC IT South Australia Department of Premier and Cabinet Page 76 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 15 HOW DO I ENTER INCIDENT DETAILS The Incident Details screen allows the user to enter the descriptions in relation to the incident as indicated on the Claim Form The Date Injury Illness Occurred can be a historical date but cannot be a future date The system will validate the deceased details for a fatal claim The Incident Details screen consists of one tab e Incident Details 15 1 Incident Details The Incident Details tab of the Incident Deta
82. not appear as you move your mouse over the toolbar only when you stop over a particular icon The table below details the SIMS toolbar buttons Icon ToolTip Description O O S O i Allows the user to enter a New Claim Upon clicking the this function a new claim is created and the mandatory screens are displayed in the tree window Adds a new vendor payment in the tree window for the active claim This will be disabled if a claim is not displayed in the tree control 2a New Compensation Adds a new compensation payment in the tree window Payment for the active claim This wil be disabled if a claim is not displayed in the tree control Claim Search Opens the Claim Search screen fP Provider Search Opens the Provider Search screen F Payment Search Opens the Payment Search screen Commercial in Confidence SBC IT South Australia Department of Premier and Cabinet Page 26 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 Spell Check Performs a Spell Check on the selected field Puts the currently displayed screen into modify mode Selection of this icon when the open screen is in modify mode will close the screen without saving the changes Saves the current screen Add New Saves the details of the current screen and creates a new screen of the same type Deletes the currently selected screen Generate Letters Opens the Generate Letters screen Generate R
83. on the SAVE amp icon and the fields will become inactive and your changes will be saved When you add further File Note screens to the claim the system will automatically check that the details you have entered into the previous screen are valid before creating a new screen For example the User created one File Note screen but forgot to fill in a Mandatory field This system would not let the user use the ADD NEW function as the previous screen is invalid 51 2 6 How dol Delete a File Note Step 1 To remove the File Note screen from the claim firstly select the claim you PN wish to remove the File Note screen from we Step 2 Once you have the claim open select the File Note branch from the tree control which is to be removed If the File Note is selected the background behind the text will appear blue Step 3 Click on the DELETE amp icon from the toolbar When the confirmation message appears click on OK L I The File Note will be removed from the claim Message from webpage 2 Are you sure you wish to delete this screen Cancel If you are unable to DELETE the File Note screen selected you may not have access to complete this function Check with the SIMS System Administrator that you have the correct access level 51 3 File Note Additional Information The following sections contain additional information about the File Note screen functionality and validation File Notes Email Notif
84. order to successfully save the Nominated Treating Doctor into the SIMS database e lt is mandatory to search for a Provider using the Provider Search button 47 2 2 Tree Control When the Nominated Treating Doctor screen is saved the system will display the following detail in the Tree Control as a reference to the screen contents lt Provider Name gt The Tree Control will display all Nominated Treating Doctors for the Claim by their Provider Name in alphabetical order An example is displayed below o Nominated Treating Doctor Details ow it Dr Joh Songer hue St Jerry Wallace Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 235 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 48 HOW DO I ENTER WITNESS DETAILS The Witness screen allows the User to enter details of witnesses of the Incident which resulted in the Claim Multiple Witnesses may be recorded on a Claim The Witness screen consists of a single tab e Witness 48 1 Witness The Witness screen is displayed as follows Person Details FamilyName O E Givennames OOO E CI Statement of Witness Provided Suburb s s i isSCCS Stat Say Postcode Sar Phone Mobile C International Address Country Email PT Comments Comments File Name upload _ Clear 48 2 Witness Step by Step The follow
85. other Screens within the SIMS The Worker s Full Name and Date of Birth fields are populated from the Injured Worker screen Worker Details Full Name Michaels William Date of Birth 8 03 1974 Step 4 Enter details of the Work Capacity Certificate including the Date Examined and Stage Certificate Details Date Examined Te Stage Date Entered 10 06 2015 Entered By SAPS Test Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 101 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 Step 5 Enter details of the Occurrence of Condition and the Clinical Diagnosis based on examination and other information into the appropriate fields Injury Details and Assessment The stated cause of the injury condition s C Injury condition consistent with the stated cause Stated Date injury condition s occurred developed pa Occurrence of Condition O New Condition Recurrence of pre existing condition Clinical Diagnosis based on examination and other information Other comments clinical findings Step 6 If the Work Capacity Certificate shows the worker has capacity to continue with normal duties and hours select the Have recovered from injury condition s and are fit to return to normal duties and
86. saved to the computer so that next time that a user accesses that computer the list of records on which the user was most recently working is made available This list is saved in the user s profile so if a user logs in to the SIMS on a different machine the same list will be available If the user s profile is cleared regularly the history will be cleared at that time This means that the claims you have previously viewed will not appear when you select the Activity List 3 2 Quick Search To open a Claim record quickly simply enter the Claim Number into the Activity List as illustrated below and then press TAB or ENTER or use the mouse to click outside the field Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 25 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 Ww 1 171 lf you entered an invalid Claim Number the following message will be displayed The supplied reference number 12121 does not match any records in the systern 3 3 SIMS Toolbar The SIMS toolbar provides the user with shortcuts to frequently accessed screens and system functions The toolbar icons have associated tooltips Tooltips are displayed when you hold your mouse over an icon on the toolbar The tooltip will tell you what function will be performed when you click the icon There is a slight delay in the provision of the tooltip so that they do
87. second time Your changes will not be saved and the claim will stay open If you wish to discard you changes and close the claim click on the CLOSE RECORD gt icon from the toolbar 45 2 3 How do I Add Multiple Medical Referral screens to a Claim How do I Delete the Medical Referral Screen Step 1 To remove the Medical Referral screen from the claim firstly select the claim you wish to remove the Medical Referral screen from Step 2 Once you have the claim open select the Medical Referral branch from the tree control which is to be removed If the Medical Referral is selected the background behind the text will appear blue Step 3 Click on the DELETE X icon from the toolbar When the confirmation message appears click on okl J The Medical Referral will be removed from the claim Message from webpage Commercial in Confidence SBC IT South Australia Department of Premier and Cabinet Page 223 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 45 3 Medical Referral Additional Information The following sections contain additional information about the Medical Referral screen functionality and validation e Medical Referral Mandatory Fields e Medical Referral Tree Control 45 3 1 Mandatory Fields The following fields must be completed in order to successfully save the Medical Referral Details into the SIMS database e Type e Date e Reason
88. selected as recipients on the Email Notifications list When you assign a File Note to a SIMS user the Note will appear in the user s Task List Please refer to Task List for more details gt Og 51 2 4 How dol Modify the File Note Step 1 Open the claim record you wish to modify and click on an existing File Note screen in the tree control See How do search for a Claim to locate a specific claim for modification Step 2 Click on the MODIFY icon The fields will become active and you will be able to select different values Step 3 Make the desired changes to the File Note Screen Step 4 Click on the SAVE icon and the fields will become inactive and your changes will be saved If you Modify a File Note Screen and do not wish to save your changes click on the MODIFY icon for a second time Your changes will not be saved and the claim will stay open If you wish to discard you changes and close the claim click on the CLOSE RECORD icon from the toolbar 51 2 5 How dol Add more than one File Note Step 1 Open the Claim record you wish to add a New File Note to and click on an existing File Note in the tree control Step 2 Select the ADD NEW c icon from the toolbar Add the details of a new File Note Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 258 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 Step 3 Click
89. so The total recovered for a claim must not be greater than the total paid total outstanding for a claim 44 1 Recoveries The Recoveries screen will be as follows Recoveries ries Other External Current Employment Details Recovery Category Date Received Recovered From Amount gt Totals 0 00 Insert Remove Date Recovery Received Recovery Amount Date Entered 17 06 2015 Entered By SAPS Test Recovery Category Payment Category y Recovered From Address Suburb State Postcode Country Payment Method E iy Cheque Number Finalised Date Finalised Finalised Amount Finalised By File Name Recovery Details 44 2 Recoveries Step by Step The following topics are available to assist you in the use of the Recoveries screen How do Add Recoveries to the Claim How do Modify the Recoveries Screen after it has been saved How do Add Multiple Recoveries to a Claim How do upload a Document to the Recoveries screen How do Delete Recoveries The following sections are related to the Recoveries screen are available in other sections of this User Guide e How do I search for a Party Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 214 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 0
90. the ADD NEW function as the previous screen is invalid 21 2 4 How do I Delete a Work Capacity Certificate Step 1 To remove a Work Capacity Certificate screen from the claim firstly select the claim you wish to remove the Work Capacity Certificate from Step 2 Once you have the claim open select the Work Capacity Certificate branch from the tree control which is to be removed If the Work Capacity Certificate is selected the background behind the text will appear blue Step 3 Click on the DELETE amp icon from the toolbar When the confirmation message appears click on L x The Work Capacity Certificate will be removed from the claim Commercial in Confidence SBC IT South Australia Department of Premier and Cabinet Page 104 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 Message from webpage 21 2 5 How dol Upload a Document NS Step 1 To attach a Document Work Capacity Certificate click on the Upload button and use the Windows File Browser to locate and select the desired file i Choose File to Upload BJ X OO gt Libraries gt v Search Libraries 2i Organize v 7 Oh Ft Favorites Libraries W Desktop Open a library to see your files and arrange them by folder date and other properties b Downloads 73 Recent Places A Documents Music a Pictures i Library Library 5 gt Library amp OneDrive Y z LII y I y Videos Libra
91. the details entered select the SAVE al icon from the toolbar On selecting the Save lal icon you will be taken to the Injured Worker screen to complete Please refer to How do Enter the Injured Worker s Details for more information 11 2 2 How dol Modify the Claim Details screen Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 61 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 Step 1 Open the claim record you wish to modify and click on an existing Claim screen in the tree control See How do search for a Claim to locate a specific claim for modification Step 2 Click on the MODIFY A icon The fields will become active and you will be able to select different values x Step 3 Make the desired changes to the Claim Details screen Step 4 Click on the SAVE lal icon and the fields will become inactive and your changes will be saved 11 2 3 How do I Determine a Claim Step 1 Open the claim record you wish to determine and click on an existing Claim screen in the tree control See How do I search for a Claim to locate a specific claim for modification Step 2 Click on the MODIFY A icon The fields will become active and you will be able to select different values C enneg S en Pe Semat caus i chased om Step 3 Select the Determination from the list of values and record the period of the determination If the d
92. the claim open select the Payment Restrictions folder from the tree control If the Payment Restrictions folder is selected the background behind the text will appear blue eee ayment Restriction Step3 Select the MODIFY Z icon The fields will become active Step 4 Select the row in which you wish to delete the Payment Restriction details of Payment Category Payment Type Date Form Date To Reason gt Legal 17 06 2015 20 06 2015 Medical Services 17 06 2015 20 06 2015 Medical Payment Restriction To select the row click on the grey column to the left of the Payment Category Payment Type field Before Payment Category Payment Type Payment Category Payment Type A right arrow P will display in the grey column when the row is selected Please note that only one row at a time may be selected Step 5 Select the REMOVE Remove hyperlink This will remove the selected row from the Compensation Recipient Details table Step 6 Click on the SAVE lal icon and the fields will become inactive and your changes will be saved 43 3 Payment Restrictions Additional Information The following sections contain additional information about the Payment Restrictions screen functionality and validation e Payment Restrictions Mandatory Fields Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 212 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Prin
93. the desired field is selected You can also use Shift Tab to go backward through the fields if you missed the desired field 4 2 Special Fields 4 2 1 Combo Boxes Combo boxes are a special type of field that does not require the user to explicitly enter data The Combo Box instead provides the user with a list of options from which to select There are a number of ways to select an option from a combo box e Click on the down arrow on the right hand side of the box and scroll through the list of options Click on the required option The selected option will then display in the combo box e Navigate to the combo box clicking on the combo box and then use the up and down arrows to select the required option e Type the first letter of the option you wish to select For example if knew that wanted to select Left Leg however wasn t sure how to spell it but didn t want to scroll through all the options until got to it could navigate to the combo box and then type to bring the options to the beginning of those options starting with L It is then easy to scroll through using either the mouse or the arrow keys to select the correct option 4 2 2 Text Fields Text field is where the user can enter a single line of text When you click in a text field and if its editable a flashing cursor is displayed indicating you can begin typing PO 4 2 3 Check Boxes Check boxes like Combo boxes are a special type of field that
94. to Work File Notes for the Claim in order of Date Entered descending most recent date entered first An example is displayed below B Rehabilitation File Note Summa a 20 11 2014 Rehabilitation Lindt 20 11 2014 Rehabilitation 8 3 1 Confidential Return to Work File Notes lf the Return to Work File Note has security applied the Privileged and Confidential checkbox will be selected This flag indicates that the Return to Work File Note may only be viewed by users who have the appropriate level of security access This access is defined by the System Administrator Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 271 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 54 HOW DO I VIEW THE RETURN TO WORK FILE NOTE SUMMARY The Return to Work File Note Summary screen will be displayed on the top of the folder populating the details for all Return to Work notes recorded for a claim The Return to Work Note Summary screen displays when the Return to Work Notes folder is selected Return to Work Notes listed can be filtered by entering one or more criteria in the Search fields and selecting the Search screen Return to Work Notes marked Privileged and Confidential may only be seen in the Return to Work Note Summary by Users with the Privileged and Confidential Access Menu Item Security Object currently applied to one of the Users Securi
95. to locate a specific claim for modification Step 2 Click on the MODIFY A icon The fields will become active and you will be able to select different values Commercial in Confidence SBC IT South Australia Department of Premier and Cabinet Page 227 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 Step 3 Make the desired changes to the Treatment Service Plans screen Step 4 Click on the SAVE icon and the fields will become inactive and your changes will be saved If you Modify a Treatment Service Plans screen and do not wish to save your changes click on the MODIFY A icon for a second time Your changes will not be saved and the claim will stay open If you wish to discard you changes and close the claim click on the CLOSE RECORD icon from the toolbar 46 2 3 How dol Add Multiple Treatment Service Plans screens to a Claim SIMS will not allow multiple Treatment Service Plans screens to be added to the Claim Users can enter multiple Treatment Approval Records into the one screen as applicable 46 2 4 How dol Upload a Document to the Treatment Service Plans screen Step 1 To attach a Document to the Treatment Service Plans record click on the Add hyperlink and use the Windows File Browser to locate and select the desired file TE Choose File to Upload Gj 2s OU ila gt Libraries Search Libraries Pi Organize v z fi t F
96. to the Claim How do Modify the Nominated Treating Doctor Screen after it has been saved How do Add Multiple Nominated Treating Doctor Screens to a Claim How do Delete the Nominated Treating Doctor Screen The following sections are related to the management of Nominated Treating Doctor Profiles are available in other sections of this User Guide e How do I Use the Provider Search e How do l Enter Maintain Provider Profiles 47 2 1 How dol Add a Nominated Treating Doctor to the Claim J N Step 1 Open the Claim you wish to add the New Nominated Treating Doctor to Step 2 Go to the Claim Summary branch of the tree control and click on the FLOATING MENU micon A list of options will appear to the right of the icon as shown below tiClaim Summary uu Claim Details New Injury Details E amp Injured Worker New Certificate of Capacity pii i Employment D New Surgery Related Incapacity Incident Detaili New Permanent Impairment Assessment a Injury I New Vendor Payment _ OTime Off Work s New Income Support Payment iv Notional Weekl t New Recoveries m Certificates 7 aia a New File Note Permanent Imp m Paym MEI New Other Injuries or Diseases mB Income Suppo New Correspondence In _ amp Estimate New Correspondence Out eae SP Estimate Histo New Medical Referral A Related Claims New Investigation Referral CQRTW Assessme g New Motor Vehicle New Nominated Treating
97. user may add any additional notes to the Legal Representative screen if required Paragraph Font Family Font Size hd Step 7 Once you are satisfied with the Legal Representative details entered into the fields on the screen click on the SAVE el icon and the fields will become inactive and your changes will be saved against the claim If you have multiple screens in MODIFY mode A when saving the screen SIMS will check to see if any other screens are in modify mode If there are any screens which meet this criteria the system will open the screen which needs saving and you will need to click on the SAVE lal icon again You do not need to modify and re add the Provider each time the Provider details are changed in the Provider Profile The link between the Provider Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 304 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 Profile and Claim is dynamic and any updated to the Profile will automatically come across to any linked Claims 63 1 3 How dol Add Multiple Legal Representative Screens to a Claim Step 1 Open the claim record you wish to add a New Legal Representative to and nes click on an existing Legal Representative in the Tree control Step 2 Select the ADD NEW al icon from the toolbar Add the details of a new Legal Representative Step 3 Click on the SAVE lal icon and
98. window Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 27 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 File Search Gene a New Provider fat New Site The File menu consists of the following items Menu Name Description Z OZ S O New Claim Creates a New Claim in the SIMS The user will need to enter details of the claim before it can be saved to the database All mandatory details required to submit a new claim will be displayed Creates a New Provider Profile in the SIMS 3 4 2 Search Menu The Search Menu contains a group of functions which allow the user to search Providers Claims or Payments within the SIMS To access the Search menu you need to click on Search in the Menu at the top of the SIMS window Search S Provider Search im Claim Search Payment Search 4 Site Search The Search menu consists of the following items Menu Name Description ss Claim Search Opens the Claim Search screen Provider Search Opens the Provider Search screen Payment Search Opens the Payment Search screen 3 4 3 Generate Menu The Generate Menu contains a group of functions which allow the user to Generate Documents from the SIMS To access the Generate menu you need to click on Generate in the Menu at the top of the SIMS window Generate Submission Files SA Submission Generate Letters a Standard Re
99. with the changes made click on the SAVE lal icon in the toolbar 37 2 5 How dol Authorise Recurring Payments Enter a New Income Support Payment see How do Add an Income Support Payment or open an existing unauthorised compensation payment Unauthorised Recurring Payments are distinguished by missing Authorised Details in the Recurring group box Recurring Payments f Date of First O Number of ag E eon ane Payment Recurring Weeks Week of _ Authorised C Pre Authorise Recurring Payments Date Authorised Authorised By Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 186 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 Step 2 Go to the Recurring Payments group box of the Unauthorised Income Support Payment If you are completing a New Income Support Payment enter relevant details Step 3 If you are viewing an existing Income Support Payment ensure that the screen is in MODIFY mode by selecting the MODIFY icon on the toolbar Q Step 4 Select the Authorised checkbox to authorise the Recurring Income Support Payment Once authorised the Income Support Payment Item screen will be read only A user may Pre Authorise Recurring Payments by selecting the relevant check box when Income Support Payments are created for the schedule by the System This means all Payments in the schedule will be marked as Aut
100. 0 User Guide Printed 18 06 2015 When you add further Return to Work File Note screens to the claim the system will automatically check that the details you have entered into the previous screen are valid before creating a new screen For example the User created one Return to Work File Note screen but forgot to fill in a Mandatory field This system would not let the user use the ADD NEW function as the previous screen is invalid How do I Delete a Return to Work File Note Step 1 To remove the Return to Work File Note screen from the claim firstly select the claim you wish to remove the File Note screen from Step 2 Once you have the claim open select the Return to Work File Note branch from the tree control which is to be removed If the Return to Work File Note is selected the background behind the text will appear blue Step 3 Click on the DELETE amp icon from the toolbar When the confirmation message appears click on OK L The Return to Work File Note will be removed from the claim Claims Management System 2 Are you sure you wish to delete this screen If you are unable to DELETE X the Return to Work File Note screen selected you may not have access to complete this function Check with the SIMS System Administrator that you have the correct access level 8 3 1 Return to Work File Note Additional Information The following sections contain additional information about the Return to Work Fi
101. 0 2014 789 200 00 Step 2 Enter criteria in to the fields at the top of the Summary Screen to locate a specific Payment For example select a Service Date Range and the Status to refine the Search Results Service Date From js Service Date To a Status y Note The Service Date From and Service Date To range will pick up all Payments which cover the same days selected Step 3 Once you have selected one or more criteria select the Search button The Payment Summary screen will refresh and the Payments matching the criteria entered will appear in the Summary Tip Once you have finished with the Search Results and want to return to the full list of Payments for the claim select the Clear button 34 2 3 How dol Open a Payment from the Payment Summary screen Step 1 To view the Payment Summary for the claim click on the Payment Summary folder in the Claim Tree Control Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Claims Management System Self Insurance SA User Guide Step 2 Step 3 Date Authorised Payment Category Payment Type Page 168 of 309 Version 1 0 Printed 18 06 2015 g Pay ments eE 31 10 2014 12345 380 00 fy 30 10 2014 8789 45 00 om j29 10 2014 23165 22 00 E 29 10 2014 26326 50 00 Li 29 10 2014 23165 198 00 om j29 10 2014 789 200 00 Review the list of Payments listed in the Summary until you h
102. 000 BRISBANE CITY QLD 4000 BRISBANE GROVE NSW 2580 BRISBANE MARKET QLD 4106 Step 2 lf you have entered the wrong Suburb or wish to change it repeat steps 1 until the correct selection is available Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 39 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 5 5 1 5 2 5 3 GENERAL SYSTEM FEATURES Screen flow As data is entered into the SIMS and each screen is saved the SIMS will automatically display the next screen The next screen is any screen that has not been saved and is currently enabled i e being entered or modified There are certain fields that are mandatory within these screens and must be completed before the SIMS will allow users to save the screen No screens are saved to the database until all screens that are currently enabled are saved without error Data will be lost if you leave the claim without saving all screens SIMS will warn you when you attempt to leave a claim that data may be lost You should take this warning to mean one or more screens have not yet been saved If any screen is not saved the Close Record icon will appear to be highlighted see example below To determine whether a screen has been saved you should look at that screen and if the fields are enabled i e white the screen is not saved Saving Details When a new claim is being entered det
103. 015 TBA hen 28 12 2014 TBA 61 1 2 How do I Open a Correspondence Out from the Correspondence Out Summary screen 4 Step 6 To view the Correspondence Out Summary for the claim click on the File Wie Note Summary folder in the Claim Tree Control wW Commercial in Confidence SBC IT South Australia Department of Premier and Cabinet Page 295 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 E r Correspondence Out 2 5 01 2015 TBA em 28 12 2014 TBA Step 7 Review the list of Correspondence Out listed in the Summary until you have located the Correspondence Out you wish to open Step 8 Click on the Number hyperlink and the Correspondence Out will open in the Screen window Correspondence Out Summary Correspondence Out Summary Number Document Category Date Sent Entered By Description Confidential File Name 1 TBA 28 12 2014 NicoleHoward Cease treatment over New Year Period T Test docx 2 TBA 5 01 2015 NicoleHoward Recommence Treatment as previously approved E Test docx lf a Correspondence Out has been marked as Privileged and Confidential the Correspondence Out will only display as Confidential in the Correspondence Out Summary screen with no other information or hyperlink associated with the file See Privileged and Confidential above for more information Commercial in Confidence SBCIT South Australia Department of Premi
104. 18 06 2015 8 HOW DO I USE THE EMPLOYEE SEARCH The Employee Search screen allows the user to search for Employees of the Organisation This function is available within the following screens e Injured Worker e Payment Search 8 1 Employee Search The Employee Search screen will appear as follows Employee Search Family Name OOOO o Empioyeenumber CCS Sach Given Name s id Cate or ith OOOO OS ea Suburb St a Postcode 8 2 Employee Search Step by Step 8 2 1 How dol Search for an Employee Step 1 Open the Employee Search by selecting the o 8 Select Employee link within Injured Worker screen or e The f button on the Payment Search screen next to the Injured Worker field Step 2 Once the Employee Search screen opens select the Criteria associated with the desired Employee Step 3 Press the OK 4 button The Employees matching the selected criteria will appear in the Search Results list box Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 49 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 Employee Search Family Name Employee Number search Given name OOO DateofBirth T Daear Address cancel Employee No Address Suburb Date of Birth 1 Pitt Street 1 05 1970 Step 4 Select the Employee Profile you wish to open by clicking on the Employee Name hyperlink associated to the Employee in the Search Results
105. 2014 Incident Form a 1 04 2014 Individual Rehabilitation Plan 58 3 3 Privileged and Confidential If the Correspondence In has security applied the Privileged and Confidential checkbox will be selected This flag indicates that the Correspondence In screen may only be viewed by users who have the appropriate level of security access This access is defined by the System Administrator Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 287 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 59 HOW DO I VIEW THE CORRESPONDENCE IN SUMMARY SCREEN This screen displays a summary of all Correspondence In received for the claim The grid will allow the user to sort the results by any of the column headings The default view will be by date received in descending order Correspondence In records marked Privileged and Confidential may only be seen in the Correspondence In Summary by Users with the Privileged and Confidential Access Menu Item Security Object currently applied to one of the User s Security Profiles The Correspondence In Summary screen contains one tab e Correspondence In Summary Correspondence In In Correspondence In Summary Number Document Category Date Received Received From Description Confidential File Name 5 01 2015 Dr Jane Jane s Physio Report O Test docx 28 12 2014 New Year Closure Notification for Jane s P
106. 6 2015 44 2 1 How dol Add Recoveries to the Claim Step 1 Open the Claim you wish to add the New Recoveries to WKC LY step 2 Go to the Claim Summary branch of the tree control and click on the FLOATING MENU icon A list of options will appear to the right of the icon as shown below tClaim Summary wu Claim Details New Injury Details oe g Injured Workel SA New Notional Weekly Earnings T Employment Die New Certificate of Capacity Incident Detail New Permanent Impairment Assessment E Injury I New Vendor Payment dD TY _ ne Off Work New Income Support Payment 4 Certificates 5 New Recoveries L Surgery Relate oO Jj z m Permanent Imp _ New File Note a New Rehabilitation File Note E Er Payments _ow _ Compensation New Other Injuries or Diseases sree SS Estimate New Correspondence In Sr Estimate Histoi New Correspondence Out A Related Claims New Medical Referral Ea Payment Restr New Investigation Referral New Motor Vehicle New Nominated Treating Doctor New Claim Provider Ey New Legal Representative A New Dependant 63 New Witness a New Purchase Order New Treatment Service Plans New RTW Assessment z New RTW Plan y saa Step 3 Select New Recoveries from the floating menu A new tree branch and screen window will automatically appear This process is creating a new screen against a claim To add further details to th
107. 75 55 2 1 How do I View the Document Summary cccccecceceeceeaeeeceeeesaeeeeseeeesseeeeseeeesseeees 275 55 2 2 How do I Modify the Document Summary cccccccceeeeceeeeeceeeesaeeeeseeeesaeeeeseeeeseaeeeas 275 55 2 3 How do I Delete the Document Summary cccccccceececaeeeeceeeesaeeeeseeeeseeeeeseeeeseeeees 275 56 HOW DO I SEARCH FOR A DOCUMENT ccccssscsescsscnesenseneseneeneeeaseeseaeenesensenessaees 276 OG DOCUMENTS EARG Himoitiiioni eo i ei n E E 2 6 56 2 DOCUMENT SEARCH STEP BY STEP nurises aa Gea tenes Gra enact ease 2 6 56 2 1 How do I Use the Document Search o oo ccc cccceccecseesueeeeseeeeeseuseeeeeesaueueueueeeeasenss 276 56 3 DOCUMENT SEARCH ADDITIONAL INFORMATION 0 ccccecseecceseecceeseeceeeeeuceueueueeaueeueeueeeaeenenes 278 56 3 1 No Records Match the Criteria Entered icin cree cic Gra ea alia Grou teehee Gro tetas 278 5 oS oe Sr 5 0 em eR een ne er ee PE SO ea SE on TR ra rere eee TCS eee 279 57 HOW DO I ACCESS amp MAINTAIN DOCUMENTS IN THE DOCUMENT DETAILS SCREEN 280 57 1 DOCUMENT DETAILS veiccnsacustenieaussuniavesiuniausnreaianenteniienvantauesianisiercaniaaesiuntcueroantacueiunicdeerennlonts 280 57 2 DOCUMENT DETAILS STEP BY STEP ac maisosckc alc pated ta crtien a encad aaatied oa patadcaateadd oateeceetensezes 281 57 2 1 How do I Maintain the Document DetailS 0 cece cc cceccecececececeeeacecececeavaeeeeneneneas 281 57 2 2 How do I View a Document
108. 9 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 Payment Type service Date Description Quantity Total Amount excl GST Tax Status Total Amount incl GST Reasons for Variation if the Total Amount excl GST is greater than the Scheduled Amount 33 4 2 Tree Control More than one Provider Payment screen may exist for each claim The screens will appear in the Claim Tree Control in the following format e lt lnvoice Date gt lt nvoice Number gt lt Total Invoice Amount incl GST gt E Payments nu 2 11 2014 12345 380 00 onl 28 10 2014 4586789 110 00 The Provider Payment screens will be grouped into Financial Year sub folders by Invoice Date For example a Payment with an Invoice Date 1 1 2014 will appear in the financial year folder 2013 2014 as demonstrated below E 9 Payments 29 11 2014 12345 380 00 wi 28 10 2014 4586789 110 00 Lo 2013 2014 Luu 19 01 2014 F456789 380 00 Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 166 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 34 HOW DO I VIEW THE PAYMENT SUMMARY The Payment Summary screen appears when the Payments folder is selected from the Claim Tree Control The Payment Summary screen displays a listing of all Payments for the Claim ordered by Date From in descending orde
109. Claim Provider to the Claim Step 3 Click on the SAVE lal icon and the fields will become inactive and your changes will be saved 62 1 4 How do I Delete the Provider Screen Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 299 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 Step 1 To remove the Claim Provider screen from the claim firstly select the claim wie you wish to remove the Claim Provider screen from Step 2 Once you have the claim open select the Claim Provider branch from the tree control which is to be removed If the Claim Provider is selected the background behind the text will appear blue Step 3 Click on the DELETE icon from the toolbar When the confirmation message appears click on OK Lo The Claim Provider will be removed from the claim Claims Management System 2 Are you sure you wish to delete this screen Cancel If you are unable to DELETE the Provider screen selected you may not have access to complete this function Check with the SIMS System Administrator that you have the correct access level Note This action will not remove the Provider from the system altogether only the link between the Provider and Claim No other screens will be affected 62 2 Claim Provider Additional Information The following sections contain additional information about maintaining Providers on a Claim in the
110. Claims screen displays as seen below and contains the following fields Related Claims Claim No Injury Date Claim Status Status Date Liability Status Incident Description Injury Description 201400001 01 01 2014 Claim Open 01 01 2014 Claim Accepted Tripped down stairs Broken ankle Originally Accepted 201400002 01 03 2014 Claim Closed 01 04 2014 Claim Accepted Cut finger while opening Cut index finger Originally Rejected boxes 19 2 Related Claims Step by Step The following topics are available to assist you in the use of the Related Claims screen e How do View Related Claims e How do Delete a Related Claims screen 19 2 1 How do I View Related Claims Note The Related Claims screen will only display in the tree when the selected Injured Worker has another Claim in the System Step 1 Navigate to the Related Claims screen which is added automatically when the Injured Worker has another Claim in the System This screen is titled Related Claims jn the tree node Step 2 By clicking on the Claim Number hyperlink the user is able to navigate to the selected related Claim Claim Number 19 2 2 How do I Delete a Related Claims screen Note SIMS will not allow the Related Claims screen to be deleted Commercial in Confidence SBC IT South Australia Department of Premier and Cabinet Page 94 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 20 HOW DO I
111. Control ORIEN Lvl 30 10 2014 Claims Management Leni 30 10 2014 General soul 29 10 2014 General 52 1 2 How dol use the File Note Summary Search MS Step 1 To use the File Note Summary for the claim click on the File Note Summary ew folder in the Claim Tree Control and this will display the File Note Summary screen Oz Note Summa oul 30 10 2014 Claims Management ltt 30 10 2014 General ult 29 10 2014 General Step 2 Enter criteria in to the fields at the top of the Summary Screen to locate a specific File Note For example select a Date Range and Category to refine the Search Results File Note Summary Note Summary Search for Emo To Category y Search O Clear Note The Date From and Date To range will pick up all File Notes with a Date Entered range covering the same days selected Step 3 Once you have selected one or more criteria select the Search button The File Note Summary screen will refresh and the File Nots matching the criteria entered will appear in the Summary Tip Once you have finished with the Search Results and want to return to the full list of File Notes for the claim select the Clear button 52 1 3 How do I Open a File Note from the File Note Summary screen N Step 1 To view the File Note Summary for the claim click on the File Note AJ Summary folder in the Claim Tree Control FOz Note Summa h 30 10 2014 Claims Management uli 30 10 2014
112. Date From Date To Impairment Code wm 4 Search U Clear Date of Assessment Act Reference Impairment Code Impairment 16 10 2014 Section 24 1101 Loss of thumb 13 10 2014 Section 24 1121 Loss of little finger 29 1 Permanent Impairment Summary Step by Step The following topics are available to assist you in the use of the Permanent Impairment Summary screen e How do I View the Permanent Impairment Summary e How do I Use the Permanent Impairment Summary Search J How do Open a Permanent Impairment from the Permanent Impairment Summary screen The following sections are related to the Permanent Impairment Summary screen are available in other sections of this User Guide How do Add a Permanent Impairment to the Claim How do Modify the Permanent Impairment Screen after it has been saved How do Add Multiple Permanent Impairment screens to a Claim How do I Delete the Permanent Impairment screen 29 1 1 How do I View the Permanent Impairment Summary Step 1 To view the Permanent Impairment Summary for the claim click on the Permanent Impairment Summary folder in the Claim Tree Control o OEE Impairment Summar Permanent Impairment No 2 caine a Permanent Impairment No 1 29 1 2 How do I use the Permanent Impairment Summary Search Step 1 To use the Permanent Impairment Summary for the claim click on the Permanent Impairment Summary folder in the Claim Tree Control and thi
113. Delete the Employment Details screen Note The SIMS will not allow the Employment Details screen to be deleted as it contains key Claim details Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 71 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 13 4 Employment Details Additional Information The following sections contain additional information about the Employment Details screen functionality and validation e Employment Details Mandatory Fields e Employment Details Tree Control 13 4 1 Mandatory Fields The following fields must be completed in order to successfully save the Employment Details into the SIMS database Portfolio Region Agency Service Division Cost Centre Address Line 1 Suburb State and Postcode Industry Occupation Employment Type Employment Classification Does the Injured Worker have any other Employment Licence Registration RTWSA Location 13 4 2 Tree Control Only one Employment Details screen may exist for each claim The screen will appear in the Claim Tree Control in the following format Employment Details E i Claim Summary A Claim Details E Injury m Injury Details Time Off Work hn sy Estimate Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 72 of 309 Claims Management System Self Insurance SA Version
114. Details Family Name Title Iv Given Name s Date of Birth E C Requires An Interpreter Language C Dependant is undertaking full time education Step 7 Select the Status of the Dependant for the Claim Status Joined By Reason Joined Withdrawn Step 8 Enter the Dependant s Residential Address Suburb State and Postcode Step 9 If the Dependant s Postal Address is different to their Residential Address uncheck the Postal Address is the same as Residential Address check box and enter the Address Suburb State and Postcode Postal Address _ Postal Address is the same as Residential Address Oe The Postal Address is the same as Residential Address check box Is defaulted to selected If the Dependant s Postal Address is different to their Residential Address uncheck the check box which will enable the Postal Address fields Step 10 Enter the Contact Details for the Dependant if applicable Contact Details Home Phone Work Phone Mobile Phone Email Address Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 127 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 Step 11 The Dependant screen can be saved once all mandatory details have been entered by selecting the SAVE lad icon 26 2 2 How do
115. Doctor New Claim Provider New Legal Representative amp New Dependant 2 New Witness ee New RTW Assessment lt New RTW Plan Step 3 select New Nominated Treating Doctor from the floating menu A new tree branch and screen window will automatically appear This process is creating a new screen against a Claim The Nominated Treating Doctor screen will appear in the screen window Step 4 Open the Provider Search by selecting the Provider Search hyperlink on the Nominated Treating Doctor screen Use the search to locate the desired Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 232 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 Provider and import into the Nominated Treating Doctor screen For details on using the Provider Search refer to How do Use the Provider Search Once the Provider details have been imported into the Nominated Treating Doctor screen the screen will display as follows the below is an example only The value shown in the Nominated Treating Doctor screen will depend on the data available in the Provider profile selected using the Provider Search Nominated Treating Doctor Treating Doctor Claim Provider Provider Type Medical Centre M1 Active 4 Provider Search Provider Nane es ABN See Provider Numbers vendor Number 0000000005 Street Address Postal Address Address
116. E icon for a second time Your changes will not be saved and the claim will stay displayed in the tree window If you wish Commercial in Confidence SBC IT South Australia Department of Premier and Cabinet Page 79 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 to discard you changes and close the claim click on the CLOSE RECORD 2 icon from the toolbar 15 2 3 How do Add Multiple Incident Details screens 15 2 4 How do I Delete the Incident Details screen 15 3 Incident Details Additional Information The following sections contain additional information about the Incident Details screen functionality and validation e Incident Details Mandatory Fields e Incident Details Tree Control 15 3 1 Mandatory Fields The following fields must be completed in order to successfully save the Incident Details into the SIMS database Date Injury illness Occurred Time Occurred Duty Status Accident Location Specific Location Location Where Injury Occurred Address Line 1 Only Suburb State and Postcode Where Injury Occurred Description of Incident Description of Injury Illness Date Deceased only when Injured Worker Deceased checkbox is selected 15 3 2 Tree Control Only one Incident Details screen may exist for each claim The screen will appear in the Claim Tree Control in the following format Incident Details satii Claim Summary a Cla
117. ENTER A RTW ASSESSMENT This screen allows users to enter details of a RTW Assessment for the Injured Worker Multiple RTW Assessment screens may be associated to the Claim The RTW Assessment screen consists of one tab e RTW Assessment 23 1 RTW Assessment The RTW Assessment screen will be displayed as follows IRTW Assessment Assessment Assessment Details Assessment Type Internal iv Status Open y RTW Consultant SAPS Test y Start Date 10 06 2015 i Completion Date Assessment Outcome Assessment Comments File Name upload Q Clear RTW Provider Name 4 Phone 23 2 RTW Assessment Step by Step The following topics are available to assist you in the use of the RTW Assessment screen How do Add a RIW Assessment to the Claim How do Upload a Document How do Modify the RTW Assessment Screen after it has been saved How do Add Multiple RIW Assessment screens to a Claim How do Delete the RTW Assessment screen The following sections are related to the RIW Assessment Summary screen are available in other sections of this User Guide How do View the RIW Assessment Summary How do use the RTW Assessment Summary Search How do Open a RTW Assessment from the RTW Assessment Summary screen How do Use the Provider Search 23 2 1 How do I Add a RTW Assessment to the Claim NS step 1
118. GAL REPRESENTATIVE STEP IBY STEP iccsictacobuioraccsioiy cc a a i 301 63 1 1 How do I Add a Legal Representative to the Claim cccccceeccseeeceeeeceeeeseeeseeeeneees 302 63 1 2 How do I Modify the Legal Representative Screen after its been saved 303 63 1 3 How do I Add Multiple Legal Representative Screens to a Claim cccceeeeeseeeees 304 63 1 4 How do I Delete the Legal Representative Screen cccccceeeeeeeeeeeeeeeeeeeeseeeesaeeeens 304 63 2 LEGAL REPRESENTATIVE ADDITIONAL INFORMATION 0cccssscecesceeesececeeceteeeeeeeeeteeetaneeenens 305 63 221 Mandatory Fields science essosscuadorasosemecadostdehesansuonstioundauancgeaacesentdatesnadbonmiexadolaeaseunsatenadensaete 305 O3 2 2 WES COMM ccaecssacescwsnnebeawasteta a T A A 305 64 HOW DO I USE THE TASK LIST wcccsccacencoceceversicnceacecssaveriresscavecsaneeetcsompecaneen cence 306 G41 TASKLST STEP BY OTEP inun sn n E a 307 64 1 1 How do I Access the Task List Screen ccccccccseccceececseeeeeeeteueeseeeteucessueesseetaneeneees 307 64 1 2 How do I Search for Actions Due within a Certain Period ccccceccseeeeeeeeeeeeeeeeees 308 64 1 3 How do I Search for Task List Actions by Status cccccccecccsseeeeeeeeeseeeeeseeeesaeeeees 308 64 1 4 How do I View the Status and Type of Claims assigned a Claims Manager 308 64 1 5 How do I Open a Claim associated with Task List entries ssenns
119. General aout 29 10 2014 General Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 262 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 Step 2 Review the list of File Notes listed in the Summary until you have located the File Note you wish to open Step 3 Click on the Subject hyperlink and the File Note will open in the Screen window File Note Summary Note Summary Search for 20 11 2014 5 01 2015 Category y Search D clear File Note entered by SBC System Admin 20 11 2014 5 28 PM Category Phone Note Subject Phone Call Phone call from Joe File Note entered by SBC System Admin 5 01 2015 11 11 AM Category General Subject File Audit File Audit completed Confidential lf a File Note has been marked as Privileged and Confidential the File Note will only display as Confidential in the File Note Summary screen with no other information or hyperlink associated with the file See Confidential File Notes above for more information Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 263 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 53 HOW DO I ENTER A RETURN TO WORK FILE NOTE One or many RTW File Notes can be recorded for a claim On the first entry of a File Note the user mus
120. Guide Printed 18 06 2015 64 HOW DO I USE THE TASK LIST The Task List functionality within SIMS provides the ability to see the schedule of tasks due for completion in relation to claim management The Task List gives the user the ability to search for and display outstanding tasks using the following criteria e Person Responsible e Tasks Due Between Date Range e Tasks Outstanding Completed or All Tasks The Task List screen consists of two tabs e Task List Actions e Task List Claims The Task List Actions tab will appear as follows Task List iE eo ae tents Task List Claims Person Responsible SAPS Test v Search bd Export Cancel Date From 10 05 2015 Date To 10 07 2015 E Open Claims 1 Undetermined Claims jo Open Rehab Claims Total Claims Allocated 2 Actions Assigned Task Type V Outstanding O Completed O All Task Description Due Date Start Date Worker Email Email S File Note 29 05 2015 25 05 2015 Andrew McKay Letter Prepare a letter 1 File Note 29 05 2015 27 05 2015 William Michaels File Note test S File Note 31 05 2015 26 05 2015 John Gilmore Commercial in Confidence SBC IT South Australia Department of Premier and Cabinet Page 307 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 The Task List Claims tab will appear as follows Task List Task List Act
