Rhea cuts through the noise with clarity and warmth, breaking down why reform was necessary, what's actually changed, and most importantly, EPs can not just survive but genuinely thrive within the updated scheme.

Rhea explains the scheme faced a massive deficit and a 64% rise in psychological claims, making sustainability and cost efficiency unavoidable, and clarifies scheme agents manage claims rather than underwrite risk. She highlights key reform impacts for ESSA members: tighter, faster and more forensic decision-making focused on medical/treatment entitlements, return to work and prevention, including a 42-day liability decision window for psychological claims where treatment can cease if liability is declined.

The discussion emphasises “scheme literacy” alongside evidence-based care: translating clinical measures into functional work capacity, aligning goals to certificates of capacity, “bundling goals,” “consistently creeping capacity,” reducing weekly benefits by increasing work capacity, and proactively building rapport and communicating with claims managers.

Copyright Notice

This video is brought to you by Threesticks Productions, Rhea Mercado HQ and The Intelligent Rebellion in collaboration with Exercise & Sports Science Australia. Copyright Threesticks Pty Ltd, Rhea Mercado, The Intelligent Rebellion

See omnystudio.com/listener for privacy information.

Rhea cuts through the noise with clarity and warmth, breaking down why reform was necessary, what's actually changed, and most importantly, EPs can not just survive but genuinely thrive within the updated scheme.

Rhea explains the scheme faced a massive deficit and a 64% rise in psychological claims, making sustainability and cost efficiency unavoidable, and clarifies scheme agents manage claims rather than underwrite risk. She highlights key reform impacts for ESSA members: tighter, faster and more forensic decision-making focused on medical/treatment entitlements, return to work and prevention, including a 42-day liability decision window for psychological claims where treatment can cease if liability is declined.

The discussion emphasises “scheme literacy” alongside evidence-based care: translating clinical measures into functional work capacity, aligning goals to certificates of capacity, “bundling goals,” “consistently creeping capacity,” reducing weekly benefits by increasing work capacity, and proactively building rapport and communicating with claims managers.

Part 1:

00:00 ESSA Dr Isabel King x Rhea Mercado NSW Workers Compensation Reforms

00:09 Introduction

01:58 Why reform was needed

04:36 What are the changes?

05:54 Scheme Literacy

06:50 How to Navigate the System

08:57 Translating your clinical findings

09:30 Provisional Liability for Psychological Claims

Part 2 delves into:

12:01 Tighter Definitions for Psychological Injury

12:47 Tip: Look at the Certificate of Capacity

15:09 Bundling Goals & Consistently Creeping Capacity

16:24 How EPs demonstrate their value

19:02 Claims Managers are Humans Too 

21:14 Developing Trust and Rapport

24:07 The Mindset Shift

26:06 Closing and Thanks

See omnystudio.com/listener for privacy information.

Rhea cuts through the noise with clarity and warmth, breaking down why reform was necessary, what's actually changed, and most importantly, EPs can not just survive but genuinely thrive within the updated scheme.

Rhea explains the scheme faced a massive deficit and a 64% rise in psychological claims, making sustainability and cost efficiency unavoidable, and clarifies scheme agents manage claims rather than underwrite risk. She highlights key reform impacts for ESSA members: tighter, faster and more forensic decision-making focused on medical/treatment entitlements, return to work and prevention, including a 42-day liability decision window for psychological claims where treatment can cease if liability is declined.

The discussion emphasises “scheme literacy” alongside evidence-based care: translating clinical measures into functional work capacity, aligning goals to certificates of capacity, “bundling goals,” “consistently creeping capacity,” reducing weekly benefits by increasing work capacity, and proactively building rapport and communicating with claims managers.

00:00 ESSA Dr Isabel King x Rhea Mercado NSW Workers Compensation Reforms

00:09 Introduction

01:58 Why reform was needed

04:36 What are the changes?

