Getting back in the saddle A guide to understanding the ins and outs of workers compensation and encouraging return to work

Defining workers comp An insurance policy that is compulsory for most employers Covers medical expenses for sickness and injuries that occur in course of work

Background The longer a worker is absent from work, the less likely they are to return. Time off work Probability of RTW within 3 months 3 months 50% 6 months 40% 9 months 33% One year 25% Two years 12% Three years 6% Four years 4%

Key terms and concepts Certificate of Capacity: Used by insurer to help understand your capacity for work and the payments you are entitled to Provisional liability: allows employer to pay weekly benefits and medical expenses for up to 12 weeks without admitting or incurring liability Uninsured employers: if you employer is uninsured you can still make a claim Time limit: Claims should be generally be made within six months of injury or illness

Making a claim Notify employer immediately if injury or illness occurs If time off work is required see a doctor and have them complete a WorkCover certificate of capacity Provide certificate to employer Cooperate with injury management plan and consult with employer’s insurer Make all reasonable efforts to return to work as soon as possible

Return to work (RTW) Most recover from an injury without intervention Acute phase 14 to 30 days no work capacity Clinical/occupational management Sub-acute phase 30 to 90 days no work capacity Assess risk and workplace rehabilitation Chronic phase 90 days plus no work capacity Intensive rehabilitation

Psychological injuries Promote Stay at Work with Doctor – time off is not necessary or usual Seek specialist intervention in complex cases Aim to control treatment providers

Encouraging RTW Support and empowerment Provide reassurance and encouragement to resume normal activities Be empathetic Communicate and educate about health benefits of work Set expectations around RTW process Empower to take responsibility

Best practice Integrate the best available evidence with practitioner expertise and characteristics, state, needs, values and preferences of those who will be affected.

Best practice treatment Goal oriented Evidence based Clinically justified Most efficient Facilitates progress

Workplace rehabilitation providers (WRP) Provide individualised, strategic and creative interventions Recognise distinction between diagnosis and work capacity Promote a win-win outcome Focus on benefits of good work Look at cost-benefit for all proposed solutions

WRP services Assess claims for ‘Yellow Flags’ Apply ‘SMART’ for complex claims Conduct case conferences and promote the bio-psychosocial model with doctors Develop, review and update RTW Programs Offer proactive job seeking Monitor the efficacy of treatment Oversee compliance

Promoting RTW Encourage self-management Pay attention to psychological and social issues Avoid inconsistency in treatment of employees Involve rehabilitation providers as soon as possible