121. How do I Modify the Estimate screen cccceccccscccceececeeeeeceeeeseeeeseeeeseeeeensesensaeeens 148 31 3 ESTIMATE ADDITIONAL INFORMATION c 0sccceeceseectencececeeeetececeeeeeuceteueeseeteeeteueesseetaeess 149 Slo Mandatory Fields essensie a ASe 149 32 HOW DO I VIEW THE ESTIMATE HISTORY 0 ccccssceeeeceeneecneeeeneeeeneeenseseneeenneseneees 150 32 ESTIMATE HISTOR Y inao E a A A 150 32 2 ESTIMATE HISTORY STEP BY STEP poroi a a aa S 150 32 2 1 How do I View the Estimate HIStory cccccccccseccceeeeceeeceeeeceeseeeceeeneesseeesseesseeess 150 33 HOW DOTENTER A PAYMENT 2 itiiciiiitnn Ai arenas aint ia vse 152 39 PAYMENT cosce E E EE E EES 152 332 PAYMENT ITEM racen T E ai a ceconsaasaeaaih aeteios 154 39 0 VENDOR PAYMENT STEP BY STEP skor iania REE R RE 154 339 1 HowdolAdda Payment ticscannsachyecnsamsetinvsannad cemmasudnusamneteeenabutenieametataebatroummeandiestane 154 33 3 2 How do I Enter an Employee Reimbursement PayMent cccceecceeeeeeeeeeeeeeeeaees 157 333 9 Mow do l Enter Payment Kems oenar a dies ec seen and eeeanee 158 33 3 4 How do I Enter Multiple Payment Items for a PayMent cccccecseeeeeeeeeeeeeeeeeeeeees 160 33 3 5 How do I Authorise Payment Items nnnennnennnennnennnrnnornnnsrrnsrrnsrrrsrrrsrrrsnrrerrernrrennee 161 33 3 6 How do I determine the Status of a Payment cccccccccseeeceeeeeeeeseeeeeeeeseeeeseesaeess 162 333 7 HOW AO
122. How do I Modify the Medical Referral Screen after it s been Saved ccceeeeeee 221 45 2 3 How do I Add Multiple Medical Referral screens to a Claim ccccceeeeceeeeneeeeeeeees 222 45 2 4 How do I Delete the Medical Referral SCre n cccccccceeccsecceeeceeeeeeeceueeseeeseeeaeeeaees 222 45 3 MEDICAL REFERRAL ADDITIONAL INFORMATION 0scccescecseececeseetaeeeceseeceueeteeeeetsneetaneeenens 223 Aok Mada OFE eee ee een ree ene ee omen eee nee eee ee ee en eee ey eee eee ee 223 BOS WEES COMM Ol E EA 223 46 HOW DO I ENTER TREATMENT SERVICE PLANS 0 ccccesescceseseeseeeseeeeseseneeeeeesens 224 AO l TREATMENT SERVICE PEANS scicinscetitetensds Sone Absenadans agane Aisaaetane teases Aeviadane A 224 46 2 TREATMENT SERVICE PLANS STEP BY STEP ccccccsceceeecceeeceeeeceeeccseeceueeceeeeeeeeseuseneeeseaeens 224 46 2 1 How do I Add a Treatment Service Plan to the Claim ccccccsececeeeeeeeeseeeseeeeneeens 225 46 2 2 How do I Modify the Treatment Service Plans Screen after it s been saved 226 46 2 3 How do I Add Multiple Treatment Service Plans screens to a Claim ccc0eeee 227 46 2 4 How do I Upload a Document to the Treatment Service Plans screen 0000 227 46 2 5 How do I Delete the Treatment Service Plans SCree n cccceccseccseeeeeeeeeeeeeeeeeeeaees 228 46 3 MEDICAL REFERRAL ADDITIONAL INFORMATION sscccesceceeececescet
123. I UpPlOaG a DOCUMENT serrie a a aa ai 163 3338 H wdo lDelete Payment seisan 163 33 4 PROVIDER PAYMENT ADDITIONAL INFORMATION cccescecseeeecesceteeceeeescecenceeseeeeteeetsneeenens 164 334 1 Mandatory Fields smesna a TE 164 SOc Tee Contolera EE A AEEA 165 34 HOW DO I VIEW THE PAYMENT SUMMARY 0 ccccccseceeneeeeseeeneeeeneecnseeeneeeeneseaeees 166 34T PAYMENT SUMMARY sccctictccteseciccete e a a e a aaa L aa EEE 166 34 2 PAYMENT SUMMARY STEP BY OEP aasnsssesssrrinssrrrrnrerirrnrnnrrrtrnnsertennrnrtennnetirnarnntrnnnnntnnn nanne 166 34 2 1 How do I View the Payment Summary cccccccseeccceeeeeaeeeseeeesaeeeeseeeesaaeeeseeeessaeeeas 167 34 2 2 How do I use the Payment Summary Search ccccccseccceeeeceeeeeeeeseeeeeeeeseeeeneeeeaeess 167 34 2 3 How do I Open a Payment from the Payment Summary SCreen cccceeeeeeeeeeees 167 35 HOW DO I SEARCH FOR AN UNAUTHORISED PAYMENT cccccssseeeseneeeeneeeeeneees 169 35 1 UNAUTHORISED PAYMENTS irosen gorena on aT T ONE 169 35 2 UNAUTHORISED PAYMENTS STEP BY STEP c scccesceceececeeecoecesaececseesoeeecenesceeeseeeeseeeseeeess 169 35 2 1 How do I Search for an Unauthorised Payment ccccccccceeceseeeeeseeeeseeeeseeeeeaaeeees 169 35 2 2 How do I Approve one or more PayMentS ccccccccssceceseeeceeeseeeeesseeeseeeeenseeesseeeens 170 Commercial in Confidence SBC IT South Australia Department of Premier a
124. ISEASES 0 0 eee cece eneeeeeeneeeneeneeeneenees 86 i OTHER INJURIES OR DISEASES sos sussiannneict oat aaswauauel a xatanuel ann dais eatanuel apnea amunnclcenneatnannad 86 17 2 OTHER INJURIES OR DISEASES STEP BY STEP sascecnssonadetsedauacnowevadahseduaeencdnendetessnexeeseeetdenenseeds 86 17 2 1 How do I enter Other Injuries or DiS ASES ee cecececceceseneneneeeeneneeeeeaeeensaeeeesanenenen 86 17 2 2 How do I Modify the Other Injuries or Diseases screen ccceecccseeeeseeeeeeeeeseeeeesaeees 88 17 2 3 How do I Add Multiple Other Injuries or Diseases screens ccccccseeeceeeeneeeseeeeeeees 88 17 2 4 How do I Delete the Other Injuries or Diseases screen from a Claim cccceeeee eee 88 17 3 OTHER INJURIES OR DISEASES ADDITIONAL INFORMATION 0ccccseeceeseeceeseeseucseeseueaeeeueeeeasss 89 Atego Mandato CIOS 6 hatch tone eat icon a ala tie th fala Gta eral fant a etal hoah iat 89 dee UCC TCOM Ol eh tata hscetate Sac seta t asst eet E aaa ttt nate aesehe tate e Jota stated 89 18 CLAIM SUMMARY scicsscssscvcicechascecucnccecendenteiwenlosecs ehenteawsncaiecvedawenewekceanece eiawaneesaceeavedantiewvackeds 91 18 1 CAINS UMMA RY rrin a E E E 91 18 2 CLAIM SUMMARY STEP BY STEP ecctascnssczsnciacctar a a A aA a AE 91 18 2 1 How do I view the Claim Summary Screen oonnnonnnnnnnnnnnnennnrnnnrnrrnnrrrnrnnnrrenensnernnenne 92 19 HOW DO I VIEW RELATED CLAIMS sasnannsnnnnunnnnunnnn
125. Injury all levels Mechanism of Injury all levels Breakdown Agency of Injury all levels Agency of Injury all levels only if Agency of Injury is the same as Breakdown Agency checkbox has not been selected 16 3 2 Tree Control Only one Other Injuries or Diseases screen may exist for each claim The screen will appear in the Claim Tree Control in the following format Injury ati Claim Summary a A Claim Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 86 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 17 HOW DO I RECORD OTHER INJURIES OR DISEASES This screen allows users to enter details of any other Injuries or Diseases that the Injured Worker may have had relevant to the Claim and indicated on the Claim form The Other Injuries or Disease screen may only be added once and may be deleted if the User has relevant Security Privilege to do so The Other Injuries or Diseases Screen includes one tab Other Injuries or Diseases 17 1 Other Injuries or Diseases The Other Injuries or Diseases tab will be displayed as follows Other Injuries or Diseases Injuries or Diseases Other Similar Injuries or Diseases Has the worker suffered any similar injury or disease It need not be work related Yes O No Date of Injury Name of Employer Nature of Injury Date of Injury ay Name of Employer Insert MRem
126. Insurance SA Version 1 0 User Guide Printed 18 06 2015 Step 4 Click on the SAVE lal icon and the fields will become inactive and your changes will be saved If you Modify a Work Capacity Certificate screen and do not wish to save your changes click on the MODIFY A icon for a second time Your changes will not be saved and the claim will stay displayed in the tree window If you wish to discard your changes and close the claim click on the CLOSE RECORD icon from the toolbar 21 2 3 How do I Add Multiple Work Capacity Certificate Screens to a Claim Step 1 Open the claim record you wish to add a New Work Capacity Certificate to and click on an existing Work Capacity Certificate in the Tree control Step 2 Select the ADD NEW Ci icon from the toolbar alternatively you can go to the floating menu and select New Work Capacity Certificate Add the details of a new Work Capacity Certificate referring to the instructions outlined in How do Add a Work Capacity Certificate to a Claim Step 4 Click on the SAVE icon and the fields will become inactive and your changes will be saved When you add further Work Capacity Certificate screens to the claim the system will automatically check that the details you have entered into the previous screen are valid before creating a new screen For example the User created one Work Capacity Certificate screen but forgot to fill in a Mandatory field This system would not let the user use
127. Location of Injury 1 Bodily Location of Injury 2 Bodily Location of Injury 3 lt is not mandatory to populate the Bodily Location of Injury using the Code field The Bodily Location of Injury Level 1 2 and 3 fields may be manually selected from the drop down lists provided The Bodily Location of Injury 1 is populated with the TOOCS Version 3 1 Defined Bodily Location Level 1 Classifications Codes Upon selecting a value in the first level the corresponding associated values are populated into the Bodily Location of Injury Level 2 field Upon selecting a value in the Level 2 field the associated values are populated into the 3 level Step 7 The Mechanism of Injury Description field allows the user to enter a description of the mechanism of the injury recorded The Code field allows the user to enter the Mechanism of the Injury code which will then populate the Mechanism of Injury Level 1 and 2 fields Mechanism of Injury Description Mechanism of Injury 1 Mechanism of Injury 2 lt is not mandatory to populate the Mechanism of Injury using the Code field The Mechanism of Injury Level 1 and 2 fields may be manually selected from the drop down lists provided The Mechanism of Injury 1 is populated with the TOOCS Version 3 1 Defined Mechanism of Injury Level 1 Classifications Codes Upon selecting a value in the first level the corresponding associated values are populated
128. Motor Vehicle screens to a Claim Step 1 Open the claim record you wish to add a New Motor Vehicle to and click on an existing Motor Vehicle in the Tree control Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 245 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Step 2 Step 3 Printed 18 06 2015 Select the ADD NEW lt icon from the toolbar alternatively you can go to the floating menu and select New Motor Vehicle Add the details of a new Motor Vehicle referring to the instructions outlined in How do Add a Motor Vehicle to the Claim Click on the SAVE lal icon and the fields will become inactive and your changes will be saved 49 2 5 How dol Delete the Motor Vehicle Screen ws Step 1 Step 2 Step 3 To remove a Motor Vehicle screen from the claim firstly select the claim you wish to remove the Motor Vehicle from Once you have the claim open select the Motor Vehicle branch from the tree control which is to be removed If the Work Capacity Certificate is selected the background behind the text will appear blue Click on the DELETE amp icon from the toolbar When the confirmation message appears click on L The Motor Vehicle will be removed from the claim Message from webpage gt Are you sure you wish to delete this screen _ 49 3 Motor Vehicle Additional Information The following sections contain additio
129. N y Additional Comments Other functional considerations Medication s prescribed that could impact ability to undertake some activities iv Recommended a graduated increase in working hours over weeks from hours a day to normal hours hours a day Recommended non consecutive working days for a period days or weeks V Has requested more information about the options abailable for return to work v Has requested a copy of their recovery and return to work plan Step 10 Select any applicable communication and preferred method of contact if required Communication _ Case Manager to contact Doctor on receipt of Certificate Preferred Method of Contact y L Employer to contact Doctor on receipt of Certificate Step 11 Click on the SAVE lal icon and the fields will become inactive and your changes will be saved 21 2 2 How do I Modify the Work Capacity Certificate Screen after its been Saved Step 1 Open the claim record you wish to modify and click on an existing Work Capacity Certificate screen in the tree control See How do search for a Claim to locate a specific claim for modification Step 2 Click on the MODIFY E icon The fields will become active and you will be able to select different values Step 3 Make the desired changes to the Work Capacity Certificate screen Commercial in Confidence SBC IT South Australia Department of Premier and Cabinet Page 103 of 309 Claims Management System Self
130. New Medical Referral _ New Investigation Referral amp New Motor Vehicle a New Nominated Treating Doctor New Claim Provider E New Legal Representative amp New Dependant 2 New Witness rr Ls New Purchase Order New Treatment Service Plans z New RTW Plan da New Compensation Recipients Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 226 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 Step 3 Select New Treatment Service Plans from the floating menu A new tree branch and screen window will automatically appear This process is creating a new screen against a claim Step 4 Enter the From Date To Date Number of Services Requested or Treatment Service Amount Limit Requests and select the Payment Category Treatment Service Plan No TS9 2015 Add MRemove Recommendation By Doctor Service Provider Date Recommendation Approved ey Date Entered Entered By ISAPS Test From Date To Date No Expiry Document Date Document Type Name View ae Add Remove Payment Category v Payment Type v GL Code Provider 4 Additional Notes Number of Services Requested Treatment Service Amount Limit Requested Step 5 Select the Provider and enter any other details where applicable Provider a Additional Notes Number of Services pec
131. Notes will be locked for Editing by Users 48 hours after they have been entered When a File Note is locked all Fields on the File Note screen cannot be altered with the exception of the Date Completed field Locked File Notes cannot be unlocked File Notes where a due date has not been entered will be displayed in the tree window as a green icon File Notes where a due date has been recorded but a date completed has not been entered will be displayed in the tree window as a red icon File Notes where a due date and a date completed have been recorded will be displays in the tree window as a blue icon The Return to Work File Note screen consists of a single tab e Return to Work File Note Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Claims Management System Self Insurance SA User Guide Page 264 of 309 Version 1 0 Printed 18 06 2015 1 2 Return to Work File Note Return to Work File Note Return to Work File Note Category Subject Description B Z U ac S amp S B Format Font Family Font Size File Name Upload Clear Entered By SAPS Test __ Date Entered 17 06 2015 Time Entered 10 26PM Assign Action 1 3 Return to Work File Note Step by Step The following topics are available to assist you in the use of Return to Work File Notes How do Add a Return to Work File Note to a Claim How do Upload a Document to th
132. PROVIDER SEARCHOTER BY OTEP oeo onan adhd new onan dae mae onde iaenronats 45 7 2 1 How do lSearch fora Provider errora uisiasaanvtats Sean ARAA RN 45 7 3 PROVIDER SEARCH ADDITIONAL INFORMATION ccccceccecceeceeeeeeeeececeeceenececeeeeeseaeeeesaseeenaneess 46 Test Using the Sede ioisnan aaa a T NO 46 7c Search Warning Messages esceninesiica tiana ia RRs 46 7 4 HOW DOI USE THE PROVIDER QUICK SEARCH csssesscscserescusesencusussseusseneususcueuerensuuereneuenss 47 8 HOW DO I USE THE EMPLOYEE SEARCH D c cccssssccsseccnsesecsseeenseseneseeeusssensseeenseeenseeseaas 48 Gal EMPLOYER SEAR CEM cernir A ctabeeiuns 48 8 2 EMPLOYEE SEARCH STEP BY STEP corrie icona a a 48 8 2 1 Howdol Search for an EMDIOVYEEZ siie a a N 48 8 3 EMPLOYEE SEARCH ADDITIONAL INFORMATION 00ccccceeccecceeececeeceeeeececeeaeseeeeeneeeeaeeeeeeaeeeeeas 49 83 WSIMG IMS SCAG Meshes cceti cis teaket nice cin otinheeieaieahs ais eee dinategiieseGedinste hela eisai 49 832 Search aNg MCSSACeS 25 4 saris patch N ota Goa a ctu radii hase Gaatici 50 9 HOW DO I SEARCH FOR A PAYMENT ccccsscccssescnnseccnseccnneecenseeensesenneenensesennseecnsesenness 51 I1 PAYMENT AIR G Eel spies serena ed tanh tela a Ac halen a a 51 92 PAYMENT SEARCH STEP BY STEP srr aa AT E E 51 921 H wd lse achtora Payment orsoni a sate ste aO 51 9 3 PAYMENT SEARCH ADDITIONAL INFORMATION ccccccececcecccceeeeteceeeeeeeeceneeeaeeeeeeneeseneeeneneenaness 52 OG A MISINGINS
133. Payee Numbers Address State Postcode E Step 5 Record any additional details in relation to the payment of the account such as the payment particulars or the cost centre applied to 33 3 2 How do I Enter an Employee Reimbursement Payment Step 1 Open the Claim record for the Claim the payment relates to Step 2 Create a Payment if one does not already exist using the floating menu next to the Claim Summary screen _ 4 SETS Claim Details New Injury Details Injured Worker New Notional Weekly Earnings Employment Die New Certificate of Capacity om Incident Detail New Surgery Related Incapacity EQ Injury _ New Permanent Impairment Assessment ren an Work g New Vendor Payment Z 7 an as I New Income Support Payment e a Estimate iy New Recoveries ase New File Note a S Estimate Histol wow A Related Claims _ New Other Injuries or Diseases New Correspondence In New Correspondence Out a New Medical Referral C New Investigation Referral New Motor Vehicle New Nominated Treating Doctor New Claim Provider El New Legal Representative amp New Dependant 2 New Witness New RTW Assessment ge New RTW Plan lf a Payment Screen already exists for the claim subsequent payment screens may be added by selecting a payment in the tree window and clicking the ADD NEW icon in the toolbar Commercial in Confidenc
134. Postal Address Postal Address is the same as Residential Address Suburb State Postcode Postcode C International Address Country Contact Details Home Phone Work Phone Mobile Phone Email Address 26 2 Dependant Step by Step The following topics are available to assist you in the use of the Dependant screen How do Add a Dependant to the Claim How do Modify the Dependant Screen after ithas been saved How do Add Multiple Dependant screens to a Claim How do Delete the Dependant screen Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 125 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 26 2 1 How do Add a Dependant to the Claim Step 1 Open the Claim you wish to add the New Dependant to Step 2 Go to the Claim Summary branch of the tree control and click on the FLOATING MENU icon A list of options will appear to the right of the icon as shown below Sak tClaim Summarys Claim Details New Injury Details ces g Injured Workel S New Notional Weekly Earnings dg Employment Dia New Certificate of Capacity Incident Detail gt New Surgery Related Incapacity E Injury __ New Permanent Impairment Assessment ADT _ Time Off Work lt New Vendor Paym
135. Premier and Cabinet Page 4 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 5 GENERAL SYSTEM FEATURES anaoa aaa aa aa aaaea 39 De SOREN T TOWN auaa ori pane acne eb ta ne ah sas tau sh tegen ates gt ns es ne ean 39 52 SAVING DETAILS asopo 39 Bio REFRESHING THE C GAN aeran ennn a ots orishas 39 54A IVI ING DEA O O 40 55 REMOVAL OF UNWANTED SCREENS cccccecccceececeeeeueuceeeueueueueeueueueuuueeceueeeuueeeueueaeaueeeueueananess 40 5 6 ENTERING TWO OR MORE OF THE SAME SCREEN ON A CLAIM cccecceecceeeeeeteeeeesteeeeeeeeeeaeenees 40 6 HOW DO FUSE THE CLAIM SEARCH 2 rosisu aoieanna a a E EPa 41 61 CLAIM SEARCH STEP BY STEP nui aerate 41 6 1 1 How do Search for a Claim oo ccc ccc cece esc eccescesceescecceeeeeeueeeueeeecuaaeaueeeeeeeeueeueeeuanuaaes 41 6 1 2 How do I create a New Claim from the Claim Search cccccccsecceeceseteeeeeeteeeeeeeseeeaees 43 6 1 3 Alternative Quick SSAC isiicaccssAwsceccncd Ron ence baie idlreladeecetuidcduudaudesueccididuadsudasuuecudcauelsemese 43 6 2 CLAIM SEARCH ADDITIONAL INFORMATION vaiiais fowicoshswatiiniorluvincaawasiebledatinewihiwalddnblndebswaSawalsvnundssatcs 43 6 2 1 Search Warning Messages cccccccccsececeeceseeeeeceeceseaeeeceueeseueeeseueessaeesseeeseeetsaeeesaes 43 7 HOW DOI USE THE PROVIDER SEARCH ccccccssscccsseccnseeecsseeenssseneseecueeeensesensesenaeesseas 45 Tot IPROVIDER SEARCH canen pn 45 fic
136. RT PAYMENT SUMMARY The Income Support Payment Summary screen will display as follows Income Support Payment Summary Support Payment Summary Payment Summary Compensation Date From Compensation Date To Status Date Authorised From Date Authorised To Payment Category Payment Type amp Search Clear Date To Payment Category Payment Type Status Date Authorised Total Payment Days Lost Hours Lost 16 06 2015 Income Support Income reimbursement Australian Entered 1 800 00 Taxation Office Totals 1 1 800 00 z 21 00 39 1 Income Support Payment Summary Step by Step The following topics are available to assist you in the use of the Income Support Payment Summary screen e How do I View the Income Support Payment Summary e How do I Use the Income Support Payment Summary Search e How do Open an Income Support Payment from the Income Support Payment Summary screen The following sections are related to the Income Support Payment Summary screen are available in other sections of this User Guide How do Add an Income Support Payment How do Enter Multiple Income Support Payments How do Authorise Income Support Payments How do add Recurring Payments How do Authorise Recurring Payments 39 1 1 How dol View the Income Support Payment Summary gt Step 1 To view the Income Support Payment Summary for the claim cli
137. RTW Plans folder is selected from the Claim Tree Control The Return to Work Plans Summary screen displays a listing of all RTW Plans for the Claim ordered by Date From in descending order i e the most recent record will display at the top of the list The user may select the RTW Plans Date hyperlink to open the desired RTW Plan in the Screen window if required The user may select Criteria in order to refine the list of RTW Plans which appear in the Return to Work Plans Summary screen A combination of Rehabilitation Plan Program Period Date From and To and Program Type may be used to refine the list The Return to Work Plans Summary consists of one tab Return to Work Plans Summary 27 1 Return to Work Plans Summary The Return to Work Plans Summary screen will display as follows Return to Work Plans to Work Plans Date Prepared Date From Date To Review Date j RTW Consultant Nominated Treating Doctor 11 06 2015 2 06 2015 27 06 2015 B The worker s return to different employment with the pre injury employer 27 2 Return to Work Plans Summary Step by Step The following topics are available to assist you in the use of the Return to Work Plans Summary screen e How do I View the Return to Work Plans Summary e How do I Use the Return to Work Plans Summary Search e How do I Open a RTW Plan from the Return to Work Plans Summary screen The following sections are related to the RIW Plan screen are available in other se
138. SCAG sessed fonascnds sega REEE E anssedesnanseded nagsececeaatedadengsadaceaated seg edeces 52 93 2 Search Warming M6SSages screccseccteaisoees tence e aa a deinen imate etait 52 10 HOW DOI CREATE A NEW CLAIM IN SIMS 2 cccccccsssscnsesensssecsesecesseenssseneseensesenesens 54 TOT NEW GCUAIM STER BY STEP iri tao eenanaaal 54 10 1 1 How do I Create a New Claim in the SIMS oo cccceccccsceeeeeeeeeeeeseeeeeeeeeeeaeeeeeeneeees 55 10 2 NEW CLAIMS ADDITIONAL INFORMATION sivscnctercrecsccevecnctedcvitesitvevestndccccesciveueetadeciuasciqictee ites 55 Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 5 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 1022 1 MANGAlOry Screens oideccct2eit sachs insna e a eE E dees 55 Oe EEG TO ctaaa haan nnttere wien ssaa sane sal puaat pace meted Wea trac tune nel aanaeanean 56 11 HOW DOVENTER CLAIM DE VAIS 2 iaiccticad ciacicdeatincudiciavesadealanadiciananed aa a 57 Ail CS IND es We eee atta tee a ere Gea aaa ate ee ee Goa asa Gra eae Gael ea 57 11 2 GLAM DETAILS STEP BY OTEP miniai a seated ct aah letet eect aad 57 11 2 1 Howdo Enter the Claim Details norsiiergiirsrie a 58 11 2 2 How do I Modify the Claim Details screen cc eccccecccceeeeeeeeeeseeeesaeeeeneeeeeeeeeaeeeenaaees 60 11 2 3 How do Determine amp Claim anesan cece eese cece eeseeeseeesaceseeseeesaeeseeeseeeses 61 11 2 4 How do I Add Mu
139. South Australia Department of Premier and Cabinet Page 161 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 If you have successfully completed the first payment item click on the Insert hyperlink to add another row the row will be populated in the table above 33 3 5 How do I Authorise Payment Items There are multiple methods for Authorising Provider Payments on a claim This can be done on either the Payment Payment Item Tab or within the Unauthorised Payment screen For details on Authorising Payments on the Unauthorised Payment screen please refer to How do Approve One or More Payments Navigate to an existing unauthorised payment Unauthorised Payments are distinguished by missing Authorised Details on the Payment Tab as shown below Payment Details Date Authorised Authorised By Total Amount excl GST 0 00 Date Transferred C Payment manually processed Total GST 0 00 Date Paid Cheque No EFT Recipient No Total Amount incl GST 0 00 Date Presented C Decline Total Payment Declined By Date Declined Each Payment Item can be authorised individually The Payment Details section shown above is only updated when all Items are authorised Step 2 Go to the Payment Item tab of the Unauthorised Payment If you are completing a New Payment enter relevant details on the Payment tab before navigating to the Payment
140. Step 1 Open the claim record you wish to add a RIW Plan to and click on an we existing Rehabilitation Details screen in the Tree control Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 122 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 Step 2 Select the ADD NEW a icon from the toolbar alternatively you can go to the floating menu and select New RTW Plan Add the details of a new Rehabilitation Plan Screen referring to the instructions outlined in How do Add details of a RTW Plan to a Claim Step 3 Click on the SAVE icon and the fields will become inactive and your changes will be saved When you add further RIW Plan screens to the claim the system will automatically check that the details you have entered into the previous screen are valid before creating a new screen For example the User created a RIW Plan screen but forgot to fill in a mandatory field This system would not let the user use the ADD NEW 4 function as the previous screen is invalid 25 2 6 How do I Delete the RTW Plan Screen Step 1 To remove the RTW Details screen from the claim firstly select the claim EO you wish to remove the RTW Plan from Step 2 Once you have the claim open select the RTW Summary screen under the RTW Plans folder from the tree control which is to be removed If the RTW Plan is selected the background behind the text will appear
141. Support Payment D g New Recoveries A Estimate Histol wow Related Claims New File Note OREG New Other Injuries or Diseases ott 10 06 2015 New Correspondence In Ei New Correspondence Out a New Medical Referral __ New Investigation Referral amp New Motor Vehicle a New Nominated Treating Doctor New Claim Provider New Legal Representative amp New Dependant 2 New Witness er z New RTW Assessment New RTW Plan Step 3 Select New RTW Plan from the floating menu A new tree branch and screen window will automatically appear This process is creating a new screen against a claim To add further details to the claim you must select the option from the FLOATING MENU and create a screen Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 119 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 Step 4 The RTW Plan screen will appear in the screen window Step 5 Complete the Details section including the Date Plan Received Select the Search ra to enter the Nominated Treating Doctor and RTW Provider if Known RTW Plan Number Consultation Date Date Plan Received RTW Consultant Phone Supervisor Phone Nominated Treating Doctor a Phone RTW Provider 4 Phone Step 6 Complete the RTW Period details including the Date From and
142. User Guide e How do I Enter Worker s Earnings e How do I Enter a Payment Reversal 37 2 1 How do I Add an Income Support Payment Note The method used to record an Income Support Payment is dependent on whether the claim already has other Payments attached to it or not Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 180 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 Step 1 Open the Claim record for the Claim the Income Support Payment relates to Step 2 Create an Income Support Payment if one does not already exist using the floating menu next to the Claim Summary DEERE _ Claim Details New Injury Details g Injured Worker 2 New Certificate of Capacity gus ij Employment D New Surgery Related Incapacity Incident Detaili New Permanent Impairment Assessment CQ Injury New Vendor Payment oe Time Off Work ir _ 4 Notional Week o Certificates i pl 2015 3 _ 2 10 06 2015 New Other Injuries or Diseases 10 06 2015 New Correspondence In Permanent Im 2 New Correspondence Out Payments New Medical Referral eae ay Estimate _ New Investigation Referral Estimate Histol es New Motor Vehicle A Related Claims New Nominated Treating Doctor CORTW Assessme New Claim Provider New Income Support Payment tS New Recoveries a New File Note New Legal Re
143. User Guide Printed 18 06 2015 30 2 2 How dol Modify the Surgery Related Incapacity screen after it has been saved XS step 1 Open the claim record you wish to modify and click on the existing Surgery x J Related Incapacity screen in the tree control Step 2 Click on the MODIFY A icon The fields will become active and you will be able to select different values Step 3 Make the desired changes to the Surgery Related Incapacity screen Step 4 Click on the SAVE lal icon and the fields will become inactive and your changes will be saved lf you modify a Surgery Related Incapacity screen and do not wish to save your changes click on the MODIFY icon for a second time Your changes will not be saved and the claim will stay displayed in the tree window If you wish to discard you changes and close the claim click on the CLOSE RECORD icon from the toolbar 30 2 3 How do Add Multiple Surgery Related Incapacity records for a claim Multiple Surgery Related Incapacities may be added for each Claim To add an additional record Step 1 Open the claim record you wish to add a Surgery Related Incapacity record to and click on the existing Surgery Related Incapacity screen in the Tree control gery Related Incapacity Step 2 Select the MODIFY A icon The fields will become active Step 3 select the ADD F Add hyperlink to add the details of a new Surgery Related Incapacity record This will add a new row below th
144. Witness Additional Information The following sections contain additional information about the Witness screen functionality and validation e Witness Mandatory Fields e Witness Tree Control 48 3 1 Mandatory Fields The following fields must be completed in order to successfully save the Witness details into the SIMS database Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 240 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 Person Type Family Name Given Name s 48 3 2 Tree Control When the Witness screen is saved the system will display the following detail in the Tree Control as a reference to the screen contents Witness lt Family Name Given Name s gt The Tree Control will display all Witnesses for the Claim in order of Date Entered ascending earliest date entered first An example is displayed below a Witness Sss iWitness Lindsay Linroc Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 241 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 49 HOW DO I ENTER MOTOR VEHICLE DETAILS The Motor Vehicle screen allows the user to enter details of Motor Vehicle s involved in the incident which precipitated the claim Multiple Motor Vehicle details may be recorded per incident The Motor Vehicle screen c
145. a cats daaaapeneaadhusudngaphecunisbute i 115 24 2 RTW ASSESSMENT SUMMARY STEP BY STEP csccceeeceeecaeecaeecaeecaeesaeesaeesanesaessaeesaeesaeees 115 24 2 1 How do I View the RTW Assessment Summary ccccseeeecseeeeeeeeeeeeeeseeeeeseeeenseeeess 115 24 2 2 How do I Open a RTW Assessment from the RTW Assessment Summary screen 116 25 HOW DO I ENTER A RTW PLAN 0 0 cccceeceeceeeeeneeeeneeenseceneecaseeensenenescaseeeaseoaneseaseoesesoas 117 2T IATA PLAN pre ee Rr re nee ee ener eee eee eee eer ee hore n te 117 252 RTW PLAN STEP BY OTEP cece o O deledeteie amt ededencae eae eee 118 25 2 1 How do I Adda RTW Plan and its Outcomes to the Claim cccccceeeeeeeeeeeeeeeeeees 118 Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 8 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 25 2 2 How do I record an Outcome for a RTW Plan occ ccccecccceeeeeeeeceeeeseeeteneeneeeaaeens 120 2523 HIOW GO Upoad A DOCUMEN asrini a 120 25 2 4 How do I Modify the RTW Plan screen after it has been saved cceecceeeeeeeeeees 121 25 2 5 How do I Add Multiple RTW Plan screens to a Claim ccceecceseeeeceeeeeeeeeeeeeeeeaeeeens 121 25 2 6 How do I Delete the RTW Plan Screen cc ccccccccccceececeeeeeceeeesaeeeeseeeeseeeeseeeessneeeas 122 253 RTW PLAN ADDITIONAL INFORMATION irene E E A 122 25 3 Mandator
146. acking New RTW Assessment Y New RTW Plan Y Step 3 Select New Claim Provider from the floating menu A new tree branch and screen window will automatically appear This process is creating a new screen against a Claim The Claim Provider screen will appear in the screen window Step 4 Open the Provider Search by selecting the hyperlink on the Claim Provider screen Use the search to locate the desired Provider and import into the Claim Provider screen For details on using the Provider Search refer to How do Use the Provider Search Once the Provider details have been imported into the Claim Provider screen the screen will display as follows the picture is an example only The value shown in the Provider screen will depend on the data available in the Provider profile selected using the Provider Search Claim Provider Provider Claim Provider Provider Type Physiotherapist 4 Provider Search Provider Name Jane s Physio Provider Numbers yendor Number 0000000004 Street Address Postal Address 32 Sliver Street 32 Sliver Street ADELAIDE State Postcode 5000 ADELAIDE State Postcode 5000 Country Country Contact Details Telephone Fax Number Mobile Email Contact Name Step 5 The user may add any additional n
147. age 302 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 e How do Use the Provider Search e How do l Enter Maintain Provider Profiles 63 1 1 How do Add a Legal Representative to the Claim J A Step 1 Open the Claim you wish to add the New Legal Representative to XI SMC Step 2 Go to the Claim Summary branch of the tree control and click on the FLOATING MENU icon A list of options will appear to the right of the icon as shown below GEMETiinES Claim Details New Injury Details B Injured Worke New Certificate of Capacity Employment D New Surgery Related Incapacity Incident Detail New Permanent Impairment Assessment aO Injury i New Vendor Payment O Time Off Work lt New Income Support Payment t Certificates New Recoveries aO Payments Estimate se New File l Estimate Histo New Other Injuries or Diseases a8 Claim Provider New Correspondence In Related Claims New Correspondence Out mCIRTW Assessme New Medical Referral _ New Investigation Referral New Motor Vehicle New Nominated Treating Doctor New Claim Provider amp New Dependant 2 New Witness lll New File Tracking y New RTW Assessment New RTW Plan Step 3 Select New Legal Representative from the floating menu A new tree branch and screen window will automatically appear This process is creating a new screen against a Claim The Legal Representative s
148. ails should be saved using the SAVE al icon after each screen has been completed This may require saving several times until all screens have been saved Once all mandatory fields are entered a Claim number is allocated to the claim and the details are recorded in the SIMS You must select to save every screen to enable the SIMS to validate the screens The SIMS will only save permanently when all screens have been saved and validated successfully Information is not saved until the inserted modified screen fields have become grey and the Close Record icon is not partially depressed in appearance Refreshing the Claim Once a claim has been entered into the system and a claim number has been allocated you should refresh the claim using the Refresh icon on the toolbar before making any further changes Click on this toolbar button and this will refresh the data from the database Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 40 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 5 4 Modifying Details Details may be modified once entered provided that e The user has Modify access to the screen If the user does not have this access the MODIFY amp icon will appear greyed out and inactive To obtain access the user must contact the SIMS System Administrator e The field does not have an underlying business rule which ensures t
149. al Investigation Referral Investigation Type y Investigator FA C Privilege and Confidential i pma Date to be pma Date Referred H Appointment Date jii Approved Hours Completed m Investigation Report Report Due Date jip C Report Completed Date Completed Attach File Upload L Clear Investigation Comments Comments BZ U Font Family Font Size 50 1 Investigation Referral Step by Step The following topics are available to assist you in entering and maintaining an Investigation on a claim How do Add an Investigation Referral to the Claim How do Upload a Document to the Investigation Referral How do Modify the Investigation Referral Screen after ithas been saved How do Add Multiple Investigation Referral screens to a Claim How do Delete the Investigation Referral Screen The following sections are related to the Investigation Referral and are available in other sections of this User Guide e How do I Use the Provider Search e How do l Enter Maintain Provider Profiles 50 1 1 How dol Add an Investigation Referral to the Claim s Step 1 Open the Claim you wish to add the New Investigation Referral to O Commercial in Confidence SBC IT South Australia Department of Premier and Cabinet Page 248 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 Step 2
150. al Services Other Non compensation Other Goods and Services Non Medical Property Damage Redemption of Medical Expenses Redemption Commutation of Income Support Rehabilitation ravel Gross Totals Recovery Estimate Catego Recovered g Recoveries Outstanding Reason for Change Recovered Amounts Total Recoveries Net Totals Step 5 Enter a new amount value for the selected Category Repeat Steps 4 5 for each Estimate Category which needs to be updated Step 6 Select the Reason for Change of the Estimate click on the SAVE al icon The Estimate changes will be saved to the database Estimate Category Paid Pending Payments Outstanding Incurred Reason for Change Common Law 0 00 0 00 0 00 0 00 Deed of Release 0 00 0 00 0 00 0 00 Hospital Inpatient 0 00 0 00 0 00 0 00 Hospital Outpatient 0 00 0 00 0 00 0 00 Income Support 0 00 0 00 0 00 0 00 Investigation 0 00 0 00 500 00 500 00 Legal 0 00 0 00 0 00 0 00 Adjusted Permanent Impairment Assessment Case Manager Re assessment Lump Sum Economic Loss 0 00 0 00 0 00 0 00 Change in Condition Lump Sum Non economic Loss 0 00 0 00 0 00 0 00 Estimate Changed in Error f n a Estimate Decrease as the Result of an Audit Medical Allied Health 0 00 0 00 0 00 50 00 Estima
151. al may only be seen in the Correspondence Out Summary by Users with the Privileged and Confidential Access Menu Item Security Object currently applied to one of the User s Security Profiles The Correspondence Out Summary screen contains one tab e Correspondence Out Summary Correspondence Out Summary Out Summary Correspondence Out Summary Number Document Category Date Sent Entered By Description Confidential File Name 1 TBA 28 12 2014 NicoleHoward Cease treatment over New Year Period E Test docx 2 TBA 5 01 2015 NicoleHoward Recommence Treatment as previously approved E Test docx 61 1 Correspondence Out Summary Step by Step The following topics are available to assist you in the use of the Correspondence Out Summary screen e How do I View the Correspondence Out Summary e How do I Open a Correspondence Out screen from the Correspondence Out Summary screen The following sections are related to the Correspondence Out Summary screen are available in other sections of this User Guide How do I create a New Correspondence Out Screen How do I upload a Document How do I add more than one Correspondence Out Screen How do I delete the Correspondence Out Screen O O O 61 1 1 How do I View the Correspondence Out Summary Step 5 To view the Correspondence Out Summary for the claim click on the Correspondence Out Summary folder in the Claim Tree Control E Ta Correspondence Out nn BI 5 01 2
152. an Treatment Service Amount Limit Requested Number of Services Authorised L Treatment Service Amount Limit Authorised Number of Services Used lo Treatment Service Amount Paid 0 00 Number of Services Remaining Treatment Service Amount Limit Remaining C Create Associated Purchase Order Purchase Order Status Awaiting Authorisation y Authorised By Date Authorised Step 7 Once you are satisfied with the Treatment Service Plans details entered into the fields on the screen click on the SAVE al icon and the fields will become inactive and your changes will be saved against the claim You may remove a Treatment Approvals row by selecting the associated row in the Details peer table and selecting the REMOVE hyperlink This action cannot be undone If you have multiple screens in MODIFY mode A when saving the screen SIMS will check to see if any other screens are in modify mode If there are any screens which meet this criteria the system will open the screen which needs saving and you will need to click on the SAVE icon again You should save the screen before creating the next screen or modify another screen If you do not you risk losing the information you have entered O ee How do I Modify the Treatment Service Plans Screen after it s been saved Step 1 Open the Claim record you wish to modify and click on an existing Treatment Service Plans screen in the tree control See How do search for a Claim
153. anagement lk 30 10 2014 General fae 29 10 2014 General 51 3 4 Confidential File Notes If the File Note has security applied the Privileged and Confidential checkbox will be selected This flag indicates that the File Note may only be viewed by users who have the appropriate level of security access This access is defined by the System Administrator Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 260 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 52 HOW DO I VIEW THE FILE NOTE SUMMARY The File Note Summary screen will be displayed on the top of the folder populating the details for all file notes recorded for a claim The File Note Summary screen displays when the File Notes folder is selected File Notes listed can be filtered by entering one or more criteria in the Search fields and selecting the Search screen File Notes marked Privileged and Confidential may only be seen in the File Note Summary by Users with the Privileged and Confidential Access Menu Item Security Object currently applied to one of the User s Security Profiles Privileged and Confidential File Notes will display to unauthorised Users with only the word Confidential and no other values The File Note Summary screen contains one tab only e File Note Summary File Note Summary Note Summary Details Fom Eo E Category y A Search _
154. and symbols AND amp OR or NOT may be substituted for the full operators Step 3 Select the SEARCH f Search hyperlink to display the search results At least one search criterion must be entered in order for the search to be conducted A message will display if at least one criterion is not entered Commercial in Confidence SBC IT South Australia Department of Premier and Cabinet Page 278 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 Message from webpage A At least one criterion field must be completed to conduct a search Document No Claim Number Injured Worker Document Source Document Cateq Document Type 51 15000003 01 Correspondence In Incident Form Incident Report 4452 P 15000003 01 Correspondence In General Correspondence In General Correspondence In 4456 15000003 01 Correspondence In Forms Claim Form 4505 15000003 01 Correspondence In General Correspondence In General Correspondence In 4506 15000003 01 Correspondence In General Correspondence In General Correspondence In Where more than one field is completed in the search criteria the SIMS will return results that match the requirements of ALL the fields entered Step 4 Click on the Document No hyperlink to a desired document Once selected the Document Details screen will be displayed Step 5 Once you are satisfied and have completed with the Document Search dialog select the CANCEL
155. ar in the Claim Tree Control in the Surgery Related Incapacity folder in the following format Surgery Related Incapacity gery Related Incag acity Commercial in Confidence SBC IT South Australia Department of Premier and Cabinet Page 147 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 31 HOW DO I ENTER CLAIM ESTIMATES The Estimate screen allows the user to record details of the estimated costs of the Claim The Estimates are broken down into Estimate Categories mapped to Payment Categories The following information is recorded on the Estimate screen e Paid The total amount of authorised Payments for each Category for this Claim including GST e Pending The total amount of Payments that have not yet been authorised for each Category for this Claim including GST e Outstanding The additional amount that it is estimated that the Claim will cost in addition to what has already been paid In order for a Payment to be made there must be an Outstanding Estimate for the relevant Category e Incurred The total estimated cost of the Claim including GST including what has already been paid any pending payments and any additional estimates In summary ncurred Paid Pending Payments Outstanding The following rules will be applied when recording the estimate values for a claim e Estimates may not be modified or deleted on a claim that has a st
156. arch Libraries Pi Organize v w Favorites sb Downloads Recent Places d OneDrive C Libraries Documents a Music t Pictures Videos 1 Computer t Network File name L yy Librar a Libraries MD Desktop O pen a library to see your files and arrange them by folder date and other properties Documents lt Pictures lt S 4 Librar D Music wy Library AIS 8 Videos iy Library All Files ht Open Cancel Step 2 Step 3 28 2 3 saved Step 1 Step 2 Step 3 Step 4 Once the desired file is selected click on the OPEN button in the File Browser If successfully attached the filename will be visible in the File Name field Once a document is uploaded to a Permanent Impairment Assessment screen it cannot be modified If you have selected the wrong document you can select the Clear button to delete the uploaded file and start again Once all the details have been entered onto the screen the user would save the details by pressing the SAVE la icon Attach File View How do Modify the Permanent Impairment Assessment screen after it has been Open the claim record you wish to modify and click on an existing Permanent Impairment Assessment screen in the tree control See How do search for a Claim to locate a specific claim for modification Click on the MODIFY A icon The fields will become active and you w
157. arked as Active Current If they are you will not be able to save the new record as Active Current until the old record has been made Inactive 36 2 3 How do Add Multiple Worker s Earnings Screens to a Claim 36 3 Worker s Earnings Additional Information The following sections contain additional information about the Workers Earnings screen functionality and validation e Worker s Earnings Mandatory Fields e Worker s Earnings Tree Control 36 3 1 Mandatory Fields The following fields must be completed in order to successfully save the Worker Earnings into the SIMS database Date Effective Status Base Weekly Earnings This Employment Normal Weekly Hours This Employment Normal Days per Week This Employment Normal Weekly Overtime Hours This Employment Normal Weekly Hours Other Employment if an entry is made in the Base Other Employment field 36 3 2 Tree Control Only one Workers Earnings screen may exist for each claim The screen will appear in the Claim Tree Control as demonstrated below Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 177 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 dy Claim Summary wou A Claim Details ae amp Injured Worker Sd Employment Details Incident Details E Injury kD Time Off Work ae SaaNotional Weekly Earning Commercial in Con
158. ate in the same way on any screen Optional text field Optional fields are indicated with a white background It is optional for the user to enter details into these fields Mandatory field Mandatory fields are indicated with a yellow background The user must enter details into these fields in order to save the form Read only field Read only fields are indicated with a grey background The user is unable to enter details into these fields as they are automatically populated by the system Free text description field Free text description fields are indicated with a vertical scroll bar The user is able to enter a lengthy description for this field Date field Date fields are indicated with a text field and a calendar icon beside the field The user can manually enter the date using a valid date format please refer to section 4 3 1 for more information or they can select the calendar icon Selection of the calendar icon will open the calendar below the date field where the user can select a month and date 2013 Jan Feb Mar Apr May Aug Sep Oct Nov Dec 21 October 2014 Mon Tue Wed Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 34 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 To enter data into a field the field must first be selected This can be done by clicking on the field with the mouse or by pressing the Tab key until
159. ations Be particularly aware when going to attend a meeting going to lunch or leaving of an evening that all data has been saved Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 24 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 1 8 06 2015 3 SIMS LAYOUT Once you have logged into the Self Insured Management System the following screen will appear Key features of this screen have been highlighted below File Search Generate Document Administration Help CABG s L APA k MI Ba me Y ki Menu Options i l Activity List Toolbar Icons Tree Control Screen Tab Window The Task List screen will appear when the user first logs into the system Users may select to open a claim from the list of Task List tasks or select the CANCEL hyperlink to exit the Task List and view the home screen as shown in the diagram above 3 1 Activity List The combo box within the toolbar known as the Activity List displays details of the currently open Profile The Activity List also stores the 60 most recent Profiles accessed on the current computer Profiles in the SIMS include Claims and Providers The idea of the Activity List is to minimise the number of times that you have to perform searches as the details you are currently working on are available for you from the list A When you exit the SIMS the records in the Activity List are
