We have put together information to keep injured or ill persons informed of what to expect.
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All employers play a crucial role in the prevention and management of workplace injuries.
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Information for Psychologists, Occupational Therapists, Nurses, Exercise Physiologists and Doctors.
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Other key stakeholders are also encouraged to provide Information and comments about issues of relevance .
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When to Refer to a Rehabilitation Provider

 

One of the many roles your  insurer /  agent has  is to monitor progress of a claim and injury and to determine if there are any other services that need to be included to promote recovery.  One type of service required and frequently referred to is the accredited rehabilitation service provider. 

 

When the Agent or Eployer should make a Referral

 

Referrals to rehabilitation are advisable when:

 

  • Issues arise concerning the worker returning to work (rtw) with the same employer
  • Suitable duties cannot be identified
  • The injured worker cannot RTW with same employer or in the same job
  • There are difficulties in the worker RTW in the same job, a similar job or different job with same employer
  • Employer-employee relations are problematic
  • The injured worker needs vocational retraining and redirection
  • The injured worker needs to establish a new vocational goal
  • Job seeking assistance is required to locate suitable employment
  • Functional limitations need to be explored to increase suitable duties certification
  • Extra assistance is required regarding monitoring of RTW capacities
  • There is a need for more face to face contact and monitoring of the injured worker
  • RTW progress needs to be monitored closely

 

For small to medium size employers it is most likely that the agent will be the chief manager / "expert" on the direction  of a claim. It is also likely that they will be the instigator of most referrals to external rehabilitation providers.  All agents have their"preferred providers". These providers have contracts with the agent that  are cost driven and are consitent with the agent's business model and injury management philosphy.  Although the agent's  preferred providers may initally be marketed and presented as  the  the most  cost effective service for your business, they may not necessarily be the best and most cost effective service in the long run.  This is partiualry the case when the injury and claim is  complex and there are multiple stakeholders involved.  

 

Why: Because  agent's preferred  providers are  frequently  medium to large employers whose focus is on appeasing the agent with a low cost  structure, but promise of a quick return to work outcome, and /or service to assist in claim finalisation.  To be able to do this,  a significant percentage of staff employed are junior staff, fresh from university with little work experience and injury management knowlege. Often they are offered  limited training and limited ongoing support  -  their primary objective to facilitate quick fix injury management practices.  Unfortunertaly this practice , along with a number of other stresses associted with the industry results in a very high rate of staff turnover.  It means  the injured worker and you as the employer are likely having to regualry deal with a  new case manager, and someone who is unfamilar with the case.  With simple and non complex claims this model can be adequate, however when the claim and injury is complex and there are multiple stakholders involved,  an experienced rehabilitation provider and  case manager with excellent communicaion and negotiation skills are essential.

 

You as the employer can choose the rehabilitation provider for your worker rather than your insurer and can continue to have control over the claim and its direction.

 

How to Refer to a Rehabilitation Service Provider?

 

  • Identify appropriate provider; bearing in mind that the IW may have a rehabilitation provider of their choice.
  • Phone rehabilitation provider and advise of incoming referral.
  • Fill out the referral sheet and email or fax.
  • The referral sheet should include information from claim forms and an up to date account of events so far, services requested and when you want them to occur.
  • If appropriate, send copies of claim forms, medical certificates and reports to date.

 

Evaluating Performance

 

  • Rehabilitation provider’s performance needs to be monitored closely to prevent performance falling below accepted standards.
  • Do not be fearful of asking questions, giving feedback or requesting more detail be entered in reports. This will ensure quality service and help the injured worker RTW more quickly.

 


Evaluating Specific Assessments and Interventions

 

The content within reports should include:

 

Initial Assessment:

 

  • Detailed account of current injury situation, RTW barriers, strategies to deal with barriers, time frames and costs.

 

Functional Assessment:

 

  • Clearly defined limitations and restrictions.
  • Goals and recommendations that are realistic, innovative and are not “sausage-machine driven”.

 

Vocational Assessment:

 

  • Education and employment experiences to date.
  • Work Skills including skills acquired to date, skills effected by injury and transferable skills.
  • Expressed work interests.
  • Literacy level, aptitudes - Tests used, scoring and interpretation.
  • Labour market analysis – not just job supply – must include demand e.g. relative competitiveness for entry into identified jobs.
  • Potential barriers to employment and strategies to over come these.
  • More than 2 jobs listed in recommendations that are realistic, innovative and achievable in context of worker’s injury, skills experience and current labour market.

 


Workplace Assessment:

 

  • Detailed account of session
  • Realistic suitable duties and modifications that are in place and if there are none – an explanation as to why.

 

Progress Reviews:

 

  • Should be individually tailored to each case.
  • Must contain goals that were established, plans implemented and results achieved in the last month.
  •  A list of goals, and strategies that have been implemented. A plan of what will be implemented over the next month.

 

  • Job seeking assistance reports comprise monthly progress reviews.  The insurer must be informed about the number of jobs searched for and progress. If job seeking comes to a standstill, the rehabilitation provider must devise new strategies to help injured worker RTW rather than continue with old strategies that are no longer relevant and not working.

 

Closing Report:

 

  • Must summarise interventions to date and outcomes, and reasons for closure.

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