Psychologists working within the South Australian workers compensation scheme, also known as WorkCover or ReturntoWorkSA, may be requested by the claims manager or self-insured employer to provide a Summary Report (fee schedule item PS820). This report type provides a brief clinical opinion covering the worker’s diagnosis, medical status, and treatment. It may also be self-initiated by the psychologist after every 6th consultation.
This report template synthesises information from NovoNote and NovoPsych psychometrics to assist clinicians in preparing a concise Summary Report in plain English that can be understood by ReturnToWorkSA claims managers and other decision-makers who may not have a medical or allied health background.
Note: NovoNote also includes the related template, ReturnToWorkSA Treating Psychologist Comprehensive Report, for psychologists providing a Comprehensive Report (fee schedule item PS810).
Treating Psychologist Summary Report
Prepared under: ReturnToWorkSA Psychology Fee Schedule, Item PS820
Worker:
Date of Birth:
ReturnToWorkSA Claim Number:
Employer:
Date of Report:
Report Requested By:
Diagnosis
Current Medical and Psychological Status
Treatment Provided
Outcome Measures
Functional Capacity and Return to Work
Barriers to Recovery and Return to Work
Recommendations
Responses to Specific Questions
If you require any further information, please do not hesitate to contact me.
Yours sincerely,
Psychologist first and last name
AHPRA Registration Number
Practice Name
Treating Psychologist Summary Report
Prepared under: ReturnToWorkSA Psychology Fee Schedule, Item PS820
Worker: James Brown
Date of Birth: 14/03/1981
ReturnToWorkSA Claim Number: RTW-2024-04471
Employer: Statewide Logistics Pty Ltd
Date of Report: 26/03/2026
Report Requested By: Claire Nguyen, Claims Manager, ReturnToWorkSA
Diagnosis
Post-Traumatic Stress Disorder (PTSD), 309.81; Major Depressive Disorder, Moderate, 296.32.
Current Medical and Psychological Status
James continues to experience moderate PTSD symptoms including intrusive memories, nightmares, and hypervigilance, alongside low mood and fatigue consistent with moderate depression. He is not currently working and reports difficulty with basic daily tasks, though some improvement in mood and sleep has been noted since commencing treatment.
Treatment Provided
James has received 22 individual sessions of Trauma-Focused Cognitive Behavioural Therapy (TF-CBT) since 14 November 2023, initially weekly and transitioning to fortnightly from February 2025. Treatment has focused on reducing trauma symptoms and depression through psychoeducation, cognitive restructuring, and graduated exposure to trauma-related cues, consistent with Phoenix Australia guidelines for PTSD.
Outcome Measures
PTSD Checklist for DSM-5 (PCL-5)
The reduction in PCL-5 scores indicates a meaningful decrease in trauma-related symptom severity since treatment commenced, though symptoms remain clinically significant.
Depression Anxiety Stress Scales – Short Form (DASS-21)
These results indicate moderate improvement across all three domains, consistent with James’s reported gains in functioning.
Trauma Recovery Measure (TRM)
Progress from early to middle stage of trauma recovery reflects meaningful movement through the recovery process, consistent with clinical observations.
Functional Capacity and Return to Work
James does not currently have capacity to return to his pre-injury role as a logistics coordinator, given ongoing impairments in concentration, emotional regulation, and tolerance of workplace-related cues. It is anticipated that a graduated return to work may be achievable within three to six months, subject to continued treatment progress and identification of suitable modified duties.
Barriers to Recovery and Return to Work
The primary barriers are James’s persistent avoidance of workplace-related cues, financial stress, and the current absence of suitable modified duties at his pre-injury employer. A coordinated approach involving the treating team, claims manager, and a return to work coordinator is recommended to identify host employment options and support timely reintegration.
Recommendations
Ongoing Psychological Treatment: Ongoing TF-CBT is recommended at a fortnightly frequency for approximately 12 additional sessions over six months, to continue addressing trauma symptoms and prepare James for graduated return to work.
Return to Work: A graduated return to work programme is recommended, commencing with low-demand duties at a host employer if suitable duties are unavailable at Statewide Logistics, with a target commencement date of July 2026.
Other Recommendations: A case conference between this clinician, James’s GP, and the claims manager is recommended to coordinate care and align return to work planning.
Responses to Specific Questions
No specific questions were provided.
If you require any further information, please do not hesitate to contact me.
Yours sincerely,
Dr Sarah Brown
PSY0012345
NovoPsych Psychology Practice
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