160. atus of Active Current e Payments may only be entered for Claims on which a Primary Injury has been recorded The Income Support Payment screen will consist of one tab e Income Support Payment 37 1 Income Support Payment The Income Support Payment tab will be displayed as follows Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 179 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 Income Support Payment Support Payment Compensation Period Payment Details Date From ei Date To on Week of Payment Period Weeks Days Serious Injury Whole Person Impairment Payment Type Surgery Supplementary Income Support Payment From Date i o Compensation Type EEEN heehee aii be a p n F nice State AWE Ma pplied 1 A 2 x State AWE Days of Incapacity in Period Full Shifts Lost in Period SSSA Capped Notional Weekly Earnings This Employer Other Employer f i Hours Lost in Period Earnings in Period This Employer Hours Employed in Period C Earnings in Period Other Employer Normal Weekly Hours d Designated Earnings in Period Compensation Rate Authorisation Date Entered 10 06 2015 Entered By ISAPS Test Calculated Compensation Amount Payable Part Time Ratio Date Authorised Authorised By aiai ito Payment Mi
161. atus of Closed e Estimates are not allowed to be less than 0 00 e A claim cannot be Closed with outstanding estimates e When the Claim is being Closed the SIMS will provide a message to the user There are currently outstanding estimates for this claim Do you wish to have these estimates set to 0 00 automatically If Yes is chosen the estimates will all be set to 0 00 if the user chooses not to accept this option the Claim s Status will not be set to Closed and the user will be taken back to the claim to manually close the statutory estimates i e set the estimate values to 0 00 The Estimate screen consists of a single tab e Estimates 31 1 Estimate The Estimate screen will be displayed as follows Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 148 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 Pending Payments Outstanding Incurred Reason for Change Deed of Release Hospital Inpatient Hospital Outpatient Income Support Investigation Legal Lump Sum Economic Loss Lump Sum Non economic Loss Medical Allied Health Medical Other Goods and Services Medical Services Other Non compensation Other Goods and Services Non Medical Property Damage Redemption of Medical Expenses
162. ave located the Payment you wish to open Click on the Payment Category Payment Type hyperlink The Payment will open in the Screen window Amount Incl GST Amount exc GST Service Provider Status Service Date AAT authority legal disbursement Acupuncture 29 10 2014 Acupuncture Commercial in Confidence AAT authority legal disbursement Entered 28 10 2014 100 00 10 00 110 00 Jerry Wallace Entered 30 09 2014 100 00 0 00 100 00 Jerry Wallace Approved 27 10 2014 52 00 5 20 57 20 Jerry Wallace Entered 30 09 2014 200 00 0 00 200 00 SBC IT South Australia Department of Premier and Cabinet Page 169 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 35 HOW DO SEARCH FOR AN UNAUTHORISED PAYMENT The Unauthorised Payment Search screen allows the user to search for an Unauthorised Payment This Search may be accessed by selecting Administration gt Unauthorised Payments from the Menu Compensation Payments are displayed on the Unauthorised Compensation Payments screen see the How do Search for Unauthorised Compensation Payments for further information The Unauthorised Payment Search screen consists of one tab e Unauthorised Payment 35 1 Unauthorised Payments The Unauthorised Payment Search screen will appear as follows Unauthorised Payments iim elle Employer Details Claim Number Injured Worker Invoice Number Provi
163. aved Step 1 Open the claim record you wish to modify and click on the Payment Restrictions screen in the tree control SE Payment Restriction Step 2 Click on the MODIFY E icon The fields will become active and you will be able to select different values Step 3 Make the desired changes to the Payment Restrictions screen Step 4 Click on the SAVE icon and the fields will become inactive and your changes will be saved Note lf you modify the Payment Restrictions screen and do not wish to save your changes click on the MODIFY A icon for a second time Your changes will not be saved and the claim will stay displayed in the tree window If you Commercial in Confidence SBC IT South Australia Department of Premier and Cabinet Page 210 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 wish to discard you changes and close the claim click on the CLOSE RECORD icon from the toolbar 43 2 3 How dol Add Multiple Payment Restrictions to a claim Multiple Payment Restrictions may be added for each Claim To add an additional Payment Restriction J Step 1 Open the claim record you wish to add a Payment Restriction to and click on S6 Payment Restrictions in the Tree control Payment Restrictions Step 2 Select the MODIFY A icon The fields will become active Step 3 Select the INSERT _lnsert hyperlink to insert the details of a new Payment Restriction
164. avorites Libraries WE Desktop Open a library to see your files and arrange them by folder date and other properties l ig i Documents a Music Ey Pictures i ute a a Music i ft Pictures E Videos amp Computer Cu Network File name AIl Files Open Cancel Once the desired file is selected click on the OPEN button in the File Browser Step 3 If successful the Document Date will auto populate with the date the file was added to the Treatment Approval record the user will need to select the Document Type and the Name of the field will be visible in the Name field If you have selected the wrong document you will need to select Remove to remove the attached document and upload the correct document Document Date Document Type 17 06 2015 v 19000101_20141217_Claim csv P Remov Step 4 Once all the details have been entered onto the screen the user would save the details by pressing the SAVE la icon Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 228 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 46 2 5 How dol Delete the Treatment Service Plans Screen Once a Treatment Service Plans screen has been added to a Claim the screen cannot be deleted The user must select a row and then select the REMOVE Remove hyperlink Removal of all rows will result in the R
165. aying the correct amount If not then check all entries made in Step 4 above to ensure they are correct Current Notional Weekly Earnings 1 200 00 The Current Notional Weekly Earnings field is read only and calculates the Base Overtime and Non Pecuniary Benefits allowances fields If an adjustment is required to the Normal Weekly Earnings field then one of the above listed fields needs to be updated in order to re calculate the Normal Weekly Earnings field 36 2 2 How do I Modify the Worker s Earnings screen after it s been Saved Open the claim record you wish to modify and click on an existing Worker s Earnings screen in the tree control See How do search for a Claim to locate a specific claim for modification Step 2 Click on the MODIFY A icon to enable the INSERT F icon to add a new row to the Earnings History table This will clear and enable all fields for the user to add a new Workers Earning record Step 3 Make the desired changes to the Worker s Earnings screen Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 176 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 Step 4 Click on the SAVE lal icon and the fields will become inactive and your changes will be saved When you enter a new record to the Worker s Earnings you need to ensure that the any previous records listed in the Earnings History table are not m
166. ayment Search screen will appear as follows Payment Search iim c EA Employer Details Payment Details Claim Number Status Injured Worker Invoice Number Jurisdiction South Australia Provider Cheque EFT No Item Number Payment Category Claims Manager Payment Type Description View Results By Payment Amount From Incl GST To ASearch Clear Qcancel qeExport Totals 9 2 Payment Search Step by Step 9 2 1 How dol Search for a Payment MS Step 1 Open the Payment Search by selecting Search gt Payment Search from the AJ menu or by selecting the toolbar icon Step 2 Once the Payment Search screen opens select the Criteria associated with the desired Payment Step 3 Press the 4 Search button The Payments matching the selected criteria will appear in the Search Results list box number of different criteria Select a Status value to search for payments s Note The Payment Search screen allows you to search for the payment using a Commercial in Confidence SBC IT South Australia Department of Premier and Cabinet Page 52 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 Authorised Declined Presented Paid Presented Transferred or those which have been entered Once you have run the Search and results are displayed in the
167. blue Step 3 Click on the MODIFY A icon to enable the DELETE X icon and select this from the toolbar When the confirmation message appears click on OK L _ The RTW Plan screen will be removed from the claim Message from webpage 2 Are you sure you wish to delete this screen If you are unable to DELETE X the Rehabilitation Plan screen selected you may not have access to complete this function Check with the SIMS System Administrator that you have the correct access level 25 3 RTW Plan Additional Information The following sections contain additional information about the Rehabilitation Plan screen functionality and validation e RTW Plan Mandatory Fields e RTW Plan Tree Control Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 123 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 25 3 1 Mandatory Fields The following fields must be completed in order to successfully save the Rehabilitation Plan details into the SIMS database 6 Date Plan Received Date From Date To 25 3 2 Tree Control Multiple Rehabilitation Details screens may exist for each claim and it will be displayed in descending order i e the most recent rehabilitation plan will be displayed at the top of the list in the menu tree with the most recent date recorded in the Date From field within the Program Period group box The screens will appear i
168. by selecting a previously saved Correspondence Out record from the tree control and selecting the ADD NEW icon E Step 2 Complete the Correspondence Out screen following the instructions in How do I Create a New Correspondence Out screen starting from Step 2 60 2 4 How do I Delete the Correspondence Out Screen Step 1 Click on the Correspondence Out Screen which is to be deleted ME Step 2 Click on the Toolbar icon DELETE A the selected screen will now disappear from the Tree Window If deleting the last Correspondence Out Screen from the Claim the Correspondence Out Branch will also disappear When the Correspondence Out is deleted from SIMS the file which was attached to the screen is also deleted If the file is required click on the VIEW button and save the document before deleting the screen Once a Correspondence Out Screen is deleted it cannot be recovered 60 3 Correspondence Out Additional Information Details The following sections contain additional information about the Correspondence Out screen functionality and validation e Correspondence Out Mandatory Fields e Correspondence Out Tree Control e Correspondence Out Privileged and Confidential 60 3 1 Mandatory Fields The following fields must be completed in order to successfully save the Correspondence Out into the SIMS database Document Type Date Sent File Upload 60 3 2 Tree Control When the Correspondence screen is save
169. cal Referral Details row by selecting the associated row in the Details peer table and selecting the REMOVE hyperlink This action cannot be undone If you have multiple screens in MODIFY mode A when saving the screen SIMS will check to see if any other screens are in modify mode If there are any screens which meet this criteria the system will open the screen which needs saving and you will need to click on the SAVE icon again You should save the screen before creating the next screen or modify another screen If you do not you risk losing the information you have entered 45 2 2 How dol Modify the Medical Referral Screen after it s been saved Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 222 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 Step 1 Open the Claim record you wish to modify and click on an existing Medical Referral screen in the tree control See How do search for a Claim to locate a specific claim for modification Step 2 Click on the MODIFY A icon The fields will become active and you will be able to select different values Step 3 Make the desired changes to the Medical Referral screen Step 4 Click on the SAVE lal icon and the fields will become inactive and your changes will be saved If you Modify a Medical Referral screen and do not wish to save your changes click on the MODIFY A icon for a
170. capacity 30 1 Surgery Related Incapacity Surgery Related Incapacity Related Incapacity Surgery Related Incapacity Details Date Of Surgery Injury Related Comments Estimated Date Fit be E a Ad Remove 30 2 Surgery Related Incapacity Step by Step The following topics are available to assist you in the use of the Surgery Related Incapacity screen How do Add Surgery Related Incapacity to the Claim How do Modify the Surgery Related Incapacity Screen after it has been saved How do Add Multiple Surgery Related Incapacity records for a Claim How do Delete a Surgery Related Incapacity record 30 2 1 How do I Add Surgery Related Incapacity to the Claim Rt Step 1 Open the Claim you wish to add the New Surgery Related Incapacity to Step 2 Go to the Claim Summary branch of the tree control and click on the FLOATING MENU icon A list of options will appear to the right of the icon as shown below Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 143 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 i ETE ee Claim Details New Injury Details T pan Injured Worker New Notional Weekly Earnings dg Employment Dia New Certificate of Capacity amp Incident Detaili TE EE E PE Injury C New Permanent Impairment Assessment OTime Off Work New Vendor Payment a _ New Compensation Recip
171. ce SBCIT South Australia Department of Premier and Cabinet Page 13 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 49 2 4 How do I Add Multiple Motor Vehicle screens to a Claim cccccceeceseeeeeeeeeeeeeaeeens 244 49 2 5 How do I Delete the Motor Vehicle Screen ccc ccccccccccecceeceeeeeseceeceeeeeeeeeeeeeseeeeeees 245 49 3 MOTOR VEHICLE ADDITIONAL INFORMATION cccceccecceccecsecsceseuseeseueeueeueeueeuesaeeueueueeeeaeeasens 245 AGS Mandator Fields missir a e beii 246 4932 WSC Cont Olas a 246 50 HOW DO I ENTER AN INVESTIGATION REFERRAL sasannnnnnunnnnnnunnnnnnunnnnnnnnnnnnnnnnnnnnnn 247 50 1 INVESTIGATION REFERRAL STEP BY STEP rupesin gerere A AA A 247 50 1 1 How do I Add an Investigation Referral to the Claim ccccccseeeeceeeeeeeeeeseeeeeeeeeens 247 50 1 2 How do I Upload a Document to an Investigation Referral ccceccsecceeeeeeeeeeeeeees 249 50 1 3 How do I Modify the Investigation Referral Screen after it has been saved 250 50 1 4 How do I Add Multiple Investigation Referral screens to a Claim ccccceeceeeeeeees 250 50 1 5 How do I Delete the Investigation Referral Sereen cc cccecceeccseceeeeceeeeeeeeeeeeaeeeaees 250 50 2 INVESTIGATION REFERRAL ADDITIONAL INFORMATION ccccccceccceececseeeeeceeeeeeeeeeeeeeeeeeeeneees 251 50 21 Mandatory FICIOS goss case nsacnascanaseace senctsectaunu
172. ck on the Income Support Payment Summary folder in the Claim Tree Control AOR support Payment Ube i Y 10 06 2015 16 06 2015 1 800 00 39 1 2 How dol use the Income Support Payment Summary Search Wg step 1 To use the Income Support Payment Summary for the claim click on the Income QW Support Payment Summary folder in the Claim Tree Control and this will display the Payment Summary screen Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 196 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 Step 2 Enter criteria in to the fields at the top of the Summary Screen to locate a specific Payment For example select a Compensation Date Range and the Status to refine the Search Results Payment Summary Compensation Date From Compensation Date To E Status Date Authorised From Date Authorised To Payment Category Payment Type 4 Search P Clear Note The Compensation Date From and Compensation Date To range will pick up all Payments which cover the same days selected Step 3 Once you have selected one or more criteria select the Search button The Income Support Payment Summary screen will refresh and the Payments matching the criteria entered will appear in the Summary Tip Once you have finished with the Search Results and want to return to the full list of Pa
173. click on the OPEN button in the File Browser Step 3 If successfully attached the filename will be visible in the File Name field Once a document is uploaded to a Correspondence In screen it cannot be modified If you have selected the wrong document you will need to delete the Correspondence In Screen and start again File Name Test docx l l l l l l l l l l l l l l l View Step 4 Once all the details have been entered onto the screen the user would save the details by pressing the SAVE a icon Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 285 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 Step 5 To view the document entered in the File Name field the user can select the View hyperlink The View hyperlink will not be enabled until the screen is saved and a document has been uploaded 58 2 3 How do I Add More than one Correspondence In screen Step 1 If Correspondence In already exists for the Claim the user can add a new Correspondence In record by selecting a previously saved correspondence in record from the tree control and selecting the ADD NEW icon T Step 2 Complete the Correspondence screen following the instructions in the How do l Create a New Correspondence In Screen from Step 2 How do I Delete the Correspondence In Screen Step 1 Click on the Correspondence In Screen which is to be deleted St
174. compensation Weekly Compensation Total Incapacity 19 12 2014 25 12 2014 1 200 00 0 No o Commercial in Confidence SBC IT South Australia Department of Premier and Cabinet Page 199 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 hyperlink can be used to select all Payments displayed on the screen Please use this function wisely Step 5 Confirm you have selected all Payments which are to be Authorised and select the Approve Selected Items bution located at the bottom of the screen Providing you have the correct Security Access Level each Payment may be authorised on the Payment screen within the Claim Refer to How do Authorise Payment ltems 40 3 Unauthorised Payments Additional Information The following sections contain additional information about the Unauthorised Payment Search screen functionality and validation e Unauthorised Payments Using the Search e Unauthorised Payments Search Warning Messages e Unauthorised Payments Navigation of multiple search result pages 40 3 1 Using the Search Where multiple criteria are entered the SIMS will search for records that meet all of the criteria For example if a specific Payment Category is selected and an Invoice Date From and To then all Payments for the Category within the Invoice From and To Dates will be displayed in the Search Results lf you search and no results are returned but you are co
175. coveries screen Step 4 Click on the SAVE lal icon and the fields will become inactive and your changes will be saved If you modify the Recoveries screen and do not wish to save your changes click on the MODIFY A icon for a second time Your changes will not be saved and the claim will stay displayed in the tree window If you wish to discard you changes and close the claim click on the CLOSE RECORD J icon from the toolbar 44 2 3 How dol Add Multiple Recoveries to a claim Multiple Recoveries may be added for each Claim To add an additional Recovery Recoveries in the Tree control s ap Open the claim record you wish to add a Recovery to and click on Step 2 Select the MODIFY icon The fields will become active Step 3 Select the INSERT _lnsert hyperlink to insert the details of a new Recovery record This will add a new row below the existing record Commercial in Confidence SBC IT South Australia Department of Premier and Cabinet Page 216 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 Recovery Category Recovered Amounts d Date Recovery Received Recovery Category Recovered From Address Suburb Payment Method Finalised File Name Recovery Details Step 4 Step 5 Date Received Recovered From 17 06 2015 PhillipLim 1 000 00 Totals 1 000 00 ae Insert M
176. creen will appear in the screen window Step 4 Open the Provider Search by selecting the Provider Search hyperlink on the Legal Representative screen Use the search to locate the desired Provider and import into the Legal Representative screen For details on using the Provider Search refer to How do I Use the Provider Search Once the Provider details have been imported into the Legal Representative screen the screen will display as follows the below is an example only The value shown in the Legal Representative screen will depend on the data available in the Provider profile selected using the Provider Search Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 303 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 Legal Representative Representative Claim Provider Provider Name 5weeny amp Associates ADN E Provider Numbers vendor Number 0000000006 Street Address Postal Address Address 111 Flemington Street 111 Flemington Street Pd PT DE ere ee CRT ieee E Suburb FLEMINGTON State vic Postcode 3031 Suburb FLEMINGTON State vic Postcode O International Address Country oO O O International Address Country D Contact Details Telephone Fax Number Mobile Email Contact Name Step 5 Select if the Legal Representative is a Representative of either the Employer or the Injured Worker Step 6 The
177. creen against a claim To add further details to the claim you must select the option from the FLOATING MENU F and create a screen Step 4 The Compensation Restrictions screen will appear in the screen window Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 209 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 Step 5 Select the INSERT S2tt hyperlink to insert the details of a new Payment Restrictions record This will add a new row to the Payment Restrictions table Payment Restrictions Payment Category Payment Type Date Form Date To Reason iInsertt M Remove Date From at Date To ae Date Entered 17 06 2015 Entered By SAPS Test Payment Category y All Categories and Types Payment Type Reason Notes Step 6 Enter the Date From Date To and select the Payment Category Date From ay Date To gi Date Entered 17 06 2015 Entered By SAPS Test Payment Category y C All Categories and Types Step 7 Select the Payment Type Reason and enter any Notes if applicable Payment Type Reason y Step 8 The Payment Restrictions screen can be saved once all mandatory details have been entered by selecting the SAVE i l icon 43 2 2 How dol Modify the Payment Restrictions screen after it has been s
178. cription Code Breakdown Agency of Injury 1 j y Breakdown Agency of Injury 2 y Breakdown Agency of Injury 3 Breakdown Agency of Injury 4 y lt Agency of Injury is the same as Breakdown Agency 16 2 Injuries Details Step by Step The following topics are available to assist you in the use of the Injury Details screen How do enter Injuries or Diseases How do Modify the Injury Details screen How do Add Multiple Injury Details screens How do Delete the Injury Details screen Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 81 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 16 2 1 How do enter Injuries or Diseases D Step 1 Open the Injury Details screen by selecting it from the Claim Tree Control IWW at Claim Summary ae Claim Injured Worker li Employment Details Incident Details g Injury ee minjury Details Step 2 Select the Primary Injury checkbox if this is the Primary Injury being recorded for the claim Note Each Claim must only have one Primary Injury but can have multiple injuries recorded Step 3 Select the Injury Side and Result Code Severity as applicable to the Injury Injury Details v Primary Injury Injury Side Recurrent Injury Date of Recurrence Step 4 Select the Recurrent Injury checkbox if this Injury is
179. ctions of this User Guide How do Add a RTW Plan to the Claim How do Upload a Document How do Modify the RTW Plan screen after it has been saved How do Add Multiple RTW Plan screens to a Claim How do Delete the RTW Plan screen 27 2 1 How dol View the Return to Work Plans Summary Step 1 To view the Return to Work Plans Summary for the claim click on the RTW Plans folder in the Claim Tree Control SIaiRTW Plans 9 06 2015 27 06 2015 we Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 131 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 27 2 2 How dol Open a RTW Plan from the Return to Work Plans Summary screen To view the Return to Work Plans Summary for the claim click on the Rehabilitation Summary folder in the Claim Tree Control SIaRTW Plans 9 06 2015 27 06 2015 Step 2 Review the list of RTW Plans listed in the Summary until you have located the RTW Plan you wish to open Step 3 Click on the Number hyperlink The RTW Plan will open in the Screen window Return to Work Plans to Work Plans Number Date Prepared Date From Date To Review Date j RTW Consultant Nominated Treating Doctor 11 06 2015 2 06 2015 27 06 2015 B The worker s return to different employment with the pre injury employer Commercial in Confidence SBCIT South Australia Department of Premier and Cabin
180. d the system will display the following detail in the Tree Control as a reference to the screen contents lt Date Sent gt lt Document Type gt Commercial in Confidence SBC IT South Australia Department of Premier and Cabinet Page 293 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 The Tree Control will display all Correspondence for the Claim in order of Date Sent descending most recent date sent first An example is displayed below 5 Correspondence Out 11 04 2014 Medical Certificate 1 04 2014 General Correspondence 60 3 3 Privileged and Confidential If the Correspondence Out has security applied the Privileged and Confidential checkbox will be selected This flag indicates that the Correspondence Out screen may only be viewed by users who have the appropriate level of security access This access is defined by the System Administrator Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 294 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 1 8 06 2015 61 HOW DO I VIEW THE CORRESPONDENCE OUT SUMMARY This screen displays a summary of all correspondence sent for the claim The grid will allow the user to sort the results by any of the column headings The default view will be by date received in descending order Correspondence Out records marked Privileged and Confidenti
181. d Claims New Investigation Referral H RTW Assessme eg New Motor Vehicle tS New Recoveries New File Note New Other Injuries or Diseases a New Nominated Treating Doctor New Claim Provider New Legal Representative A New Dependant New Witness New RTW Assessment i New RTW Plan If a File Note already exists for the Claim you will need to use a different method to add the new File Note Refer to How do Add More than One File Note Step 3 Select New File Note from the floating menu A new tree branch and screen window will automatically appear 9 File Note Summary Ee ERE Step 4 Select a Category and add a Subject for the File Note If required select the Privileged and Confidential checkbox Category iv Privileged and Confidential Subject Step 5 Enter a Description of the File Note Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 255 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 Description B Z U age Format Font Family Font Size X Tip You may use the toolbar in the Description text box menu to format the File Note Description Step 6 Upload a document to the File Note if required see the section below on How do Upload a Document Entered By SBC System Admin Date Entered 7 11 2014 Time Entered 12 22PM Step
182. d additional Injuries which will add additional row s to the Assessed Injuries section Assessed Injuries a Add Injury Remove Injury Body Part or System Workcover Yo Pre existing Compensable Guidelines WPI Step 7 Select the person who assessed the permanent impairment claim by selecting the Search F which will open the Provider Search screen if applicable An assessment report may also be uploaded Select the Upload button to search for and upload a file attachment to the assessment if applicable please refer to How do Upload a Document for further details Once a file is selected and uploaded the file name will appear in the File Name field Assessor Details Assessed By a Phone Assessment Report Upload _Clear Step 8 The user may enter any notes if applicable gt Font Family Font Size Step 9 Select the SAVE lal icon to save the screen once all details have been entered 28 2 2 How dol Upload a Document MS Step 1 To attach a Document click on the Upload button and use the Windows File Ag Browser to locate and select the desired file Commercial in Confidence SBC IT South Australia Department of Premier and Cabinet Claims Management System Self Insurance SA User Guide i Choose File to Upload Page Version Printed B 135 of 309 1 0 18 06 2015 Xs O gt gt Libraries gt X 4 I Se
183. d do not wish to save your changes click on the MODIFY A icon for a second time Your changes will not be saved and the claim will stay displayed in the tree window If you wish to discard you changes and close the claim click on the CLOSE RECORD icon from the toolbar 38 2 3 How do I Add Multiple Compensation Recipient s Details to a claim Multiple Compensation Recipients may be added for each Claim To add an additional Compensation Recipient Commercial in Confidence SBC IT South Australia Department of Premier and Cabinet Page 192 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 Step 1 Open the claim record you wish to add a Compensation Recipient to and click on Compensation Recipients in the Tree control Wi i Compensation Recipients Step 2 Select the MODIFY A icon The fields will become active Step 3 Select the INSERT insert hyperlink to insert the details of a new Compensation Recipient record This will add a new row below the existing record Compensation Recipient Details Priority Date From Date To Recipient Amount per Payment per Payment 17 06 2015 Robert Wilkenson Third Party Step 4 Enter the Date of Surgery and any other details following instructions provided in How do add a Compensation Recipient to the Claim Step 5 Click on the SAVE lal icon and the fields will become inactive and your changes will be saved 38 2 4
184. der Item Number Payment Category Jurisdiction South Australia Fi Payment Type Exclude if Injured Worker is Payee Claims Manager Invoice Date Service Date Date From Date To Bl Date From Date To E Date From Date To ASearch Approve Selected Items Select All Totals 35 2 Unauthorised Payments Step by Step The following topics are available to assist you in the use of the Unauthorised Payments screen e How do I Search for an Unauthorised Payment e How do I Approve one or more Payments 35 2 1 How do I Search for an Unauthorised Payment Note x Administrator if you have trouble accessing the screen or using this function Step 1 Open the Unauthorised Payment Search by selecting Administration gt b Unauthorised Payments from the Menu Commercial in Confidence SBC IT South Australia Department of Premier and Cabinet Page 170 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 Step 2 Once the Unauthorised Payment Search screen opens select the Criteria associated with the desired Unauthorised Payment Step 3 Press the 4 amp 4 Search icon The Unauthorised Payments matching the selected criteria will appear in the Search Results list box Unauthorised Payments iim CEA Employer Details Payment Details Claim Number Injured Worker Invoice Number Provider
185. do I Add Multiple Incident Details SCrE NS ccc ccecccseecceeeceeeeeeeeeeeeeseeesaeeeneees 79 15 2 4 How do Delete the Incident Details screen cc ccecceccecceeeeeeeeeeceeeeeeeeeeeeeeeeeeeeeeeees 79 15 3 INCIDENT DETAILS ADDITIONAL INFORMATION c0sccecceseteeccseteeceneteeeeseteeeseteeeeeeeeeeeeeeaeeeaees 79 T5334 Ma ndatory Fields screener ventas cio chew eles teas te e a a es a 79 532 ree GF 11 ener name ee ee ee Ot Pree ee 79 16 HOW DO RECORD INJURY DETAIL S 2 aere aa onene e reenen reame aAa nan aih renen adas 80 16 INJURY DETAIE S ricana a a a aa a a 80 16 2 INJURIES DETAILS STEP BY STEP tanhiverasninchetahiarebadaianebiybienebadaiensetyaiawatidaianserybiwwatadacanteanaiauert 80 16 2 1 How do l enter Injuries or DiSCASES ccccccccsececeeeceeeeceueeceeceueecsueseueeceuseseeessueensess 81 16 2 2 How do I Modify the Injury Details screen n nnnennnnnnennnenenenrnnnrrrnrrrerrrrrrrrrrresrrrsreene 83 16 2 3 How do I Add Multiple Injury Details screens ccc ccecccseeeceeeeceeeseeeeeeeeseesaeeeneees 84 16 2 4 How do I Remove an Injury from a Claim cccceccccsecceceeeeeaeeeseeeeseeeeeseeeeseeeesseeesaaees 84 16 3 INJURY ADDITIONAL INFORMATION sscsusin tsaer pna a a a leew 85 1631 Mandatory Fields meisneri aioe aiieat ds euteataadbend dadeiealgrauts 85 WO see WCC COMO catia he sa SN ih Rs ih Bd rN A Rt at Nd ct aan back 85 17 HOW DO RECORD OTHER INJURIES OR D
186. does not require the user to explicitly enter data Ex Employee Check boxes allow users specify a Boolean yes or no value by checking the box to specify true value or un checking the box to specify a false value In the above example from the Injured Worker screen the Checkbox is unchecked meaning that the Injured Worker does not require an interpreter To select a checkbox simply click on the empty checkbox To deselect a checkbox click on the selected checkbox Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 35 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 Selected EE v Primary Injury Not Selected MEE Recurrent Injury 4 2 4 Radio Buttons Radio Buttons like Check boxes are a special type of field that does not require the user to explicitly enter data Not Selected gt GHEE Selected Unlike Check boxes groups of radio buttons are mutually exclusive This means that if one radio button is selected within a group of radio buttons the rest will be deselected For example in the above example if Male is selected Female will be deselected automatically 4 3 Validated Fields There are a number of fields within SIMS that look like standard fields but are validated after data is entered in them These fields are Date Fields Time Fields Money Fields and Suburb Fields Validat
187. e SBCIT South Australia Department of Premier and Cabinet Page 158 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 Step 3 Enter the Invoice details including the Date Received Invoice Date and Invoice Number Invoice Details Date Received iz Payment Status Entered Total Amount excl GST Invoice Date jr Invoice Number Total GST Date Entered 31 10 2014 Entered By SBC System Admin Total Amount Incl GST Step 4 Select the Reimbursement To Worker checkbox in the Payee section and the Payee Details Then search for an Injured Worker Provider in the SIMS via the Provider Profile search screens Note Only Providers with a type of Injured Worker may be linked to reimbursements Payee Name Chloe Fenney Q amp Y Reimbursement To Worker Provider Type Payment Particulars ABN Payment Method Payee Numbers Employee Number 456987 Address 15 Flinders Street ADELAIDE Postcode 5000 33 3 3 How dol Enter Payment Items the second tab Payment Item for the services performed are required to be completed Click on the Payment Item tab name Step 1 Once you have completed the details on the Payment tab of the payment Payment Deities Note Upon entering a payment one 1 payment item will be insert
188. e Clear button To Generate a RTW Plan select the Generate Plan button Generate Plan Upload _ Clear a Generate Plan Step 12 Select the Add button to add Suitable Duties stages If no Suitable Duties exist tick the No Suitable Duties Available checkbox Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 120 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 Stay at Work Return to Work Arrangements No Suitable Duties Available Stage Date From Date To Days Hours Work Activities Consideration Restrictions a f Add Remove Step 13 Complete the Suitable Duties roster by entering the Date From Date To Days Hours and Work Activities Step 14 Select the Add button again to add each Suitable Duties stage required Step 15 Select the Work Conducted site and the Position the worker will be working in Complete the Supervisor in Position Position Details and Worksite Details as required Work Conducted at Pre Injury Worksite Alternative Worksite Position Pre Injury Position O Alternative Position Supervisor in Position Position Details Worksite Details Step 16 The RTW Plan can be saved once all details have been entered by selecting the SAVE al icon 25 2 2 How do I record an Outcome for a RTW Plan Details screen in the t
189. e RTW Assessment screen functionality and validation e RTW Assessment Mandatory Fields e RIW Assessment Tree Control 23 3 1 Mandatory Fields The following fields must be completed in order to successfully save the RTW Assessment details into the SIMS database Assessment Type Status RTW Consultant Start Date 23 3 2 Tree Control Multiple RTW Assessment screens may exist for each claim and it will be displayed in descending order i e the most recent RTW Assessment will be displayed at the top of the list in the menu tree with the most recent date recorded in the Rehab Assessment Date field within the RTW Assessment group box The screens will appear in the Claim Tree Control under the Rehabilitation Summary folder in the following format RTW Assessments S laRTW Assessments nee 10 06 2015 Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 115 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 24 HOW DO I VIEW THE RTW ASSESSMENTS SUMMARY The RTW Assessments Summary screen appears when the RTW Assessments folder is selected from the Claim Tree Control The RTW Assessments Summary screen displays a listing of all RTW Assessments for the Claim ordered by RIW Assessment Date in descending order i e the most recent record will display at the top of the list The user may select the Rehab Assessment Date hyperlink to
190. e Return to Work File Note How do Notify a Person of an Assigned Action How do Modify the Return to Work Note How do Add more than one Return to Work Note How do Delete a Return to Work Note The following are related to Return to Work File Note and are available in other sections of this User Guide e How do I Use the Task List e How dol View the Return to Work Note Summary 8 3 1 How do I Add a Return to Work File Note to a Claim Step 1 Open the Claim you wish to add the New Return to Work File Note to Step 2 Go to the Claim branch of the tree control and click on the FLOATING MENU icon A list of options will appear to the right of the icon Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 265 of 309 Claims Management System Self Insurance SA Version 1 0 4 SETRESTITGETS Claim New Injury Details Injured Worker New Dependant isEmployment D New Vendor Payment A Incident Detail New Incapacity Payment CQ Injury 1s New File Note nEppependant F RTW File Note S ee _ New Investigation Referral Estimate Histo Payments amp New Motor Vehicle S worker Earnin Ei New Correspondence In Other External Z New Correspondence Out 3 Other Injuries 3 New Witness aO File Note Sumr New Claim Provider a Rehabilitation if New Legal Representative Medical Referr 3 New Nominated Treating Doctor OTime Off Work New Reconsideration aO
191. e below Step 3 Select an option point the mouse to the required menu option and click the mouse The system will add the relevant screen to the claim and the screen will be displayed ready for input Note Not all nodes in the Tree Control will have floating menus Nodes that have floating menus and the clusters they belong to are documented below Claim Summary Claim New Injury Details New Notional Weekly Earnings New Certificate of Capacity New Surgery Related Incapacity New Permanent Impairment Assessment New Vendor Payment New Income Support Payment New Recoveries New File Note New Other Injuries or Diseases New Correspondence In New Correspondence Out New Medical Referral New Investigation Referral Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 32 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 New Motor Vehicle New Nominated Treating Doctor New Claim Provider New Legal Representative New Dependant New Witness New File Tracking New RTW Assessment New RTW Plan Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 33 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 4 SIMS SCREEN FIELDS 4 1 Standard Fields There are a number of standard fields throughout the SIMS with which you should be familiar These fields oper
192. e claim you must select the option from the FLOATING MENU and create a screen Step 4 The Recoveries screen will appear in the screen window Step 5 Enter the Date Recovery Received Recovery Amount and select the Recovery Category Date Recovery Received E Recovery Amount Date Entered 17 06 2015 Entered By ISAPS Test Recovery Category y Payment Category y Step 6 Select the Recovered From by selecting the SEARCH icon Commercial in Confidence SBC IT South Australia Department of Premier and Cabinet Page 215 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 Recovered From aa Selection of the SEARCH icon will open the Party Search dialog Refer to How do Search for a Party For more information Selection of a Party from the Party Search dialog will auto populate the Recovered From Address Suburb State Postcode and Couniry fields where applicable Step 7 The Recoveries screen can be saved once all mandatory details have been entered by selecting the SAVE lad icon 44 2 2 How dol Modify the Recoveries screen after it has been saved Step 1 Open the claim record you wish to modify and click on the Recoveries screen in the tree control meee eRecoveries Step 2 Click on the MODIFY A icon The fields will become active and you will be able to select different values Step 3 Make the desired changes to the Re
193. e existing record Surgery Related Incapacity Details Date Of Surgery Injury Related Comments Estimated Date Fit 17 06 2015 gi mma a Add _Remove Step 4 Enter the Date of Surgery and any other details following instructions provided in How do add Surgery Related Incapacity to the Claim Step 5 Click on the SAVE lal icon and the fields will become inactive and your changes will be saved 30 2 4 How do Delete a Surgery Related Incapacity record Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 145 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 Once a Surgery Related Incapacity screen has been added to a Claim the screen cannot be deleted The user must select a row and then select the REMOVE Remove hyperlink Removal of all rows will result in the screen displaying as follows Surgery Related Incapacity Details Step 1 To remove a Surgery Related Incapacity record from the claim firstly select the claim you wish to remove the record from Step 2 Once you have the claim open select the Surgery Related Incapacity folder from the tree control If the Surgery Related Incapacity folder is selected the background behind the text will appear blue ry Related Incap Step 3 Select the MODIFY amp icon The fields will become active Step 4 Select the row in which you wish to d
194. e populated in the 4 level Step 9 If the Agency of Injury is the same as the Breakdown Agency of Injury the user may select the Agency of Injury is the same as Breakdown Injury checkbox which will disable and hide the Agency of Injury group on the screen If the Agency of Injury is different it is mandatory for the user to complete that section Step 10 The Agency of Injury Description field allows the user to enter a description of the agency of the injury recorded The Code field allows the user to enter the Agency of Injury code which will then populate the Agency of Injury Level 1 2 3 and 4 fields Agency of Injury Description Agency of Injury 1 Agency of Injury 2 Agency of Injury 3 d cl cl Ik Agency of Injury 4 lt is not mandatory to populate the Agency of Injury using the Code field The Agency of Injury Level 1 2 3 and 4 fields may be manually selected from the drop down lists provided The Agency Injury 1 is populated with the TOOCS Version 3 1 Defined Agency Level 1 Classifications Codes Upon selecting a value in the first level the corresponding associated values are populated into the Breakdown of Injury Level 2 field Upon selecting a value in the Level 2 field the associated values are populated into the 3 level and upon selecting a value in the Level 3 field the associated values are populated in the 4 level Step 11 Once all of the mandatory fields are complet
195. ead only field and will contain the cost of the payment excluding GST This field is automatically populated from the Payment Item screen upon saving the payment Commercial in Confidence SBC IT South Australia Department of Premier and Cabinet Page 156 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 The Total GST field is a read only field which contains the total GST of the Payment This field is automatically populated from the Payment Item s on the Payment when the payment is saved The Total Amount Including GST is a read only field and contains the cost of the payment including GST This field is automatically populated from Step 4 Step 5 the payment item s on the payment when the payment is saved An Invoice File can be added as an attachment Refer to How to Upload a Document The following fields will be populated automatically from the system when the payment has been authorised The fields display information about the date payment was authorised who authorised the payment and the total amount authorised The following fields will be populated automatically from the system when the payment has been transferred to the Accounts Payable System where an Accounts Payable System has been implemented The fields display information about the date the payment was transferred Date Transferred fs Select the provider the account is to be paid to Pa
196. easons why the SIMS may not locate the payment you are searching for Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 172 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 e The Criteria are incorrect Check the Payment Details you have entered as criteria It might be that the criteria you are entering will not match the details entered when the Payment was recorded e You are using too many Search Criteria Simplifying your search by entering fewer search criteria Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 173 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 36 HOW DO ENTER WORKER S EARNINGS This screen allows users to set up the calculation of the weekly compensation prompted by the SIMS Upon entering a Weekly Compensation Payment the amount payable will be derived from this screen as the amount payable on the current record The system will also use the ReturnToWorkSA Rates in order to calculate the compensation payment which can be made for the Injured Worker This is a mandatory screen which must be completed before any Weekly Compensation Payments can be entered for the Injured Worker Multiple Worker s Earnings screens cannot be added to a claim however the user can add more than one on the same screen The Notional Weekly Earnings
197. ecoveries table displaying as follows Date Entered Date Authorised Payment Category Provider Number Limit Remaining Remaining There are no Treatment Approvals Step 1 To remove a Treatment Approval record from the claim firstly select the claim you wish to remove the record from Step 2 Once you have the claim open select the Treatment Service Plans folder from the tree control If the Treatment Service Plans folder is selected the background behind the text will appear blue Treatment Service Plans Step 3 Select the MODIFY amp icon The fields will become active Step 4 Select the row in which you wish to delete the Treatment Approvals details of Date Entered Date Authorised Payment Category Provider Number Limit Remaining Remaining gt 17 06 2015 Medical Services To select the row click on the grey column to the left of the Date Entered field Before Date Entered 17 06 2015 Date Entered P 17 06 2015 A right arrow P will display in the grey column when the row is selected Please note that only one row at a time may be selected Step 5 Select the REMOVE Remove hyperlink This will remove the selected row from the Treatment Approvals table Step 6 Click on the SAVE al icon and the fields will become inactive and your changes will be saved Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 229 of 309 Claims Management System Sel
198. ed and you are satisfied with the details entered select the SAVE lal icon from the toolbar The system will now save the claim and create an entry in the SIMS 16 2 2 How do I Modify the Injury Details screen Step 1 Open the claim record you wish to modify and click on an existing Injury Details screen in the tree control See How do search for a Claim to locate a specific claim for modification Step 2 Click on the MODIFY ZAicon The fields will become active and you will be able to select different values Step 3 Make the desired changes to the Injury Details screen Step 4 Click on the SAVE lal icon and the fields will become inactive and your changes will be saved Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 84 of 309 Claims Management System Self Insurance SA Version 1 0 i Printed 18 06 2015 User Guide If you Modify the Injury Details screen and do not wish to save your changes click on the MODIFY icon for a second time Your changes will not be saved and the claim will stay displayed in the tree window If you wish to discard you changes and close the claim click on the CLOSE RECORD icon from the toolbar 16 2 3 How do Add Multiple Injury Details screens Step 1 Step 2 Once you have created an Injury there is a different method for adding subsequent nF Injuries following these instructions Open the claim record you wish to add a New Injur
199. ed into the table Each Payment must contain at least one Payment Item The Service Provider field will be automatically populated with the Service Provider assigned to the Payment tab If the invoice being entered has a different Service Provider for each line item then user may link another Service Provider either using the Quick Search or the Provider Search function Service Provider Dr Rudy BE Step 2 Add a Supplier Reference if required The Status field will default to Entered when a Payment is added to a Claim Status Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 159 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 Step 3 Select the Payment Category and Payment Type Payment Category y Payment Type iy Step 4 Enter the Service Date using the calendar control or manually entering into the field for the first payment item Item Number Oooo Step 5 Enter an Item Number if it is indicated on the account being entered If the Item Number is valid then the Description will be automatically populated If the item number is not known click on the Description 4 button to display all services the service provider nominated in the account screen is authorised to conduct Service Rates Item Source Item Number Descri Amount SA Medical Fee Professional attendance at other than 164 00 Sc
