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Better Practice Guide

Maintaining & Returning Injured Workers to Work

March 2013

This Better Practice Guide examines the key drivers for achieving favourable rehabilitation and return to work outcomes including:

 Early intervention

 Immediate medical treatment

 Key stakeholders

 Care and support for the injured workers family

 Sourcing suitable duties

 Use of professional rehabilitation providers

 Communication and consultation

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1. Introduction

Bis Industries is committed to preventing injury and disease in the workplace. Should any of the company’s employees be injured in the course of their employment, the company will ensure that appropriate treatment is obtained in a timely manner in accordance with established policies and procedures. Legislative requirements set out under the Safety, Rehabilitation and Compensation Act 1988 (SRC Act) shall form the minimum standard.

Following a serious incident at a Bis Industries site, the Workers Compensation Insurances Services (WCIS) took the opportunity to reflect on the existing injury management practises. Drawing on this experience and in consultation with other licensees and members of the Safety, Rehabilitation and Compensation Licensees Association, Bis Industries developed this Better Practice Guide for Maintaining and Returning Injured Workers to Work.

The document has been prepared as a practical tool for improving injury management and seeks to add to the existing body of literature in this area for practitioners in the Commonwealth jurisdiction.

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Does your organisation understand the benefits of

having an effective injury management system?

2. Why Rehabilitation Matters

There is a general acceptance that early access to rehabilitation, injury management and return to work leads to improved outcomes for the injured worker and the workers’ compensation system.

A rehabilitation framework with clear policies and procedures is crucial in delivering optimal results in the return to work process, and most importantly, equity of outcome for injured workers.

When rehabilitation is done well, everyone shares the benefits;

 Injured workers feel supported and their chance of a timely recovery and return to their lifestyle is maximised,

 Injured workers families feel supported and part of the recovery process;

 Employers enjoy costs savings as productivity is restored sooner, expenses such as incapacity payments are contained, business disruptions are minimised and legal obligations are met; and

 Overall staff can see the commitment of the organisation to providing a safe workplace and helping injured workers, this has a positive effect on workplace culture and morale.

3. Injury Management

3.1 Early Intervention

Early intervention is most successful when it occurs prior to absence from the workplace, at the first sign of, or report of injury or illness. A strong focus on early intervention in all cases of workplace injury is an important element of any injury management system.

Early intervention does not always mean getting the injured worker back to work early. Rather, it is about early and immediate support to the worker as soon as possible

after the injury.

Early intervention is beneficial because it:

 Demonstrates support and commitment from

management and interest in the injured worker’s wellbeing;

 Prevents long-term absence from the workplace;

How does your organisation demonstrate immediate support

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How does your organisation encourage an environment of

early reporting and early treatment?

 Ensures treatment is obtained immediately, contributing to a more timely recovery;

 Is financially favourable to the organisation;

 Contributes to a more durable return to work.

When examining the issue of early intervention, consideration should be given to:

 The development of an early intervention policy and procedures which aligns with your organisations core values;

 Will the early intervention program treat non-work and work related injuries and illnesses the same;

 Ongoing education and training of the policy and relevant procedures to all stakeholders; and

 Monitoring and measurement of compliance to procedures and overall performance. 3.2 Immediate Medical Treatment

If medical treatment is required, the injured worker should be supported to seek treatment from a suitably qualified person. Depending on the nature and location of your organisation, a suitably qualified person may be a first aid officer, on-site medic, general pracitioner, ambulance officer, Royal Flying Doctors Services (RFDS) or local hospital.

Providing immediate treatment and support post injury ensures the workers injury is stabilised as quickly as possible and contributes to a more timely recovery for the injured worker. It can also aid with maintaining an injured worker in

the workplace, particularly where suitable duties can be readily sourced. However, the provision of timely treatment is solely dependent on the injured worker reporting the injury to management or other relevant stakeholder within the organisation.

