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

Problems with you, the Employer

 

Industrial and workplace issues can be a major barrier to an injured worker returning to full or near full capacity in their preinjury work place.  In the information file 1-3 Months - What is happening / should be happening the following issues were mentioned as common workplace barriers: 

  • The employer is reluctant to accept that an injury is work related (despite liability being partially or fully accepted by the insurer) and therefore also reluctant to support the restrictions made on the medical certificate.
  • An employer is not aware unwilling to accept their obligations to provide suitable duties  for an injured worker
  • An employer agrees to provide but then doesn’t accommodate the restrictions or hours of a medical certificate.
  • Lack of management and co-worker support - an attitude that the injured worker is a malingerer, weak or not pulling their weight and “dragging the chain”.
  • Subsequent problems with the injured worker being fearful of returning to work 

 

Twelve Months down the track most employers will have accepted that the injury is work related (even if they have continuing suspicions that it is not) and will be aware of their obligations to provide suitable duties. It is also likely (and recommended) that the employer will have had advice about their legal and injury management responsibilities at this stage and will be attempting to provide at least token levels of support. The vast majority of employers, particularly if they are being provided with good information and support from an external rehabilitation provider and their insurer will be active participants in the return to work process.  

 

After 12 months many small to medium size employers will be finding it costly to have had to make a workers compensation in terms of time, money, and unexpected considerations addressing staffing and business requirements.  Employers are required to provide suitable duties for their workers.  For a small employer, i.e. less than 20 staff their obligations can seem onerous.  The personality of the manager and business owner, the circumstances of injury, their experiences with the worker since injury, and the general health of the business  are all factors that can strongly influence the attitude of the an employer to the injured worker, to the treatment team and to injury management experience generally.  Where there relationship and attitude with the  injured worker is poor, additional barriers to a successful return to work outcome are likely. These include:

  • Suitable duties not being offered at all
  • Duties being offered that are not consistent with medical restrictions
  • Close monitoring of performance and discrimination by the employer
  • An unhelpful attitude from the worker concerning retuning to work -  e.g. avoidance, hostility, taking regular leave, arriving late , leaving early
  • Pressure from the employer to the agent to have the worker assessed as work ready or generally, anything that will lead to the claim being declined and their obligations ending

 

What the worker needs to consider:

  1. Try and be aware of the challenges employers faces and be understanding of their situation
  2. Try to discuss concerns with key staff
  3. Make sure you have a good and experienced rehabilitation provider and experienced case manager who is a good negotiator and mediator.  They can be helpful in explaining  the situation and getting support for common goals acceptable to all parties
  4. Consider mediation if suggested
  5. If all else fails discuss alternate work directions with your NTD and rehabilitation provider

 

What you, the employer need to consider

  1. Try and be aware of the challenges workers face and be understanding of their situation
  2. Try to discuss concerns with your employee
  3. Educate and advise key staff involved in the return to work process of your injured worker
  4. Create and encourage a supportive environment
  5. Make sure you have a good and experienced rehabilitation provider and experienced case manager who is a good negotiator and mediator.  They can be helpful in explaining  the situation and getting support for common goals acceptable to all parties
  6. Consider mediation if suggested

 

If all else fails consider the process of withdrawing suitable duties being aware of the implications for:

  1. future premiums
  2. staff recruitment and costs
  3. training times

 

Discuss and try to get advice from Workcover, your agent and, or your business or professional association

 

 

Problems with Diagnosis and Treatment

After 12 months from date of injury the vast majority of injuries will have healed completely.  For those that haven’t it is unlikely that the pain and functional restrictions from the injury will improve significantly, even with a different approach.  There are exceptions of course such as head injuries - which may take up to 3 years and some complex injuries where there were unexpected complications and side effects.  

There are also situations where the management of the injury has been poor.  Some of the circumstances include:

  1. Inaccurate diagnosis from NTD
  2. Inadequate Investigations by NTD
  3. Inadequate or inappropriate referrals by the NTD
  4. Premature certification of fit to return to work, for selected or full duties resulting in significant injury exacerbation
  5. Inadequate information and feedback from the NTD ignoring significant symptoms - i.e. red flags resulting in complications or exacerbation of symptoms. Alternatively an over cautious approach to maintain activities of daily living, working resulting in the injured worker becoming disproportionally fearful of reinjure and or becoming deconditioned from reincur -  Both scenarios can result in slower response times to treatment  and rehabilitation and lower work capacity.
  6. The NTD  fails to recognise secondary psychological difficulties that are emerging due to factors such as poor pain management, associated chronic sleep difficulties, family problems, medication issues  prescribed and non-prescribed .  Treatment responses are frequently affected by issues such as anxiety, agitation, poor decision making and memory problems, impaired motivation, fearfulness of attempting a new treatment or upgrading duties a t work.
  7. The NTD through either not identifying psychological and social difficulties (see Red and Yellow Flags) does not attempt to address the issues affecting his/ her patient.  They may not adjust medication or treatment regime air refer for psychological assessment and support when much need.   Most injured workers who have a claim that goes over 12 months are likely to be experiencing significant changes in their life section and will have been put under stress attempting long term  injuries

 

Treatment provider problems such as

  1. Inappropriate treatment strategies for the symptoms
  2. Treatment irregularity -  appointment schedules too far apart
  3. Abrupt and inappropriate treatment cessation.  Although the emphasis in Worker compensation injury management is for “evidence based practices” that are “reasonable and necessary” there is often disagreement between service providers and the agents paying for the treatments as to what is evidence based, “and what is reasonable and necessary”.  You are frequently not given clear guielines  and parameters concerning the time frame required for treatment responses.

 

One of the roles of agents is to regularly monitor treatment progress and outcomes. Although this is essential, there is considerable variation between agents and case managers knowledge of case manager and in how they do this resulting, at times, in the agents having unrealistic expectations. Often and not always having an adequate understanding of all the facts effecting outcomes. “Independent medical assessments” are often organised by the agent to assess treatment progress and future support needs.

 

CHANGE IN APPROACH TO MANAGING INJURIES AFTER 12 MONTHS

As general rule, by 12 months there need to be an overall change in approach to injury management with most injuries and most workers.  The emphasis needs to change from finding the best treatments to one where the focus moves to adjusting to living with permanent residual restrictions and pain.   Psychological counselling / and or pain management counselling is often very helpful with this.  (See Pain Management and Injury Adjustment Interventions and Pain Management and Injury Adjustment Interventions)

More Information

Useful Information

Member Login

User:
Password:
Forget Password?