200. eeeseeeeceeeeeeeeeeeeeseeeeeeees 269 8 3 1 Return to Work File Note Additional Information ccccccceccccccceeeeseeseeseeseeeeeeeveneeeses 269 8 3 1 Return to Work File Note Email Notifications cccccccccecceseeeeseeeeseeseeeeseeeeseeeeeeesanes 269 Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 14 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 53 8 Mandatory Fields eescessccta rei eeietd nsa eai Sacha 270 DO Eee COnN Oana ae aunt cet nteata ater aiuaGua anatieatel Gia lac iniiat a eeteataninera eae alan 270 8 3 1 Confidential Return to Work File Notes cc cccccccccccceseessesseseeseeseeeeeeeaeeueveueeaseaeeass 270 54 HOW DO I VIEW THE RETURN TO WORK FILE NOTE SUMMARY cssssseseseeees 271 5A JRTW FILE INGTE SUMMAR Y ciernie AN AAO 271 1 4 RETURN TO WORK FILE NOTE SUMMARY STEP BY STEP ccceccecceeceeeeceeeeeeeeeeeeeeeeeeeeeeeeeees 271 54 1 1 How do I View the Return to Work File Note Summary cccseeeeeeeeeeeeeeeeeeeeeaeeeees 272 54 1 2 How do I use the Return to Work Note Summary Search ccceceeceeeeeeeeseeeseeeees 272 54 1 3 How do I Open a Return to Work Note from the Return to Work Note Summary screen 272 55 HOW DO I VIEW THE DOCUMENT SUMMARY ccsccseccsscnescsscnssensenssnseneeeneeessaees 274 55 DOCUMENT SUMMAR Yersin E EEE E e EERE 274 552 OTEP Bo TEP eTa ANS 2
201. een may exist for each claim The screens will appear in the Claim Tree Control in the following format e lt Date From gt lt Date To gt lt Gross Amount Payable gt The Provider Payment screens will be grouped into Financial Year sub folders by Invoice Date For example a Payment with an Invoice Date 1 1 2014 will appear in the financial year folder 2013 2014 as demonstrated below Payments Lit 2 11 2014 12345 380 00 Lui 28 10 2014 4586789 110 00 Lo 2013 2014 i 19 01 2014 F456789 380 00 Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 188 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 38 HOW DO I ADD COMPENSATION RECIPIENTS The Compensation Recipients screen allows the user to record details of third parties that are to be recipients of Income Support Payments for a Claim Only one Compensation Recipients screen may be added for a Claim All Compensation Recipients active at the period of an Income Support Payment will be automatically included as recipients of a portion of that payment This screen may be added to the Claim from the floating menu This screen will be displayed in the Folder titled Compensation Recipients Upon adding the screen for the first time if the claim is a claim classification Fatal Claim the system will automatically insert a row for each active dependant previous
202. eeneeeeenenenener renen 309 64 2 TASK LIST ADDITIONAL INFORMATION vsisssicsssincesssdesssuvndssscsusdeasesssdanaesesdeusrssdavatsesdneseussoauanses 309 Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 16 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 64 2 1 Interpreting Task List Search RESUItS ccccecccccseeeeeseeeeeceeeeeeseaeeeseeeeeeseaeeesseeeeesaaes 309 Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 17 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 1 CLAIMS MANAGEMENT SYSTEM OVERVIEW The Claims Management System Self Insurance SA SIMS has been designed and developed by SBC for South Australia Public Sector SAPS to assist with the recording management and reporting of all workers compensation claims The SIMS will provide an efficient and effective method of assisting SAPS in the management of claims by Minimising the reliance on paper files Ensuring that all claims entered into the SIMS are accountable and auditable Providing statistical information Making use of standard Windows functionality for ease of data capture Providing workflow facilities to aid with ensuring deadlines are met and work is able to be readily allocated 1 1 Purpose of User Guide The User Guide has been developed to assist the us
203. eeseeeesaeeeess 72 14 2 1 How do l Enter the Other External Current Employment cccccseeeeeeeeeeeeeeeeaeees 73 14 2 2 How do I Modify the Other External Current Employment Screen cccceseeeeeeeees 73 14 2 3 How do I Add Multiple Other External Current Employment screens 0cccceeee 74 14 2 4 How do I Delete the Other External Current Employment Screen cccccseeeeeeeees 74 14 3 OTHER EXTERNAL CURRENT EMPLOYMENT ADDITIONAL INFORMATION ccc0sccceeeeeeseeteeeeees 74 Ge IVIL Oy lr NOS tect tte tate cae a Peceh ite eee eee ee Pana tee ace an ee ee Panta 75 Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 6 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 VAS WESC IC ONIN Ol ceo di an tteleaccceecci a a gnaretecab ated guaubhecckiee Me esues 75 15 HOW DO I ENTER INCIDENT DETAILS 00 0 cc ccccsecsecnenseseescesensenseueeeeeeeeesenseauensenseneens 76 tot INCIDENT DETAILS oice5 iced cin htc s cicudaey shcthcheaiwialeta shat catniaiatidah deiadebaatunhedsdiecsdeaentendethdeeatcanntenhea sds 76 15 2 INCIDENTIDETAILS STEP BY OIEPrrcnuian aoa a a 76 15 2 1 How do I Enter the Incident Details sa sicengas ccycteartondaivceyetaurieySelareestaaienchaiareytawie ede 77 15 2 2 How do I Modify the Incident Details SCrE N cc ccccccccceeceseeeceeeeceeeeaeeseeeeseesaeeenaees 78 15 2 3 How
204. eesseeeeseueesseeeeseeeetseeees 293 61 HOW DO I VIEW THE CORRESPONDENCE OUT SUMMARY ccsceeseeeeseseneees 294 61 1 CORRESPONDENCE OUT SUMMARY STEP BY STEP cccccescccceesceeceeceeseeeeseueceeseeeesseeeeesaees 294 61 1 1 How do I View the Correspondence Out Summary ccccceeeeeseeeeeeeeeseeeeeseeeesseeeens 294 61 1 2 How do Open a Correspondence Out from the Correspondence Out Summary screen 294 62 HOW DO I ASSOCIATE A PROVIDER TO A CLAIM cccceseseeesseeeeneeseeseeeeneesennenes 296 62 1 GLAIM PROVIDER STEP BY STEP ccnp ieia scssaupis pacteernsateacpnnce van ats taapn ree arn ce aupe nearness 296 62 1 1 How do I Add a Claim Provider to the Claim ccccecccseeeeceeeeeeeeeeseeeesseeeeseeesseeeess 297 62 1 2 How do I Modify the Claim Provider Screen after it s been Saved ccccceeeeeeees 298 62 1 3 How do I Add Multiple Claim Provider screens to a Claim cccccceeccceeeeeeeeeeeeeneees 298 62 1 4 How do Delete the Provider Sereen cccccecccssecceeeeceeeeaeeeceueeseeeeeceseueeseetaneeneees 298 62 2 CLAIM PROVIDER ADDITIONAL INFORMATION cccsssercseecceseecenceteneeecensetseeeeeasetsueeteneeeneas 299 62 2 1 Mandatory Fields siccectexiecc cence siet n a Aieseaeeeeiuee 299 6222 Tree Contolera riea A sande nats A E E E E A T E A 299 63 HOW DO I LINK LEGAL REPRESENTATIVES ccsccccsseecenseecnseeceneeeeaseesensesennenes 301 63 1 LE
205. elds on the screen click on the SAVE al icon and the fields will become inactive and your changes will be saved against the claim If you have multiple screens in MODIFY mode 4 when saving the screen the SIMS will check to see if any other screens are in modify mode If there are any screens which meet this criteria the system will open the screen which needs saving and you will need to click on the SAVE l icon again You should save the screen before creating the next screen or modify another screen If you do not you risk losing the information you have entered 49 2 2 How dol Upload a Document to the Motor Vehicle screen Step 1 Once a New Motor Vehicle screen has been created Type in the details of the motor vehicle into each field Step 2 To attach a Police Report to the Motor Vehicle screen click on the Upload hyperlink and use the Windows File Browser to locate and select the desired file Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 244 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 i Choose File to Upload 2s Joli gt Libraries gt v 4 n Search Libraries p i Organize v il Ft Favorites Libraries E Desktop Open a library to see your files and B Downloads Recent Places A Documen ts es Music Pictures i gt Library Library wm Library amp OneDrive l
206. elected user is responsible for 64 1 4 How do I View the Status and Type of Claims assigned a Claims Manager The Person Responsible defaults to the user currently logged in The list of Claims will default to all Claims assigned to the Person Responsible amp Step 1 Open the Task List screen and select the second tab Task List Claims Commercial in Confidence SBC IT South Australia Department of Premier and Cabinet Page 309 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 Select Undetermined Claims to refine the Task List results Any claims with a current Determination Status of Undetermined will be displayed in the Task List when you select the Search button Person Responsible SAPS Test iv C Undetermined Claims 4 Search bl Export Cancel Open cians e Undetermined Claims o Open Rehab Claims fi Total Claims Allocated 2 J How do I Open a Claim associated with Task List entries Step 1 Step 2 Step 3 Locate the Claim Task List task which you wish to view in further detail Click on the ACC 45 No hyperlink The Claim selected will open in the Screen and Tab Window and the Task List screen will be closed Open the relevant Screen i e File Note to view the File Note Details 64 2 Task List Additional Information The following sections contain additional information about the Task List screen functionality and validation
207. elete the Surgery Related Incapacity details of Date Of Surgery Injury Related Comments Estimated Date Fit gt 17 06 2015 fv iy To select the row click on the grey column to the left of the Date of Surgery field Before Date Of Surgery 17 06 2015 Bey Date Of Surgery t 17 06 2015 By A right arrow P will display in the grey column when the row is selected Please note that only one row at a time may be selected Step 5 Select the REMOVE Remove hyperlink This will remove the selected row from the Surgery Related Incapacity Details table Step 6 Click on the SAVE lal icon and the fields will become inactive and your changes will be saved Commercial in Confidence SBC IT South Australia Department of Premier and Cabinet Page 146 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 30 3 Surgery Related Incapacity Additional Information The following sections contain additional information about the Surgery Related Incapacity screen functionality and validation e Surgery Related Incapacity Mandatory Fields e Surgery Related Incapacity Tree Control 30 3 1 Mandatory Fields The following field must be completed in order to successfully save the Surgery Related Incapacity into the SIMS database e Date of Surgery 30 3 2 Tree Control A single Surgery Related Incapacity screen may exist for each claim The screen will appe
208. eminder Dates unless the Date Completed has been entered Due Date x E Reminder Date Date Completed E Step 4 If the Person you wish to notify is a SIMS user Type the name of the Employee into the Name Email Address field and the system will identify the person s profile If the Person you wish to notify is NOT a SIMS user Type the full email address of the Person into the Name Email Address field A Commercial in Confidence SBC IT South Australia Department of Premier and Cabinet Page 257 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 Note If only one result is found the System will populate that name automatically into the Email Notifications table You may select the Remove _ button to remove a Person from the Email Notifications lists Select the row you wish to delete and click on the Remove 2 button Note If you have entered the incorrect email address the SIMS will not be able to send the File Note correctly Step 5 Once you are satisfied with the File Note details entered into the fields on the screen click on the SAVE amp icon and the fields will become inactive and your changes will be saved against the claim lf you enter a Date Completed the Notification will not be sent The SIMS will consider the workflow on the notification completed Note The System will prompt the user to enter a Due Date if Employees have been
209. en of that type for the claim Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 41 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 6 HOW DO I USE THE CLAIM SEARCH The Claim Search screen allows the user to enter the details of a claim which already exists in the SIMS A range of Search Criteria is available for the user to Search 6 1 Claim Search Step by Step 6 1 1 How do I search for a Claim toolbar option or by selecting the menu item Search gt Claim Search option MS Step 1 Open the Claim Search by clicking on the Claim Search i icon in the i Y The Claim Search screen is displayed as follows Claim Search Claim Details Search Claim Number Jurisdiction South Australia Claim Type y Clear Claim Status y Claims Manager N Classification cancel Registration Status y Rehab Manager N Rehab Status lelExport Determination y Injured Worker Details Family Name Given Name s kor ag Date of Birth Employment at DOI Portfolio Region Agency Service Division Cost Centre Organisation Unit Date Injury Illness Occurred Date Claim Entered Date Received Employer Date Received Insurer Date Registered ma Date From ag Date From pa
210. eneceeeseeceneetseeeetsneetsneeenens 229 46 31 Mandatory Fields wre sccts hc ea aeaea e aa eaa e teatsseiueana tes teuhesesecesabestectsteiieane Sees 229 Oe eS OM MO a oueetare trtouteioctapbinatee treater abeataameutuenuneaaredcreaiesaeaareameaeermabaareamtutnonn 229 47 HOW DO I ASSOCIATE A NOMINATED TREATING DOCTOR c ccccceeseeeeneeeeeneeeees 230 47 1 NOMINATED TREATING DOCTOR waccsiciiscveccstsceiseccnsvsieedecsiscusecssdnsdvatisusiasdedenduaredesinesedvessensin s 230 47 2 NOMINATED TREATING DOCTOR STEP BY STEP siticsiintsecedacdiaenihiisnedintiaubtiaaelntiadaedianetints 230 47 2 1 How do I Add a Nominated Treating Doctor to the Claim cccceeceeeeeeeeeeeeeeeeeees 231 47 2 2 How do Modify the Nominated Treating Doctor Screen after it s been saved 233 47 2 3 How do I Add Multiple Nominated Treating Doctor Screens to a Claim 005 233 47 2 4 How do I Delete the Nominated Treating Doctor Sereen cccecccseeeeeeeeeeeeeeeeeeeees 233 1 1 NOMINATED TREATING DOCTOR ADDITIONAL INFORMATION sccceececeeeceeeeceeeeeeeseneeneeeeaes 234 Arl Mandatory Fields rroak T 234 Ale TEE cConNtoliean a a 234 48 HOW DO I ENTER WITNESS DETAILS o eee eee ece eee eneeeeeeeeneeceseeeaseeeneeeaseseneeeenesons 235 AS WINES sacecten cs retaniactaentactcenidh acer oncstente Baan cased ealawaratendsh Rava oaiaiadsl Ram ae Raawae 235 AG WITNESS oe BY OTEP aici cies eae altel ntteael a eee 235 48 2 1 H
211. ent beeen a Estimate _ New Compensation Recipients oi Estimate Histol New Income Support Payment QQRTW Assessme i tS New Recoveries ave New File Note s New Rehabilitation File Note New Other Injuries or Diseases New Correspondence In New Correspondence Out New Medical Referral _ New Investigation Referral New Motor Vehicle New Nominated Treating Doctor New Claim Provider New Legal Representative New Dependant 2 New Witness a New Purchase Order New Treatment Service Plans New RTW Plan Ja New Compensation Recipients Step 3 Select New Dependant from the floating menu A new tree branch and screen window will automatically appear This process is creating a new screen against a claim To add further details to the claim you must select the option from the FLOATING MENU and create a screen Step 4 The Dependant screen will appear in the screen window Step 5 Select the Dependant Details and check the Partial Dependant check box if applicable Dependant Details Relationship to Claimant Partial Dependant Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 126 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 Step 6 Complete the Personal Details section for the Dependant including the Family Name Given Name s and Date of Birth Personal
212. ent Category Claims Manager Payment Type Date Entered Date From ee E Date To Compensation Date Search clear Ocancel Comp Date From Comp Date To Amount Number of Recurri Payments Amoun 1 800 00 0 No Claim Number Injured Worker Payment Category Payment Type ng Approve t 15000005 03 William Michaels Income Support Income reimbursement Australian Taxation Office 10 06 2015 16 06 2015 Approve Selected Items Select All 40 2 2 How dol Approve one or more Compensation Payments Step 1 Open the Unauthorised Payment Search by selecting Administration gt Unauthorised Compensation Payments from the Menu SWS Step 2 Once the Unauthorised Payment Search screen opens in the Screen window select the Criteria associated with the desired Unauthorised Payment Step 3 Press the 4 Search button The Unauthorised Payments matching the selected criteria will appear in the Search Results list box Step 4 Select the Approve checkbox to the right of each of the Payments in the Search Results Payment Category Payment Type Comp Date From Comp Date To Amount Number of Recurring Approv Payments Amount 20141000034 Chloe Fenney Weekly compensation Weekly Compensation Total Incapacity 2 11 2014 8 11 2014 0 00 0 No o 20141000039 Cloud Strife Weekly compensation Weekly Compensation Total Incapacity 3 11 2014 9 11 2014 1 530 00 0 No g 20141000045 Daniel Givens Weekly
213. ep 2 Click on the DELETE icon from the toolbar When the confirmation message appears click on _ J The screen will be removed from the claim Claims Management System Are you sure you wish to delete this screen If deleting the last Correspondence In Screen from the Claim the Correspondence In Branch will also disappear 58 3 Correspondence In Additional Information The following sections contain additional information about the Correspondence In screen functionality and validation e Correspondence In Mandatory Fields e Correspondence In Tree Control e Correspondence In Privileged and Confidential Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 286 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 58 3 1 Mandatory Fields The following fields must be completed in order to successfully save the Correspondence In into the SIMS database Document Type Date Received Document Date File Upload 58 3 2 Tree Control When the Correspondence In screen is saved the system will display the following detail in the Tree Control as a reference to the screen contents lt Date Received gt lt Document Type gt The Tree Control will display all Correspondence In for the Claim in order of Date Received descending most recent date received first An example is displayed below Correspondence In 11 04
214. eports Opens the Generate Reports screen G Ad hoc Report Opens the Ad hoc Report system g Close Record Closes the current record without saving any unsaved changes Refresh Record Refreshes the current record Ends the session and exits SIMS 3 4 Menus The following menus are accessed from the menu bar at the top of the screen as shown below File Search Generate Document Administration Help BB New Clair a New Provider fai New Site The following menus are available within the SIMS File Provides access to create a New Claim and a New Provider Search Provides access to the Provider Claim and Payment Search screens Generate Provides access to generate Data Warehouse reporting Generate Standard Reports and Generate Letters Administration Provides access to functionality such as maintaining payment codes viewing the task list viewing the audit trail changing password details setting authorisation levels access to unauthorised payment details access to payment batches codes and maintain security Provides access to the on line help facility and information about the SIMS The tables in the following section display each of the menu options available within the above mentioned menus 3 4 1 File Menu The File Menu contains a group of functions including Creating New Claims New Providers and New Sites To access the File menu you need to click on File in the Menu at the top of the SIMS
215. er and Cabinet Page 296 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 62 HOW DO I ASSOCIATE A PROVIDER TO A CLAIM Users are able to associate Providers to a claim who are used on a continual basis for reference One or more Providers can be associated to a Claim record Address and contact details for the provider may not be modified from this screen To modify details the user must open the provider profile The Organisation will define the access required to the provider profiles The Clam Provider Screen consists of one tab Claim Provider The Claim Provider screen will be displayed as follows Claim Provider Provider Claim Provider Provider Type 4 Provider Search Provider Name Provider Numbers Street Address Postal Address Suburb Postcode State ell Postcode LJ Country Contact Details Telephone Fax Number Mobile Email Contact Name Font Family Font Size v 62 1 Claim Provider Step by Step The following topics are available to assist you in the management of Providers for a Claim in the SIMS How do I Add a Claim Provider to the Claim How do Modify the Claim Provider Screen after it s been saved How do Add Multiple Claim Provider screens to
216. er in How to use the menus and tree control How to use the toolbar icons How to utilise basic functions available in the SIMS How to utilise the Windows features of the SIMS How to navigate freely throughout the SIMS Understanding the information recorded in the SIMS 1 2 Assumptions lt is assumed that users of the SIMS will have a general understanding of the Windows environment and the standard functions available in that environment lt is further assumed that the user is familiar with the legislation associated with the SAPS Claims Management process and relevant legislations Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 18 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 1 3 Conventions This User Guide refers to a number of different Conventions These conventions are defined below 1 3 1 Image Conventions Throughout this User Guide images and highlighting have been used to make it easier for you to locate specific elements of the User Guide Images are located on the left hand side of the User Guide and highlighted sections will cover the tips or notes displayed A key to these features of the User Guide are as follows Indicates that there are some notes or tips for using the SIMS This image appears next to Step by Step instructions for using a specific screen or SIMS function Indicates Mandatory fields which mus
217. er may deselect the Active tickbox on the Provider screen 7 3 2 Search Warning Messages 7 3 2 1 No RECORDS MATCH CRITERIA ENTERED If you click on the Search tt hyperlink and the SIMS returns the following message the SIMS has been unable to locate the claim you are searching for Provider Name Provider Numbers Address ype o records matched the supplied criteria The following are is a list of reasons why the SIMS may not locate the Provider you are searching for Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 47 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 e The Provider Details are incorrect Check the Provider details you entered in the criteria It might be that the criteria you are entering do not match the details entered when the Provider was recorded e You are using too many Search Criteria Simplify your search by entering fewer search criteria or e Incorrect Spelling Use the Like Search to broaden your Search A Like Search involves replacing one or more letters in the word with the percentage character For example instead of the Provider s full Name the user may enter T to view all Providers with the Name beginning with T i e Taylor 7 4 How do I Use the Provider Quick Search The Quick Search button is used to perform a quick search for a Provider The Quick search button is displa
218. ersal Type Reversal Date and Reversal Amount will also be automatically populated in the Reversal Details section Reversal Details Reversal Type Full Reversal Reversal Date 5 01 2015 Reversal Amount 100 00 Step 6 Add the Reversal Method and Reversal Reason If you select Vendor Cheque or EFT you must enter the Cheque EFT Number as well Reversal Method Vendor Cheque EFT No Payment Made Cheque EFT Number Reversal Reason Step 7 When you save the Reversal and click on Refresh the Payment Reversal will display under the payment that has been reversed E 9 Payments hwy 1 06 2015 12545 329 00 ee 1 06 2015 12545 329 00 41 2 2 How dol Modify the Payment Reversal Screen after it s been saved 41 2 3 How dol Add Multiple Payment Reversal Screens to a Claim Step 1 Open the Claim you wish to add the Payment Reversal to Highlight the SA Authorised Payment that you wish to reverse Step 2 see Section 37 1 2 above to create the Payment Reversal for each Payment that requires one 41 2 4 How dol Delete the Payment Reversal Screen Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 204 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 42 HOW DO I ENTER A PAYMENT REVERSAL FOR INCOME SUPPORT PAYMENTS The Payment Reversal screen allows the user to reverse a full previously auth
219. ersion 1 0 User Guide Printed 18 06 2015 If you are unable to DELETE X the Permanent Impairment Assessment screen selected you may not have access to complete this function Check with the SIMS System Administrator that you have the correct access level 28 3 Permanent Impairment Assessment Additional Information The following sections contain additional information about the Permanent Impairment Assessment screen functionality and validation e Permanent Impairment Assessment Mandatory Fields e Permanent Impairment Assessment Tree Control 28 3 1 Mandatory Fields The following fields must be completed in order to successfully save the Permanent Impairment details into the SIMS database Assessment Date Assessment Type Injury Type Body Part or System WPI 28 3 2 Tree Control Multiple Permanent Impairment Assessment screens may exist for each claim and it will be displayed in descending order i e the most recent Permanent Impairment Assessment will be displayed at the top of the list in the menu tree with the most recent date recorded in the Assessment Date field The screens will appear in the Claim Tree Control under the Permanent Impairment folder in the following format Permanent Impairment No lt No gt Permanent Impairment Summary T a Permanent Impairment No 1 Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 138 of 309 Claims Manage
220. ersion 1 0 User Guide Printed 18 06 2015 The Date Status Changed field will populate with the Current System Date The Changed By column in the history table will populate with the User logged into the SIMS recording who made the change These fields cannot be modified The Claim Status History is recorded in the list below the Claim Status field The initial Claim Status must always be Claim Open and this first Status and Date will appear in the Claim Status History when the Claim is initially saved Any changes to the status will also be recorded in this list Note the below example has been taken from a claim which has been Opened and then Closed This field will not populate until the claim is saved and refreshed Claim Status Reason Status Changed Date Status Changed Changed By laim Closed Returned to Work 28 10 2014 SBC System Admin laim Open 8 10 2014 SBC System Admin Step 4 The Rehabilitation Status Details field will default to Open and the Rehabilitation Status Date field will default to the Current System Date The Rehabilitation Status field can only be modified as applicable once the Claim has been initially saved The Date Rehabilitation Status Changed will automatically populate with the Current System Date and cannot be modified Rehabilitation Status Details Rehabilitation Status Open Rehabilitation Status Date 28 10 2014 iz Date Rehabilitation Status Changed 28 10 2014 E Rehabilitatio
221. es Libraries E Desktop Open a library to see your files and arrange them by folder date and other properties Pi Downloads E Recent Places Al Documen ts a Music lt Pictures OneDrive S Library SS Library SS 4 Library Videos 3 Libraries E Library Document l ad Music i Pictures E vid 9 Comput Gu Network File name AllFiles Open Cancel Once the desired file is selected click on the OPEN button in the File Browser Step 2 If successfully attached the filename will be visible in the File Name field Once a document is uploaded to a File Note screen it cannot be modified If you have selected the wrong document you can select the Clear button to delete the uploaded file and start again File Name Test docx View Clear Step 3 Once all the details have been entered onto the screen the user would save the details by pressing the SAVE la icon 51 2 3 How do Notify a person of an Assigned Action Tip The File Note may be sent to SIMS users and other Staff if the Assign checkbox is checked and Due Date details have been entered Step 1 Select the Category and enter details of the File Note A I So Step 2 Click on the Assign checkbox to display and enable the other fields Step 3 Enter a value in the Due Date and Reminder Date The system will send an email notification to the persons selected in the Email Notifications table on the Due and R
222. estigations If the Investigation Referral has security applied the Privileged and Confidential checkbox will be selected This flag indicates that the Investigation Referral may only be viewed by users who have the appropriate level of security access This access is defined by the System Administration guide Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 253 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 51 HOW DO I ENTER A FILE NOTE The File Note screen allows users to enter file notes relating to the Claim Multiple notes can be recorded against each Claim Once File Notes have been added to the Claim a File Note Summary screen will be available when the File Note folder is selected in the Tree Control level above the File Note screens The File Note screen consists of a single tab e File Note 51 1 File Note The File Note screen displays as follows File Note Category y C Privileged and Confidential Subject Description B Z U ag v Font Family Font Size File Name _Upload Clear Entered By SBC System Admin Date Entered 7 11 2014 Time Entered 12 14PM Assign Due Date gi Reminder Date Date Completed Name Email Address insert Remove Person Responsible Nicole Howard 51 2 File Note Step by Step The
223. et Compensation Amount Payable 2 050 00 Override Calculation Overriding Amount fs Top Up Required Top Up Amount fs Gross Amount Payable The Earnings in Period This Employer and Earnings in Period Other Employer and Potential Earnings in Period is mandatory to complete for all Payment Types The Overriding Amount field will be enabled and mandatory if the Override Calculation checkbox is checked The Top Up Amount field will be enabled and mandatory if the Top Up Required checkbox is checked Step 9 The Payee Details section records details of the payment A Payee can be added by selecting af Add which will open the Party Search dialog Payee Details Payee Role Invoice Invoice Amount Payable Date Date Paid Cheque Manually Compensation Ref Document Date Transferred EFT Ref Processed William Michaels Injured Worker T a Add Remove Step 10 Record any additional Notes in relation to the Income Support Payment The Cost Centre for the Payment may also be updated if required Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 183 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 y Font Family Font Size 7 Cost Centre Payment Applied Portfolio Department of Planning Transport and Infrastructure Region Department of Planning Transport and Infrastructure Agency Department of Planning Tran
224. et Page 132 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 28 HOW DO I ENTER A PERMANENT IMPAIRMENT ASSESSMENT This screen allows users to enter details of the assessment and notice of Permanent Impairment of an Injured Worker Multiple Permanent Impairment Assessment screens may be associated to the Claim The Permanent Impairment Assessment screen consists of one tab Permanent Impairment Assessment 28 1 Permanent Impairment Assessment The Permanent Impairment Assessment tab will be displayed as follows Permanent Impairment Assessment Impairment Assessment Permenant Impairment Assessment Date Assessment Type Aa z Injury Type y Degree of Whole Person Impairment Examination B Z U Font Family FontSize Diagnosis B Z U Font Family FontSize Assessed Injuries F Add Injury Remove Injury Body Part or System Workcover Pre existing Compensable Guidelines WPI WPI Assessor Details Assessed By 44 Phone Assessment Report _Upload O _Clear v Font Family Font Size a 28 2 Permanent Impairment Assessment Step by Step The following topics are available to assist you in the use of the Permanent Impairment screen e How do Add a Permanent Impairment Assessment to the Claim e How do I Upload a Document e How do Modify the Permanent Im
225. etermination is a fixed period a determination date from and date to is required Step 4 Click on the SAVE lal icon and the fields will become inactive and your changes will be saved x How do I Add Multiple Claim Details screens 11 2 5 How do I Delete the Claim Details screen Commercial in Confidence SBC IT South Australia Department of Premier and Cabinet Page 62 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 11 3 Claim Details Additional Information The following sections contain additional information about the Claim Details screen functionality and validation e Claim Details Mandatory Fields e Claim Details Tree Control 11 3 1 Mandatory Fields The following fields must be completed in order to successfully save the Claim Details into the SIMS database Claim Classification State Claims Manager Date Employee Signed Claim Form Date Employer Received Claim Form Date Employer Signed Claim Form Date Insurer Received Claim Form 11 3 2 Tree Control Only one Claim Details screen may exist for each claim The screen will appear in the Claim s Tree Control in the following format e Claim Details a i Claim Summary ETRE 3 ae g Injured Worker A Employment Details 3 ssn Incident Details o Injury 3 Injury Details Time Off Work a sy Estimate Commercial in Confidence SBCIT South Australia Department of Premier and Cabine
226. f Insurance SA Version 1 0 User Guide Printed 18 06 2015 46 3 Medical Referral Additional Information The following sections contain additional information about the Medical Referral screen functionality and validation e Medical Referral Mandatory Fields e Medical Referral Tree Control 46 3 1 Mandatory Fields The following fields must be completed in order to successfully save the Medical Referral Details into the SIMS database e Type e Date e Reason for Failure to Attend when Failed to Attend check box is selected 46 3 2 Tree Control When the Medical Referral screen is saved the system will display the following detail in the Tree Control as a reference to the screen contents Medical Referral Only one Medical Referral screen will be displayed in the Tree Control Medical Referral Commercial in Confidence SBC IT South Australia Department of Premier and Cabinet Page 230 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 47 HOW DO I ASSOCIATE A NOMINATED TREATING DOCTOR This screen is used to associate a Nominated Treating Doctor Vendor Profile for the Claim for easy reference when managing the Claim The Nominated Treating Doctor screen is provided for reference only and no details may be altered on this screen with the exception the ability to select new Provider to associate to this screen and to record any Notes Multiple Nominated Treating Docto
227. fidence SBCIT South Australia Department of Premier and Cabinet Page 178 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 37 HOW DO I ENTER INCOME SUPPORT PAYMENTS The Income Support Payment screen records the details of Weekly Compensation Payments made to Injured Workers as a result of their Incapacity due to Injury Multiple Income Support Payments may be recorded for each Claim and these will be displayed in a Folder titled Income Support Payments A Payment that is not yet Authorised may be deleted if the User has the relevant Security Privilege however Authorised Payments may not be deleted Authorised Payments can be reversed by creating a Payment Reversal The System can be configured to schedule recurring Income Support Payments for long term incapacity Claims Once configured the System will automatically create these Payments each Week Recurring Payments can only be configured for a period of seven days for each Payment The following rules apply to the ability to enter an Income Support Payment e Income Support Payments may only be entered for Claims with a current Registration Status of Claim Registered e Income Support Payments may only be entered for Claims with a Current Claim Status of Open or Reopened e Income Support Payments may only be entered for Claims that have a current Earnings record on the Worker s Earnings screen that has a St
228. following topics are available to assist you in the use of File Notes How do Add a File Note to a Claim How do I Upload a Document to the File Note How do Notify a Person of an Assigned Action How do Modify the File Note How do Add more than one File Note How do Delete a File Note The following are related to File Note and are available in other sections of this User Guide e How do I Use the Task List e How dol View the File Note Summary Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 254 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 51 2 1 How dol Add a File Note to a Claim Step 1 Open the Claim you wish to add the New File Note to a19 Y Step 2 Go to the Claim branch of the tree control and click on the FLOATING MENU icon A list of options will appear to the right of the icon E i EEL wu Claim Details New Injury Details amp Injured Worker New Certificate of Capacity i Employment DD New Surgery Related Incapacity oe amp Incident Detail _ New Permanent Impairment Assessment E Injury New Vendor Payment DT eo O Time Off Work s New Income Support Payment oo Se Notional Weekl E 9 Certificates m Permanent Imj m Payments m Income Suppo New Correspondence In ow amp Estimate New Correspondence Out _ Estimate Histol New Medical Referral A Relate
229. for Failure to Attend when Failed to Attend check box is selected 45 3 2 Tree Control When the Medical Referral screen is saved the system will display the following detail in the Tree Control as a reference to the screen contents Medical Referral Only one Medical Referral screen will be displayed in the Tree Control Medical Referral Commercial in Confidence SBC IT South Australia Department of Premier and Cabinet Page 224 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 46 HOW DO I ENTER TREATMENT SERVICE PLANS The SIMS will allow the entry of Treatment and Service Plans for the Claim Multiple Treatment Service Plans may be recorded on this screen The Treatment Service Plans screen displays in the Claim Profile Tree with a description of Treatment Service Plans The Treatment Service Plans screen cannot be deleted once a Plan has been saved A Treatment Service Plans screen may only be created for a Claim that has a Registration Status of Claim Registered and may not be created for a Claim that has a Registration Status of either Claim Awaiting Registration or Claim Invalid The following rules apply when deleting a Treatment Service Plan e A Treatment Service Plan may not be deleted if it has been authorised at any point The Treatment Service Plans screen consists of a single tab e Treatment Service Plans 46 1 Treatment
230. from the claim firstly select the claim you wish to remove the Nominated Treating Doctor screen from Once you have the claim open select the Nominated Treating Doctor branch from the tree control which is to be removed If the Nominated Treating Doctor is selected the background behind the text will appear blue Click on the DELETE icon from the toolbar When the confirmation message appears click on OK L _ The Nominated Treating Doctor will be removed from the claim Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 234 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 Message from webpage 2 Are you sure you wish to delete this screen SIMS System Administrator that you have the correct access level Note This action will not remove the Provider from the system altogether only the link between the Provider and Claim No other screens will be affected If you are unable to DELETE the Nominated Treating Doctor screen selected you may not have access to complete this function Check with the 1 1 Nominated Treating Doctor Additional Information The following sections contain additional information about maintaining Nominated Treating Doctors on a Claim in the SIMS e Nominated Treating Doctor Mandatory Fields e Nominated Treating Doctor Tree Control 47 2 1 Mandatory Fields The following fields must be completed in
231. fter it has been saved How do Add Multiple Payment Reversal screens to a Claim How do Delete a Payment Reversal Screen Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 202 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 The following sections are related to Payment Reversal are available in other sections of this User Guide e How do I Enter a Payment 41 2 1 How do I Add a Payment Reversal for a Vendor Payment to the Claim 4 Step 1 Open the Claim you wish to add the Payment Reversal to Highlight the WG Authorised Payment that you wish to reverse Step 2 Select the Administration gt Reverse Payment menu item as shown below SEESE Claim 15000001 01 Gilmore Jot Task Uist g a Unauthorised Payments 2 Bd Clai ae i a Claim Summary Wi Unauthorised Compensation Payments i A Claim Details Injured Worker pinance A Employment Details ii ZONY ssn Incident Details Workflow d mB Injury Codes b Time Off Work 8 Change Password SS Notional Weekly Earnings a Audit Trail m Permanent Impairment J Reverse Payment o Payments Service Rate Payment Item Search J 1 06 2015 12545 3 SA Licences H an Estimate tj Transfer Claims Owner snes SY Estimate History gt Set Authorisation Levels QFile Note Summary a Claims to be Coded mO Correspondence In Summ Modify Claim Numbe
232. g Income Support Payments on a claim This can be done on either the Income Support Payment screen or within the Unauthorised Compensation screen For details on Authorising Payments on the Unauthorised Compensation screen please refer to How do Approve One or More Compensation Payments Only Authorised SIMS users will have access to Authorise Payments Please see your system administrator if you do not have access and believe that this should be added to your user profile Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 184 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 1 8 06 2015 Step 1 Enter a New Income Support Payment see How do Add an Income Support Payment or open an existing unauthorised compensation payment Unauthorised Payments are distinguished by missing Authorised Details in the Authorisation group box Authorisation _ Authorised ee ia Step 2 Go to the Authorisation group box of the Unauthorised Income Support Payment If you are completing a New Income Support Payment enter relevant details Step 3 If you are viewing an existing Income Support Payment ensure that the screen is in MODIFY mode by selecting the MODIFY amp icon on the toolbar Step 4 Select the Authorised checkbox to authorise the Income Support Payment Once authorised the Income Support Payment Item screen will be read only _ A
233. he person s profile If the Person you wish to notify is NOT a SIMS user Type the full email address of the Person into the Name Email Address field Name Email Address Note If only one result is found the System will populate that name automatically into the Email Notifications table You may select the Remove button to remove a Person from the Email Notifications lists Select the row you wish to delete and click on the Remove button Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 268 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 Note If you have entered the incorrect email address the SIMS will not be able to send the Return to Work File Note correctly Step 5 Once you are satisfied with the Return to Work File Note details entered into the fields on the screen click on the SAVE amp icon and the fields will become inactive and your changes will be saved against the claim lf you enter a Date Completed the Notification will not be sent The SIMS will consider the workflow on the notification completed been selected as recipients on the Email Notifications list Tip When you assign a Return to Work File Note to a SIMS user the Note will appear in the user s Task List Please refer to Task List for more details x The System will prompt the user to enter a Due Date if Employees have
234. he Claim s Work Duties Indicator i e the Injured Worker s progress in returning to work where appropriate A Date Effective for each Work Status needs to be entered as well Return to Work Status 03 Not working injury related y Date Effective 01 01 2015 Changed By SBC System Admin Date Changed Step 5 Changes in a Claim s Work Status are recorded in the Work Status History Work Duties Indicator Date Effective Date Status Changed Changed B Not working with income maintenance 26 05 2015 26 05 2015 SAPS Test Not working with income maintenance 25 05 2015 25 05 2015 SAPS Test Step 6 Once all the relevant Time Off Work Details have been entered select SAVE ial and all the fields in the screen will be inactive and your changes will be saved 20 2 2 How do I Modify the Time Off Work Details Screen Step 1 Open the claim record you wish to modify and click on an existing Time Off Work screen in the tree control See How do I search for a Claim to locate a specific claim for modification Step 2 Click on the MODIFY EZ icon The fields will become active and you will be able to select different values Step 3 Make the desired changes to Time Off Work screen Step 4 Click on the SAVE icon and the fields will become inactive and your changes will be saved Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 96 of 309 Claims Management Syste
235. he FLOATING MENU and create a screen Step 4 The RTW Assessment screen will appear in the screen and tab window Step 5 Select the Assessment Type Status RTW Consultant and Start Date Select the Upload button to search for and upload a file attachment to the assessment if applicable Please refer to How do Upload a Document for further details Once a file is selected and uploaded the file name will appear in the File Name field Assessment Details Assessment Type Internal y Status Open y RTW Consultant SAPS Test y Start Date 10 06 2015 H Completion Date Assessment Outcome y Assessment Comments upload _ Clear File Name Step 6 Select the Provider Search i to enter the Rehabilitation Provider that performed the Assessment when the Assessment Type selected is External SBC IT Commercial in Confidence South Australia Department of Premier and Cabinet Page 112 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 RTW Provider Name 4 Phone Step 7 Select the SAVE al icon to save the screen once all details have been entered 23 2 2 How dol Upload a Document b Step 1 To attach a Document click on the Upload button and use the Windows File Y x A Browser to locate and select the desired file i Choose File to Upload A
236. he Mandatory Fields section below for a full list of fields which must be completed before the screen is saved Occupation at DOI Occupation C Apprentice Job Title Tasks Duties Employment Type y Employment Classification Does the Injured Worker have any other Employment O O O Unknown Step 5 Select the value for Does the Injured Worker have any other Employment If the user selects Yes indicating the Injured Worker has employment with another external employer an additional screen Other External Employment will be inserted in the tree window for the user to complete Does the Injured Worker have any other Employment J es CINo Unknown Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 70 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 Note See the section for instructions on entering the details of an Injured Worker s Other External Employment Step 6 Select the value for Licence Registration and RTWSA Location The Registration list will populate based on the Licence value selected The RTWSA Location list will populate based on the Registration value selected When entering a new Claim the list of Registrations and Locations will be limited to display only those that are associated with the selected Agency and are current as at the current date If the Claim be
237. he content of the field may not be modified To modify the details the user would select the appropriate screen they wish to amend This means that they must be viewing the correct screen they wish to modify To do this use the tree control to select the screen to amend and then press the MODIFY A icon Note Modifiable fields will change from disabled greyed out to white or yellow Modify the fields as required Press TAB after entry of new data appropriate mandatory messages will appear when required AN To save the modification made select the SAVE 4 amp icon on the toolbar The 5 5 Removal of Unwanted Screens lf you wish to delete the screens that are not mandatory you will need to click on the DELETE icon A message will be displayed to make sure you are certain that the screen is to be deleted Message from webpage 2 Are you sure you wish to delete this screen Cancel Click OK if the screen is to be deleted or CANCEL _ 22 _ if the screen is not to be deleted from the claim 5 6 Entering Two or More of the Same Screen on a Claim In certain places the SIMS will allow for more than one of a specific type of screen to be entered into the system This will be evident when the ADD NEW icon is active and not greyed out The user must currently have a screen of the same type selected in the tree control When the same screen type is selected press the ADD NEW icon This will insert a new scre
238. hedule consulting rooms by a general practitioner on not more than 1 patient on the 1 occasion each attendance other than an attendance in unsociable hours in an after hours period if a the attendance is requested by the patient or a responsible person in or not more than 2 hours before the start of the same unbroken after hours period and b the patient s medical condition requires urgent treatment SA Medical Fee 02 Frofessional attendance at consulting 164 00 Schedule rooms by a general practitioner on not more than 1 patient on the 1 occasion each attendance other than an attendance in unsociable hours in an after hours eriod if a the attendance is requested yy the patient or a responsible person in or not more than 2 hours before the start of the same unbroken after hours period and b the patient s medical condition reguires urgent treatment and c it is necessary for the practitioner to return to and specially open consulting rooms for Cancel The details for the Item Number and Date of Service will be populated into the remaining fields on the screen Item Number Description 4 occasion each attendance other than an attendance in unsociable hours in an after hours period if a the attendance is requested by the patient or a responsible person in or not more than 2 hours before the start of the same unbroken after hours period and b the patient s medical condition requires urge