When examining the issue of immediate medical treatment, consideration should be given to:

 What is the process established for reporting workplace injuries;

 Does your organisation have a culture of late reporting and how can this be changed;

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 What first-aid should be delivered and by whom;

 How will the injured worker access initial medical treatment; and

 What medical / treatment facilities are available in the case of an emergency. 3.3 Injury Management Stakeholders

Rehabilitating an injured worker back to health requires a collective approach. There are many stakeholders involved and various stages. Stakeholders may include, but are not limited to:

 the injured employee  General Practitioner

 RTW / Injury Management Coordinator  Treating Specialist

 Supervisor / Manager  Consultant Specialists

 Claims Manager  Allied health professionals

 Rehabilitation Manager  Approved Rehabilitation Provider (ARP) Given the many number of internal and external stakeholders that can be involved in the process, it is important that the roles and responsibilities of each key

stakeholder are clearly defined and communicated from the outset. This will ensure that each party is accountable for their area of responsibility and reduces the risk of issues that require actioning falling through the gaps. It also helps the injured

worker know who to direct their queries to e.g. issues about liability should be directed to the Claims Manager.

When examining the issue of stakeholders, consideration should be given to:

 Who are the relevant stakeholders;

 How are internal stakeholders appointed;

 Are the roles and responsibilities of each stakeholder clearly defined and understood;

 How are the various stakeholder holder roles and responsibilities communicated to an injured worker; and

 What training is provided to maintain skills and expertise of stakeholders.

Who are the key injury management stakeholders

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3.4 Care and Support for the Family Unit

When a person is injured in the workplace, it is important to understand the affect the injury can have on the family life of the individual. Research has demonstrated that family and friends can be deeply impacted which may eventually lead to problems within these relationships.

Care and support of the injured worker’s family unit is important and it demonstrates the level of

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How does your organisation demonstrate care and support for

the family of an injured worker?

When examining the issue of care and suport for the family of an injured worker, consideration should be given to:

 Under what circumstances should a company representative make contact with the injured workers family e.g. serious incident;

 Who should be responsible for maintaining contact with the injured workers family;

 What happens if the injured workers has no immediate family and lives independently;

 When is the right time to conduct an assessment of activities of daily living (ADL assessments) where an injured worker lives independently, or is unable to perform particular tasks;

 In serious cases, such as severe injuries warranting hospitalisation, would your organisation consider funding the costs of travel and accommodation for the family to the visit the injured employee in hospital and to stay close by;

 If immediate family members also worked within your organisation would you consider offering shift / roster changes and /or paid leave to allow greater support whilst at work; and

 Do you have an Employee Assistance Program (EAP) and is this service available to employees well as their immediate family including spouses and children.

3.5 Sourcing Suitable Duties

When an employee is injured, the focus should be on maintaining them in the workplace provided it is safe to do and has been supported by their treating medical practitioner. In most cases, this outcome will be reliant upon being able to identify alternative, modified or restricted duties within the organisation. The identification of suitable duties is also important where a serious injury may have occurred and the injured worker requires assistance and support to return to work on a graduated basis

The provision of suitable duties is beneficial to both the injured worker and the organisation because:

 Maintains the focus for all stakeholders on maintenance or return to work;

 Allows the organisation to retain skills, knowledge and experience;

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How does your organisation sources meaningful suitable duties which comply with medical

restrictions?

When is the right time to seek the assistance of a professional

rehabilitation provider?

