Early Intervention- Being Proactive-"A Stitch in TIme Saves Nine"
There are some basic principles your organisation can
follow to increase the likelihood of a timely return to work for an injured
worker and they include:
a) Prompt Reporting
Promptly
reporting the claim to your Insurer/Agent along with any suspicious
circumstances that may require further investigation is very important. Late
reporting of claims increases potential lost time and medical costs, can encourage abusive claims, and increases the probability of
expensive litigation. Companies can consider asking the Insurer to investigate
any past claims as well as review your own records as an injury may be able to
be attached to an old claim or shed some light on the worker. Advise the Agent
of any information such as second employment or if the person received any
benefits.
b) Obtain Medical or Treatment
Have
the supervisor accompany the injured worker to the provider for emergency or,
with the employee’s permission, to the initial non-emergency treatment. First Aiders can arrange initial
treatment needs for example RICE including an ice pack for sprain, strains,
pulled ligaments to hospitalisation.
The
supervisor should observe the quality of treatment and report any problems to
the company, e.g long delays, rude treatment, or doctors that seem to be “out
of touch” with Workplace injuries. Getting the injured worker to high quality
doctors that are savvy to occupational medicine is one of your best means of
avoiding exaggerated claims. The supervisor should try to talk to the Doctor
about the nature of the injury and options for
early return to work.
You company may also consider
physiotherapist and even Psychologists can visit a site regularly if required
to provide treatment and early intervention at the direct cost of the company
which can diffuse a potential claim or reduce claim costs.
If there is no progress with treatment, companies can influence or
suggest a change in the physiotherapist or arrange a specialist review. We tend to like the approach of sports
physicians/medicine as the diagnosis is sometimes wrong. Poor treatment can
lead to costly claims.
c) Return to Work (RTW) Options
Experience shows us those
involved at any stage ideally should be a health professional or someone with
related experience e.g. with the role of the RTW Coordinator to improve
potential for outcome.
We all know the longer a worker/person
is off work the more difficult or
less likely it is for them to return to work (based on statistics). A focus on
RTW in the early stages is important. Set goals with the worker, e.g. return to work and treatment.
The
employer should periodically check with the medical and treatment providers to
discuss return to work options and if they note any concerns with the injured
worker.
Health professionals can monitor the timeframe for Return to Work (RTW)
in the early stages as well as ongoing. Many companies outsource the role of
handling the investigation to managing the RTW. Having experienced people
involved is very important.
d) Value the Employee
Stay
in touch with your injured employee. Encourage them to stay faithful to the
prescribed therapy. Encourage employees to keep medical appointments and to be
available when you call. Opportunity to build a relationship of care and trust. We still see unnecessary bullying from
employers in early stages of a return to work program. Ensure you consult with your workforce to prevent
injuries.
e)
Adopt
the BioPsychosocial model to manage the RTW
More complex claims need an approach involving close
communication with all treaters and health professionals/casemanagers in
general. Companies
can detect Psychological barriers early and lifestyle and RTW barriers and use
screening tools to detect biospychosocial factors.
Once flags or risks/gaps have been identified in a persons
coping skills, confidence, work relationships and emotional state these areas
need to be addressed. Case conferences with multiple parties are an effective
way to keep a RTW on track.
e)
Remain
Involved
Companies can utilise health professional with the development of self
managed strategies via education/coaching so the injured worker feels empowered
with treatment and rehabilitation.
Regular reviews can be arranged to:
- Monitor risk factors
- Check outcomes
- Provide close management
and monitoring of return to work program in consultation with all parties
- Allow for use of tools to
identify risks if recovery is delayed and/or risk factors observed
- Allow for collaboration and
information collection to reduce risks
- Address issues if pain
persistent after 3 months ie. psychosocial barriers
f) Evaluate your companies
performance
Ensure your business measures variable such as:
- Return to work outcomes. The ARPA study 2011 showed that based on 76781
case records those referred within the first 12 months achieved 80% return to
work rate, had shorter intervention and significant lower costs
- Workers Compensation Premium
- Problems associated with productivity and quality
- Absenteeism
- Incidents and near misses to determine trends
- Turnover with workers i.e. resignations, length of service
By adopting a proactive approach your business will see results across
all variables.
REFERENCES
Biopsychosocial Injury Management – Heads of Workers Compensation
Authorities and Heads of Compulsory Third Party June 2011
Effectiveness of Rehabilitation
- An Analysis of the data by Cortes Solutions 2011
Campbell Research & Consultation (2009) – Australia & New
Zealand Return to Work Monitor 2008/2009
Australian Faculty of Occupational & Environment Medicine (AFOEM)
2010 Position Statement “Helping People Return to Work”