239. hole Person Impairment will be populated from the Assessment with the greater Degree of Whole Person Impairment The Serious Injury checkbox will default to checked if the value of the Degree of Whole Person Impairment is equal to or greater than 30 If the degree is lt 30 the field may be checked by the user Upon checking the serious injury checkbox manually the Serious Injury Assessment Date and the Worker s decision on entitlement to pursue Common Law fields will be enabled for entry selection Impairment Degree of Whole Person Impairment Serious Injury Serious Injury Assessment Date Worker s decision on entitlement to pursue Common Law Step 8 The Date Referred field allows the user to indicate the date the claim was referred to the Rehabilitation Manager The Date Received field allows the user to indicate the date the Rehabilitation Manager received the claim The First RTW Date is read only and will populate with the earliest return date recorded on the Time Off Work screen The First Contact Date allows the user to enter the date first contact was made with the Injured Worker The Date Referred Date Received and First Contact Date fields are mandatory when a RTW Assessment has been recorded for the claim First Contact Date Referred i Date Received lE H First RTW Date First Contact Date Step 9 Once all of the mandatory fields are completed and you are satisfied with
240. horised Step 5 Once you are satisfied with the changes made click on the SAVE lal icon in the toolbar 37 3 Income Support Payment Additional Information The following sections contain additional information about the Income Support Payment screen functionality and validation e Income Support Payment Mandatory Fields e Income Support Payment Tree Control 37 3 1 Mandatory Fields The following fields must be completed in order to successfully save the Income Support Payment Details into the SIMS database Date From Date To SRC Act Reference Payment Type Compensation Type Days of Incapacity in Period Full Shifts Lost in Period Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 187 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 Hours Lost in Period This Employer Hours Lost in Period Other Employer Determination Earnings in Period This Employer if Payment Type of Weekly Compensation Partial Incapacity is selected Earnings in Period Other Employer if Payment Type of Weekly Compensation Partial Incapacity is selected Top Up Amount if Top Up Required check box is checked Overriding Amount if Override Calculation check box is checked Number of Recurring Weeks if Recurring Payment check box is checked 37 3 2 Tree Control More than one Income Support Payment scr
241. horised Vendor Payment This screen is not mandatory When a Vendor Payment is reversed all Payment ltems are reversed All Payment Reversals will appear in the Payments folder in the Claim with a different icon The following rules apply when reversing a Payment e A Payment Reversal cannot be reversed e A Payment cannot be reversed if it has already been reversed and e Only Authorised Payments can be reversed Payment Reversals are automatically authorised when entered and cannot be deleted The Payment Reversal screen consists of a single tab e Payment Reversal 41 1 Payment Reversal The Payment Reversal screen is displayed as follows Payment Reversal Reversal Payment Details Invoice Date 1 06 2015 Invoice Number Payee Name Invest Date Entered 10 06 2015 Date Authorised 10 06 2015 Total Amount excl GST 329 00 Total GST 0 00 Total Amount incl GST 329 00 Date Transferred Date Paid Reversal Details Reversal Type Full Reversal Reversal Date 10 06 2015 Reversal Amount 329 00 Reversal Method O Vendor Cheque EFT No Payment Made Cheque EFT Number Reversal Reason 41 2 Payment Reversal Step by Step The following topics are available to assist you in entering and Payment Reversal details on a claim How do Add a Payment Reversal for a Vendor Payment to the Claim How do Modify the Payment Reversal Screen a
242. hysio C Test docx treatment stoppe 59 1 Correspondence In Summary Step by Step The following topics are available to assist you in the use of the Correspondence In Summary screen e How do I View the Correspondence In Summary e How do Open a Correspondence In screen from the Correspondence In Summary screen The following sections are related to the Correspondence In Summary screen are available in other sections of this User Guide How do create a New Correspondence In Screen How do upload a Document How do add more than one Correspondence In Screen How do delete the Correspondence In Screen 59 1 1 How dol View the Correspondence In Summary Step 1 To view the Correspondence In Summary for the claim click on the Correspondence In Summary folder in the Claim Tree Control E Correspondence In B 5 01 2015 TBA he 28 12 2014 TBA 59 1 2 How dol Open a Correspondence In from the Correspondence In Summary screen p Step 1 To view the Correspondence In Summary for the claim click on the File Note A Summary folder in the Claim Tree Control Commercial in Confidence SBC IT South Australia Department of Premier and Cabinet Page 288 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 ta lm Correspondence In Step 2 Review the list of Correspondence In listed in the Summary until you have located the Correspondence In you wish to o
243. i ii a a aa aena aaea aa Sa 19 2 ACCESSING THE CLAIMS MANAGEMENT SYSTEM ccccececececececececececececececenseeeeeeeeees 20 2 1 INFORMATION ON ACCESSING SIMS cxsceesitntcthectetauectid a a a a 20 2 1 1 How do I Add the SIMS Shortcut to the Desktop ce eeceeeecseeeeeeeeeeseeeeseeeesseeeeeees 20 2 1 2 How do Ilog in to the Self Insured Management System cccceececeeeeeeeeeeeeeseeeeaes 21 2 2 ADDITIONAL INFORMATION FOR ACCESSING THE SIMS ccecececeeeceeeceeeeeeeeeeeeaeaeaeeeeeeeeeaeas 22 2 2 1 Why am I getting an error when trying to log into the SIMS ceeeecceseeeeeeeeeeeeeeeeees 22 2 2 2 Why can t Access all of the SIMS Features ccecceccccccecceeceeeeeeeeeeseeseeeseesaeeseeees 23 220 Why las SIMS TIME O osu Miciccs crasts Scetetaaacuacns Aeseaenaen tensdadnaeiaeaauewseacneuisauseaseenaons 23 3 SIMS LY OUT eisai er ae as ew ee 24 3 1 PS TI Vo MIG Te trset doce teeae aancets dodo paancatel Daicd eee adanioed Aide fbeDohdans of ladaedeiy a datecdseee ahaa ath 24 3 2 QUICK SEAR eccetaice tan dente theuecateetetettnt aides faade teens annara dnd dis oucaneedactanie ie udaten tate he secdoseedacteds 24 Biot SIMS FOO AR oan ech cae a Cah Gt Ce Cah te ha ee Aah rh a 25 34 MEND Soest ra taccnte natercteenn a aden bem tian aes A atnnd nt a Dotan teeR veins cbadnaanteeroeeaniedn 26 3 4 1 File MG ccccceccecccecccccccccccccccececuencenecueccenecueaceneeneaueneeneaueneeneaueceenta
244. ia Receipt Method Paper Form y Date Employer Signed Claim Form j Claims Manager y Date Insurer Received Claim Form es Rehab Manager y Date Entered 10 06 2015 L Confidential Claim Potential Recovery Date Registered 10 06 2015 The Date Entered and Date Registered fields will automatically populate with the date the Claim was entered in SIMS i e the date the screens were created and saved into the database These fields are read only and cannot be modified A The Date Injury Illness Occurred field is a read only field and displays the date of the Injury Illness Occurred that is entered by the user via the Incident Details screen This field will populate once the value has been entered in the Date Injury Illness Occurred field on the Incident Details screen A Step 2 The Claim Status field can be modified as applicable to the Claim The Date Status Changed will automatically populate with the Current System Date and cannot be modified Step 3 The Reason Status Changed field will be enabled and mandatory when a Claim Status has changed The user must record why the Claim Status has changed in this field The Status fields will default to Claim Open and will not require modification The first status of the claim must be Claim Open Commercial in Confidence SBC IT South Australia Department of Premier and Cabinet Page 59 of 309 Claims Management System Self Insurance SA V
245. ications File Notes Mandatory Fields File Notes Tree Control File Notes Confidential File Notes 51 3 1 File Note Email Notifications The Name Email Address field allows the user to enter the Name or the Email Address of the person to which reminder emails are to be sent The Due Date and Reminder Date fields specify the dates on which these emails are sent Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 259 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 If SIMS users are selected from in the Email Notifications table then the user will have Task List entries inserted for this File Note If no SIMS users have been selected in the Email Notifications fields email reminders cannot not be sent 51 3 2 Mandatory Fields The following fields must be completed in order to successfully save the File Note into the SIMS database Category Subject Description Due Date if the Assign checkbox has been checked 51 3 3 Tree Control When the File Note screen is saved the system will display the following detail in the Tree Control as a reference to the screen contents lt Date Entered gt lt Category gt The Tree Control will display all File Notes for the Claim in order of Date Entered descending most recent date entered first An example is displayed below SS File Note Summary lk 30 10 2014 Claims M
246. ick on the SAVE lal icon and the fields will become inactive and your changes will be saved When you add further Investigation Referral screens to the claim the system will automatically check that the details you have entered into the previous screen are valid before creating a new screen For example the User created one Investigation Referral screen but forgot to fill in a Mandatory field See Additional Details for a full list of Mandator fields on this screen the SIMS will not let the user select the ADD NEW function as the previous screen is invalid 50 1 5 How do I Delete the Investigation Referral Screen KON A Aii in Confidence SBCIT South Australia Department of Premier and Cabinet Page 251 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 Step 1 To remove the Investigation Referral screen from the claim firstly select the claim you wish to remove the Investigation Referral screen from Step 2 Once you have the claim open select the Investigation Referral branch from the tree control which is to be removed If the Investigation Referral is selected the background behind the text will appear blue Step 3 Click on the DELETE amp icon from the toolbar When the confirmation message appears click on OK L The screen will be removed from the claim Message from webpage Are you sure you wish to delete this screen Cancel If you are unable t
247. ider associated to the Medical Referral You may enter a partial name and select the Provider Quick Search or select the SEARCH button to launch the full Provider Search Once the Search is completed and a result is selected the Provider field will appear as follows Provider 1 A Commercial in Confidence SBC IT South Australia Department of Premier and Cabinet Page 221 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 Once a Provider is selected you can clear the value entered by selecting the AN CLEAR _licon to the right of the provider field This will clear the value entered and allow for the entry of a new value as applicable Step 6 Add the Venue and add any additional Comments Comments The display table will update when values are entered into the Details fields Provider Failed To Comments Attend p 28 11 2014 Rehabilitation Assessment Jane s Physio Jane s Physio E The Failed to Attend checkbox should be selected if the Appointment is in the past and the Injured Worker failed to attend Failed to Attend Reason for Failure to Attend When selected the Reason for Failure to Attend will be enabled Step 7 Once you are satisfied with the Medical Referral details entered into the fields on the screen click on the SAVE el icon and the fields will become inactive and your changes will be saved against the claim You may remove a Medi
248. ider in the Search Results a screen on a claim see Provider Search Overview for a list of screens the Provider Search is linked to x You may only select one Provider Profile when you are searching from within 7 3 Provider Search Additional Information The following sections contain additional information about the Provider Search screen functionality and validation e Provider Search Using the Search e Provider Search Search Warning Messages 7 3 1 Using the Search Where multiple criteria are entered the SIMS will search for records that meet the criteria For example if the user enters a Medical Practitioners name and a provider type Solicitor no records will be returned lf you search and no results are returned but you are confident that the record exists you should either Check spelling accuracy of input details Reduce your criteria i e if you entered two 2 or more criteria remove one of them Use Like searching use the symbol as a wildcard i e sm th to locate both Smith and Smyth or Use alternative or broader criteria If you cannot locate someone by name try searching by provider type Providers cannot be deleted from the SIMS without engineer database administrator intervention This is because deletion of a provider previously linked to a claim as a Medical Provider Legal Representative etc would cause serious problems with historical data in the SIMS The us
249. ields e Injured Worker Tree Control 12 3 1 Mandatory Fields The following fields must be completed in order to successfully save the Injured Worker into the SIMS database Employee Number lt is mandatory to search for an Injured Worker using the Select Employee button Family Name Commercial in Confidence SBC IT South Australia Department of Premier and Cabinet Page 66 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 Given Name s Date of Birth Termination Resignation Date only if Ex Employee tick box is selected Potential Adverse Impact only if Potential Adverse Impact tick box is selected Gender Country of Birth Language Residential Address Line 1 Suburb State and Postcode 12 3 2 Tree Control Only one Injured Worker screen may exist for each claim The screen will appear in the Claim Tree Control in the following format Injured Worker ai Claim Summary gt ww Claim Details Painjured Worke ij Employment Details aan Incident Details a Injury r Injury Details Time Off Work i Estimate Commercial in Confidence SBC IT South Australia Department of Premier and Cabinet Page 67 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 13 HOW DO I ENTER THE EMPLOYMENT DETAILS The Employment Details screen allows the user to record the employer of the Injured Worker
250. ients S Estimate Histol PEE E m Dependant Cy New income support Faymen _ CQRTW Assessme tj New Recoveries m New File Note New Rehabilitation File Note New Other Injuries or Diseases I New Correspondence In Ey New Correspondence Out a New Medical Referral _ New Investigation Referral New Motor Vehicle New Nominated Treating Doctor New Claim Provider E New Legal Representative A New Dependant 62 New Witness a New Purchase Order New Treatment Service Plans New RTW Plan ro si New Compensation Recipients i kii t Step 3 Select New Surgery Related Incapacity from the floating menu A new tree branch and screen window will automatically appear This process is creating a new screen against a claim To add further details to the claim you must select the option from the FLOATING MENU and create a screen Step 4 The Surgery Related Incapacity screen will appear in the screen window Step 5 Enter the Date of Surgery and add comments the Estimated Date Fit and uncheck the Injury Related check box if the surgery is not applicable to the Injury for the Claim Step 6 The Surgery Related Incapacity screen can be saved once all mandatory details have been entered by selecting the SAVE al icon Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 144 of 309 Claims Management System Self Insurance SA Version 1 0
251. ill be able to select different values Make the desired changes to the Permanent Impairment Assessment screen Click on the SAVE lal icon and the fields will become inactive and your changes will be saved lf you modify a Permanent Impairment Assessment screen and do not wish to save your changes click on the MODIFY A icon for a second time Your changes will not be saved and the claim will stay displayed in the tree window If you wish to discard you changes and close the claim click on the CLOSE RECORD icon from the toolbar Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 136 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 28 2 4 How dol Add Multiple Permanent Impairment Assessment screens to a claim D lt 7 Step 1 Step 2 Step 3 Multiple Permanent Impairment Assessment screens may be added for each Claim To add pan additional Permanent Impairment screen Open the claim record you wish to add a Permanent Impairment Assessment to and click on an existing Permanent Impairment Assessment in the Tree control Select the ADD NEW a icon from the toolbar alternatively you can go to the floating menu and select New Permanent Impairment Assessment Add the details of a new Permanent Impairment Assessment screen referring to the instructions outlined in How do Add a Permanent Impairment Assessment to a Claim
252. ils screen is displayed as follows Incident Details Details When Injury Iliness Occurred Date Injury Illness Occurred E LC Deemed Injury Date Time Occurred e Day Occurred C Work Was Ceased Where Injury Illness Occurred Location Where Injury Illness Occurred puysttus SSOOCOCC NSNNNU WW Accident Location SOC SC C d Specific Location C International Address Country Description Description of Incident Description of Injury Illness Description of Task Being Performed Report Details Cl An Incident Report was Submitted CC Claim Hospital Details C Injured Worker was taken to Hospital Deceased Details C Injured Worker Deceased 15 2 Incident Details Step by Step The following topics are available to assist you in the use of the Incident Details screen How do Enter the Incident Details How do Modify the Incident Details screen How do Add Multiple Incident Details screens How do Delete the Incident Details screen Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 77 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 15 2 1 How do I Enter the Incident Details MS step 1 Enter the Date Injury Illness Occurred and Time Occurred fields using 4 the correct date and time formats If the injury is a gradual onset injury such as Hear
253. im Injured Worker sees Employment Details Injury i E Injury Details Commercial in Confidence SBC IT South Australia Department of Premier and Cabinet Page 80 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 16 HOW DO I RECORD INJURY DETAILS When creating a new claim the Injury Details screen is automatically inserted but not displayed It is not mandatory to complete this screen before saving the Claim This screen allows users to enter details of Injuries sustained by the Injured Worker as a result of the Claim An Injured Worker may have multiple injuries but must have one and only one primary injury The Injury Screen includes one tab e Injury Details 16 1 Injury Details The Injury Details tab will be displayed as follows Injury Details Details Injury Details Primary Injury Injury Side y C Recurrent Injury Date of Recurrence Nature of Injury Description Code Nature of Injury 1 y Nature of Injury 2 D MI Bodily Location of Injury Description Code Bodily Location of Injury 1 M Bodily Location of Injury 2 y Bodily Location of Injury 3 Mechanism of Injury Description Code Mechanism of Injury 1 a MI Mechanism of Injury 2 iv Breakdown Agency of Injury Des
254. in the Screen Tab window select the VIEW 7 iS hyperlink A new box will open and the Download message similar to the following will appear Step 3 If the user wishes to save the document in the hard drive or to a Network select the SAVE button To open the document select the OPEN button To cancel select the CANCEL button Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 282 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 58 HOW DO ENTER CORRESPONDENCE IN Correspondence In such as Reports Letters Faxes or Emails Received can be recorded in the Correspondence In screen Multiple Correspondence In screens can be attached to a Claim The Correspondence In screen consists of one tab Correspondence In Once Correspondence Screens have been added to the Claim a Correspondence In Summary screen will be available when the Correspondence In folder is selected in the Tree Control level above the Correspondence In screens 58 1 Correspondence In The Correspondence In screen will be displayed as follows Correspondence In In Correspondence In Document Category y C Privileged and Confidential Document Type Date Received am Document Date HEY Receipt Method Received From File Name Description v Font Family Font Size k 58 2 Correspondence In Ste
255. ing Loss the user should check the Deemed Injury Date checkbox lf work was ceased at the time of the Incident the user should check the Work was Ceased checkbox This will trigger the Time off Work screen to be displayed for the Claim and the User must enter a Time off Work row in order to save the Time off Work screen The Day Occurred is a read only field and will automatically populate with the Day of the Week the Injury occurred on Upon entry of the Date Occurred field the Day Occurred field will be populated When Injury Illness Occurred Date Injury Illness Occurred al Deemed Injury Date Time Occurred Day Occurred Work Was Ceased Step 2 Select the Place and Location of the Incident If the worker selects the Accident Location of Normal Workplace the address will be populated as indicated on the Employer DOI screen All other Accident Location values will require the address to be completed Where Injury Illness Occurred Location Where Injury Occurred Duty Status Accident Location Specific Location Suburb State Postcode C International Address Country The Address of Workplace details will only automatically populate if the Employment Details screen has already been completed Step 3 Enter a Description of the Incident and a Description of the Injury IIIness and a Description of Task Be
256. ing Performed Description Description of Incident Description of Injury Illness Description of Task Being Performed Step 4 If the Injury has been reported as a part of an Incident Report then select An Incident Report was Submitted checkbox Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 78 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 Enter details of the Incident Number the Individual the Incident was reported to as well as their Phone Number and the Date Time the Incident was reported Selection of the C Claim checkbox allows the user to indicate that the claim is a confidential Police claim The C Claim checkbox will be visible and modifiable only to users who have access via the Security module of SIMS If you cannot view this checkbox 15 2 2 but you think you should have access to it see the System Administrator Report Details v An Incident Report was Submitted LIC Claim Incident Number Date Reported Time Reported Reported To Phone Number Step 5 Enter details of the Hospital the Injured Worker was taken and or admitted to if applicable The Name of Hospital field will only become enabled once the Injured Worker was taken to Hospital or Injured Worker was admitted to Hospital checkbox is selected Hospi
257. ing entered is for an old Date Injury IIIness Occurred the user will need to refresh the Claim using the Refresh button in the Toolbar and update the Registration and Location after the Claim has been saved Step 7 Once all of the mandatory fields are completed on both the Employer DOI and Current Employer tabs click on the SAVE lal icon Upon saving the user will automatically be navigated to the Incident Details screen 13 3 2 How do Modify the Employment Details screen Open the Employer record you wish to modify and click on an existing Employment Details screen in the tree control See How do search for a Claim to locate a specific claim for modification Step 2 Click on the MODIFY A icon The fields will become active and you will be able to select different values Step 3 Make the desired changes to the Employment Details screen Step 4 Click on the SAVE icon and the fields will become inactive and your changes will be saved If you Modify the Employment Details screen and do not wish to save your changes click on the MODIFY 4 icon for a second time Your changes will not be saved and the claim will stay displayed in the tree window If you wish to discard your changes and close the claim click on the Close Record icon from the toolbar 13 3 3 How do I Add Multiple Employment Details screens amp Note The SIMS will not allow multiple Employment Details screens to be added to the Claim 13 3 4 How do I
258. ing topics are available to assist you in entering and maintaining Witness Details on a claim How do Add a Witness to the Claim How do I Upload a Document to the Witness screen How do Modify the Witness Screen after it has been saved How do Add multiple Witness Screens to a Claim How do Delete the Witness Screen 48 2 1 How dol Add a Witness to the Claim Step 1 Open the Claim you wish to add the New Witness to a J Step 2 Go to the Claim Summary branch of the tree control and click on the FLOATING MENU icon A list of options will appear to the right of the icon as shown below Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 236 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 Eti Claim Summary L Claim Details New Injury Details e amp Injured Worker 2 New Certificate of Capacity on i Employment D New Surgery Related Incapacity Incident Detail New Permanent Impairment Assessment m Injury d New Vendor Payment OT OTime Off Work New Income Support Payment 48 Notional Weekl New Recoveries m Certificates o i ae New File Note mO Permanent Imj EE f m Paym arie New Other Injuries or Diseases mB Income Suppo New Correspondence In _ amp Estimate New Correspondence Out i Estimate Histol 4 New Medical Referral a Nominated Tre New Investigation Refer
259. ing you have the correct Security Access Level each Payment may be authorised on the Payment screen within the Claim Refer to How do Authorise Payment ltems 35 3 Unauthorised Payments Additional Information The following sections contain additional information about the Unauthorised Payment Search screen functionality and validation e Unauthorised Payments Using the Search e Unauthorised Payments Search Warning Messages e Unauthorised Payments Navigation of multiple search result pages 35 3 1 Using the Search Where multiple criteria are entered the SIMS will search for records that meet all of the criteria For example if a specific Payment Category is selected and an Invoice Date From and To then all Payments for the Category within the Invoice From and To Dates will be displayed in the Search Results lf you search and no results are returned but you are confident that the record exists you should either Check spelling accuracy of input details Reduce your criteria i e if you entered two 2 or more criteria remove one of them Use alternative or broader criteria If you cannot locate someone by name try searching by claim number 35 3 2 Search Warning Messages 35 3 2 1 NORECORDS MATCH CRITERIA ENTERED If you click on the SEARCH button and the SIMS returns the following message then the SIMS has been unable to locate the payment you are searching for The following is number of r
260. inted 18 06 2015 What item would you like to create a shortcut for This wizard helps you to create shortcuts to local or network programs files folders computers or Internet addresses Type the location of the item _https test sbcit com au sims Click Next to continue Step 3 Enter a name for the Icon in the text box and select FINISH What would you like to name the shortcut Type a name for this shortcut Self Insured Management System Test Click Finish to create the shortcut Step 6 To access the SIMS you will need to follow the steps in the next section How do log in to the Self Insured Management System 2 1 2 How dol log in to the Self Insured Management System Step 1 To access the SIMS either click on the Icon that was created in the previous section or type the link into the Internet Explorer Address Bar Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 22 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 Step 2 Type your details into the User Name and Password fields on the Log in Screen Your username may have already appeared if you are currently logged into the Windows session E httpv 192 168 10 45 8093 SIMS NET Windows Intemet Explorer SA Public Sector SIMS NET Test Environment AUSER NAME 8PASSWORD PR A EN SS Step 3 Click on the v Login button The SIMS main
261. into the Mechanism of Injury Level 2 field Step 8 The Breakdown Agency of Injury Description field allows the user to enter a description of the breakdown agency of the injury recorded The Code field allows the user to enter the Breakdown Agency of Injury code which will then populate the Breakdown Agency of Injury Level 1 2 3 and 4 fields Breakdown Agency of Injury Description Breakdown Agency of Injury 1 Breakdown Agency of Injury 2 Breakdown Agency of Injury 3 Breakdown Agency of Injury 4 Agency of Injury is the same as Breakdown Agency Note It is not mandatory to populate the Breakdown Agency of Injury using the Code field The Breakdown Agency of Injury Level 1 2 3 and 4 fields may be manually selected from the drop down lists provided The Breakdown of Agency Injury 1 is populated with the TOOCS Version 3 1 Defined Agency Level 1 Classifications Codes Upon selecting a value in the first level the corresponding associated values are populated into the Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 83 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 Breakdown of Injury Level 2 field Upon selecting a value in the Level 2 field the associated values are populated into the 3 level and upon selecting a value in the Level 3 field the associated values ar
262. io followed by Region Agency Service and so on depending on the level of the organisation structure they wish to go down to Employment at DOI Portfolio y Region Agency y Service y B Division y Cost Centre Organisation Unit y Users can also enter Dates specific to Claims as criteria to search for This includes the Date the Injury lllness Occurred the Date the Claim was Entered the Date the Claim was received by the Employer or Insurer and the Date the Claim was Registered Date Injury Illness Occurred Date Claim Entered Date Received Employer Date Received Insurer Date Registered Date From HF Date From Date To ji Date To Step 3 Click on the SEARCH 4 button Step 4 lf the SIMS has located any results they will be displayed in the Search Results listing at the bottom of the screen The table includes columns which advises the Claim s Determination Determined Disability the Agency the Claim is for the Claims Manager and their Phone Number assigned to the Claim and if the Claim has Redemption Lump Sum Death and or Commutation Category payments displayed as a Y value in each column as well as advising if the Claim is a Serious Injury and if it has a Common Law Proceeding screen attached The SIMS will also display the number of Claims which match the Search Criteria in the Total Claims field gt 15000002 815 2 06 2015 Self Insu
263. ion occurs after the data is entered in the field and the user selects something else on the screen If the entered data is invalid or needs to be amended an error message will be displayed These error messages are described in the following sections 4 3 1 Date Fields Dates must be entered into Date Fields in a specific format If the correct format is not entered a message will display to the user Message from webpage Invalid format for a date The valid formats are DD MM AYY DDMMYYYY and DD MM YY All date fields within the SIMS are labelled with Date followed by extra information such as Date Received Date Entered etc As specified in the above message the following date formats are acceptable DD MM YYYY 01 01 2014 DD MM YY 01 01 14 DDMMYY 010114 Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 36 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 DDMMYYYY 01012014 DD MM YYYY 01 01 2014 DD MM YY 0101 14 D D YYYY 112014 Automatically inserts CTRL D today s date SIMS will automatically format the date to DD MM YYYY when the when the user leaves the field 4 3 2 Time Fields Time fields will only accept a specific format If the correct format is not entered a message will display to the user Message from webpage Invalid format for a time field Valid formats are HAMM H MMa H MMLAM H MMam Field
264. ions Bf ait ae Person Responsible SAPS Test v C Undetermined Claims Search bd Export Cancel Open Claims 1 Undetermined Claimsjo Open Rehab Claims 1 Total Claims Allocated Claims Portfolio Claim No Injured Worker Injury Date Claim Classification Determination Description of Injury Illness 15000005 03 William Michaels 26 05 2015 Partial Incapacity Undetermined Phillip Lim 10 06 2015 High Risk New Claim Undetermined 64 1 Task List Step by Step The following topics are available to assist you in the use of the Task List features How do Access the Task List Screen How do Search for Actions Due within a Certain Period How do Search for Task List Actions by Status How do View the Status and Type of Claims assigned a Claims Manager How do Open a Claim associated with Task List entries The following sections are related to the Task List are available in other sections of this User Guide e How do l Enter a File Note e How do l Enter Claim Details 64 1 1 How do I Access the Task List Screen Step 1 select the Administration gt Task List menu item The Task List Screen will WG open in the Screen and Tab window Note The Task List screen will also appear when you first log into SIMS Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 308 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 Tip To exit
265. irment Degree of Whole Person Impairment CI Serious Injury Serious Injury Assessment Date Worker s decision on entitlement to pursue Common Law First Contact Date Referred E Date Received si H First RTW Date e First Contact Date E 11 2 Claim Details Step by Step The following topics are available to assist you in the use of the Claim Details screen Commercial in Confidence SBC IT South Australia Department of Premier and Cabinet Page 58 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 How do Enter the Claim Details How do Modify the Claim Details screen How do Determine a Claim How do Add Multiple Claim Details screens How do Delete the Claim Details screen 11 2 1 How do I Enter the Claim Details Step 1 Enter the Claim Classification relevant for the claim Select the State and Claims Manager responsible for the Claim Enter the following Dates Date Employee Signed Claim Form e Date Employer Received Claim Form Date Employer Signed Claim Form and Date Insurer Received Claim Form Claim Details Claim Number Return to Work SA Claim Number Date Injury Illness Occurred Claim Type Self Insured Claim y Date Employee Signed Claim Form Ea Claim Classification y Date Employer Received Claim Form iz State South Austral
266. ishes to view the desired document Document Details Content Searching Examples Document Number Here are some examples of common content search expressions Each NETE search operator has a shorthand symbol Each example shows the full Jurisdiction South Australia operator example on the left and symbolic version on the right Document Source ats AND dogs cats amp dogs Document Category L lt L lt kI Returns documents containing both the words cats and dogs Document Type Content cats OR dogs cats dogs Registered By lt l Returns documents containing either word File Name ats AND NOT dogs cats amp dogs Date Registered Date From E Date To HEY Claim Details Returns documents containing the word cats but not dogs Claim Number g Note The user may use the Content criteria field to search for text within the Uploaded document using the AND amp OR or NOT operators to refine search results Examples of how to use these operators are as follows cats AND dogs cats amp dogs Returns documents which contain both the word cats and the word dogs cats OR dogs cats dogs Returns documents containing either cars or dogs cats NOT dogs cats dogs Returns documents which contain the word cats but not the word dogs At any time the Operator shorth
267. l Modify the Dependant screen after it has been saved nes Step 1 Open the claim record you wish to modify and click on an existing 3 7 Dependant screen in the tree control Dependant E Dependant Franklin Sam Step 2 Click on the MODIFY icon The fields will become active and you will be able to select different values Step 3 Make the desired changes to the Dependant Details screen Step 4 Click on the SAVE lal icon and the fields will become inactive and your changes will be saved lf you modify a Dependant screen and do not wish to save your changes click on the MODIFY icon for a second time Your changes will not be saved and the claim will stay displayed in the tree window If you wish to discard you changes and close the claim click on the CLOSE RECORD icon from the toolbar 26 2 3 How do I Add Multiple Dependant screens to a claim Multiple Dependants may be added for each Claim To add an additional Dependant screen Step 1 Open the claim record you wish to add a Dependant to and click on an wie existing Dependant screen in the Tree control a Dependant pendant Franklin Sam Step 2 Select the ADD NEW al icon from the toolbar alternatively you can go to the floating menu and select New Dependant Add the details of a new Dependant Screen referring to the instructions outlined in How do Add a Dependant to a Claim Step 3 Click on the SAVE lal icon and the fields will become inactive and you
268. l and click on the FLOATING MENU icon A list of options will appear to the right of the icon as shown below Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 100 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 is ET 7 Claim Details New Injury Details amp Injured Workei New Notional Weekly Earnings nee iZEmployment OMER EM eC ite e me mer Ea M Incident Detail New Surgery Related Incapacity E Injury P New Permanent Impairment Assessment oo Time Off Work u A Estimate P Estimate Histol wom Related Claims New Vendor Payment ey New Income Support Payment tS New Recoveries a New File Note New Other Injuries or Diseases New Correspondence In New Correspondence Out a New Medical Referral _ New Investigation Referral amp New Motor Vehicle New Nominated Treating Doctor New Claim Provider Ey New Legal Representative amp New Dependant 62 New Witness New RTW Assessment y New RTW Plan Step 3 Select New Certificate of Capacity from the floating menu A new tree branch and screen window will automatically appear This process is creating a new screen against a claim To add further details to the claim you must select the option from the FLOATING MENU and create a screen The Employee group of fields displays a Read Only Summary of claim details stored on
269. laim How do Add a Payment How do Enter an Employee Reimbursement Payment How do Enter Payment Items How do Enter Multiple Payment Items for a Payment How do Authorise Payment Items How do determine the Status of a Payment How do Upload a Document How do delete a Payment The following sections are related to Provider Payment are available in other sections of this User Guide e How do Use the Provider Quick Search e How do Use the Provider Search e How do Adjust Estimates 33 3 1 How dol Add a Payment Note The method used to record a Payment is dependent on whether the claim already has other Payments attached to it or not refer to the next section How do Enter an Employee Reimbursement T If you wish to add a New Payment as an Employee Reimbursement please Payment Step 1 Open the Claim record for the Claim the payment relates to ANN oN wi cial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 155 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 Step 2 Create a Payment if one does not already exist using the floating menu next to the Claim Summary _ 4 SETS _ Claim Details New Injury Details panier i Injured Workel S New Notional Weekly Earnings er Employment Die New Certificate of Capacity om Incident Detail New Surgery Related Incapacity m Injury _ Ne
270. laims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 63 2 Legal Representative Additional Information The following sections contain additional information about maintaining Legal Representatives on a Claim in the SIMS e Legal Representative Mandatory Fields e Legal Representative Tree Control 63 2 1 Mandatory Fields The following fields must be completed in order to successfully save the Legal Representative Details into the SIMS database lt is mandatory to search for a Provider using the Provider Search button lt is mandatory to select who the Legal Representative if a Representative of either the Employer or the Injured Worker 63 2 2 Tree Control When the Legal Representative screen is saved the system will display the following detail in the Tree Control as a reference to the screen contents Legal Representative lt Provider Name gt The Tree Control will display all Legal Representatives for the Claim in order of Date Entered ascending earliest date entered first Foodstuffs SI Legal Representatives are highlighted in red and Injured Worker Legal Representatives in blue An example is displayed below 10 Legal Representative Details Tes Legal Representative Sweeny amp Associates Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 306 of 309 Claims Management System Self Insurance SA Version 1 0 User
271. lbar or a hyperlink it is displayed in capitals with bold text E g SAVE al icon refers to the icon or ADD WF Add refers to the hyperlink 1 3 5 Keyboard Conventions When one of the steps to completing a task requires the use of a key that key appears in square brackets e g Press Delete Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 20 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 2 ACCESSING THE CLAIMS MANAGEMENT SYSTEM This section of the User Guide describes the initial setup of the Application and process for accessing the SIMS database It is expected that each machine will have a shortcut to the application available on their desktop 2 1 Information on Accessing SIMS 2 1 1 How do I Add the SIMS Shortcut to the Desktop J A Link to the Test SIMS ANN Me httos test sbcit com au sims Link to the Production Claims https saps sbcit com au sims Step 1 Right Click on your Desktop and select New gt Shortcut option View b Sort by b Refresh Paste Paste shortcut New t Folder ES Screen resolution Elbetea at Gadgets w Bitmap image E Personalize Contact Step 2 Enter the appropriate link in the text box and select NEXT Commercial in Confidence SBC IT South Australia Department of Premier and Cabinet Page 21 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Pr
272. le Note screen functionality and validation Return to Work File Notes Email Notifications Return to Work File Notes Mandatory Fields Return to Work File Notes Tree Control Return to Work File Notes Confidential File Notes 8 3 1 Return to Work File Note Email Notifications The Name Email Address field allows the user to enter the Name or the Email Address of the person to which reminder emails are to be sent The Due Date and Reminder Date fields specify the dates on which these emails are sent Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 270 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 If SIMS users are selected from in the Email Notifications table then the user will have Task List entries inserted for this Rehabilitation Note If no SIMS users have been selected in the Email Notifications fields email reminders cannot not be sent 53 1 8 Mandatory Fields The following fields must be completed in order to successfully save the Return to Work File Note into the SIMS database o Subject Description Due Date if the Assign checkbox has been checked 53 1 9 Tree Control When the Return to Work File Note screen is saved the system will display the following detail in the Tree Control as a reference to the screen contents lt Date Entered gt lt Category gt The Tree Control will display all Return
273. lect the Provider associated with the Work Capacity Certificate using the Provider Search See Provider Search for details on searching for a Provider Once you have selected a Provider the associated details will populate into the Provider fields on the Work Capacity Certificate screen Enter a Date Signed as applicable Upload any Work Capacity Certificate if Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 102 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 applicable Refer to How to upload a file to the Work Capacity Certificate for more information Provider Provider Number Provider Type Phone Provider Name Date Signed File Name upload Step 9 Enter any applicable Functional Abilities If Recommended a graduated increase in working hours checkbox is selected enter the over and weeks from values Functional Ability C No Restrictions Physical Function itti Reaching above Sitting y shoakdar y Neck Movement y Standing Walking V Bending X Suip pret X Use of affected ae Kneeling Squatting y body part y Driving y Carrying Holding Lifting y Mental Health Function Attention Concentration PY y ANERO
274. lf there is a second vehicle involved in the incident record the Motor Vehicle details in the Motor Vehicle Details 2 screen Motor Vehicle 2 Details Name of Driver State of Registration Vehicle Registration Step 6 The user may record if there is a CTP Potential Recovery by selecting the checkbox When this checkbox is selected the CTP Reference Number and CTP Reference Date fields are displayed for the user to complete CTP Potential Recovery Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 243 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 Step 7 The user may also record if the Liability Accepted by Employer and if a Driver was at Fault Liability Accepted by Employer O Yes No Driver at Fault Yes No Unknown Step 8 lf a Police Report was obtained for this incident the user must select the Police Report Obtained checkbox which will display and allow the user to enter the Police Report Number and the Police Station the Report was completed at A use may also attach a copy of the Police Report 4 Police Report Obtained Police Report Number Police Station o l Attach File upload Clear Tip Refer to How do I Upload a Document to the Motor Vehicle screen for instructions on uploading documents Step 7 Once you are satisfied with the Motor Vehicle details entered into the fi
275. lorer e It can be used as a navigation tool It allows easy movement through the Claim record For example by expanding the Injury folder and selecting a specific Injury screen in the above example the Injury screen for the Claim record currently displayed will be displayed in the Screen and Tab window in the SIMS Provider profiles are also displayed in the Tree Control e Displays a summary of the Claim as it shows the sections currently completed e t can be used to identify the contents of nodes The tree control label will also display some information about the details held within that node e g File Notes can be identified on the tree node by the date and name of the file note created To view details where there is a small symbol in a box to the left of the node label you need to click on that small plus to open the node Similarly you can click on the symbol to close the node Qj 4CcClaim Summary od Claim Summary n SE E Injured Worker Closed Node amp Injured Worker JEmployer Detaili ijEmployer Details amp Incident Details A Incident Details o Injury m Inju s E jury A Injury Details Open Node 3 7 Floating Menu Additional screens can be added to Claims via the floating menu To access the floating menu click the icon next to the appropriate node in the Tree Control For example clicking on the icon next to the Claim Summary node for a Claim will bring up the floating menu illust
276. low on How do I Upload a Document Entered By SBC System Admin Date Entered I7 11 2014 Time Entered 12 22PM Step 7 The user may elect to Assign a Person Responsible to the Return to Work File Note if an action is required by clicking on the Assign checkbox When the checkbox is selected the Due Date Reminder Date Date Completed and Name Email Address fields are displayed and active for the user to enter the required information Multiple people may be assigned and removed to from the File Note by selecting the INSERT and REMOVE icons Assign Due Date E Reminder Date Date Completed gii Name Email Address insert WRemove Person Responsible Type Nicole Howard User You may select to send the Return to Work File Note to an Employee and assign a Due Date and Reminder Date for the Task Refer to How do Notify an Employee of my Return to Work File Note Step 8 Once you are satisfied with the Return to Work File Note details entered into the fields on the screen click on the SAVE icon and the fields will become inactive and your changes will be saved against the claim 53 1 4 How dol Upload a Document NS Step 1 To attach a Document click on the Upload button and use the Windows File Browser to locate and select the desired file Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 267 of 309 Claims Management System Self Ins
277. ltiple Claim Details screens cccccceecccseeeeceeeeceeeeeseeeeeaeeeeseeeesaaees 61 11 2 5 How do I Delete the Claim Details screen 0 0 eee cccecceceeeeeeeeeeseeeeseeeeseeeesseeeeseneesaaees 61 11 38 CLAIM DETAILS ADDITIONAL INFORMATION 0scccesceceeeeeceseeteeeeceeceteueeeeeececeneetaneceneneetaneeees 62 TES Mandt Fields hese catia tak te Raul oh tata Sato aati ath haha Gatch faint elite a 62 ESL TESCO O earner ene mn eet OOP RN ETT GR em RE maT Pe Penner TiS emt eRe MNE LTS orn PC NNT TI Penn TT 62 12 HOW DO I ENTER THE INJURED WORKER S DETAILS ccccceseeeeseeeneeeeneeeneeeeneees 63 t21 INJURED WORKER rrn rN EREN EN ONENE ER 63 12 2 INJURED WORKER STEP BY STEP rriei tan aaa a e aa a aaria aani a raaa a Ean 63 12 2 1 How do l Enter an Injured Worker to a Claim cccecccceecceseeeeceeeeseeeeeseeeeseneeeseeeenaaees 64 12 2 2 How do Add a New Injured Worker to the Claim sssssssosnssesnnssrnsesrrnesrrresrrresrrresrrren 64 12 2 3 How do I Modify the Injured Worker SCre n cccccccseccceeeeseeeeeeeeseeeeseeeeeeeeseeesaueenenes 65 12 2 4 How do I Add Multiple Injured Worker SCre ns cccccceeccceeeceeeeeeeeeeeeeseeeeseeesaeeesaees 65 12 2 5 How do I Delete the Injured Worker SCre n cccccceccceeeeceeeceeeeceeeceeeeseueeseeessusesaess 65 12 3 INJURED WORKER ADDITIONAL INFORMATION 0cc0sccceeeceececeeeeseeceeeeceueeseeeseuseseueeseeeseeeseees 65 123 1 Mandato