 Prevents the injured worker from becoming isolated at home during recovery and

 Helps support the injured worker with their physical and mental recovery following an injury. When examining the issue of suitable duties, consideration should be given to:

 Do stakeholders understand the importance of having the injured worker undertake suitable duties;

 Who is responsible for sourcing suitable duties;

 Should a collective approach be taken to source suitable duties e.g. site manager, supervisor and RTW Coordinator ;

 What forms are required to capture the available suitable duties and communicate these duties to key stakeholders;

 Does your organisation have a ‘duties manual’ or equivalent document which highlights the tasks and associated physical demands of the injured workers role which serves to assist the treating medical practitioner to ascertain the injured workers fitness for work following an injury;

 Is the process for completing relevant forms known and understood;

 What happens when an injured worker is unable to return to their usual workplace for a temporary period, is there a process for communicating with other sites within your organisation to source suitable duties; and

 How do your existing processes deal with injured workers who live interstate, especially in rural areas e.g. are home-based duties considered.

3.6 Use of Approved Rehabilitation Provider (ARP):

Utilising the professional services of a rehabilitation provider can help achieve optimal return to work and rehabilitation outcomes. A rehabilitation provider is

generally a health professional with qualifications suited to managing different injury types such as, but not limited to, an Occupational Therapist, Physiotherapist and

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How does your organisation maintain good communication with stakeholders in the injury

management process?

The use of a rehabilitation provider is especially important when managing complex injuries e.g.

psychological injuries, injuries which have resulted from a traumatic event, multiple injuries, permanent injuries and chronic long-term conditions.

Stakeholders should monitor claims for any indicators which may prompt a referral to a rehabilitation provider e.g. issues sourcing suitable duties, the nature and severity of the injury, issues with the injured workers capacity and any other relevant return to work barrier.

When examining the issue of professional rehabilitation providers, consideration should be given to:

 Does your organisation have a process for referring for rehabilitation services;

 How are rehabilitation providers selected and monitored;

 What are the triggers for referring a claim for rehabilitation services; and

 What happens if an injured worker does not like the appointed rehabilitation provider.

3.7

Communication and Consultation:

Return to work and rehabilitation outcomes often depend on how well the stakeholders can work together and support the injured worker. This relies upon the stakeholders taking a consultative approach with open, two-way communication.

Communication and consultation is important from the moment an injury occurs and throughout the process of claims and injury management. Post injury, the focus should be on communicating with the medical practitioner about the nature and extent of the injuries, relevant treatment and available suitable duties. Additionally, the workers compensation process should be explained to the injured worker e.g. lodging a claim, reimbursments, treatment and expectations about participation in the return to work process.

Without effective communication between all key stakeholders, progress with the injured worker’s rehabilitation can become stagnant.

When examining the issue of commuication and consultation, consideration should be given to:

 What is the preferred method of communication for the relevant stakeholders e.g. email, phone, fax;

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What information should be contained in a rehabilitation

program?

 How regularly should follow ups be conducted with injured workers and should this differ depending on whether the employee is at work or at home unfit;

 How regularly should you be contacting the medical practitioner, treatment providers, specialist etc; and

 What steps should be taken to address poor communication or a breakdown in communication.

3.8 Rehabilitation Programs

A rehabilitation program includes elements of both medical and occupational rehabilitation which together provide for an effective return to work program for an injured

workers. A rehabilitation program included return to work goals, stakeholder responsibilities, key dates, expected outcomes and costs. A written plan is important to maintain an outcomes-based focus and keep all stakeholders on task.

The development of a rehabilitation program should be a collective process engaging all relevant stakeholders, especially the injured worker. If the injured worker is not engaged in this process, they will be less likely to actively participate in the program and this will delay recovery. Evidence of consultation should be included the program.

When examining the issue of rehabilitation programs, consideration should be given to:

 Appropriateness of the duties that form the program, having regard to the injured workers restrictions and capabilities;

 Ensuring that all parties, including the injured worker, are aware of the obligations of those involved;

 Ensuring that the injured worker is aware of their right to request a reconsideration should they not agree;

 Ensuring that a collective approach has been taken in developing the program;

 Ensuring that the conditions of the program are reasonable; and

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4. Further Information Bis Industries

Workers Compensation Insurance Services (WCIS) Department Level 5, 146 Arthur Street

References

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