05:54 Scheme Literacy

06:50 How to Navigate the System

08:57 Translating your clinical findings

09:30 Provisional Liability for Psychological Claims

Part 2 delves into:

12:01 Tighter Definitions for Psychological Injury

12:47 Tip: Look at the Certificate of Capacity

15:09 Bundling Goals & Consistently Creeping Capacity

16:24 How EPs demonstrate their value

19:02 Claims Managers are Humans Too 

21:14 Developing Trust and Rapport

24:07 The Mindset Shift

26:06 Closing and Thanks

See omnystudio.com/listener for privacy information.

Dr Isabel King and Rhea Mercado discuss communicating with Claims Managers in Workers Compensation. Case managers are doing a very difficult job and the role of clinicians should adjust their language and reporting to match scheme needs, noting that technical measures like degrees of flexion may not be meaningful to a claims manager.

The conversation highlights the scrutiny claims managers face including decisions and reports may be litigated, phone calls recorded and reviewed, and large volumes of requests assessed against regulations and policies. The key takeaway is for Eps to help claims managers make decisions by writing in understandable language and maintaining direct communication.

00:00 Case Managers

00:07 Case / Claims Managers

Copyright Notice

This video is brought to you by Threesticks Productions, Rhea Mercado HQ and The Intelligent Rebellion in collaboration with Exercise & Sports Science Australia. Copyright Threesticks Pty Ltd, Rhea Mercado, The Intelligent Rebellion

See omnystudio.com/listener for privacy information.

Scheme Literacy: Translating Clinical Evidence for Workers Compensation Decisions

Dr Isabel King and Rhea Mercado discuss reframing what “evidence” means in workers’ compensation, emphasising that it is used for liability and approval decisions rather than only clinical research. They note that clinical care and compensation scheme decision-making run in parallel, creating complexity. They define being “scheme literate” as understanding how clinicians make treatment plans and reports and how these are interpreted within the compensation framework, including interpreting outcome measures and communicating them effectively. An example is provided where reporting 110 degrees of shoulder flexion is less useful than explaining how that measurement translates to functional capacity, such as performing overhead work, in a workers’ compensation-friendly message.

00:00 Evidence Reframed

00:16 Parallel Decisions

00:31 Scheme Literacy Basics

00:47 Outcome Measures Translation

00:52 Shoulder Flexion Example

Navigating Workers Compensation with Dr. Isabel King and Rhea Mercado

Copyright Notice

This video is brought to you by Threesticks Productions, Rhea Mercado HQ and The Intelligent Rebellion in collaboration with Exercise & Sports Science Australia. Copyright Threesticks Pty Ltd, Rhea Mercado, The Intelligent Rebellion

See omnystudio.com/listener for privacy information.

Rhea and Isabel discuss how exercise physiologists and ESSA members can better demonstrate their value in early intervention within the New South Wales workers compensation system to avoid being sidelined. Rhea emphasises that while stakeholders may want clearer economic value supported by improved data collection, in the meantime professionals can show value by building “scheme literacy” and understanding cost drivers. The speaker explains that the most expensive part of a claim is weekly benefits paid when someone is off work or on reduced duties, and that increasing a person’s functional capacity to return to work—even for a few hours a day—reduces these benefits and overall claim costs. Clinicians should link treatment plans to measurable work capacity improvements, showing progression from no capacity to suitable duties, which strengthens their case with doctors and claims managers.

00:00 How can EPs demonstrate their value - Navigating NSW Workers Compensation Reforms with Dr. Isabel King and Rhea Mercado

00:02 How EPs can demonstrate their value

This is a clip from: Navigating Workers Compensation with Dr. Isabel King and Rhea Mercado

Copyright Notice

This video and audio is brought to you by Threesticks Productions, Rhea Mercado HQ and The Intelligent Rebellion in collaboration with Exercise & Sports Science Australia. Copyright Threesticks Pty Ltd, Rhea Mercado, The Intelligent Rebellion

See omnystudio.com/listener for privacy information.