278. lue from the combo box or launching the Investigator Provider search by selecting the Investigator Search 4 button See Provider Search for details on locating the desired Investigator Provider Investigation Type Investigator Step 5 Add the Date Referred Appointment Date if Known the Approved Hours for the Investigation Date to be Completed and use the checkbox to indicate if this record is Private and Confidential C Privilege and Confidential 7 e T ANE oo oe Date to b att Date Referred Appointment Date Approved Hours Completed Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 249 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 Step 6 The User can add the details of the Investigation Report and Upload a copy of the Investigation Report Investigation Report Report Due Date CO Report Completed Date Completed Attach File B Upload _ Clear Tip Refer to How do Upload a Document to the Investigation Referral screen for instructions on uploading documents Step 7 Add any further Investigation Comments as required Investigation Comments Comments mM il i m s B Z U a Font Family FontSize 50 1 2 How do I Upload a Document to an Investigation Referral Step 1 Once a new Investigation Referral screen has been created type in the details of the Inves
279. ly entered in the Dependant screen with a date effective being the date of injury illness and the type Dependant The user will then need to complete all other details for the Dependants The Compensation Recipients screen contains one tab e Compensation Recipients 38 1 Compensation Recipients The Compensation Recipients tab will be displayed as follows Compensation Recipients Recipients Compensation Recipient Details Priority Date From Date To Recipient Amount per Payment per Payment lv View Active Only Insert Remove Priority Date Effective From al Date Effective To Type y Recipient per Payment Amount per Payment Max Amount per Payment Max Amount per Claim Total Paid to Date Recipient Reference Telephone Contact Name Fax Number Email Mobile Postal Address Street Residential Address Address Address State Postcode Suburb State Postcode Country Country Commercial in Confidence SBC IT South Australia Department of Premier and Cabinet Page 189 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 38 2 Compensation Recipients Step by Step The following topics are available to assist y
280. m Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 lf you Modify a Time Off Work screen and do not wish to save your changes click on the MODIFY A icon for a second time Your changes will not be saved and the claim will stay displayed in the tree window If you wish to discard you changes and close the claim click on the CLOSE RECORD 4 icon from the toolbar 20 2 3 How dol Add multiple Time Off Work for the Claim Step 1 Open the claim record you wish to add multiple time off work and select the time off work screen Step 2 Select the Add hyperlink This will insert a new row into the Time Off Work table Step 3 Complete all the relevant information For more information on how to enter the Incapacity Details refer to How to Add Time Off Work Details to a Claim If you select the 3 Remove hyperlink the selected row is removed from the Time Off Work Table This button is only functional if a single row is selected from the Time Off Work table A 20 2 4 How do Delete a Time Off Work screen Note The SIMS will not allow the Time Off Work screen to be deleted as it contains key Claim details Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 97 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 21 HOW DO I ENTER CERTIFICATES This screen allows users to enter Work Capacity Certificate in relation to a
281. m in the SIMS e New Claims Mandatory Fields Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 55 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 The following sections of the User Guide will be referenced following the creation of a New Claim in the SIMS How do Enter Claim Details How do Edit the Injured Worker Details How do Enter the Employment Details How do Enter Incident Details How do Enter Other Injuries or Diseases How do Enter Injury Details Generating a Claim Number How do Enter a Claim Estimate 10 How do I Create a New Claim in the SIMS 1 1 we Step 1 To Create a New Claim click on the New Claim toolbar icon select File gt New Claim from the Menu or New Claim _ from the Claim Search Step 2 Complete the Claim Details screen Step 3 Complete the Injured Worker Details screen Step 4 Review the Employer Details screen and change any details if required Step 5 Complete the Incident Details screen Step 6 Complete the Injury Details screen AN When you have created a New Claim the claim will open in the Tree The user will be navigated to complete each screen as they appear in the tree window starting with the Claim Details can be saved Refer to the Mandatory Fields for more information on the x Validation This screen and all mandatory screens must be completed before the claim manda
282. ment System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 How do View the Permanent Impairment Assessment Summary The Permanent Impairment Summary screen appears when the Permanent Impairment folder is selected from the Claim Tree Control The Permanent Impairment Summary screen displays a listing of all Permanent Impairments for the Claim in descending date order i e the most recent record will display at the top of the list The user may select the Permanent Impairment hyperlink to open the desired Permanent Impairment in the Screen window if required The user may select Criteria in order to refine the list of Permanent Impairments which appear in the Permanent Impairment Summary screen A combination of Permanent Impairment Date To Date From and Impairment Code can be selected The Permanent Impairment Summary consists of one tab Permanent Impairment Summary Commercial in Confidence SBC IT South Australia Department of Premier and Cabinet Page 139 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 140 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 29 PERMANENT IMPAIRMENT SUMMARY The Permanent Impairment Summary screen will display as follows Permanent Impairment Summary Impairment Summary
283. ministration of the Claim The Claim Details screen contains one tab e Claim Details 11 1 Claim Details The screen will appear as follows Claim Details Details Claim Details Claim Number Return to Work SA Claim Number Date Injury Illness Occurred Claim Type Date Employee Signed Claim Form Claim Classification Date Employer Received Claim Form State South Australia si Receipt Method v Date Employer Signed Claim Form Rehab Manager v Date Entered 10 06 2015 C Confidential Claim C Potential Recovery Date Registered 10 06 2015 Claim Status Details Claim Status Claim Open Reason Status Changed Date Status Changed 10 06 2015 Status Reason Status Changed Date Status Changed Changed By here is no historical claim status for this claim Rehabilitation Status Details Rehabilitation Status Yet to be refered Rehabilitation Status Date 10 06 2015 Date Rehabilitation Status Changed 10 06 2015 Rehabilitation Status Rehabilitation Status Date Date Rehabilitation Status Changed here is no historical claim rehabilitation status for this claim Determination Details Determination U i Date i inati pma pma ndetermined Ll Interim Payments Determined 10 06 2015 Period of Determination From E To EEE Disability Determination Date Determined Determination From Determination To here is no determination histo South Australia Claim Management Details Impa
284. move the Payment from Once you have the claim open expand the Payments folder in the tree control and select the branch which is to be removed If the Payment is selected the background behind the text will appear blue Payments fe 10 06 2015 IN332 672 40 Step 3 Click on the DELETE amp icon from the toolbar When the confirmation message appears click on okl l The Payment screen will be removed from the claim Message from webpage Are you sure you wish to delete this screen If you are unable to DELETE X the Payment screen selected you may not have access to complete this function Check with the SIMS System Administrator that you have the correct access level Alternatively check if the Payment has been Authorised Refer to How do Add a Payment Reversal to the Claim if the Payment has been Authorised and requires reversal 33 4 Provider Payment Additional Information The following sections contain additional information about the Provider Payment screen functionality and validation e Provider Payment Mandatory Fields e Provider Payment Tree Control 33 4 1 Mandatory Fields The following fields must be completed in order to successfully save the Provider Payment Details into the SIMS database Date Received Invoice Date Invoice Number Payee Name Service Provider Payment Category Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 165 of 30
285. ms Management System Self Insurance SA Version 1 0 User Guide Step 2 Step 3 Step 4 Step 5 Printed 18 06 2015 Go to the Claim Summary branch of the tree control and click on the FLOATING MENU con A list of options will appear to the right of the icon as shown below E de ETE ee o Claim Details New Injury Details ow Injured Worker New Certificate of Capacity i Employment D New Surgery Related Incapacity A Incident Detail New Permanent Impairment Assessment Injury lt New Vendor Payment OTime Off Work o New Income Support Payment or 4 pial Weekl Pirie Recoveries rE Certincates e New File Note Permanent Imp r l m Payments New Other Injuries or Diseases m Income Suppo New Correspondence In ow amp Estimate New Correspondence Out fakin t Estimate Histo EaR EAE eL A Related Claims New Investigation Referral H RTW Assessme es New Motor Vehicle a New Nominated Treating Doctor New Claim Provider New Legal Representative amp New Dependant 2 New Witness yn New RTW Assessment y New RTW Plan Select New Medical Referral from the floating menu A new tree branch and screen window will automatically appear This process is creating a new screen against a claim Select the Add hyperlink below the display table to insert a new Referral into the list Select the Type and enter the Date and Time Dae JE mme O Enter the name of the Prov
286. n Confidence South Australia Department of Premier and Cabinet Page 284 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 Step 8 Upload a Document to the Correspondence In if required see the section below on How do Upload a Document Step 9 Enter a Description for the Correspondence In Description Description BE 7 U ARE Font Family Font Size Correspondence In Description A Tip You may use the toolbar in the Description text box menu to format the 58 2 2 How dol Upload a Document XS Step 1 Once a New Correspondence In screen has been created Type in the details of WG the correspondence into each field Step 2 To attach a Document to the Correspondence In click on the Upload button and use the Windows File Browser to locate and select the desired file Choose File to Upload G xs O SE gt Libraries gt i PFOP E p i Organize v il e Ft Favorites Libraries gE Desktop Open a library to see your files and arrange them by folder date and other properties mi Downloads Recent Places Documen ts Music x Pictures ly Librar brar brary OneDrive S gt Sa brary SS L ibrar Videos pe Libraries E a A SS Documents ad Music j t Pictures Videos j Computer Gu Network File name gt Al Files x Open Cancel Once the desired file is selected
287. n Status Status Date Date Status Changed here is no historical claim rehabilitation status for this claim Step 5 The Determination field will default to Undetermined When the Interim Payments checkbox is selected this indicates that the worker has been offered interim payments The Date Determined field will default to the Current System Date The Period of Determination From field is mandatory while the To field is optional The Disability field will be enabled for entry upon the user selecting a value other than Undetermined in the Determination field Determination Details Inati A e Date T Determination Undetermined y _ Interim Payments Datermined SaS Period of Determination From H To Disability Determination Date Determined Determination From Determination To Step 6 The Date of First Incapacity field populates with the start date of the first certificate to indicate the unfit date from or fit for suitable duties from earliest date The SWSA Advisory Date field allows the user to enter the date the employer advised ReturnToWorkSA of the Injury The 52 Week End Date field will populate with the end date of the 52 calendar week from the Compensation Entitlement From Date and the 104 Week End Date field will populate with the end date of the 104 calendar week from the Compensation Entitlement From Date South Australia Claim Management Details Date of
288. n the Claim Tree Control under the Rehabilitation Summary folder in the following format o RTW Plan lt Date gt S RTW Plans 82 06 2015 27 06 2015 Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 124 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 26 HOW DO I ENTER A DEPENDANT The Dependant Details screen records the details of any Dependants of the Claim Multiple Dependants may be recorded for each Claim and these will be displayed in a Folder tiled Dependants A Dependant screen may be deleted if the User has permission to do SO Screens display in the Directory Tree with a Description in the following format Dependant lt Family Name gt lt Given Name s gt For example Dependant Smith Mary Dependants are ordered in the folder by their Description in alphabetical order The Dependant screen contains one tab e Dependant Details 26 1 Dependant Details The Dependant Details screen displays as seen below Dependant Details Details Dependant Details Relationship to Claimant y C Partial Dependant Personal Details Family Name Title Given Name s k Date of Birth _ Requires An Interpreter Language _ Dependant is undertaking full time education Current Status on Claim Status Reason Joined Withdrawn Residential Address
289. nal information about the Motor Vehicle screen functionality and validation e Motor Vehicle Mandatory Fields e Motor Vehicle Tree Control Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 246 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 49 3 1 Mandatory Fields The following fields must be completed in order to successfully save the Motor Vehicle Details into the SIMS database Name of Driver Vehicle Registration State of Registration 49 3 2 Tree Control When the Motor Vehicle screen is saved the system will display the following detail in the Tree Control as a reference to the screen contents e Motor Vehicle lt Vehicle Registration gt The Tree Control will display all Motor Vehicles for the Claim in order of Date Entered ascending earliest date entered first An example is displayed below E 9 Motor Vehicles ow 54521 459 Commercial in Confidence SBC IT South Australia Department of Premier and Cabinet Page 247 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 50 HOW DO I ENTER AN INVESTIGATION REFERRAL The Investigation screen allows the user to record the details of any Investigation being conducted in relation to a claim The Investigation Referral screen consists of one tab Investigation Referral Investigation Referral Referr
290. nd Cabinet Page 10 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 35 3 UNAUTHORISED PAYMENTS ADDITIONAL INFORMATION cccesceceeeeeeceeeseeceeeteneeteueeseeesaneess 171 10 roe WSE ct 66 peerless averse MER EN cn RE ne ee Eo ene oe 171 39 32 Search Warning Messages ci csctincaeteecscidascsus shpine agaa hinaia aa aaa 171 36 HOW DO I ENTER WORKER S EARNINGS 0 cccccceseeeeeeeeeneeeeseeenseeeneecnsesenseeneseaeees 173 36 1 WORKERS EARNINGS srtacssanbsacnesad ass castnnaneredoinusictananatataawierstarauabatgantathanuseeRsomienitananetadaen 173 36 2 WORKER S EARNINGS STEP BY STEP 0 0ceccceceseececsecccecccseeccecescececesesoucesaeenceeesceeeseeesceeese 173 36 2 1 Howdol Add Worker s Earnings cccccscceccceeceeeceecaeecuecaeeceecaeeceesaeeceesaeeseeeaeesaes 174 36 2 2 How do I Modify the Worker s Earnings screen after it s been Saved 0000 175 36 2 3 How do I Add Multiple Worker s Earnings Screens to a Claim ccccccceeeeeeeeeeeees 176 36 2 4 How do I Delete a Worker s Earnings screen cccccceccceeceecceeceeeceeeeeeseeeaeeseeeaeeeaes 176 36 3 WORKER S EARNINGS ADDITIONAL INFORMATION ccssecccececesceceeeeeceteneeeeeeteeeteueesseesaeess 176 30k Mandatory Fields 4 tepid tte a tetete noes ieee etete e Aarti toe eae Mic a e 176 Ope WS CONTO lice rccpsminea ce ssuteteatemneepequrmenacganea A 176 37 HOW DO I
291. nd Cabinet Page 15 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 59 1 1 How do I View the Correspondence IN Summary cccsccceceeeeeeeeeeseeeesaeeeeseeeesseeeeas 287 59 1 2 How do I Open a Correspondence In from the Correspondence In Summary screen 287 60 HOW DO I ENTER CORRESPONDENCE OUT 1 0 0 0 ccccceeeeeeeneeceseeenseeeneeenseseneeeneeneneees 289 60 CORRESPONDENCE QUT cuect Gad i e coer Grate aan Grattan Grant t aed Gear as ted Geet oleate 289 60 2 CORRESPONDENCE OUT STEP BY STEP 0cccccsececsseecceeeccaseeceeeeceaseecaeeseueeecaseeseuaesseeeesaes 289 60 2 1 How do I Create a New Correspondence Out Screen cccccceseeeeeeeeceeeeeeeeseneeneees 290 6022 HOW GOW DIOAG a DOCUMEN gs cud siete ewet A eedte ne buecand meeiae esdann etn 291 60 2 3 How do I Add More than one Correspondence Out screen ccceeeeceeeeeeeeteeeeneees 292 60 2 4 How do I Delete the Correspondence Out SCree n cccceeccceeeeeeeeceeeeceeeseeesaneenaees 292 60 3 CORRESPONDENCE OUT ADDITIONAL INFORMATION DETAILS 0cccceeeeeeeeeeseeeeseeeesaeeeeeaes 292 6031 Mandal ICIS sariin ial a acelat hietsa al ieacecal aia Siasatet es 292 6032 TREO CONTO lees castes ie hashes otk heh saute d oh heath coiled able heath tesla old abla heath teasdal dnd abla hoshsteasdafadnd abies 292 60 3 3 Privileged and Confidential ccccccccsscccceeceeeeeeeseeeeseeeeeseeeese
292. ndee e a a E dabei 259 5134 lt Contidentiall File NOTES serceru a a a a a 259 52 HOW DO I VIEW THE FILE NOTE SUMMARY ccccsecsessssesscnseneeneeeseeseessaseneeneenees 260 52 1 FLE NOTE SUMMARY STEP BY STEP ieran A AE wertanarntienn 260 52 1 1 How do I View the File Note Summary aannnannnennnannnennnnnnnnnnnnnrnenennnrrsnrrnnrrnnrrnerrennns 261 52 1 2 How do l use the File Note Summary Search n nnnennnenensnnnenrsrresnrrsrresrrrerrrerrreenee 261 52 1 3 How do I Open a File Note from the File Note Summary screen ccceseeeeeeeeeees 261 53 HOW DO I ENTER A RETURN TO WORK FILE NOTE ccccsccsecnscneeneseeseesensenseneenees 263 t2 RETURN TO WORK FILENOTEccsceiirn a N hatin aca wate aden eadeess 264 1 3 RETURN TO WORK FILE NOTE STEP BY STEP korrodere a 264 8 3 1 How do Add a Return to Work File Note to a Claim cc ccccecceccseeceeeeeeteeeeeeteeeeeeees 264 53 1 4 How do Upload a Document ccc ccccccsececeeeceeeeceeeeceecceueeseeeceueeseueeseeessuseseeesseeens 266 53 1 5 How do I Notify a person of an Assigned ACtiON ccccceeceseeeeeeeeceeeseeesaeeeseeeeneeees 267 8 3 1 How do I Modify the Return to Work File Note cccccceeceseeeeeeeeseeeeeeeeseeeeseeeseeeens 268 53 1 6 How do Add more than one Return to Work File Note cccccccseseseeeseeseeeeeeees 268 53 1 7 How do Delete a Return to Work File Note cccccccecceecee
293. nfident that the record exists you should either Check spelling accuracy of input details Reduce your criteria i e if you entered two 2 or more criteria remove one of them Use alternative or broader criteria If you cannot locate someone by name try searching by claim number 40 3 2 Search Warning Messages 40 3 2 1 No RECORDS MATCH CRITERIA ENTERED If you click on the SEARCH button and the SIMS returns the following message then the SIMS has been unable to locate the payment you are searching for The following is number of reasons why the SIMS may not locate the payment you are searching for e The Criteria are incorrect Check the Payment Details you have entered as criteria It might be that the criteria you are entering will not match the details entered when the Payment was recorded e You are using too many Search Criteria Simplifying your search by entering fewer search criteria Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 200 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 201 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 41 HOW _DO ENTER A PAYMENT REVERSAL FOR VENDOR PAYMENTS The Payment Reversal screen allows the user to reverse a full previously aut
294. nfidential for more information Privileged and Confidential Step 3 Enter a Date Sent and if known enter who the correspondence is being Sent To Date Sent Sent To upload File Name Step 4 Upload a Document to the Correspondence Out if required see the section below on How do Upload a Document Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 291 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 Step 5 Enter a Description for the Correspondence Out Description Description BJ U Font Family FontSize t Tip You may use the toolbar in the Description text box menu to format the Correspondence Out Description 60 2 2 How dol Upload a Document Step 1 Once a New Correspondence Out screen has been created Type in the details of the correspondence into each field Step 2 To attach a Document to the Correspondence Out click on the Upload button and use the Windows File Browser to locate and select the desired file i Choose File to Upload amp 28 OU a b esa gt _ E gt lg Sean lianas l Pi Organize v fl w Favorites Libraries MB Desktop Open a library to see your files and arrange them by folder date and other properties pi Downloads i erat Wlnce A Documents a Music S Pictures my Library wy Library i Library amp OneDrive
295. nformation When Have recovered from injury condition s and are fit to return to normal duties and hours the fields associated with that type are mandatory e g Date From When Are fit to perform suitable duties that accommodate functional abilities is selected the fields associated with that type are mandatory e g Date From and Date To e When Are medically unfit to undertake suitable duties is selected the fields associated with that type are mandatory e g Date From and Date To Date Signed When Recommended a graduated increase in working hours is selected the fields associated with that type are mandatory e g over and weeks from 21 3 2 Tree Control Multiple Work Capacity Certificate screens may exist for each claim The screens will appear in the Claim Tree Control under the Work Capacity Certificate Summary folder in the following format lt Period Date From gt lt Period Date To gt E Certificates 2015 fee 10 06 2015 13 06 2015 The Work Capacity Certificate screens are sorted in Work Capacity Certificate Date To order descending latest Date To at the top of the list The Work Capacity Certificate Period covers all Incapacity Types for the Work Capacity Certificate from the Unfit for Work to Date Fit for Return to Pre injury Duties inclusive 21 3 3 Work Capacity Certificate Periods The Work Capacity Certificate will be validated using the date from and date to for all
296. nimum Wage Net Compensation Amount Payable Recurring Payments Date of First Number of C Override Calculation Overriding Amount l ayer Recurring Weeks _ Top Up Required Top Up Amount Week of E Authorised gt re Authorise Re J Payme Gross Amount Payable Date Authorised Authorised By Payee Details Payee Role Invoice Invoice Amount Payable Date Date Paid Cheque Manually Compensation Ref Document Date Transferred EFT Ref Processed william Michaels Injured Worker T Total 0 00 a Add Remove gt Font Family Font Size ki Cost Centre Payment Applied Portfolio Department of Planning Transport and Infrastructure Region Department of Planning Transport and Infrastructure v Agency Department of Planning Transport and Infrastructure Service Public Transport Services Division v Division Integrated Transport Services Cost Centre Old Claims y Organisation Unit y 37 2 Income Support Payment Step by Step The following topics are available to assist you in entering and maintaining Income Support Payments on a claim How do Add an Income Support Payment How do I Enter Multiple Income Support Payments How do I Authorise Income Support Payments How do set up Recurring Payments How do I Authorise Recurring Payments The following sections are related to Income Support Payment are available in other sections of this
297. nnunnnnnnunnnnnnunnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnn nae 93 Qual RELATED CLAIMS cearo O O A 93 19 2 RELATED GLAIMS STEP BY STEP vinuiichstaniasttatne cht sawasiekatnedataatiedttabiedtnetetabiivatataadbia 93 19 2 1 How do I View Related Claims cc cccccccccceccesseseeseeeeseeseuueeeeeeeeeeeuueesaesaueeeenvaneaess 93 19 2 2 How do I Delete a Related Claims screen cc ccccecceccseeesecceeeeeteeeeeeteeeseteeeeseteeeeeetes 93 20 HOW DO I ENTER TIME OFF WORK DETAILS ccccsessescescnsceseneeneeeseeseesenseneenesnens 94 20 1 TME OFF WV ORK eiin na Aaa see Stan aso hes ee Shan ce toc aa Aaaa pndai 94 Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 7 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 20 2 TIME OFF WORK STEP BY STEP i secitegscectsegineriaeoscenseadennwiebateabiedencts Se eabiadenteic Se netindiis ene 94 20 24 JAOW do Ada Time Off Work toa Clll cuniitas 94 20 2 2 How do I Modify the Time Off Work Details Screen nnnensnennnenenenenennerrreerresrresrenne 95 20 2 3 How do I Add multiple Time Off Work for the Claim n nnannnnnnannnennennnnnnnnnnnnnnnnnnnnennnnn 96 20 2 4 How do I Delete a Time Off Work screen ccc cecceccseeceeeeeeteeeeeeteeeeeeteeeeseteeeeseteeeeetes 96 21 HOW DO I ENTER CERTIFICATES 2 cccessecseseceneecesecenseeeseeceseeeaseceseeeaseeeneeeaseseasenenes 97 21h
298. nt Restriction to the Claim Step 1 Open the Claim you wish to add the New Payment Restrictions to 43 2 1 S6 Step 2 Go to the Claim Summary branch of the tree control and click on the FLOATING MENU icon A list of options will appear to the right of the icon as shown below Sak tClaim Summary _ Claim Details New Injury Details nm B Injured Workei New Notional Weekly Earnings dg Employment D48 New Certificate of Capacity Incident Detail gt New Surgery Related Incapacity mO Injury _ New Permanent Impairment Assessment DTi ETT gt be Work New Vendor Payment DA B New Compensation Recipients Permanent Imp New Income Support Payment Payments 9 10 06 2015 o New Recoveries fe Estimate e e New File Note wii Estimate Histou New Rehabilitation File Note 2 Dependant New Other Injuries or Diseases m New Depend 7 New Correspondence In A Related Claims New Correspondence Out a New Medical Referral _ New Investigation Referral amp New Motor Vehicle a New Nominated Treating Doctor New Claim Provider Ei New Legal Representative amp New Dependant 2 New Witness 2 New Purchase Order New Treatment Service Plans New RTW Assessment za New RTW Plan da New Compensation Recipients Step 3 Select New Payment Restrictions from the floating menu A new tree branch and screen window will automatically appear This process is creating a new s
299. nt screen The following sections are related to the Other External Current Employment screen are available in other sections of this guide e How do I Enter the Employer DOI and Current Employer Details Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 73 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 14 2 1 How do I Enter the Other External Current Employment to the question Does the Injured Worker have any other Employment As T This screen will automatically appear when the user selects Yes in response shown below Does the Injured Worker have any other Employment OyYes No Unknown If this option is not selected the screen will not be available for the Claim Ms Step 1 Open the Other External Current Employment screen by selecting it from the AQ Ke Tree Control gti Claim Summary woe Claim _ B Injured Worker Employment Details om Incident Details m Injury 2 ae SS Estimate i Estimate History m Payments apa JTS Other External Current Employment Step 2 Click on the Insert osert hyperlink to add a New Employer to the table Name of Employer Address Average Weekly Earnings Days Hours Telephone gt Step 3 Enter the Details of the Other Employer including the Name of Employer Address Average Weekly Earnings Normal Hours per Week and Normal Days per Week Repeat steps 2 3 to add more than one O
300. nt treatment Surcharge tA Scheduled Amount Professional attendance at other than consulting rooms by a general practitioner on not more than 1 patient on the 1 Quantity m Total Amount Excl GST Tax Status Not Applicable Tax Free y GST Reason for variation Total Amount Incl GST Step 6 If the item doesn t have a valid Item Number then enter the Description Quantity Total Amount and Tax Status as required Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 160 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 Step 7 lf the item amount populated using the scheduled Amount Rate is not the same as the fee charged by the Service Provider you may increase the amount payable to reflect the Surcharge The value should be recorded in the Total amount excl GST Note If the Item number entered incurs GST please change the Tax Status to be Cost incurs GST Step 8 lf an amount that is different to the Scheduled Amount Rate has been entered for the payment item the reason field is enabled and mandatory You must complete this field for the item Reason for variation Step 9 lf all details in relation to the payment have been successfully recorded the user may add another payment item see the section on adding multiple payment items or save the payment using the Save ic
301. o DELETE A the Investigation Referral screen selected you may not have access to complete this function Check with the SIMS System Administrator that you have the correct access level 50 2 Investigation Referral Additional Information The following sections contain additional information about the Investigation Referral screen functionality and validation e Investigation Referral Mandatory Fields e Investigation Referral Tree Control e Investigation Referral Privileged and Confidential 50 2 1 Mandatory Fields The following fields must be completed in order to successfully save the Investigation Referral Details into the SIMS database Investigation Type Date Referred 50 2 2 Tree Control When the Investigation Referral screen is saved the system will display the following detail in the Tree Control as a reference to the screen contents When the reference is selected the details are displayed in the Screen window o lt lnvestigation Type gt lt Date Referred The Tree Control will display all Investigation Referrals for the Claim in order of Date Referred descending the most recent date referred first An example is displayed below Commercial in Confidence SBC IT South Australia Department of Premier and Cabinet Page 252 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 oO Investigation Referral he Factual 7 11 2014 50 2 3 Confidential Inv
302. of the Claim in terms of claim details costs certificates return to work and determination This screen will be the first screen that appears in the tree window when a claim is displayed using the claim search quick search or a hyperlink The Claim Summary screen is automatically displayed when a claim is recorded for the first time or refreshed using the refresh icon The Claim Summary screen consists of a single tab e Claim Summary 18 1 Claim Summary The Claim Summary screen is displayed as follows caine O Claim Details Claim Number Claim Type Date Injury Illness Occurred Claim Status Claim Classification Date Employer Received Claim Form Worker Details Family Name Given Name s Employee No Claim Lodged of Determination Status Injury Details Determination Date Determined Latest Return to Work Plan Rehab Status Goals Review Date RTW Coordinator Objective Proposed End Date Last Certificate Last Income Support Payment Provider Payment Type Capacity Date From Date To Week Of Payment NWE Date From Date To Comp Rate Amount Paid Claim Cost Gross Paid Recovered Net Paid Hours Lost Gross Ou
303. ommercial in Confidence SBC IT South Australia Department of Premier and Cabinet Page 113 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 Step 4 Click on the SAVE lal icon and the fields will become inactive and your A changes will be saved lf you modify a RTW Assessment screen and do not wish to save your changes click on the MODIFY EZ icon for a second time Your changes will not be saved and the claim will stay displayed in the tree window If you wish to discard you changes and close the claim click on the CLOSE RECORD icon from the toolbar 23 2 4 How do I Add Multiple RTW Assessment Screens to a claim A Step 1 Open the claim record you wish to add a RTW Assessment to and click on an existing RTW Assessment in the Tree control Multiple RTW Assessments may be added for each Claim To add an additional RTW A Assessment Step 2 Select the ADD NEW al icon from the toolbar alternatively you can go to the floating menu and select New RTW Assessment Add the details of a new RTW Assessment Screen referring to the instructions outlined in How do Add details of a RTW Assessment to a Claim Step 3 Click on the SAVE lal icon and the fields will become inactive and your changes will be saved When you add further RTW Assessment screens to the claim the system will automatically check that the details you have entered into the previous screen are valid
304. on Note If the Payments exceed the estimates then you must update the Estimates prior to submission of the Payments 33 3 4 How dol Enter Multiple Payment Items for a Payment The Payment Item screen allows the user to enter multiple items for a single payment as indicated on an invoice or account Each payment item entered for a payment will be displayed in the payment table Payment Payment Item yment Item Payment Items Service Date Item Number Status Description Item Amount GST Item Amount incl GST 10 06 2015 00001 Entered Professional attendance at other than consulting roo 164 00 164 00 gt Entered ge Insert Remove 23 Copy Item Total 164 00 0 00 164 00 Service Provider Dr Curaga GP and Medical Centre L Supplier Reference Status Entered Payment Category y Payment Type Service Date E GL Code Item Number Description 4 Scheduled Amount Surcharge Quantity Total Amount Excl GST Tax Status Not Applicable Tax Free GST Reason for variation Total Amount Incl GST If the Item is for the same service Select the row in the Payment item table the same service relates to and click the Copy item All contents will be copied and the user must alter the Date Of Service to avoid duplicates If the item is for another service Commercial in Confidence SBCIT
305. on 1 File gt New Claim menu option or Option 2 New Claim i icon is selected from the Toolbar Option 3 New Claim i icon is selected from the Claim Search screen http 192 168 10 45 8093 SIMS NET Windows Intemet Explorer File Search Generate Document Administration Help j f Test Environment v7 old Dimple oyment Details Claim Number Return to Work SA Claim Number Date Injury Iliness Occurred Incident Details C3 Injury Claim Type Self Insured Claim OTime Off Work Claim Classification Estimate Date Employee Signed Claim Form Date Employer Received Claim Form State South Australia Receipt Method Paper Form Date Employer Signed Claim Form Claims Manager Date Insurer Received Claim Form E Lc Le Lc Le Rehab Manager Date Entered 10 06 2015 LJ Confidential Claim Potential Recover Date Registered 10 06 2015 Date Status Changed 10 06 2015 y Rehabilitation Status Date 10 06 2015 E Date Rehabilitation Status Changed 10 06 2015 Date of First Incapa SWSA Advisory Date 52 Week End Date 104 Week End Date Degree of Whole Person airmen i Serious Injury Assessment Date Worker s decision on entitlement to pursue Co on Law Date Referred z ate Receive z irs ate First Contact Date 10 1 New Claim Step by Step The following topics are available within this section to assist you in the creation of a New Claim in the SIMS e How do I Create a New Clai
306. on an existing Investigation Referral screen in the tree control See How do search for a Claim to locate a specific claim for modification Step 2 Click on the MODIFY Z icon The fields will become active and you will be able to select different values Step 3 Make the desired changes to the Investigation Referral screen Step 4 Click on the SAVE lal icon and the fields will become inactive and your changes will be saved If you Modify an Investigation Referral screen and do not wish to save your changes click on the MODIFY A icon for a second time Your changes will not be saved and the claim will stay open If you wish to discard you changes and close the claim click on the CLOSE RECORD icon from the toolbar You cannot modify an uploaded document on the Investigation Referral screen A new screen will need to be added if a different document must be attached to the Investigation QI gt i Ja How do I Add Multiple Investigation Referral screens to a Claim Step 1 Open the claim record you wish to add a New Investigation Referral to and click on an existing Investigation Referral in the Tree control A amp oe l Step 2 Select the ADD NEW icon from the toolbar or alternatively you can go to the Floating Menu and select New Investigation Referral Add the details of a new Investigation Referral referring to the instructions outlined in How do Add an Investigation Referral to the Claim Step 3 Cl
307. ong document you will need to select Clear to remove the attached document and upload the correct document File Name Test docx View Step 4 Once all the details have been entered onto the screen the user would save the details by pressing the SAVE a icon Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 217 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 44 2 5 How do I Delete a Recoveries record Once a Recoveries screen has been added to a Claim the screen cannot be deleted The user must select a row and then select the REMOVE Remove hyperlink Removal of all rows will result in the Recoveries table displaying as follows To remove a Recovery record from the claim firstly select the claim you wish to remove the record from Once you have the claim open select the Recoveries folder from the tree control If the Recoveries folder is selected the background behind the text will appear blue Step3 Select the MODIFY amp icon The fields will become active Step 4 Select the row in which you wish to delete the Recovery details of Recovery Category Date Received Recovered From Amount gt Recovered Amounts 17 06 2015 PhillipLim 1 000 00 To select the row click on the grey column to the left of the Recovery Category field Before Recovery Category Recovered Amounts Recovery Category t Rec
308. onsists of a single tab e Motor Vehicle 49 1 Motor Vehicle The Motor Vehicle screen is displayed as follows Motor Vehicle Vehicle Motor Vehicle 1 Details Name of Driver Motor Vehicle 2 Details Name of Driver Vehicle Registration State of Registration Other Details CI CTP Potential Recovery Liability Accepted by Employer O Yes O No Driver at Fault OyYes ONo O Unknown C Police Report Obtained Attach File Upload Clear 49 2 Motor Vehicle Step by Step The following topics are available to assist you in entering and maintaining Motor Vehicle Details on a claim How do Add a Motor Vehicle to the Claim How do Upload a document to the Motor Vehicle screen How do Modify the Motor Vehicle Screen after it has been saved How do Add Multiple Motor Vehicle screens to a Claim How do Delete the Motor Vehicle Screen 49 2 1 How do I Add a Motor Vehicle to the Claim Mi Step 1 Open the Claim you wish to add the New Motor Vehicle to I Step 2 Go to the Claim Summary branch of the tree control and click on the FLOATING MENU icon A list of options will appear to the right of the icon as shown below Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 242 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 ag Claim Summary MClaim Details New Injury Details a am
309. open the desired RTW Assessment in the Screen window if required The user may select Criteria in order to refine the list of RTW Assessments which appear in the RTW Assessments Summary screen A combination of RTW Assessment Date From and To and Assessment Type may be used to refine the list The RTW Assessments Summary consists of one tab RTW Assessments Summary 24 1 RTW Assessments Summary The RTW Assessments Summary screen will display as follows RTW Assessments Summary Assessments Summary RTW Assessments Start Date Completion Date Status RTW Consultant Assessment Type Assessment Outcome SAPS Test Internal 24 2 RTW Assessment Summary Step by Step The following topics are available to assist you in the use of the RTW Assessment Summary screen e How do I View the RTW Assessments Summary e How do Open a RTW Assessment from the RTW Assessments Summary screen The following sections are related to the RIW Assessment screen are available in other sections of this User Guide How do Add a RTW Assessment to the Claim How do I Upload a Document How do Modify the RTW Assessment Screen after it has been saved How do Add Multiple RIW Assessment screens to a Claim How do Delete the RTW Assessment screen 24 2 1 How dol View the RTW Assessment Summary Step1 To view the RTW Assessment Summary for the claim click on the RTW Assessment Summary folder in the Claim Tree Control Sala RTW
310. orised Income Support Payment This screen is not mandatory All Payment Reversals will appear in the Income Support Payments folder in the Claim with a different icon The following rules apply when reversing a Payment e A Payment Reversal cannot be reversed e A Payment cannot be reversed if it has already been reversed and e Only Authorised Payments can be reversed Payment Reversals are automatically authorised when entered and cannot be deleted The Payment Reversal screen consists of a single tab e Payment Reversal 42 1 Payment Reversal The Payment Reversal screen is displayed as follows Payment Reversal Reversal Payment Details Compensation From Date 2 01 2015 Compensation To Date 8 01 2015 Days Lost In Period i3 Hours Lost In Period Date Entered 29 05 2015 Date Authorised 29 05 2015 Total Amount 500 00 Reversal Details Reversal Type Full Reversal Reversal Date 117 06 2015 Reversal Amount 500 00 Reversal Method Vendor Cheque EFT No Payment Made Cheque EFT Number Reversal Reason 42 2 Payment Reversal for Income Support Payments Step by Step The following topics are available to assist you in entering and Payment Reversal details on a claim How do Add a Payment Reversal for Income Support Payments to the Claim How do Modify the Payment Reversal Screen after it has been saved
311. otes to the Claim Provider screen if required Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 298 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 Paragraph Font Family Font Size Step 6 Once you are satisfied with the Claim Provider details entered into the fields on the screen click on the SAVE i l icon and the fields will become inactive and your changes will be saved against the claim If you have multiple screens in MODIFY mode A when saving the screen SIMS will check to see if any other screens are in modify mode If there are any screens which meet this criteria the system will open the screen which needs saving and you will need to click on the SAVE i icon again You do not need to modify and re add the Provider each time the Provider details are changed in the Provider Profile The link between the Provider Profile and Claim is dynamic and any updated to the Profile will automatically come across to any linked Claims 62 1 3 How dol Add Multiple Claim Provider screens to a Claim Step 1 Open the claim record you wish to add a New Claim Provider to and click on an existing Claim Provider in the Tree control Step 2 Select the ADD NEW n icon from the toolbar or alternatively open the Floating Menu and select New Claim Provider Add the details of a new Claim Provider referring to the instructions on How do Add a
312. ou in the use of the Compensation Recipients screen How do Add a Compensation Recipient to the Claim How do Modify the Compensation Recipients Screen after it has been saved How do Add Multiple Compensation Recipients to a Claim How do Delete Compensation Recipients The following sections are related to the Compensation Recipients screen are available in other sections of this User Guide How do Add an Income Support Payment How do Enter Multiple Income Support Payments How do Authorise Income Support Payments How do add Recurring Payments How do Authorise Recurring Payments How do search for a Party 38 2 1 How do I Add a Compensation Recipient to the Claim MC Step 1 Open the Claim you wish to add the New Compensation Recipients to WO esz Go to the Claim Summary branch of the tree control and click on the FLOATING MENU icon A list of options will appear to the right of the icon as shown below Commercial in Confidence SBC IT South Australia Department of Premier and Cabinet Page 190 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 Sak tiClaim Summary oe A Claim Details New Injury Details SN g Injured Workel i New Notional Weekly Earnings dg Employment D48 New Certificate of Capacity mf Incident Detail gt New Surgery Related Incapacity a 9 Injury _ New Permanent Impairment Assessment OTime Off Work New
313. ove Nature of Injury Other Details Has the worker ever made a Workers Compensation Claim in this or any other name in this state or elsewhere Yes Details 17 2 Other Injuries or Diseases Step by Step The following topics are available to assist you in the use of the Other Injuries or Diseases screen How do enter Other Injuries or Diseases How do Modify the Other Injuries or Diseases screen How do Add Multiple Other Injuries or Diseases screens How do Delete the Other Injuries or Diseases screen 17 2 1 How do I enter Other Injuries or Diseases Step 1 Open the Other Injuries or Diseases screen by selecting it from the Floating Menu at the Claim Tree Control Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 87 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 SomeeClaim Summaryfkal ees A Claim Details 7 New Injury Details ow Injured Worker New Notional Weekly Earnings ri Employment Die New Certificate of Capacity JA Incident Detail gt New Surgery Related Incapacity mO Injury _ New Permanent Impairment Assessment oo 9 Time Off Work n S Sa New Income Support Payment wi Estimate Histol Bnk l i Related Claims ailment a New File Note New Vendor Payment New Other Injuries or Diseases Eil New Correspondence In Eil New Corres
314. overed Amounts d A right arrow will display in the grey column when the row is selected Please note that only one row at a time may be selected Step 5 Select the REMOVE Remove hyperlink This will remove the selected row from the Recovery Details table Step 6 Click on the SAVE lal icon and the fields will become inactive and your changes will be saved Commercial in Confidence SBC IT South Australia Department of Premier and Cabinet Page 218 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 44 3 Recoveries Additional Information The following sections contain additional information about the Recoveries screen functionality and validation e Recoveries Mandatory Fields e Recoveries Tree Control 44 3 1 Mandatory Fields The following fields must be completed in order to successfully save the Recoveries details into the SIMS database e Date Recover Received e Recovery Amount e Recovery Category 44 3 2 Tree Control A single Recoveries screen may exist for each claim The screen will appear in the Claim Tree Control in the Recoveries folder in the following format Recoveries meee EEEIEE Commercial in Confidence SBC IT South Australia Department of Premier and Cabinet Page 219 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 45 HOW DO I ENTER A MEDICAL REFERRAL The Medical Refe
315. ovider Provider Type Medical Referral Provider Nominated Treating Doctor Provider Payment Search Provider The Provider Search screen consists of a single tab e Provider Search 7 1 Provider Search The Provider Search screen appears as follows Provider Search Provider Search Provider Type y v Active Providers Only Provider Numbers aSearch Name ABN Clear Address l O cancel Suburb Postcode 7 2 Provider Search Step by Step The following topics are available to assist you in the use of the Provider Search e How do I Search for a Provider e Provider Search Additional Details 7 2 1 How do Search for a Provider J p Step 1 Open the Provider Search by selecting Search gt Provider Search from the Wie menu or by selecting the Provider Search button within one of the screens linked to Providers as defined in the Overview above Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 46 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 Step 2 Select the Criteria associated with the desired Provider Step 3 Press the Search 4 hyperlink The Providers matching the selected criteria will appear in the Search Results list box Step 4 Select the Provider Profile you wish to view by clicking on the Provider Name hyperlink associated to the Prov
316. ow do I Add Multiple Other Injuries or Diseases screens However they can add more than one Injury and or Disease to the existing screen x A user cannot add more than one Other Injuries or Diseases screen 17 2 4 How do I Delete the Other Injuries or Diseases screen from a Claim h Step 1 Open the desired Claim IZo NG Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 89 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 Step 2 Navigate to the desired Other Injuries or Diseases Screen Step 3 Press the DELETE amp toolbar button A warning message will be prompted to the user and selecting OK will remove and delete the injury screen Message from webpage 2 Are you sure you wish to delete this screen Contact your System Administrator if you feel you require access to this x Note Only users with the relevant Security Privilege may delete this screen function 17 3 Other Injuries or Diseases Additional Information The following sections contain additional information about the Other Injuries or Diseases screen functionality and validation e Other Injuries or Diseases Mandatory Fields e Other Injuries or Diseases Tree Control 17 3 1 Mandatory Fields The following fields must be completed in order to successfully save the Other Injuries or Diseases screen into the SIMS database e Has the worker suffered an
317. ow do I Add a Witness to the Claim ccc cceccceeccceeceeeeeteeeeceeesaueeteeeeseeeteneeseetaeess 235 48 2 2 How do I Upload a Document to the Witness screen 2 0 0 eee ceecceecceeeceeeeeeeeeeeeaeeeaees 237 48 2 3 How do I Modify the Witness Screen after it s been saved ccecceecceecceeeeeeeeeeeeees 238 48 2 4 How do Add Multiple Witness screens to a Claim cc cccecceecceecceeeceeeeeeeeeeeeaeeeaees 238 48 2 5 How do I Delete the Witness SCree n cccccecccsececeececeeeteeeceeeeeeeseeeeseeteneesseetsneess 239 48 3 WITNESS ADDITIONAL INFORMATION cscsescssssesoserccserencususessrencuseneuerenurencuerenserencuerseserences 239 Agak Mandatory Fields scxcpeste wegen errata gst a 239 AG 8 2 TEE CONTO ana case cea cee ses ace ati de oes rai aden ed ede at adeeb stadt Pande ne dietantcea ae 240 49 HOW DO I ENTER MOTOR VEHICLE DETAILS ccccsseceeeseeceneeeenseeeeneeseneeseeneesens 241 741 eg MOTOR VEHICLE asri RU cer oc PO 241 49 27 MOTOR VEHIGLE STEP BY VE Pitacnauieatiewiiteo nse ataciavaassanaunenashensutacneuaganhevastenevananiaeuteenauee 241 49 2 1 How do I Add a Motor Vehicle to the Claim ccccccceccceeeeceeeeeeeeseeeeseeeeeeeeseeeeaeeens 241 49 2 2 How do I Upload a Document to the Motor Vehicle screen cccecceecceeeeeeeeeeeeeees 243 49 2 3 How do I Modify the Motor Vehicle Screen after it has been Saved ccceeeeeees 244 Commercial in Confiden
