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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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Home » Employers » Injury Management- What is Happening and When? » Managing the Injuries 4-12 months

Managing the Injuries 4-12 months

 

 

More than 4 months have passed since your employee was injured and both of you are still in the workers compensation system.  If both of you are lucky their injury may have almost resolved and:

  • They a good treatment team and support. They are committed to getting better and going back to work and are doing what is necessary to progress
  • Activities they found difficult are either done another way or by someone else so that their injury is not aggravated
  • Sports or hobbies they once did may not be able to be performed in full capacity but they are starting to perform them in a limited capacity. Hopefully, any injury symptoms they had are now minimal and don’t affect them adversely too much in terms of pain and restrictions in what they can do. If they do have residual symptoms but are managing it is probable that:other interests, sports and things to relax that don’t aggravate their injury
  • You as their employer are likely to have been supportive and have helped them to upgrade by providing selected duties and have generally been supportive.

 

Common Difficulties - 4 months to 12 months

 

For those workers who are still in the system but are finding it difficult it is probable that there are a number of obstacles and unexpected things happening which are proving a barrier. 

 

These include difficulties relating physical injuries and they can include:

  • Severe pain and restrictions
  • No obvious organic basis for the symptoms identified at this stage given the symptoms
  • More comprehensive and expensive tests such as an MRI, bone scan, and nerve conduction test haven’t been performed, considered or approved
  • More comprehensive and expensive tests such as an MRI, bone scan, and nerve conduction test both physical and psychological injuries haven’t revealed a specific problems
  • The more comprehensive and expensive tests such as an MRI, bone scan etc. may have revealed a problem but it is not clear what the best treatment will be
  • Surgical opinions have suggested “conservative treatment” be tried before any surgery is considered
  • An alternative treatment to that undertaken in the first 3 months either hasn’t been proposed, approved or enough sessions undertaken to gauge its effectiveness

 

Psychological Injuries

 

The effects of primary or secondary psychological injuries are likely to be impacting on treatment and rehabilitation responsiveness and to general sense of wellbeing.

 

Primary psychological injuries include:

  1. trauma reactions if the accident was particularly traumatic such as a significant  industrial accident, an armed hold up or assault, or a significant motor vehicle accident whilst travelling from one job site to another
  2. Other psychological injuries including bullying and harassment

 

Secondary psychological injuries may be due to:

  1. Significant ongoing pain that is effecting everyday functioning in most areas of their  life.
  2. Significant functional limitations effecting everyday functioning in most areas of life
  3. Sleep deprivation from pain and worry
  4. Financial problems  resulting from lost wages, delayed payment of expenses
  5. Family tension having a family member unable to contribute to the household as before

 

Remember the advice of “key things an injured worker needs to know” that is their GP/ NTD  is:

  1.  Experienced as a GP generally
  2.  Has experience with managing compensation claims
  3.  Has empathy and understanding of the issues associated with workers compensation injuries
  4.  Someone they feel comfortable with
  5.  Efficient and organised
  6. It is also important that their NTD is aware of all aspects oftheir wellbeing and
    • Helps to provide preventive strategies to minimise secondary injuries,
    • Will instigate or is responsive to suggestions for referral to specialists and treatment provides who can support them psychologically through psychological counselling, pain management and injury adjustment counselling.

  

Problems with Treatment


There are a number of potential issues at this stage concerning treatment and responsiveness. Many of the issues in the first 3 months cited previously continue to slow progress. These include:

  • The treatment being inappropriate for the injury. The correct diagnosis may still not have been made or more information needs to be available before the most appropriate interventions are recommended. This may involve referral for a more sophisticated tests, such as an MRI because rest and interventions such as physiotherapy are exacerbating symptoms or having no positive results.
  • Treatment may have been given too early. For example a gym strengthening program ordered before the injury is treated correctly would lead to further problems with recovery or re-injury.
  • Quality of treatment may be lacking and "treaters" may have poor "bedside manner". This could lead to a lack of engagement in treatment and therefore reduce outcomes.
  • Access to treatment can be an issue. This can be caused by:
  • The Agent still not approving necessary treatment (as deemed as unreasonable and unnecessary)
  • Ongoing extended delays with approval and therefore commencement of treatment
  • Conflicting opinions continuing between the injured workers team, and the NTD, and the Agent about the best way to treat and manage an injury
  • Extensive delays in seeing specialists continue
  • Delays in being seen by treaters or for follow-up appointments

 

What the injured worker can consider:


  • Be proactive in your approach - don’t wait for others to organize things and provide you with all the information and feedback.
  • Do you’re their own research about their injury treatments and what should be happening
  • Discuss with their NTD
  • Review treating provider’s performance including theri NTD, physiotherapists, psychologist, chiropractor, rehabilitation provider.
  • If you they have concerns define them, and discuss with view to developing an agreed plan of action to address concerns
  • Be open in your response to feedback. At the end however if they are not getting better, either in terms of getting treatment to help their injury to improve or in learning to live with residual symptoms the worker will need to consider other support or different approaches.

 

What you, the employer can consider


If progress isn’t being made you may need to discuss your concerns with the doctor,  rehabilitation provider, and your agent.   The agent may need to get an independent assessment of treatment strategies and goals and get further feedback from key service providers.

 

What you the employer can consider


  • As the employer having a good relationship with your employees can be helpful when it comes to getting information and feedback about he or she is doing
  • Some problems such as wages can be quickly sorted out by a phone call to the case manager handling the claim
  • Suggested support from you as the policy holder is often more likely to be listened to than from the injured worker.

 

Poor Communication between Stakeholders


If information is not provided to agents, employers and treatment providers who are trying to support a worker to get better or return to work, inappropriate strategies and counterproductive attitudes in communication may result. Employers who are not given clear guidelines on what duties should or shouldn’t be undertaken may provide work that is beyond the injured workers capacity that results in re-injury, or at least tension and friction if the worker then refuses to do the task.

 

What you do about it

 

Case conferences with all parties can be very effective to improve communication. You as the employer worker can help to facilitate this by suggesting to their rehabilitation provider or agent.

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