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GPs and their patients face systemic issues with workers’ compensation schemes. The NSW Government’s proposed reforms to workers compensation legislation are a welcome sign that policy makers are listening.
If you ask most GPs what takes up a surprising amount of their time and emotional bandwidth, you might expect them to mention chronic disease or mental health care. But many would say unnecessary paperwork just as quickly. The Royal Australian College of General Practitioners Health of the Nation report in 2024 identified this as one of the key issues that led GPs to consider early retirement.
The New South Wales workers’ compensation system has long been a source of frustration for both patients and doctors. Its labyrinthine processes, frequent delays, and complex requirements can turn what should be a clear pathway to recovery into an exhausting ordeal.
The NSW Government is proposing reforms to the Work Health and Safety Act 2011 (NSW) to better align workers’ compensation with industrial relations and workplace safety rules. Promisingly, this includes a $344 million workplace mental health package that will fund psychological support services and appoint more than 50 new inspectors, many focused on psychosocial injury.
These changes are urgently needed. Across Australia, GPs and their patients face systemic issues with workers’ compensation schemes, including unclear communication, slow treatment approvals, and a lack of cohesive care coordination. In some cases, these administrative burdens create more harm than the original injury.
GPs on the frontline: the real toll
When a patient is injured at work, they come to their GP first. We’re not just their medical assessor, we are their advocate, their counsellor, and sometimes their only consistent point of support. Many patients navigating the system report feeling anxious, powerless, and overwhelmed.
As GPs, we see firsthand the psychological fallout from prolonged delays and disputes. Patients arrive disheartened, their physical recovery overshadowed by stress and frustration. Each delay can erode their motivation to return to work and sap their confidence in the system designed to protect them. These are not quick consultations. They often require detailed discussions about workplace duties, functional capacity, mental health, and complex social factors. Yet, like other longer, complex consults, these visits are often inadequately funded, leaving patients facing out-of-pocket costs or GPs absorbing the financial hit to ensure proper care. In NSW, many of us see patients caught in a loop: an initial injury becomes a prolonged absence from work, which then contributes to secondary mental health issues such as depression and anxiety. The longer someone is off work, the less likely they are to return at all. This leads to significant consequences for their health, livelihood, and social connectedness.
Why returning to work matters
We know that “good work” is good for health. A safe, supportive workplace offers more than a pay cheque. It provides routine, social interaction, and a sense of purpose.
There is strong evidence that an early return to work, when it is medically safe and supported, accelerates recovery from injury or illness. Staying away from work for too long, even with good intentions, can lead to social isolation, economic hardship, and poorer health outcomes. Clarity around the severity of impairment and a clear understanding of the set boundaries around the length of time to return to work are essential. When workers and their support team, clinical and allied health, have clear timelines for return-to-work goals, then the team can work together to meet these. In a system where there is no urgency to return to work before seven years after injury, there are often unnecessary delays to re-engage with the workforce. It is much harder to return as an injured worker to the workplace after a seven-year absence than it is after a few months.
As GPs, we know that each case needs careful assessment. Some patients with severe psychological injuries truly need time away to focus on recovery. However, many individuals benefit from graded, employer-supported return-to-work plans that foster independence and empowerment, whether with the same employer or a new one.
Unfortunately, the current system makes this far harder than necessary. Approval delays for workplace adjustments, inconsistent communication with insurers, and workplace resistance to modified duties can all hinder progress.
The proposed reforms: a step forward
The NSW Government’s proposed reforms are a welcome sign that policy makers are listening. Investments in mental health support and the creation of specialist inspector roles to address psychosocial injuries are positive moves.
However, to truly support recovery, we need a simpler, more transparent system. GPs want to spend time caring for patients, not navigating convoluted paperwork or chasing approvals. Patients need to feel heard and supported, not punished by red tape.
Clearer pathways, faster decision making, and better communication between insurers, employers, and health professionals would ease the burden on patients and clinicians alike. Adequate funding for longer consultations, especially those addressing mental health and return-to-work planning, is also critical.
We must also acknowledge the social determinants of health at play. Time away from work can lead to financial strain, housing insecurity, and family stress, all of which negatively impact recovery.
What we’d like to see
As GPs on the frontline, we support reforms that:
- simplify claims processes and reduce administrative delays;
- provide timely access to mental health and allied health services;
- provide clarity on impairment severity and insurance coverage;
- enable an early, supported return to work;
- adequately fund complex, longer consultations through Medicare or compensation schemes; and
- recognise and address the broader social factors affecting recovery.
If we can build a system that prioritises patient wellbeing and clinician support, everyone wins: patients recover faster, workplaces retain experienced staff, and the health system avoids the spiralling costs of long term disability.
We now have an opportunity to modernise the NSW workers’ compensation system. Let’s not waste it.
Dr Rebekah Hoffman is a GP, Practice Owner and Chair of the RACGP NSW/ACT faculty.
The statements or opinions expressed in this article reflect the views of the authors and do not necessarily represent the official policy of the AMA, the MJA or InSight+ unless so stated.
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