318. p Injured Worker New Certificate of Capacity ae i Employment D New Surgery Related Incapacity aa amp Incident Detail _ New Permanent Impairment Assessment mO Injury Y New Vendor Payment OTime Off Work lt gt New Income Support Payment 48 Notional Weekl m Certificates ae New File Note m Permanent Imj oe l m Paym anit New Other Injuries or Diseases Income Suppo New Correspondence In Estimate New Correspondence Out nse St Estimate Histol New Medical Referral E Nominated Tre New Investigation Referral ew New Nominate NEM Tele EE o8 Witness tS New Recoveries New Nominated Treating Doctor a Mew Witness Ad New Claim Provider d Related claims E RTW Assessme E d New Dependant e New Witness New Legal Representative or ya Mew RTW Assessment y New RTW Plan Step 3 Select New Motor Vehicle from the floating menu A new tree branch and screen window will automatically appear This process is creating a new screen against a Claim To add further details to the claim you must select the option from the FLOATING MENU and create a screen Step 4 The Motor Vehicle Details screen will appear in the screen window Select the Name of Driver Vehicle Registration and State of Registration relating to the Motor Vehicle Motor Vehicle 1 Details Name of Driver Vehicle Registration State of Registration N Step 5
319. p by Step The following topics are available to assist you in the use of Correspondence In How do I Create a New Correspondence In Screen How do I Upload a Document How do Add More than one Correspondence In screen How do Delete the Correspondence In Screen The following are related to Correspondence In and are available in other sections of this User Guide e How do I View the Correspondence In Summary Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 283 of 309 Version 1 0 Claims Management System Self Insurance SA User Guide Printed 18 06 2015 58 2 1 How dol Create a New Correspondence In Screen Step 5 If no previous Correspondence In has been recorded for the claim the user can create a new Correspondence In screen by clicking on the FLOATING MENU icon next to the Claim Summary screen in the Tree Control and select New Correspondence In we J GERMS Claim Details New Injury Details B Injured Worke New Certificate of Capacity Employment D New Surgery Related Incapacity A Incident Detail New Permanent Impairment Assessment a Injury gt New Vendor Payment OTime Off Work New Income Support Payment O Certificates U New Recoveries aO Payments Estimate s New File Note Estimate Histo New Other Injuries or Diseases Claim Provider CESE Related Claims New Correspondence Out CIRTW Assessme New Medical Referral _
320. pairment Assessment screen after it has been saved e How do I Add Multiple Permanent Impairment Assessment screens to a Claim e How do I Delete the Permanent Impairment Assessment screen The following sections related to the Permanent Impairment Summary screen are available in other sections of this User Guide Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 133 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 e How do I View the Permanent Impairment Summary e How dol use the Permanent Impairment Summary Search e How do Open a Permanent Impairment from the Permanent Impairment Summary screen 28 2 1 How do I Add a Permanent Impairment Assessment to the Claim a Step 1 Open the Claim you wish to add the New Permanent Impairment INZA Assessment to O Step 2 Go to the Claim Summary branch of the tree control and click on the FLOATING MENU icon A list of options will appear to the right of the icon as shown below Sak tiClaim Summary wu Claim Details New Injury Details S amp Injured Workei New Notional Weekly Earnings td Employment D 4 New Certificate of Capacity d Incident Detail gt New Surgery Related Incapacity m Injury E New Permanent Impairment Assessment mr pT zn Work 3 New Vendor Payment sai jai New Income Support Payment ow A Estimate E S Estimate Histo 9 Jeo LETT Se
321. pen Step 3 Click on the Document Type hyperlink and the Correspondence In will open in the Screen window Correspondence In Correspondence In Summary Number Document Category Date Received Received From Description Confidential File Name 5 01 2015 Jane s Physio Report O Test docx 28 12 2014 New Year Closure Notification for Jane s Physio go Test docx treatment stopped lf a Correspondence In has been marked as Privileged and Confidential the Correspondence In will only display as Confidential in the Correspondence In Summary screen with no other information or hyperlink associated with the file See Privileged and Confidential above for more information Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 289 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 60 HOW DO ENTER CORRESPONDENCE OUT Correspondence Out such as Reports Letters Faxes or Emails Sent can be recorded in the Correspondence Out screen Multiple Correspondence Out screens can be attached to a Claim The Correspondence Out screen consists of a single tab e Correspondence Out Once Correspondence Screens have been added to the Claim a Correspondence Out Summary screen will be available when the Correspondence Out folder is selected in the Tree Control level above the Correspondence Out screens 60 1 Correspondence Out The Correspondence Out screen will be
322. pondence Out a New Medical Referral _ New Investigation Referral amp New Motor Vehicle a New Nominated Treating Doctor New Claim Provider New Legal Representative amp New Dependant 2 New Witness New RTW Assessment New RTW Plan Step 2 Select Yes or No to Has the worker suffered any similar or disease it may not be work related If No is selected then proceed to Step 5 Other Similar Injuries or Diseases Has the worker suffered any similar injury or disease It need not be work related OYes No Step 3 If the user selected Yes to the question above then they need select the Insert button to add the additional Injury Details The Date of Injury Name of Employer and Nature of Injury must be completed Date of Injury Name of Employer Nature of Injury gt Date of Injury Ha Name of Employer a Insert MRemove Nature of Injury Note The User can Insert and Remove multiple Injuries or Diseases to the Claim by selecting the Insert or Remove button Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 88 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 Date of Injury Name of Employer Nature of Injury 27 10 2013 McDonalds Sprained Ankle gt 4 03 2014 Southern Football Club Right Wrist Broken Date of Injury 14 03 2014 Name of Employer Southern Football Club insert Remove Natu
323. ports Ad Hoc Report The Generate menu consists of the following items Submisssion Files Opens a sub menu which allows the user to generate the SA Submission files Generate Letters Allows the user to generate a standard letter Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 28 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 Standard Reports Allows the user to generate a standard report Ad Hoc Report Opens the ad hoc report system 3 4 4 Document Menu The Document Menu contains the function which allows the use to search for Documents recorded in the system such as Correspondence In and Out File Notes Work Capacity Certificates and Return to Work Plans To access the Document menu you need to click on Document in the Menu at the top of the SIMS window Document Administra fi Document Search The Document menu consists of the following item Document Search Opens a Document Search dialog which allows the user to search for documents recorded in the system 3 4 5 Administration Menu The Administration Menu contains a group of functions which allow the user to maintain the SIMS features such as SA Licences and Rates To access the Administration menu you need to click on Administration in the Menu at the top of the SIMS window Many of the options in the Administration menu will be restricted to System Administra
324. presentative amp New Dependant New Witness New RTW Assessment z New RTW Plan he lf an Income Support Payment Screen already exists for the claim subsequent Income Support Payment screens may be added by selecting an Income Support Payment in the tree window and clicking the ADD NEW a icon in the toolbar Step 3 Enter the Date From and Date To details of the Compensation Period This will automatically populate the Period Weeks and Days fields which are read only Compensation Period Date From 10 06 2015 DateTo 16 06 2015 EE Step 4 Select the Payment Type Compensation Type and enter the Days of Incapacity in Period and Full Shifts Lost in Period Commercial in Confidence SBC IT South Australia Department of Premier and Cabinet Page 181 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 Compensation Ty SOS SSS S yS Days of Incapacity in Period F Full Shifts Lost in Period SF Step 5 Enter Hours Lost in Period for This Employer and Other Employer if required This Employer Other Employer Hours Lost in Period SS Hours Employed in Period Normal Weekly Hours 38 00 15 00 The Normal Weekly Hours for This Employer and Other Employer is a read only field that is populated with the values entered at the Worker s Earning screen Step 6 The Authorisation section is a read only section that includes the date the income support screen was
325. r owl Document Summary tt Upload Lump Sum Return Related Claims _ View Specialties CORTW Assessments _ Maintain FTE Numbers 83 Manage Teams Delete Claim aaa Employer Reassignment Step 3 Select Reverse Payment from the menu A new tree branch and screen window will automatically appear This process is creating a new screen against a claim Step 4 The Reversal screen will appear with the Details of the source Vendor Payment such Invoice Date Invoice Number Total Amount excluding GST Date Entered Payee Name Total GST Date Authorised Date Transferred Date Paid and Total Amount including GST fields automatically populated from the Payment selected These fields are read only and cannot be changed Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 203 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 Payment Details Invoice Date 1 06 2015 Invoice Number 112545 Payee Name Invest Date Entered 10 06 2015 Date Authorised 10 06 2015 Total Amount excl GST 329 00 Total GST 0 00 Total Amount incl GST 329 00 Date Transferred Date Paid If you need to change the Payment Details section then you may have selected the wrong Payment to begin with Check to ensure you have selected the correct payment for Reversal Step 5 The Rev
326. r The SIMS will transport you to the next incomplete screen if all Mandatory fields have been completed 12 2 3 How do I Modify the Injured Worker screen Step 1 Open the claim record you wish to modify and click on an existing Injured Worker screen in the tree control See How do I search for a Claim to locate a specific claim for modification Step 2 Click on the MODIFY A icon The fields will become active and you will be able to select different values Step 3 Make the desired changes to the Injured Worker screen Step 4 Click on the SAVE lal icon and the fields will become inactive and your changes will be saved lf you Modify an Injured Worker screen and do not wish to save your changes click on the MODIFY EZ icon for a second time Your changes will not be saved and the claim will stay displayed in the tree window If you wish to discard your changes and close the claim click on the Close Record gt icon from the toolbar 12 2 4 How do I Add Multiple Injured Worker screens x Note The SIMS will not allow multiple Injured Worker screens to be added to the Claim 12 2 5 How do I Delete the Injured Worker screen Note The SIMS will not allow the Injured Worker screen to be deleted as it contains Key Claim details 12 3 Injured Worker Additional Information The following sections contain additional information about the Injured Worker screen functionality and validation e Injured Worker Mandatory F
327. r changes will be saved 26 2 4 How do Delete the Dependant Screen Ss Step 1 To remove the Dependant screen from the claim firstly select the claim you bO wish to remove the Dependant from Step 2 Once you have the claim open select the Dependant under the Dependant folder from the tree control which is to be removed If the Dependant is selected the background behind the text will appear blue Commercial in Confidence SBC IT South Australia Department of Premier and Cabinet Page 128 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 a Dependant ee Qependant Franklin Sam Step 3 Click on the DELETE amp icon from the toolbar When the confirmation message appears click on OK L The Dependant screen will be removed from the claim Message from webpage Are you sure you wish to delete this screen If you are unable to DELETE X the Dependant screen selected you may not have access to complete this function Check with the SIMS System Administrator that you have the correct access level 26 3 Dependant Additional Information The following sections contain additional information about the Dependant screen functionality and validation e Dependant Mandatory Fields e Dependant Tree Control 26 3 1 Mandatory Fields The following fields must be completed in order to successfully save the Dependant s details into the SIMS database Relation
328. r i e the most recent record will display at the top of the list The user may select the Payment Date hyperlink to open the desired Payment in the Screen window if required You may select Criteria in order to refine the list of Payments which appear in the Payment Summary screen A combination of Service Date From and To Status Date Authorised From and To Payment Category Service Provider and Payment Type may be used to refine the list The Payment Summary consists of one tab Payment Summary 34 1 Payment Summary The Payment Summary screen will display as follows Payment Summary Summary Payment Summary Service Date From Service Date To E Status Date Authorised From Date Authorised To Payment Category Provider Payment Type view Results By Search 0 Clear Date Authorised Payment Category Payment Type Service Provider Status Service Date Amount Amount Incl GST 6 01 2015 AAT authority legal disbursement Approved 28 10 2014 100 00 10 00 110 00 f AAT authority legal fees Jane s Physio Approved 4 10 2014 380 00 00 380 00 Anaesthetics Jerry Wallace Approved 19 01 2014 380 00 00 380 00 Totals 4 901 00 10 00 911 00 34 2 Payment Summary Step by Step The following topics are available to assist you in the use of the Payment Summary screen e How do I View the Payment Summary
329. ral ow i EGEL oe New Motor Vehicle i A Related Claims _ QRTW Assessme a New Nominated Treating Doctor New Claim Provider New Legal Representative amp New Dependant lt 3 New Witness New RTW Assessment New RTW Plan Step 3 Select New Witness from the floating menu A new tree branch and screen window will automatically appear This process is creating a new screen against a Claim If there is an existing Witness screen then you may choose to add a new Witness screen using the Add New function in the toolbar Refer to How do I Add Multiple Witness Screens for more information Step 4 The Witness screen will appear in the screen window Select the Person Type Family Name Given Name s Phone number if Known and select the checkbox if the Witness provided a Statement Person Details Person Type Family Name Given Name s Statement of Witness Provided PS Step 5 Enter the Address of the Witness if Known Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 237 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 Address Address Step 6 Enter the Witness Comments and upload a Witness Statement if required Comments File Name upload Q Clear Tip Refer to How do Upload a Document to the Witness screen for instructions on uploading documents Step 7 Once you a
330. rated below Commercial in Confidence SBC IT South Australia Department of Premier and Cabinet Page 31 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 JRE aoe Claim Ne 1 uo Injured Worker New Vendor Payment The Floating Menu option is dg Employment D i New File Note indicated by the icon displayed J Incident Detail New Medical Referral next to screens in the Tree Window a Injury _ New Investigation Referral ae Other Injury 2 a Other Injury oe Time Off Work mB Reconsideratio f mE Appeal Summa El New Claim Provider m Court cummari New Legal Representative Permanent Imp New Nominated Treating Doctor Rehabilitation i New Reconsideration oo _ Rehabilitation New Appeal i _ Rehabilitation _ New Court Details 2 Rehabilitation New Permanent Impairment e New Medical Certificate _ New Rehabilitation Assessment New Correspondence In New Correspondence Out 2 New Witness The contents of these menus are context sensitive This means o The options available on the floating menu depend on the status of a number of screens in the claim Note When the Payment and Compensation Payment options are not available this may be because the claim is closed Step 1 Open a Claim you wish to add new screens to Step 2 Select the desired FLOATING MENU icon from one of the Tree Control Clusters as defined in the tabl
331. re of Injury Right Wrist Broken Step 4 Select Yes or No to Has the worker every made a Workers Compensation Claim in this or any other name in this state or elsewhere If the user selects Yes they must complete the Details section Other Details Has the worker ever made a Workers Compensation Claim in this or any other name in this state or elsewhere Yes Details Step 5 Once all of the mandatory fields are completed and you are satisfied with the details entered select the SAVE al icon from the toolbar 17 2 2 How do I Modify the Other Injuries or Diseases screen Step 1 Open the claim record you wish to modify and click on an existing Other Injuries or Diseases screen in the tree control See How do search for a Claim to locate a specific claim for modification Step 2 Click on the MODIFY A icon The fields will become active and you will be able to select different values Step 3 Make the desired changes to the Other Injuries or Diseases screen Step 4 Click on the SAVE lal icon and the fields will become inactive and your changes will be saved If you Modify the Other Injuries or Diseases screen and do not wish to save your changes click on the MODIFY E icon for a second time Your changes will not be saved and the claim will stay displayed in the tree window If you wish to discard you changes and close the claim click on the CLOSE RECORD icon from the toolbar 17 2 3 H
332. re satisfied with the Witness details entered into the fields on the screen click on the SAVE al icon and the fields will become inactive and your changes will be saved against the claim dO o 48 2 2 How dol Upload a Document to the Witness screen Step 1 Once a New Witness screen has been created Type in the details of the A C Witness into each field Step 2 To attach a Document to the Witness click on the Upload hyperlink and use the Windows File Browser to locate and select the desired file Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 238 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 i Choose File to Upload _s_ xs G i 3 gt Libraries gt x 4 Search Libraries p i Organize v v fl yr Favorites Libraries W Desktop Open a library to see your files and arrange them by folder date and other properties ih Downloads Recent Places Documents a Music lt Pictures OneDrive L gt Librar lt I Library SS Librar G Dibrani K Videos Documents _ ad Music i Pictures E Videos amp Computer u Network File name AIl Files Open Cancel Once the desired file is selected click on the OPEN button in the File Browser Step 3 If successful the filename will be visible in the File Name field If you have selected the wrong document
333. reasons why the SIMS may not locate the claim you are searching for Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 44 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 e The Claim Number is incorrect Check the claim details you entered in the criteria It might be that the criteria you are entering do not match the details entered when the claim was recorded e You are using too many Search Criteria Simplifying your search by entering fewer search criteria and e Incorrect Spelling Use the Like Search to broaden your Search A Like Search involves replacing one or more letters in the word with the percent character For example instead of the Injured Worker s full Name the user may enter J to view all Injured Workers with the first initial J i e John Jack Jeffrey Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 45 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 7 HOW DO I USE THE PROVIDER SEARCH The Provider Search screen allows the user to search for a service provider This function is available within the following screens Work Capacity Certificate Provider Name Payment Provider Name Payment Item Service Provider Legal Representative Provider Type Investigation Referral Investigator Claim Pr
334. record This will add a new row below the existing record Payment Restrictions Payment Category Payment Type Date Form Date To Reason Common Law 17 06 2015 20 06 2015 gt Finset W Remove Date From ae Date To Date Entered 17 06 2015 Entered By SAPS Test Payment Category y All Categories and Types Payment Type Step 4 Enter the Date From Date To and Payment Category and any other details following instructions provided in How do add a Payment Restriction to the Claim Step 5 Click on the SAVE lal icon and the fields will become inactive and your changes will be saved 43 2 4 How do I Delete a Payment Restriction record Once a Payment Restrictions screen has been added to a Claim the screen cannot be deleted The user must select a row and then select the REMOVE Remove hyperlink Removal of all rows will result in the Payment Restrictions table displaying as follows Commercial in Confidence SBC IT South Australia Department of Premier and Cabinet Page 211 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 Payment Restrictions Payment Category Payment Type Date Form Date To Reason There are no Payments Restrictions to show To remove a Payment Restrictions record from the claim firstly select the claim you wish to remove the record from Step 2 Once you have
335. red Claim Roger Nichols Claim Reopened Undetermined 18 09 1972 Disability SA Phi 15000005 02 26 05 2015 Self Insured Claim William Michaels Claim Open Accepted 8 03 1974 Disability SA Zee Total Claims 2 Note Where more than one field is completed in the search criteria the SIMS returns results that match the requirements of ALL the fields entered Step 5 To open a claim that is displayed in the Search Results listing the user must select the Claim Number hyperlink that they wish to view Note Multiple Claim Search Results may not be selected Step 6 The Claim will be opened to the user The Export hyperlink generates an Excel file of the current Search results AN Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 43 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 6 1 2 How do I create a New Claim from the Claim Search t Note After conducting a search for a Claim it is possible to create a New Claim for an Injured Worker from the Claim Search screen Step 1 Open the Claim Search by clicking on the Claim Search fia icon in the toolbar option or by selecting the menu item Search gt Claim Search option Step 2 Search for Claims for the Injured Worker following the instructions in How do search for a Claim starting from Step 2 Step 3 Select a previous Claim for the Injured Worker from the Search Results A
336. ree control See How do search for a Claim to T a Step 1 Open the claim record you wish to modify and click on an existing RTW NG locate a specific claim for modification Step 2 Click on the MODIFY EZ icon The fields will become active and you will be able to select different values Step 3 Select an Outcome for the Plan and enter the Date of Outcome Outcome of Plan Outcome wv Date of Outcome Ea Step 4 Click on the SAVE icon and the fields will become inactive and your changes will be saved 25 2 3 How dol Upload a Document nes Step 1 To attach a Document click on the Upload button and use the Windows File AJ Browser to locate and select the desired file Commercial in Confidence SBC IT South Australia Department of Premier and Cabinet Page 121 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 S File to Upload _s le 2s O v via gt Libraries gt S Search Libraries p i Organize 5 gt il yr Favorites Libraries a Desktop Open a library to see your files and arrange them by folder date and other properties m Downloads Recent Places A Documents a Music lt Pictur amp OneDrive L r SIY Ean SS ran l 3 Libraries E es Sa Documents ad Music I t Pictures E Videos 9 Computer th Network File name AIl Files x Open Cancel Once the de
337. ries E Library e Documents a Music E Pictures E Videos jE Computer tu Network File name v All Files Me Once the desired file is selected click on the OPEN button in the File Browser Step 2 If successfully attached the filename will be visible in the File Name field Once a document is uploaded to a Work Capacity Certificate screen it cannot be modified If you have selected the wrong document you can select the Clear button to delete the uploaded file and start again Once all the details have been entered onto the screen the user would save the details by pressing the SAVE la icon Attach File View Step 3 21 3 Work Capacity Certificate Additional Information The following sections contain additional information about the Work Capacity Certificate screen functionality and validation e Work Capacity Certificate Mandatory Fields Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 105 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 e Work Capacity Certificate Tree Control e Work Capacity Certificates Work Capacity Certificate Periods 21 3 1 Mandatory Fields The following fields must be completed in order to successfully save the Work Capacity Certificate Details into the SIMS database Date Examined s Stage Occurrence of Condition Clinical Diagnosis based on examination and other i
338. ring the same days selected Step 3 Once you have selected one or more criteria select the Search button The Return to Work Note Summary screen will refresh and the Return to Work Notes matching the criteria entered will appear in the Summary Tip Once you have finished with the Search Results and want to return to the full list of Return to Work Notes for the claim select the Clear button 54 1 3 How do Open a Return to Work Note from the Return to Work Note Summary screen Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 273 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 Step 1 To view the Return to Work Note Summary for the claim click on the Return to Work File Note Summary folder in the Claim Tree Control Sl m RTW File Note Summar 5 01 2015 RTW elite 20 11 2014 RTW te 20 11 2014 RTW Step 2 Review the list of Return to Work Notes listed in the Summary until you have located the Return to Work Note you wish to open Step 3 Click on the Subject hyperlink and the Return to Work Note will open in the Screen window Return to Work File Note Summary to Work File Note Summary Details amp Search for From To Sl Category 4A Search D Clear File Note entered by SBC System Admin 20 11 2014 5 33 PM Category Rehabilitation Subject Rehab Session 1 IMP Note From Rehab Session 1 File No
339. rment Assessment Injury gt New Vendor Payment OTime Off Work New Income Support Payment a Certificates New Recoveries aO Payments Estimate 1e New File Note New Other Injuries or Diseases Estimate Histo s Claim Provider New Correspondence In 7 Related Claim MMS So a CQRTW Assessme New Medical Referral _ New Investigation Referral New Motor Vehicle New Nominated Treating Doctor New Claim Provider 7 New Legal Representative A New Dependant 2 New Witness lll New File Tracking New RTW Assessment Y New RTW Plan v lf a Correspondence Out screen already exists for the Claim you will need to use a different method to add the new Correspondence Out Refer to How do Add More than One Correspondence Out screen Step 2 Select a Document Type and Letter Type as applicable to the Correspondence Out Correspondence Out Document Type iv C Privileged and Confidential Letter Type y When a New Correspondence Out screen is created the Privileged and Confidential checkbox will not be selected This checkbox is linked to Security and User Access in the Administration Tools Only users with access to Privileged and Confidential Correspondence will see these appear in the Claim Tree Control If you believe that you require Privileged and Confidential Correspondence Out access contact your system administrator Refer to Correspondence Out Privileged and Co
340. row at a time may be selected Step 5 Select the REMOVE Remove hyperlink This will remove the selected row from the Compensation Recipient Details table Step 6 Click on the SAVE lal icon and the fields will become inactive and your changes will be saved 38 3 Compensation Recipients Additional Information The following sections contain additional information about the Compensation Recipients screen functionality and validation e Compensation Recipients Mandatory Fields e Compensation Recipients Tree Control 38 3 1 Mandatory Fields The following fields must be completed in order to successfully save the Compensation Recipient details into the SIMS database Priority Date Effective From Type Recipient Per Payment or Amount Per Payment 38 3 2 Tree Control A single Compensation Recipients screen may exist for each claim The screen will appear in the Claim Tree Control in the Compensation Recipients folder in the following format Compensation Recipients ii Compensation Recipi Commercial in Confidence SBC IT South Australia Department of Premier and Cabinet Page 194 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 195 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 39 HOW DO I VIEW THE INCOME SUPPO
341. rral screen allows the user to record details of referrals for the Injured Worker including Medical Assessments This screen allows the recording of medical reviews and assessments requested by the Organisation for the Injured Worker This screen is not mandatory The Medical Referral screen consists of a single tab e Medical Referral 45 1 Medical Referral The Medical Referral screen is displayed as follows Medical Referral Referral Medical Referral Provider Failed To Comments Attend padd Remove Type y Provider PA PERA Date H Venue C Failed to Attend Comments 45 2 Medical Referral Step by Step The following topics are available to assist you in entering and maintaining Medical Referral details on a claim How do Add a Medical Referral to the Claim How do Modify the Medical Referral Screen after it has been saved How do Add Multiple Medical Referral screens to a Claim How do I Delete the Medical Referral Screen The following sections are related to Medical Referral are available in other sections of this User Guide e How do I Use the Provider Quick Search e How do Use the Provider Search 45 2 1 How dol Add a Medical Referral to the Claim NS Step 1 Open the Claim you wish to add the New Medical Referral to SY Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 220 of 309 Clai
342. rs may be recorded for each Claim and these will be displayed in a Folder titled Nominated Treating Doctors A Nominated Treating Doctor screen may be deleted if the User has permission to do so Nominated Treating Doctors are ordered in the folder by their Provider Name in alphabetical order Screens display in the Directory Tree with a description of the selected Provider Name The Nominated Treating Doctor screen contains one tab e Nominated Treating Doctor 47 1 Nominated Treating Doctor The Nominated Treating Doctor screen will be as follows Nominated Treating Doctor Treating Doctor Claim Provider Provider Type 4 Provider Search Provider Name Provider Numbers Street Address Postal Address State Postcode Postcode Country Contact Details Telephone Fax Number Mobile Email Contact Name v Font Family Font Size 47 2 Nominated Treating Doctor Step by Step The following topics are available to assist you in the management of Nominated Treating Doctors on a Claim in the SIMS Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 231 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 How do Add a Nominated Treating Doctor
343. ry FICIOS sec sececnsesds senntiscconasescs og doeensa te ded FEG sees nated RE EE PECENE PEER ETE EEE 65 T232 WCC COMMU Ol ssctei datucaccacetdsicajtadiatsCiteapacisabe a unit ntactddetesieneiegees aus 66 13 HOW DO I ENTER THE EMPLOYMENT DETAILS cccesecseseeeceseeceneesenseeceneesenenes 67 Te i Uren ea ee ee 67 19 2 GURRENT EMPLOYE Poci ca Glace fh ca Gs a a data icenielatt dau clic atd auc 67 139 3 EMPLOYMENT DETAILS STEPIBY STEP tescteteceaniencenniciiasalecciseicadtnantecdiartlateianteathenicigereutaces 68 13 3 1 How do I Enter the Employer DOI and Current Employer Detaills cccccseeeeeees 68 13 3 2 How do I Modify the Employment Details screen cc ecccsccccsececeeeeeeeeeeeeeneeesaeeesaees 70 13 3 3 How do I Add Multiple Employment Details screens 2 2 00 ecccecccececeeeseeeseeeseeseeeees 70 13 3 4 How do I Delete the Employment Details SCre n cece cceccceeeeceeeeseeeteeeeseeeeaeeesaees 70 13 4 EMPLOYMENT DETAILS ADDITIONAL INFORMATION 0ccccesceceeeceseeceteeceeeeececeueetseeeseneetaneeees 71 14T Mandatory Fields reiini 71 VA OEE 8 10 911 9 eerie Petre ter eee er eee eS ee eee 71 14 HOW DO I ENTER DETAILS OF OTHER EXTERNAL CURRENT EMPLOYMENT 72 14 1 OTHER EXTERNAL CURRENT EMPLOYMENT c cccccesccceeeceeeeceeeeseesaeceseueeseeseueeseeeeseeesueeneess 72 14 2 OTHER EXTERNAL CURRENT EMPLOYMENT STEP BY STEP csscccceeeeceeceeeeeeeceeeeseee
344. s will display the Permanent Impairment Summary screen o O AE Impairment Summary Permanent Impairment No 2 _ a Permanent Impairment No 1 Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 141 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 Step 2 Enter criteria in Search the fields at the top of the Summary Screen to locate a specific Permanent Impairment For example select a Date Range and the Impairment Code to refine the Search Results Permanent Impairment Summary Details Date From Date To Impairment Code y 4 Search _ Clear Date Received Date of Assessment Act Reference Impairment Code Impairment 16 10 2014 Section 24 1101 Loss of thumb 13 10 2014 Section 24 1121 Loss of little finger Note The Date From and Date To range will pick up all Permanent Impairments that have a Date Received within the same days selected Step 3 Once you have selected one or more criteria select the Search button The Permanent Impairment screen will refresh and the Permanent Impairments matching the criteria entered will appear in the Summary Tip Once you have finished with the Search Results and want to return to the full list of Permanent Impairments for the claim select the Clear button 29 1 3 How do I Open a Permanent Impairment from the Permanent Impairment Summary
345. s within SIMS are labelled with Time As specified in the above message the following time formats are acceptable HH MM 24hr 14 00 HHMM 24hr 0800 HH MMam 08 00am If 2 00 is entered the system will automatically assume that this is a 24 hour time and will record the time to 02 00AM 4 3 3 Suburb State and Postcode Fields The Suburb State and Postcode fields always appear together Suburb C E Postcode Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 37 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 The Suburb field allows the user to enter the Suburb of the address The list of Suburbs includes residential Postcodes along with mail centres The user must complete this field to save the address details As the user enters a Suburb name a list of options is displayed for the user to choose from The list will be similar to the following BRIGHT VIG 3741 BRIMIN VIC 3685 BRIMBIN NSW 2430 SRINKIN NT 0810 From the list the user may select the desired Suburb If the desired Suburb is not found in the list the user must keep entering letters to drill down the options i e as Brisbane is not in the above list after entering BRI into the Suburb field the user is to enter S The following options will then be available to choose from BRISBANE QLD 4001 BRISK BAY QLD 4505 BRISBANE GPO QLD 4000 BRISBANE GROVE
346. screen will be displayed as follows Rehabilitation Details Details Prepared By Internal External Provider Entered By SAPS Test Date Entered 11 06 2015 RTW Plan Number Consultation Date Date Plan Received RTW Consultant Phone Supervisor Phone Nominated Treating Doctor Phone RTW Provider Phone Date To Eal Review Date E Prepared By Objectives Objective yv Goals Maintain Suitable duties Other Goal s _ Pre injury duties with the pre injury employe Return to independence within the Community Suitable duties in another workplace Upgrade from unfit to fit for suitable duties Upgrade in both hours and capacity Upgrade in capacity _ Upgrade in hours Additional Goal s Actions Services Responsible Person Due Date Add Remove Signed By Generate Plan Doctor Employee Manager Supervisor RTW Consultant Case Manager RTW Provider Stay at Work Return to Work Arrangements C No Suitable Duties Available Stage Date From Date To D Hours Work Activities Consideration Restrictions Add Remove Work Conducted at Pre Injury Worksite Alternative Worksite Position j Alternative Position Supervisor in Position Position Details Worksite Details Outcome of Plan Outcome y Date of Outcome ey
347. screen will consist of one tab e Worker s Earnings 36 1 Worker s Earnings The Worker s Earnings tab will be displayed as follows Worker s Earnings Earnings Payroll Details Salary Class y Payroll Code Pay Frequency y Earnings History Effective Status Entered By Base Weekly Earnings Other Employment Base Days per Week Hours per Week Weekly Earnings Active Current SAPS Test 0 Date Effective Status Active Current vy Status Date 10 06 2015 Insert Date Entered 10 06 2015 Entered By saps Test Weekly Earnings This Employment Other Employment Base Weekly Earnings Overtime Non Pecuniary Benefits Total Weekly Earnings 0 00 Base Award Rate Current Twice State Average Weekly Earnings 2 824 40 Current Average Weekly Earnings 0 00 Current Notional Weekly Earnings 0 00 Normal Weekly Hours Normal Days per Week Notes 36 2 Worker s Earnings Step by Step The following topics are available to assist you in entering and maintaining a Worker s Earnings on a claim e How do Add Worker s Earnings Commercial in Confidence SBC IT South Australia Department of Premier and Cabinet Page 174 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 e How do Modif
348. screen window will now open If you have difficulties using the login refer to the next section Additional Information for Accessing the SIMS 2 2 Additional Information for Accessing the SIMS 2 2 1 Why am I getting an error when trying to log into the SIMS There are a number of reasons why you may not be able to access the SIMS These are listed below 1 Invalid User ID or Password If your log in is not successful the following message will appear Your login and password details which are required to access the SIMS are unique to the SIMS There are two possible reasons for difficulty accessing the SIMS these are e You may have entered an incorrect Login Password Combination Check that you have the right login and password and try again If you still have no success contact the SIMS System Administrator Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 23 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 e You may not have access to SIMS Contact the SIMS System Administrator 2 Expired User ID The SIMS has expiry dates set up for the positions assigned to each user in the system This message is received when the end date has been met for the position for your User ID Contact your System Administrator to have the end date extended to a future date 2 2 2 Why can t Access all of the SIMS Features The SIMS securit
349. seamnacdqasienaceae ened aactaaneanenuaebseciaacenenasatiuseuses 251 50 22 WSCC OMIGOM cies teers Ss occas tte ene tiie eels eke Pind es ete Per aindins nc hat hiendad 251 50 2 3 Confidential INVESHOGGUOMS 2se isitiss hate eee ates eet Leia betes hcateeet Satie hat 252 51 HOW DO I ENTER A FILE NOTE ou cceceescnscnecnecnecneseesensensensenseneeeseessauensensenseness 253 Sit FILE NOTE Cuei ee Goat aati ea tate Gut han rai Wel etal Gta ae Gad sas 253 512 FILENOTE OPE RID Y OTEP morreria aa 253 51 2 1 How do I Add a File Note to a Claim ooo cc cece ececceeeeseeseeseeeeeeeeeuseusaueaeeeenuensanss 254 5k22 HOw do lUpoioad a Docume rercisnen tered reennn eee tiatcetane ear earan eas 255 51 2 3 How do I Notify a person of an Assigned ACtION ccccceeccceeeceeeeceeeseeeseeeeseeeeaeeess 256 51 2 4 How do I Modify the File Note n nnannnannnnnnennennnnnnnnnnnnnennnnnnnrrsnnnerrsnenrrrsnrrnrrsrrnerrsnene 257 51 2 5 How do I Add more than one File Note occ ccc cccecceseeseeseeeeeeeueeueeseueeeeeeeeeeneanss 257 51 26 H HowdolD l tea File NOG 2 cscceec ies tadiiucdetet eben a ecient A 258 51 3 FILE NOTE ADDITIONAL INFORMATION iiituestieth fotwceGrontueit souk seul vontees est sabl toute tevlver caida toute 258 51 3 1 File Note Email Notifications 0 0 ccccccccesecceseeseeeeseeeeseeeeseeeeuaeseuaeeueesaeeneaeeeneeeenes 258 5132 Mandatory Fields senep casement oncieadenseestaneie E OE 259 Skoa Tee IGOMMO sc ccensoteticettecde
350. ship to Claimant Family Name Given Name s Date of Birth Status Residential Address Line 1 Residential Suburb Residential State Residential Postcode Postal Address Line 1 if the Postal Address is the same as Residential Address check box is unchecked e Postal Address Suburb if the Postal Address is the same as Residential Address check box is unchecked e Postal Address State if the Postal Address is the same as Residential Address check box is unchecked e Postal Address Postcode if the Postal Address is the same as Residential Address check box is unchecked Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 129 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 26 3 2 Tree Control Multiple Dependant screens may exist for each claim and it will be displayed in alphabetical order according to the Family Name recorded The screens will appear in the Claim Tree Control under the Dependant folder in the following format Dependant lt Family Name gt lt Given Name s gt a Dependant apendant Franklin Sam Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 130 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 27 HOW DO I VIEW THE RETURN TO WORK PLANS SUMMARY The Return to Work Plans Summary screen appears when the
351. sired file is selected click on the OPEN button in the File Browser Step 2 If successfully attached the filename will be visible in the File Name field Once a document is uploaded to a RTW Plan screen it cannot be modified If you have selected the wrong document you can select the Clear button to delete the uploaded file and start again Step 3 Once all the details have been entered onto the screen the user would save the details by pressing the SAVE la icon 25 2 4 How dol Modify the RTW Plan screen after it has been saved Step 1 Open the claim record you wish to modify and click on an existing RTW Details screen in the tree control See How do search for a Claim to locate a specific claim for modification Step 2 Click on the MODIFY A icon The fields will become active and you will be able to select different values Step 3 Make the desired changes to the RTW Plan screen Step 4 Click on the SAVE lal icon and the fields will become inactive and your changes will be saved If you modify a RTW Plan screen and do not wish to save your changes click on the MODIFY icon for a second time Your changes will not be saved and the claim will stay displayed in the tree window If you wish to discard you changes and close the claim click on the CLOSE RECORD icon from the toolbar 25 2 5 How do I Add Multiple RTW Plan screens to a claim Multiple RTW Plans may be added for each Claim To add an additional RTW Plan
352. south Australia Department of Premier and Cabinet CLAIMS MANAGEMENT SYSTEM SELF INSURANCE SOUTH AUSTRALIA User Guide Version 1 0 Released 16 June 2015 Prepared By SBCIT South Australia Department of Premier and Cabinet Page 2 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 Version Control Version No Updates Made X itil Draf 0 2 Updated Draft 0 3 Internal Review 0 4 Update from Internal Review 0 5 Internal Review Update from Internal Review 1 0 Update following Quality Review Commercial in Confidence SBC IT South Australia Department of Premier and Cabinet Page 3 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 Table of Contents 1 CLAIMS MANAGEMENT SYSTEM OVERVIEW 2 0 0ccccccscecscecsccceccceneccecececncaceeecaeeeneneaes 17 1 1 PURPOSE OF USER GUIDE cccccccccccccccccccccncncaeaeacaeaeaeaeauaeavataneverstetetetetatatatetetenstetenenenenenens 17 AA a E E E E A ARE EE EA ARE EA AR AA E EE EAA E 17 Tide OONO a a AE 18 ted mage Convention ssrminisseis E E 18 k32 MOUSE CONVENTIONS nicsen a a aul death sia 18 1 3 3 Menu CONVENTIONS sxcscaivececs cue icansicdsacece clvkinasedeadevadlicbacawediadana cls bawsledvedeanclybandedssdexe dlvbaaatede 18 1 3 4 Button and Icon Conventions xctsescecscehs saaitcaccoctieedanestcncenureke shasdenceanseeerskastendeumscesnioitencss 19 13 5 Keyboard GONVENTIONS sssin
353. sport and Infrastructure Service Public Transport Services Division Division Integrated Transport Services Cost Centre Old Claims K kd k Organisation Unit Step 10 Once you are satisfied with the changes made click on the SAVE lal icon in the toolbar 37 2 2 How do Enter Multiple Income Support Payments Multiple Income Support Payments may be added for each Claim To add an additional Income Support Payment Step 1 Open the claim record you wish to add an Income Support Payment to and click on an existing Income Support Payment in the Tree control Step 2 Select the ADD NEW al icon from the toolbar alternatively you can go to the floating menu and select New Income Support Payment Add the details of a new RIW Assessment Screen referring to the instructions outlined in How do Add an Income Support Payment Step 3 Click on the SAVE lal icon and the fields will become inactive and your changes will be saved When you add further Income Support Payments to the claim the system will automatically check that the details you have entered into the previous screen are valid before creating a new screen For example the User created an Income Support Payment but forgot to fill in a mandatory field This system would not let the user use the ADD NEW al function as the previous screen is invalid 37 2 3 How do I Authorise Income Support Payments There are multiple methods for Authorisin
354. ssification Date Employer Received Claim Form z Worker Details Family Name Given Name s Employee No Claim Lodged of Empla Determination Status Injury Details Determination Date Determined Latest Return to Work Plan RTW Coordinator Objective Proposed End Date Last Certificate Last Income Support Payment Provider Payment Type Capacity Date From Date To Week Of Payment NWE Date From at Date To et Comp Rate Amount Paid Claim Cost Gross Paid Recovered Net Paid a Hours Lost Gross Outstanding Outstanding Recoveries Net Outstanding Days Lost Heard stig rs sd Gross Incurred Outstanding amp Actual Net Incurred Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 93 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 19 HOW DO I VIEW RELATED CLAIMS The Related Claims screen displays all Claims for the same Injured Worker as the currently selected Injured Worker This screen is only displayed in the Claim Directory Tree when the selected Injured Worker has another Claim in the System This screen will display in the Directory Tree with a Description of Related Claims and cannot be deleted The Related Claims screen contains one tab e Related Claims 19 1 Related Claims The Related
355. t Related To Barry Henderson Date Registered 25 05 2015 Registered By SAPS Test File Name This is a test docx Revision 1 docx Checked Out By Description i i B Z U v Font Family Font Size Sa Oc close Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 281 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 57 2 Document Details Step by Step 57 2 1 How dol Maintain the Document Details The Document Details screen is displayed upon the user selecting the Document No hyperlink from either the Document Search or Document Summary screens Note Once a Document is uploaded into the SIMS only the Description field on fo the Document Details screen may be modified Step 1 Enter the Document Description if applicable N Description TE 3 J B JZ U 2 2 Format Font Family FontSize Step 3 Click on the SAVE Save hyperlink to save the Document Description When the CLOSE OClose hyperlink is selected the Document Details screen is closed and any changes to the Description field will be discarded 57 2 2 How do I View a Document Step 1 Select the desired document from the Document Search or Document Summary screen by selecting the Document No hyperlink to open the Document Details screen Step 2 Once the Document Details screen has appeared
356. t SS arrange them by folder date and other properties i File name All Files 7 Open Cancel Once the desired file is selected click on the OPEN button in the File Browser Step 3 lf successfully attached the filename will be visible in the File Name field If you have selected the wrong document you will need to select Clear to remove the attached document and upload the correct document Attach File view Step 4 Once all the details have been entered onto the screen the user would save the details by pressing the SAVE la icon 49 2 3 How dol Modify the Motor Vehicle Screen after it has been saved Step 1 Open the Claim record you wish to modify and click on an existing Motor Vehicle screen in the tree control See How do search for a Claim to locate a specific claim for modification Step 2 Click on the MODIFY E icon The fields will become active and you will be able to select different values Step 3 Make the desired changes to the Motor Vehicle screen Step 4 Click on the SAVE lal icon and the fields will become inactive and your changes will be saved lf you Modify a Motor Vehicle screen and do not wish to save your changes click on the MODIFY icon for a second time Your changes will not be saved and the claim will stay open If you wish to discard you changes and close the claim click on the CLOSE RECORD icon from the toolbar 49 2 4 How dol Add Multiple
357. t Page 63 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 12 HOW DO I ENTER THE INJURED WORKER S DETAILS The Injured Worker screen allows the user to enter details of the Injured Worker for the Claim The Workers details will be populated from the HR interface or the user may add a New Employee to the SIMS if the Employee does not already exist in the SIMS The Injured Worker Details screen contains a single tab e Injured Worker The Injured Worker tab allows the user to enter the details of the Employee including the name address date of birth and work history associated with the claim 12 1 Injured Worker The screen will display as follows Injured Worker Employee Number 4 Select Employee New Employee Superannuation Number Family Name Title Given Name s Date of Birth Preferred Name Marital Status Employee Start Date Ex Employee Termination Resignation Date 7 Other Previous Names Reason for Name Change Date Changed Given Name s Reason for Change Country of Birth Identified as Dependants Language Special Communication child C other 7 gpeg Residential Address Suburb State Postcode State ec l Postcode Country Contact Details Home Phone Work Phone Mobile Phone Email Address
