NSCA Foundation

Improving return to work outcomes


By Denise Cullen
Tuesday, 03 July, 2018


Improving return to work outcomes

Most workers compensation claims proceed without a hitch. Safe Work Australia figures show that 52% of all serious claims are finalised within six weeks.

However, 10% of claims drag on for a year or more — increasing costs, raising the spectre of subsequent litigation and decreasing the odds that the injured employee will ever return to work.

The total amount of payments made under Australian workers compensation schemes in 2014/15 topped $8.4 billion(1). So there is a strong business case for identifying those individuals more likely to enjoy smooth sailing on their return to work journey versus those who face greater risks of running aground.

Dr Ross Iles, a physiotherapist who now works within Monash University’s Insurance, Work and Health Group, said that being able to separate straightforward from complicated claims helps direct resources where they are most needed.

He said there is an identified therapeutic window of six to 12 weeks post-injury when interventions are likely to have their greatest influence on return to work outcomes.

“This time frame strikes a balance between intervening when it is not required, and acting early enough to potentially avoid chronic complications,” Iles said.

Iles leads the Recovery Blueprint project partnership with WorkCover Queensland — evidence-based research which seeks to identify risk factors associated with a delayed return to work and ensure that injured employees access the most appropriate supports for a speedy recovery.

It is well recognised that the longer a worker is absent, the less likely it is that they will return, and the harder it will be when they do.

“You don’t need to be 100% recovered before you return to work — work is part of recovery, it’s not the end point,” Iles said. “If someone has difficulty coping, it’s crucial to provide support early on, before things become too much to deal with.”

It makes good financial sense for employers to invest in workers’ wellbeing. Aside from the benefits of retaining staff, a study published in the Harvard Business Review(2) found that every dollar invested in health interventions yielded six dollars in savings.

The type of injury naturally influences the course of any workers compensation claim, with mental health conditions and injuries involving high levels of pain associated with longer return to work times.

According to an Institute for Safety, Compensation and Recovery Research (ISSCRR) report(3), mental health conditions comprised only 3.5% of claims made between 2009 and 2012, but accounted for 11.6% of all time lost.

Demographic variables also play a part, with ageing workers and female gender associated with longer times to claims resolution.

Work specific variables also influence outcomes. For instance, physically and psychologically demanding work can be associated with a delayed return to work, as can part-time or casual employment status due to worker uncertainties around entitlements and supports.

Workplace culture can make or break the return to work process. Cultures supportive of on-the-job recovery will hasten an injured employee’s return and resumption of usual duties.

Conversely, environments in which colleagues question the legitimacy of a claim, or complain about the additional workload they’ve shouldered during a worker’s absence, are not conducive to good outcomes.

There are many ways employers may positively impact the process. Gestures such as calling injured employees to inquire as to their welfare can also have “profound impacts on return to work outcomes”, Iles said.

One Safe Work Australia study(4) found that when the employer made contact early with staff impacted by mental illness, 77% of those employees remained in work, as opposed to 52%, who had no employer contact.

Organisations which have previous experience facilitating return to work processes, and a diversity of suitable duties, are also well positioned to welcome workers back.

Ease of access to health services contributes significantly to outcomes, so new technologies which connect traditionally disadvantaged rural and remote areas are coming to the fore.

For instance, a new real-time video platform called Coviu has so far connected more than 20,000 Australians to healthcare practitioners through partnerships with organisations including Health Team Australia, HealthKit and Ramsay Healthcare.

Physiotherapy network Biosymm has conducted more than 1400 consultations on Coviu. By improving accessibility to physiotherapists, Biosymm’s early intervention treatments have reduced claim numbers by half compared to the previous year.

Yet, as Brisbane bricklayer Ben Roche amply demonstrated, one of the biggest predictors of return to work are individuals’ beliefs in, and commitment to, their own recovery.

In March 2017, Roche suffered a severe brain injury after falling more than five metres head-first onto concrete through a collapsed scaffold, according to WorkCover Queensland.

Even knowing he would no longer be able to work at heights, or deal with the mental stress of managing teams, he embarked on an intensive rehabilitation and return to work program to identify suitable duties at work and home.

Through old workmates, he accepted an offer to drive trucks for a local earthmoving company eight months after his fall, and coaches the local Under 6 rugby team in his spare time.

Streamlined case management with clear and consistent communication between stakeholders facilitated this return to work, said Roche’s WorkCover Queensland Customer Advisor, Sandra Hennessy.

“Bringing the right medical specialists together early meant that Ben’s rehabilitation program was tightly coordinated and could be modified to support his gradual recovery,” Hennessy said.

References

(1) Safe Work Australia: https://www.safeworkaustralia.gov.au/workers-compensation/comparing-workers-compensation-scheme-performance

(2) Berry, L. L., Mirabito, A. M. & Baun, W. B. (2010). What’s the Hard Return on Employee Wellness Programs? Harvard Business Review, 1-9.

(3) Lane, T., Collie, A., Hassani-Mahmooei, B. (2016). Work-related injury and illness in Australia, 2004 to 2014. What is the incidence of work-related conditions and their impact on time lost from work by state and territory, age, gender and injury type? Melbourne (AU): Monash University, ISCRR; Report No.: 118-0616-R02.

(4) Wyatt, D., Cotton, D. and Lane, D. (2017). Return to work in psychological injury claims. Analysis of the Return to Work Survey results. [online] Canberra: Safe Work Australia. Retrieved from: https://www.safeworkaustralia.gov.au/system/files/documents/1711/ return-to-work-in-psychological-injury-claims.pdf [Accessed 1 Dec. 2017].

Image credit: ©stock.adobe.com/au/princhipessa

NSCA Foundation is a member based, non-profit organisation working together with members to improve workplace health and safety throughout Australia. For more information and membership details click here
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