358. t System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 How do Add a Treatment Service Plan to the Claim How do Modify the Treatment Service Plans Screen after it has been saved How do Add Multiple Treatment Service Plans screens to a Claim How do Delete the Treatment Service Plans Screen The following sections are related to Medical Referral are available in other sections of this User Guide e How do Use the Provider Quick Search e How do Use the Provider Search 46 2 1 How dol Add a Treatment Service Plan to the Claim s a Step 1 Open the Claim you wish to add the New Treatment Service Plans to Me Step 2 Go to the Claim Summary branch of the tree control and click on the FLOATING MENU il con A list of options will appear to the right of the icon as shown below 4 ETS wow Claim Details New Injury Details ue amp Injured Workei New Notional Weekly Earnings p Employment D de New Certificate of Capacity Jh Incident Detail gt New Surgery Related Incapacity mO Injury _ New Permanent Impairment Assessment Dim j o an Off Work s New Vendor Payment 5 e _ New Compensation Recipients Recoveries ee eal n Estimate New Income Support Payment oon 5 we 8 Estimate Histo Z New File Note m Dependant z s New Rehabilitation File Note uu Related Claims New Other Injuries or Diseases New Correspondence In New Correspondence Out a
359. t be completed or Business Rules in place will prevent the user saving the screen or using a SIMS function 1 3 2 Mouse Conventions The following list details the definition of particular mouse actions Point Move the mouse until the tip of the mouse pointer is resting on the required item Click Press and release the left mouse button once Double Click Press and release the left mouse button twice in quick succession Right Click Press and release the right mouse button once Press and hold the left mouse button while moving the mouse Note These instructions relate to users that use a right handed mouse For left _ handed users the instructions would be reversed 1 3 3 Menu Conventions Menu items that the user will select are displayed in bold text When the user is required to select a succession of two or more menu items the menu selections will be listed in sequential order from left to right separated by an arrow gt In such a situation the next item in the sequence will generally be contained within a sub menu of the current menu item E g File gt New Claim Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 19 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 File Search Gene B New Claim A New Provider fat New Site 1 3 4 Button and Icon Conventions When the notes refer to a button on the too
360. t select New RTW File Note from the main floating menu Each file note entered after the first file note has been saved on the claim and can be entered by selecting the Add New button RTW File Notes provide the same functionality as File Notes and are stored in a separate Folder in the Claim This is to separate Notes made by Claims Managers and RTW Officers RTW File Notes will be displayed in descending order i e the file note with the most recent date will be displayed at the top of the list in the format lt lt Date Entered gt gt lt lt Category gt gt All RTW File Notes will display in the tree menu in the folder titled RTW File Note Summary File Notes marked Privileged and Confidential may only be seen in the Claim Directory Tree by Users with the Privileged and Confidential Access Menu Item Security Object currently applied to one of the User s Security Profiles All Users may mark a File Note as Privileged and Confidential however if the User doesn t have the required privileges once the File Note is saved and the Claim refreshed the File Note may not be visible to the User who added tt Upon entering a note and setting a due date a task will be inserted into the diary to remind the User of the deadline All CMS Users will be able to be assigned a task and populate in their diary All other staff may be assigned a task but will only receive an email as non CMS users do not have a system diary File
361. table duties Date From a Date To sa Reason Estimated functional capacity to return to work in Days Weeks _ uncertain at this stage Progressive Review Date sd _ at next medical consultation Treatment Plan Treatment plan aimed at assisting recovery and return to work C Medical Specialist Name of Specialist EE C Psychologist Name of Psychologist C C Physiotherapist Name of Physiotherapist C Other Specialist Name of Specialist Provider Provider Number Provider Type Phone Provider Name Date Signed E File Name upload _ Clear Functional Ability CI No Restrictions Physical Function itti Reaching above ias shoulder Standing Walking Bending Climbing steps stairs ladders Use of affected body part Neck Movement Kneeling Squatting Driving Carrying Holding Lifting Mental Health Function Attention Concentration Lo y Judgement Additional Comments Other functional considerations Medication s prescribed that could impact ability to undertake some activities C Recommended a graduated increase in working hours over DE weeks from hours a day to normal hours Ss hours a day C Recommended non consecutive working days for a period days or weeks C Has requested more information about the options abailable for return to work C
362. tal Details v Injured Worker was taken to Hospital _ Injured Worker was admitted to Hospital Name of Hospital Step 6 If the worker is deceased then you can select the Injured Worker Deceased checkbox and the relevant fields will be displayed The Date Deceased field will only be enabled and mandatory when the user selects the Injured Worker Deceased checkbox If the death was a result of the Incident then the user should select the Death Due to Incident checkbox Deceased Details Injured Worker Deceased Date Deceased ae Death Due to Incident Step 7 Once all of the mandatory fields are completed and you are satisfied with the details entered select the SAVE lal icon from the toolbar The system will now navigate the user to the Injury Details screen How do I Modify the Incident Details screen Step 1 Open the claim record you wish to modify and click on an existing Incident Details screen in the tree control See How do search for a Claim to locate a specific claim for modification Step 2 Click on the MODIFY A icon The fields will become active and you will be able to select different values Step 3 Make the desired changes to the Incident Details screen Step 4 Click on the SAVE lal icon and the fields will become inactive and your changes will be saved Tip lf you Modify an Incident Details screen and do not wish to save your changes click on the MODIFY
363. te Increased as the Result of an Audit Medical Other Goods and Services 0 00 0 00 0 00 0 00 Initial Estimate Third Party Review Medical Services 0 00 0 00 0 00 0 00 Other Non compensation 0 00 0 00 0 00 0 00 Other Goods and Services Non Medical 0 00 0 00 0 00 0 00 Property Damage 0 00 0 00 0 00 0 00 Redemption of Medical Expenses 0 00 0 00 0 00 0 00 Redemption Commutation of Income Support 0 00 0 00 0 00 0 00 Rehabilitation 0 00 0 00 0 00 0 00 Travel 0 00 0 00 0 00 0 00 Gross Totals 0 00 0 00 500 00 500 00 Recovered g Recoveries Outstanding Reason for Change Recovered Amounts Total Recoveries 0 00 0 00 Net Totals 500 00 500 00 All Changes recorded on the Estimate screen are recorded in the Estimate History screen If you do not see any changes select the Refresh icon from the toolbar to refresh the detail on the Estimate History screen 31 3 Estimate Additional Information The following sections contain additional information about the Estimates functionality and validation e Estimates Mandatory Fields 31 3 1 Mandatory Fields Once you have entered a value into the Estimate value field associated to an Estimate Category it is mandatory to select the Reason for Change Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 150 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Prin
364. te Summary consists of one tab Certificate Summary 22 1 Certificate Summary The Work Capacity Certificate Summary screen will display as follows Certificate Summary Summary Date From Date To Capacity y 4 Search Provider Type y Provider Date To Date Examined Stage Capacity Diagnosis Provider Name 13 06 2015 10 06 2015 Initial Are fit to perform test suitable duties that accommodate functional abilities 11 06 2015 10 06 2015 Follow Up Are medically unfit to trest undertake suitable duties 22 2 Certificate Summary Step by Step The following topics are available to assist you in the use of the Certificate Summary screen e How do I View the Certificate Summary e How do l use the Certificate Summary Search e How do Open a Work Capacity Certificate from the Certificate Summary screen The following sections are related to the Work Capacity Certificate Summary screen are available in other sections of this User Guide How do Add a Work Capacity Certificate to a Claim How do Modify the Work Capacity Certificate Screen after it s been Saved How do Add Multiple Work Capacity Certificate Screens to a Claim How do Delete a Work Capacity Certificate 22 2 1 How dol View the Certificate Summary q Step 1 To view the Certificate Summary for the claim click on the Certificates folder PN s s So in the Claim Tree Control Commercial in Confidence
365. te and select the desired file Choose File to Upload _ eo OU a gt Libraries y s x gt lf Search Libraries E p Organize v fl e Fe Favorites Libraries z Desktop Open a library to see your files and arrange them by folder date and other properties ie Downloads 3E Recent Places Documents Music a Pictures b Library Library 5 Library amp OneDrive S gt lt 7 i gt a Videos i og Libraries amp Library Documents i d Music E Pictures E Videos jE Computer ch Network File name v All Files a Open l Cancel Once the desired file is selected click on the OPEN button in the File Browser Step 3 If successfully attached the filename will be visible in the File Name field Once a document is uploaded to a Payment screen it cannot be modified If you have selected the wrong document you will need to select CLEAR to remove the document start the Upload Document process again Invoice File View Clear Step 4 Once all the details have been entered onto the screen the user would save the details by pressing the SAVE la icon 33 3 8 How dol Delete a Payment Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 164 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 To remove a Payment from the claim firstly select the claim you wish to re
366. te entered by SBC System Admin 20 11 2014 5 33 PM Category Rehabilitation Subject Claim Update Claimhas been updated File Note entered by SBC System Admin 5 01 2015 11 21 AM Category Rehabilitation Subject Confidential File Note Confidential File Note lf a Return to Work Note has been marked as Privileged and Confidential the Return to Work Note will only display as Confidential in the Return to Work Note Summary screen with no other information or hyperlink associated with the file See Confidential File Notes above for more information Commercial in Confidence SBC IT South Australia Department of Premier and Cabinet Page 274 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 29 HOW DO I VIEW THE DOCUMENT SUMMARY The Document Summary screen displays a summary of all Documents registered for a particular Claim This includes all Correspondence In Correspondence Out Medical Certificates File Notes and many more This screen displays automatically in the Claim Profile Directory Tree when the Claim has at least one Document and displays with a description of Document Summary This screen cannot be added to or deleted from a Claim The Document Summary screen contains one tab e Document Summary 55 1 Document Summary The Document Summary screen displays as seen below and contains the following fields Document Summary ment Summary Document Details
367. ted 18 06 2015 32 HOW DO I VIEW THE ESTIMATE HISTORY The Estimate History screen displays in the Tree Control below the Estimate The screen records all Payments and Estimate variations to Claim Costs displaying the total varied per Payment Estimate and the Total Estimates on the claim as at the Date Time stamp indicated for each historical record The Estimate History screen will be automatically displayed on the tree for the claim once the initial claim entry has been saved This screen will display in descending date time order Estimates and payments will be GST inclusive The Estimate History also displays the user name of the user who made the change the Estimate Category the change was applied to and the reason the estimate was modified The Estimate History screen consists of one tab o Estimate History 32 1 Estimate History The Estimate History screen will display as follows Estimate History History Estimate History Date Time Estimate Category Current Incurred Current Payments Incurred Variation Payment Variation User Reason Legal Costs Hospital Legal Costs Legal Costs Death Incapacity 1 000 00 4 000 00 1 000 00 1 000 00 50 00 5 000 00 531 00 380 00 490 00 110 00 0 00 0 00 0 00 0 00 0 00 0 00 50 00 5 000 00 41 00 380 00 380 00 110 00 0 00 Tim Benton Tim Benton Tim Benton Tim Benton SBC System Admin Change in Condition 0 00 SBC Sys
368. ted 18 06 2015 e Payment Restrictions Tree Control 43 3 1 Mandatory Fields The following fields must be completed in order to successfully save the Payment Restrictions details into the SIMS database e Date From e Date To e Payment Category 43 3 2 Tree Control A single Payment Restrictions screen may exist for each claim The screen will appear in the Claim Tree Control in the Payment Restrictions folder in the following format Payment Restrictions Commercial in Confidence SBC IT South Australia Department of Premier and Cabinet Page 213 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 44 HOW DO ADD RECOVERIES The CMS will allow the entry of recovery payments The recovery payments will be entered without linking to a specific payment as a single recovery may be received for a number of payments made on a claim The recovery refers to an actual paid amount received by the organisation for the claim from another party and is linked to the estimated recoveries The Recoveries screen displays in the Claim Profile Tree with a description of Recoveries The Recoveries screen cannot be deleted once a Recovery has been saved A recovery amount must not be greater than the estimated recovery for a given category In this case the User will be taken to the Estimates screen and they may increase the relevant outstanding amount if they have the permission to do
369. tem Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 40 2 1 How do I Search for an Unauthorised Compensation Payment ccccseeeeeseeeees 197 40 2 2 How do I Approve one or more Compensation Payments cseeceeeeeeeeeeeeeeeeeees 198 40 38 UNAUTHORISED PAYMENTS ADDITIONAL INFORMATION 0cccceececeeeeeeeeeeceeesseeeeseeeesseeeesaes 199 AQ Sil Using the SCAN wiiucin ina ctysptandiriahedeharti eda erst a E 199 40 3 2 Search Warning Messages iiieicivciancaisninedeientaahabnaiaahanmeibahas Mendarnelbaiuae Suuahcaheleaine pueteigs 199 41 HOW DO I ENTER A PAYMENT REVERSAL FOR VENDOR PAYMENTS 00 201 AE oe AYNENTREVER OAL crie ee eee ee eee ee eee ee eee eee ee 201 412 PAYMENT REVERSAL OLER BY STEP istestiabionts RA RA 201 41 2 1 How do I Add a Payment Reversal for a Vendor Payment to the Claim 0 202 41 2 2 How do I Modify the Payment Reversal Screen after it s been Saved 000008 203 41 2 3 How do Add Multiple Payment Reversal Screens to a Claim cccseceeseeeeeeeeeees 203 41 2 4 How do I Delete the Payment Reversal Screen cccsecceceeeeeeeeeceeeeseeeeeseeeesaeeeess 203 42 HOW DO I ENTER A PAYMENT REVERSAL FOR INCOME SUPPORT PAYMENTS 204 AZ A PAYMENT REV RSA eoa ennai obe aaanalomanaatanchiaeannionsuaamechiaanaeanananan 204 42 2 PAYMENT REVERSAL FOR INCOME SUPPORT PAYMENTS STEP BY STEP sscceececeeeeeeeeeeeeees 204 42
370. tem Adjusted Permanent Admin Impairment Assessment SBC System Adjusted Permanent Admin Impairment Assessment SBC System Change in Condition Admin Household services 250 00 0 00 250 00 0 00 SBC System Change in Condition attendant care Admin Legal Costs 1 000 00 0 00 1 000 00 0 00 SBC System Adjusted Permanent Admin Impairment Assessment Medical 5 000 00 0 00 5 000 00 0 00 Hospital 4 000 00 0 00 4 000 00 0 00 32 2 Estimate History Step by Step The following topics are available to assist you in the management of Estimates on a Claim e How dol View the Estimate History The following sections are related to the management of estimates are available in other sections of this User Guide e How do Modify the Estimate screen 32 2 1 How do I View the Estimate History To view the Estimate History for the claim click on the Estimate History node in the Claim Tree Control Step 1 The Estimate History screen is displayed as seen below Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 151 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 Estimate History History Estimate History Date Time Estimate Category Current Incurred Current Payments Incurred Variation Payment Variation User Reason Incapacity 5 000 00 0 00 5 000 00 0 00 SBC System Adjusted Permanent Admin Impairment Assessment Medical 5 000
371. the Task List screen select the Cancel button 64 1 2 How dol Search for Actions Due within a Certain Period amp Step 1 Open the Task List screen we Step 2 Select a Date From and Date To as Criteria Step 3 Select the Search 2 Search hyperlink To search for tasks between the 1 3 2014 and the 31 03 2014 the user would enter these dates into the Date To Date From criteria fields Person Responsible SAPS Test wy Search ld Export Cancel oma Date From 10 05 2015 Date To 10 07 2015 Task Type V Outstanding O Completed O All Open Claims 1 Undetermined Claims o Open Rehab Claims Total Claims Allocated 2 When search is selected only tasks due in March 2014 will be displayed in the Search Results Note Pressing SEARCH brings up all incomplete tasks that the selected user is responsible for that are due in March 2014 64 1 3 How do I Search for Task List Actions by Status Step 1 Open the Task List screen Step 2 Select the desired status Select either Outstanding to view all incomplete entries Complete to view all Completed tasks or All to return all tasks which have been assigned to the User selected You may only make one selection from the Radio button group Outstanding C Completed T All Note Completed tasks will have a Date in the Completion Date field Step 3 Press the SEARCH button Tip Pressing SEARCH now would bring up all tasks completed that the s
372. the checkbox Employer at DOI is the Current Employer should be unchecked The current employer will then have to be entered manually Portfolio Region Agency Service Division Cost Centre v Employer Details at DOI are the Current Employer Details Step 2 Enter an Address for the Employer at the Date of Injury Commercial in Confidence SBC IT South Australia Department of Premier and Cabinet Page 69 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 Workplace at DOI Address Step 3 Enter the Employer contact details and Industry type for the Employer at the Date of Injury Workplace at DOI Details Email The Industry code field allows the user to enter the main activity of the establishment The drop down field lists all Industry codes as defined in the SA Industry Classification SAIC 2015 lf the Date Injury IIIness Occurred is prior to 1 July 2015 the drop down field will list all Industry codes as defined in the SA WorkCover Industry Classification SAWIC 2013 14 The user will need to refresh the Claim using the Refresh button in the Toolbar and update the Industry after the Claim has been saved Step 4 Record the Occupation details for the employee as indicated on the Claim Form as at the date of incident and provided by Payroll To select an Occupation please begin typing the name of the desired Occupation in full or in part See t
373. the fields will become inactive and your changes will be saved When you add further Legal Representative screens to the claim the system will automatically check that the details you have entered into the previous screen are valid before creating a new screen AN For example the User created one Legal Representative screen but forgot to fill in a Mandatory field This system would not let the user use the ADD NEWS function as the previous screen is invalid 63 1 4 How do Delete the Legal Representative Screen Step 1 To remove the Legal Representative screen from the claim firstly select the claim you wish to remove the Legal Representative screen from Step 2 Once you have the claim open select the Legal Representative branch from the tree control which is to be removed If the Legal Representative is selected the background behind the text will appear blue Step 3 Click on the DELETE icon from the toolbar When the confirmation message appears click on OK L _ The Legal Representative will be removed from the claim Claims Management System 2 Are you sure you wish to delete this screen Cancel If you are unable to DELETE X the Legal Representative screen selected you may not have access to complete this function Check with the SIMS System Administrator that you have the correct access level rcial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 305 of 309 C
374. ther External Current Employer Enter the Start Date and End Date if relevant to the employment Norma Hours per Week Suburb State f Postcode Normal Days per Week Ss L International Address Country fo Telephone fe The details added to the above fields will appear in the table once entered Ensure that you always exit the field before viewing the table i e tab out of A the fields linked to the table The table fields are only updated once the user exits the linked peer fields Step 4 Once all of the mandatory fields are completed click on the SAVE l icon 14 2 2 How do I Modify the Other External Current Employment screen External Current Employment screen in the tree control See How do Step1 Open the claim record you wish to modify and click on an existing Other search for a Claim to locate a specific claim for modification Commercial in Confidence SBC IT South Australia Department of Premier and Cabinet Page 74 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 Step 2 Click on the MODIFY A icon The fields will become active and you will be able to select different values Step 3 Make the desired changes to the Other External Current Employment screen Step 4 Click on the SAVE lal icon and the fields will become inactive and your changes will be saved If you Modify the Other External Current Employment screen and do not wish to save your
375. tificate Summary Search cece ceeecceceeeeceeeeeseeeesaeeeeseeeesseeees 108 22 2 3 How do I Open a Work Capacity Certificate from the Certificate Summary screen 108 23 HOW DOI ENTER A RTW ASSESSMENT cceesecceeeceseeceneceneeceseecaseeeneeeaseseaseneneseas 110 ee RIN A GS IIE IIa trcctctereancieattat ceenaacetaeetnmel ote A 110 23 2 RTW ASSESSMENT STEP BY STEP sccitcciciacdedecdeitegiasaidedecdatheniesaiceducdabiegiel cicegwedavheniaaidedeeeeies 110 23 2 1 How do I Adda RTW Assessment to the Claim cccccccccecceeceeeeceeeeeeeeeeeeeeeeaeeeaees 110 23 2 2 How do I Upload a Document cccccccccceeccceeeeeeeeceeeeseeeseeeeseeeeaeeeseueeseesaeeeseeeeaeeens 112 23 2 3 How do I Modify the RTW Assessment Screen after it has been saved 006 112 23 2 4 How do I Add Multiple RTW Assessment Screens to a claim ceeceeeeeeeeeeeeeeeeeees 113 23 2 5 How do I Delete the RTW Assessment Screen ccccccecceecceeceeeeeeeeceeeeeeeeeeeeaeeeaees 113 23 3 RTW ASSESSMENT ADDITIONAL INFORMATION csccccsccsecsesscusescesensesseurenseveceeseuvenseuseusens 114 239l Mandatory ICIOS st sctced ti ccetensortets tied a diac yaeeeucendadigdceenesnedeatueaei ec 114 232 TMCS ACONMMOL eriin a dene ed oeawd dan Demecde e a a Danese o A 114 24 HOW DO I VIEW THE RTW ASSESSMENTS SUMMARY ccsscceeseceseeceseeeneeeeneseas 115 24 1 RTW ASSESSMENTS SUMMARY sc cinssdieoctanstadties deena dec
376. tigation Referral into each field Step 2 To attach an Investigation Report to the Investigation Referral screen click on the Upload hyperlink and use the Windows File Browser to locate and select the desired file Choose File to Upload s s OU amp a gt Libraries gt E gt 4 j Search Libraries Pi Organize v Ss Fil F Favorites Libraries BB Desktop Open a library to see your files and arrange them by folder date and other properties iE Recent Places A Documen ts Music lt Pictures P Ibran bran d OneDrive IY Library lt D Library Sp Library File name AllFiles z Open Cancel Once the desired file is selected click on the OPEN button in the File Browser Step 3 If successfully attached the filename will be visible in the Attach Name field If you have selected the wrong document you will need to select Clear to remove the attached document and upload the correct document Step 4 Once all the details have been entered onto the screen the user would save the details by pressing the SAVE la icon Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 250 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 50 1 3 How do Modify the Investigation Referral Screen after it has been saved Step 1 Open the Claim record you wish to modify and click
377. tors or Advanced users only Contact your System Administrator if you feel you require access to one of the options defined in the section below Pee Help xj Task List 3 Security Workflow b Codes b Audit Trail Service Rate Payment Item Search SA Licences Transfer Claims Owner g Set Authorisation Lewels 4 Claims to be Coded Modify Claim Number t Upload Lump Sum Return _ View Specialties _ Maintain FTE Numbers 83 Manage Teams Delete Claim aaa Employer Reassignment Rate Maintanence x cial in Confidence SBC IT South Australia Department of Premier and Cabinet Page 29 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 3 4 6 Help Menu The Help Menu contains allows access to the Help text available for the SIMS To access the Help menu you need to click on Help in the Menu at the top of the SIMS window The Help menu consists of the following items Menu Name Description ees Online Help Displays the Help file About the SIMS Displays information about the Self Insured Management System 3 5 Disabled Menus Toolbar Icons When a menu item within the menu is grey e g Generate Letter on the Generate Menu the menu item is not available for selection The same applies to toolbar icons There are a number of reasons why a menu toolbar icon may not be available these are e The option is not appropriate from the current screen e B
378. tory fields within each screen 10 2 New Claims Additional Information The following sections contain additional information about creating a new claim including validation e New Claim Mandatory Screens e New Claim Tree Control 10 2 1 Mandatory Screens Once a new claim is created the user must complete details on all Initial Claim screens in order to Save the Claim and receive a Claim Number The screens which must be completed are as follows Claim Injured Worker Employment Details Incident Details Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 56 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 e Injury Details 10 2 2 Tree Control An example of the Initial Tree Control following the creation of a new claim is as follows dy Claim Summary F aw fil aoe amp Injured Worker dig Employment Details mf Incident Details o Injury m Injury Details Commercial in Confidence SBC IT South Australia Department of Premier and Cabinet Page 57 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 11 HOW DO I ENTER CLAIM DETAILS This screen allows users to enter details of the Claim Only one Claim screen may be added to a Claim The Claim screen will allow the user to add details of the Claim Claim Classification and Claims Manager in relation to the ad
379. tstanding Outstanding Recoveries Net Outstanding Days Lost Total Recoveries Outstanding amp Actual Gross Incurred Net Incurred 18 2 Claim Summary Step by Step The following topics are available to assist you in the use of the Claim Summary screen e How dol view the Claim Summary Screen The following sections are related to the Claim Summary screen are available in other sections of this User Guide e How do Enter the Employee Details e How do l Enter Claim Details e How do l Enter Incident Details Commercial in Confidence SBC IT South Australia Department of Premier and Cabinet Page 92 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 How do Add an Injury How do Enter An Individual Rehabilitation Plan How do Enter Work Capacity Certificates How do Enter a Payment Reversal or Recovery How do Enter a Provider Payment How do Enter Details of Legal Representatives 18 2 1 How dol view the Claim Summary Screen Note The Claim must have been saved and refreshed before the Claim Summary can be viewed To view the Claim Summary for the claim click on Claim Summary in the Claim Tree Control The screen will open in the window as follows Claim Details Claim Number Claim Type Date Injury Illness Occurred i Claim Status Claim Cla
380. ty Profiles Privileged and Confidential File Notes will display to unauthorised Users with only the word Confidential and no other values The Return to Work File Note Summary screen contains one tab only e Return to Work File Note Summary 54 1 RTW File Note Summary The RTW File Note Summary screen displays as follows Retum to Work File Note Summary to Work File Note Summary Details gt Search for From Fe To Category 4A Search D Clear File Note entered by SBC System Admin 20 11 2014 5 33 PM ene Amal apace lag Subject R IMP Note Rehab pe 1 File Note entered by SBC System Admin 20 11 2014 5 33 PM Category Rehabilitation Subject Claim Update Claimhas been updated File Note entered uh rite System Admin 5 01 2015 11 21 AM Category Rehabilita Subject confidential File Note Confidential File Note 1 4 Return to Work File Note Summary Step by Step The following topics are available to assist you in the use of the Return to Work Note Summary screen e How do I View the Return to Work Note Summary e How do I Use the Return to Work Note Summary Search e How do Open a Return to Work Note screen from the Return to Work Note Summary screen Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 272 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 The following sections are related to the
381. ueneenesueneeneaueanens 26 SA SECA WGI eren ceeds eet bo A a setae mendes wieder meta nee emda nena 27 SAS COMO MO a a 27 3 4 4 OG UG FAT IVI GTS E S E E ee E Aa pra et A T EEEE 28 3 4 5 Administration MenU ccccccccecceccccccccccccececcecccuecuenceuecuecueaeeneaueneeneuueaeeesneacenteneanenees 28 346 ICID MENU axssusaccraskaarateaknananariaaraieanntratesktsaieaantrateshiaseiueuntretesiiariuanearetesbnertuantmausinaaias 29 35 DISABLED MENUS TOOLBAR ICONS anaa a a a te Gea a ialid 29 30 WHE REE GONTRO a sand ated fens Nad a a a a aaa 29 S7 IEOA TING M N a n a e a E E O aTe 30 A SIMS SCREEN FIELDS sarna a aidi 33 4 1 STANDARD FI OD aaa a a aie tate cua cents O cute 33 Aw O OA E N 34 4 2 1 COmMmDO BOXES selena a E a saan e E E A E 34 B22 OO FICIAS a a a a 34 42 3 Check BOXES cece cece cceccccecccccceccaceccccuceceaceceneecencaceceaeeteceuueneacenscesueneaceneaesteceaneeaneneas 34 4 2 4 RCO UL ONS ase cece as cece eens eee ese ees ns ene wenn aed nes ome eee 35 23 MAIDA TED FIELDS cnnan er eiecsin data dhipeiai ela d aia thio hia aled a Lain vista a 35 4 3 1 BiA a eer anette te aro EET E dN a OR OE ne TOS TT 35 AS MMEren aval need seater A pect oon ond aie A weaned 36 43 53 SUDU State and Postcode FicldSiciisasiceiceiileae eit a aa 36 4 3 4 How do I Search for a POStCOdG cc ccc cccccccececececccccccecececcauacscececeauacsceueneauaeseeneneaeas 37 Commercial in Confidence SBCIT South Australia Department of
382. ulars ABN Payment Method rq Payee Numbers Address State Postcode Cost Centre Payment Applied Portfolio Department for Education and Child Development Region Education and Children s Services v Agency Families SA Service Executive Families SA Division Executive Program Area Cost Centre 8219 Childrens Payment Review Organisation Unit Commercial in Confidence SBC IT South Australia Department of Premier and Cabinet Page 154 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 33 2 Payment Items The Payment Items tab is displayed as follows Payment Payment Item yment Item Payment Items Service Date Item Number Status Description Item Amount GST Item Amount incl excl GST GST a Insert Remove 23 Copy Item 0 00 0 00 Service Provider P amp Supplier Reference Status Entered Payment Category y Payment Type Service Date ey GL Code Item Number Description 4 Scheduled Amount Surcharge Quantity Total Amount Excl GST Tax Status Not Applicable Tax Free y GST Reason for variation Total Amount Incl GST 33 3 Vendor Payment Step by Step The following topics are available to assist you in entering and maintaining Provider Payments on a c
383. urance SA Version 1 0 User Guide Step 2 File Name Step 3 Printed 18 06 2015 File name Open Once the desired file is selected click on the OPEN button in the File Browser If successfully attached the filename will be visible in the File Name field Once a document is uploaded to a File Note screen it cannot be modified If you have selected the wrong document you can select the Clear button to delete the uploaded file and start again Test docx View _ Clear Once all the details have been entered onto the screen the user would save the details by pressing the SAVE la icon 53 1 5 How do Notify a person of an Assigned Action Step 1 Step 2 Step 3 Due Date Tip The Return to Work File Note may be sent to SIMS users and other Staff if the Assign checkbox is checked and Due Date details have been entered Select the Category and enter details of the Return to Work File Note Click on the Assign checkbox to display and enable the other fields Enter a value in the Due Date and Reminder Date The system will send an email notification to the persons selected in the Email Notifications table on the Due and Reminder Dates unless the Date Completed has been entered ia Reminder Date Date Completed _ E Step 4 If the Person you wish to notify is a SIMS user Type the name of the Employee into the Name Email Address field and the system will identify t
384. usiness rules do not allow the particular function to be performed This can be verified with the Functional Specification available from the System Administrator e You do not have sufficient Security Privileges to access the menu function For example if the Modify option is disabled you may not have the rights required to modify the details currently displayed If this is the case you should contact the System Administrator to negotiate a change to your security if necessary 3 6 The Tree Control The Tree Control is displayed on the left hand side of the screen in Tree Control Window an example of which is displayed below Edy Claim Summary ETRE 3 sss D Injured Worker dig Employment Details sate Incident Details g Injury ow Injury Details Time Off Work i EN Estimate Commercial in Confidence SBC IT South Australia Department of Premier and Cabinet Page 30 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 The Tree Control has many uses including the following e When there are a number of entries for one section the tree control will display a on the left of the tree node to show that the node has multiple entries If the user clicks on this that node will expand to display that node s children The will then turn into a Clicking that will collapse the sub tree and hide that node s children This behaviour is similar to that of Microsoft Exp
385. uthorised Step 5 Once you are satisfied with the changes made click on the SAVE lal icon in the toolbar 37 2 4 How dol Add Recurring Payments Step1 Enter a New Income Support Payment see How do Add an Income wig Support Payment or open an existing Income Support Payment Step 2 Go to the Recurring Payments group box of the Income Support Payment If you are completing a New Income Support Payment enter relevant details Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 185 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 Step 3 If you are viewing an existing Income Support Payment ensure that the screen is in MODIFY mode by selecting the MODIFY icon on the toolbar Step 4 Select the Recurring Payment checkbox to enable some of the fields for entry Enter the Number of Recurring Weeks Recurring Payments Recurring P epee Fee Payment Recurring Weeks Week of auth orised J Pre Authorise Recurring Payments Date Authorised Authorised By The Date of First Payment is read only and is populated from the Date From of the first Payment The Week fields are read only and records the sequence number of Payments and the maximum number of payments in the schedule For example it may display Week 2 of 5 indicating that this is payment 2 out of 5 for this payment schedule Step 5 Once you are satisfied
386. uthorised Compensation Payments iim CEA Employer Details Claim Number Injured Worker Jurisdiction South Australia i Payment Category Claims Manager Payment Type Date Entered Compensation Date Date From i Date To E Date From li Date To Search Clear cancel v Approve Selected Items Totals 40 2 Unauthorised Compensation Payments Step by Step The following topics are available to assist you in the use of the Unauthorised Compensation Payments screen e How dol Search for an Unauthorised Compensation Payment e How do Approve one or more Payments 40 2 1 How dol Search for an Unauthorised Compensation Payment Open the Unauthorised Payment Search by selecting Administration gt Unauthorised Compensation Payments from the Menu Once the Unauthorised Payment Search screen opens select the Criteria associated with the desired Unauthorised Payment Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Claims Management System Self Insurance SA User Guide Page 198 of 309 Version 1 0 Printed 18 06 2015 Step 3 Press the 4 Search icon The Unauthorised Payments matching the selected criteria will appear in the Search Results list box Unauthorised Compensation Payments FET Employer Details Payment Details Claim Number Injured Worker Jurisdiction South Australia Paym
387. w Permanent Impairment Assessment Foii an Work i t New Vendor Paym ent P P mabe namie s New Income Support Payment ESE sy Estimate tS New Recoveries ier Estimate Histol _ wo Related Claims New File Note New Other Injuries or Diseases New Correspondence In New Correspondence Out a New Medical Referral _ New Investigation Referral amp New Motor Vehicle a New Nominated Treating Doctor New Claim Provider New Legal Representative New Dependant 2 New Witness cr New RTW Assessment New RTW Plan Fate y y ka y y y lf a Payment Screen already exists for the claim subsequent payment screens may be added by selecting a payment in the tree window and clicking the ADD NEW icon in the toolbar Step 3 Enter the Invoice details including the Date Received Invoice Date and Invoice Number Invoice Details Date Received ay Payment Status Entered Total Amount excl GST Invoice Date BF Invoice Number Total GST Date Entered 3 1 10 2014 Entered By SBC System Admin Total Amount Incl GST The Date Entered and Entered By fields are read only and will be automatically populated when the Payment screen is added to the claim Date Entered defaults to the current system date the payment for the claim is entered and Entered By is the name of the person entering the payment information for the claim The Total Amount excluding GST is a r
388. wildcard character in nominated character fields This enables the search to retrieve a larger number of results For example Sm in a text search field would result in all matches beginning with Sm including Smith and Smyth etc Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 280 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 9 HOW DO ACCESS amp MAINTAIN DOCUMENTS IN THE DOCUMENT DETAILS SCREEN The Document Details screen displays the details of an individual Document that has been generated from the SIMS The Document Details screen allows for the following to be completed e Documents can be Viewed e Documents can be checked out and edited by following the Check Out process and e Notes can be recorded for a Document in the Description field Only Microsoft Word documents with a File Extension of either doc or docx may be checked out If the Document is any other File Type then it may not be checked out The Document Details pop up screen contains one tab only e Document Details 57 1 Document Details The Document Details screen display as seen below and contains the following fields Document Details Document Details Document Number 4451 Claim Number 15000003 01 Document Source Correspondence In Document Category Incident Form Document Type Incident Repor
389. y Fields sis cee estar secan ene A NE 123 2a TESCO O aa A TTA 123 26 HOW DO I ENTER A DEPENDANT sisciicuctinencireitraciowinnineiicneiniaeiei rindi 124 Zor DEPENDAN P DETA O EEE T A E 124 20 2 DEPENDANT STEP BY OTEP usro Ea ans Gacdamiatian cd ener demauience aneiletvmmnuemndans 124 26 2 1 How do I Add a Dependant to the Claim ccc cccecccceecccseeeeseeeeseeeeeseeeeseeeeeseesesseeeas 125 26 2 2 How do I Modify the Dependant screen after it has been Saved ccceeeeseeeeeeeees 127 26 2 3 How do I Add Multiple Dependant screens to a claim cceccceeeeceeeeeeeeeeeeeeeeeeaeeess 127 26 2 4 How do I Delete the Dependant Screen cc eccccecccceececeeeeeceeeesaeeeeseeeesseeeeseeeesseeeeas 127 26 3 DEPENDANT ADDITIONAL INFORMATION wi scisiecysnistortisiteaiene minnie iniwialeiay hei ee oe ReaiOR 128 203k Mandatory IFICIOS wee sccte hc tet htt cacti ksh hte aaa e a tes aAa aaa Sante 128 POs TEECNO aAA anaes eee ee 129 27 HOW DO I VIEW THE RETURN TO WORK PLANS SUMMARY ccessseeeeeeeeees 130 27 1 RETURN TO WORK PLANS SUMMARY ccsccsserecsecsossereesecseetonsenetecsestotensereosestoetensenseaeess 130 27 2 RETURN TO WORK PLANS SUMMARY STEP BY STEP cc0sccccececeececeeecceeeseeeecesesoeeeseeeseeeees 130 27 2 1 How do I View the Return to Work Plans Summary cccceeceeseeeeceeeeeeeeeeseeeeseeeeens 130 27 2 2 How do I Open a RTW Plan from the Return to Work Plans Summary screen
390. y controls the level of access that a particular user or group of users has within the SIMS The SIMS is capable of supporting various levels of access For example you may not have access to the Modify function but can do searches for information Your System Administrator in consultation with appropriate business representatives determines the levels of access for each user You may need to contact that person to determine what level access you have and to renegotiate access levels Security maintenance is detailed in the SIMS Administration User Guide 2 2 3 Why has SIMS timed out Session Timeout Exception This session has been in idle mode for too long Session timed out Description Every session is active for four hours If you keep page idle for more than four hours all cached data will be discarded for security purposes Solution Please close and restart the system For technical reasons the software times out regularly and generally set between two and four hours This means that if you have not performed an action within the SIMS for a two hour period the SIMS will disconnect from the web server The next time that you attempt to perform any function within the SIMS you will receive a message indicating that the session has timed out From this message you can select to return to the logon screen to re enter the SIMS At the time that the SIMS times out any data that has not been saved will be lost including modific
391. y similar injury or disease It need not be work related e Has the worker every made a Workers Compensation Claim in this or any other name in this state or elsewhere if Yes is selected to the question Has the worker suffered any similar injury or disease Date of Injury if Insert has been selected Name of Employer if Insert has been selected Nature of Injury if Insert has been selected Details if Yes is selected to the question Has the worker every made a Workers Compensation Claim in this or any other name in this state or elsewhere 17 3 2 Tree Control Only one Other Injuries or Diseases screen may exist for each claim The screen will appear in the Claim Tree Control in the following format Other Injuries or Diseases Commercial in Confidence SBC IT South Australia Department of Premier and Cabinet Page 90 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 Ej Claim Summary F A Claim Details sen amp Injured Worker dig Employment Details 3 vanes Incident Details m Injury Time Off Work a SS Estimate wi Estimate History New Other Injuries or Diseases Related Claims Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 91 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 18 CLAIM SUMMARY The Claim Summary refers to the current status
392. y the Worker s Earnings screen e How do Add Multiple Worker s Earnings e How do I Delete the Worker s Earnings screen The following sections are related to Worker s Earnings are available in other sections of this User Guide 36 2 1 How dol Add Worker s Earnings Step 1 Open the Claim record for the Claim the Worker s Earnings relates to Step 2 Create a new Worker s Earnings record if one does not already exist using the floating menu next to the Claim Summary ir SEES i A Claim Details gt New Injury Details _ g Injured Workei gt New Notional Weekly Earnings shea Employment Die New Certificate of Capacity e Incident Detail gt New Surgery Related Incapacity E Injury __ New Permanent Impairment Assessment Tim E e a Work New Vendor Payment E N lt S New Income Support Payment Permanent Imj i 3 New Recoveries m Payments er S Estimate ae New File Note Estimate Histo Mew Other Injuries or Diseases wo Related Claims E New Correspondence In RTW Assessme New Correspondence Out a New Medical Referral C New Investigation Referral amp New Motor Vehicle a New Nominated Treating Doctor New Claim Provider New Legal Representative amp New Dependant 2 New Witness Pa Ball a z New RTW Assessment a ya New RTW Plan Step 3 Select the Salary Class Payroll Code and Pay Frequency if applicable Payroll Details
393. y to and click on an existing Injury in the Tree control Select the ADD NEW C icon from the toolbar Add the details of a new Injury referring to the instructions outlined in How do Add an Injury to the Claim Alternatively a new Injury screen can be added from the Claim s Floating Menu Click on the SAVE lal icon and the fields will become inactive and your changes will be saved 16 2 4 How dol Remove an Injury from a Claim Step 1 WEG Step 2 Step 3 Step 4 Open the desired Claim Navigate to the desired Injury Screen Select the desired Injury from the tree menu Press the DELETE A toolbar button A warning message will be prompted to the user and selecting OK will remove and delete the injury screen Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 85 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 Message from webpage Cancel 16 3 Injury Additional Information The following sections contain additional information about the Injury Details screen functionality and validation e Injury Mandatory Fields e Injury Tree Control 16 3 1 Mandatory Fields The following fields must be completed in order to successfully save the Injury screen into the SIMS database e Injury Side Date of Recurrence only if the Recurrent Injury checkbox is selected Nature of Injury all levels Bodily Location of
394. yed on the following screens e Payment Provider Name e Payment Item Service Provider e New Medical Referral Provider e Payment Search Provider If no entry is inserted into the Provider Name fields upon selection of the button the Provider Search screen see 7 1 above will open with a list of all Providers which have been assigned to the Claim lf a name is inserted into the field such as Jane s Physio the Quick Search facility will perform a search of all Jane s Physio records stored and display all matching records on the Provider Search screen This field also performs like quick searching such as if the words Jane was inserted in the Provider fields all providers with a Provider Names starting with Jane will be displayed in the Provider Search screen The user can select the desired Provider from the list by clicking on the Provider Name hyperlink associated to the Provider in the Search Results If the Provider you need does not appear in the list select the CANCEL button on the dialog and modify the search name entered Otherwise Search for the Provider using the Provider Search select the OK hyperlink Note You may only select one provider profile when you are using the Provider Quick Search Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 48 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed
395. yee This can be done by clicking on the Quick Search icon to select a provider already linked to the claim If the provider is not in the list the user can conduct a full provider search by clicking on the Search 4 icon Refer to How do Perform a Provider Search for more information lf the user leaves the Provider Name field blank and clicks on the quick search button then the user will be displayed a list of active Providers that have previously been used on a Payment or a Work Capacity Certificate on this claim in alphabetical order If the user enters part of a provider name the system will perform a like search on the provider name i e Sydney will search as Sydney and display the first 100 providers If you have associated the wrong Provider to the Payment you may click the clear icon located next to the Provider Name This will remove the Provider selection If the user clicks on the Search 4 button the Provider Search screen will be displayed allowing the user to search for an existing provider If the Provider is selected the details of this provider are automatically inserted Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 157 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 Payee Name A amp Reimbursement To Worker Provider Type Payment Particulars ABN Payment Method
396. yments for the claim select the Clear button 39 1 3 How do I Open an Income Support Payment from the Income Support Payment Summary screen gt Step1 To view the Income Support Payment Summary for the claim click on the Income wi Support Payment Summary folder in the Claim Tree Control Step 2 Review the list of Payments listed in the Summary until you have located the Payment you wish to open Step 3 Click on the Date From hyperlink The Payment will open in the Screen window Date To Payment Category Payment Type Date Authorised Total Payment Days Lost Hours Lost 28 12 2014 Weekly compensation Weekly Compensation Total Entered 35 200 00 Incapaci Totals 1 35 200 00 440 00 Commercial in Confidence SBCIT South Australia Department of Premier and Cabinet Page 197 of 309 Claims Management System Self Insurance SA Version 1 0 User Guide Printed 18 06 2015 40 HOW DO SEARCH FOR UNATHORISED COMPENSATION PAYMENTS The Unauthorised Compensation Search screen allows the user to search for an Unauthorised Compensation payments This Search may be accessed by selecting Administration gt Unauthorised Compensation Payments from the Menu The Unauthorised Compensation Payments Search screen consists of one tab e Unauthorised Compensation Payments 40 1 Unauthorised Compensation Payments The Unauthorised Compensation Payments Search screen will appear as follows Una

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