MHCC Psychological Injury Management Guide (PIMG)

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3.2: Return to Work

 

Overview

We maintain our connection with the injured worker from the beginning

Where possible, we support the worker quickly and safely sustain a rhythm of suitable, meaningful work.

We let workers know that a clear pathway for return to work is in place

 

In this section, you will find:

  • why it is important to manage return-to-work
  • the potential impacts of time off work due to workplace injury
  • an overview of RTW Programs, stakeholders and RTW plans
  • a flow chart of the overall RTW process and RTW preparation / planning
  • strategies for managing injured workers during the RTW process
    • overall
    • immediately after injury
    • during injury recovery (including early screening)
    • suitable duties, finalising the RTW plan, and having an "immediate" RTW norm
    • rehabilitation meetings
    • training the injured worker for another job
  • resources such as:
    • Identifying RTW risks
    • Sample position statement (task analysed for suitable duties)
    • Suitable duties "contact card" for the employee to take to the treating doctor
  • RTW screening tool (Modified OMPQ)

 


3.2.1: Why is managing return to work important?

The longer an injured worker is away from work the less likely it is they will return at all - we may lose a worker with valuable skills and experience.

 

(AFOEM Position Statement (2010). Realising the Health Benefits of Work)


What are the potential impacts of time off work due to workplace injury?

(Adapted from Q-COMP: Return to Work: a 5 stage process)

 

3.2.2: About Return to Work Programs

(From WorkCover NSW Guidelines for Workplace Return to Work Programs)

 

Our Return to Work Program outlines:

  • our commitment to assist injured workers with accessing necessary treatment and rehabilitation
  • the steps to be taken to achieve a safe, timely and durable return to work.

Our Return to Work Program is:

  • consistent with our workers compensation insurer's injury management program
  • communicated to all workers and provided to any worker on request
  • developed in consultation with workers and any industrial union representing those workers.

Links

RTW Stakeholders

 

3.2.3: The Overall Return to Work Process

3.2.4: RTW Preparation and Planning

Links:

 

3.2.5 Managing our Employees During the Return to Work Process

(Adapted from Q-COMP: Return to Work: a 5 stage process)

 

Managing our worker immediately after an injury

How a worker is treated in the first few hours after an injury has a major impact on how soon they will return to work

While each person is different, it is important that we:

  • provide first aid, send the worker to their doctor or arrange ambulance transportation
  • avoid blaming the worker even if we believe they were partly responsible
  • provide the worker with an information pack
  • contact the insurer within 48hrs of the worker's injury

(Adapted from Q-COMP: Return to Work: a 5 stage process)

For more information, see "Incidents - Responsibilities"

Managing our worker during the injury recovery period

This can be a physically and emotionally challenging time for the injured worker.

In most cases, it is beneficial for the worker to return to work quickly, yet it is essential that we strike a balance …

  • keep in contact with the worker, and ask what support is needed
  • ask the worker if they have any concerns about returning to work and how we can help them with these
  • contact the worker's doctor and our insurer if we have any concerns about the worker's return to work
  • let the worker know we can offer suitable (light or alternate) duties
  • encourage the worker to keep in regular contact with the insurer
  • encourage co-workers to keep in touch with the injured worker
  • consider early screening to help plan support (eg modified OMPQ)

(Adapted from Q-COMP: Return to Work: a 5 stage process)

 

Early Screening - eg OMPQ

Screening can help make decisions about arranging independent consultations with the injured employee. Discuss this with your insurer. One tool being used is the modified OMPQ.

(Pearce et al - 2010)

Example of RTW based on results of Modified OMPQ screening

(Pearce et al - 2010)

  • This example indicates that high and medium risk workers (according to OMPQ result) routinely receive independent psychological and/or medical consultation.
  • Talk to your insurer about this if you and/or the employee are concerned about the employee's recovery

Links:

Reminder: Psychosocial factors that significantly influence RTW outcomes

(Cotton 2009)

 

Keep the employee engaged with the workplace and co-workers during recovery.

Check for the presence of the above psychosocial factors and seek help to address them according to the particular circumstances of the employee and organisation.

3.2.6: Suitable Duties

Taking the lead in planning for our worker's return can help reduce time off work.

  • develop a list of potential suitable (alternate or light) duties
  • ask the worker for ideas about return to work and assess their motivation for returning to work
  • if fearful of re-injury; encourage the worker to discuss concerns with their doctor
  • involve others in the discussion. The worker's supervisor and co-workers can be a great support
  • be flexible about deciding on suitable duties
  • ask the insurer for rehabilitation provider involvement for complex cases such as psychological injuries or complex physical injuries
  • have a written RTW program with details on suitable duties
  • set up a procedure to monitor the worker's progress
  • maintain confidentiality of the worker's rehabilitation personal information.
  • Plan for RTW risks

Key Areas of the Return-to-Work Plan

Individualised RTW planning starts with the injured worker as soon as injury occurs

(Comcare Return to Work Plan)

 

Links

Links

"Immediate" RTW is our norm …

… we encourage and support a coordinated return to work as soon as possible, consistent with medical advice.

… "immediate" RTW (within eg 3 days of injury) is our norm

Suitable duties are essential

Provision of suitable duties is the foundation for effective injury management

Offering suitable duties is critical for supporting worker recovery, because:

  • an enduring recovery from injury is more likely
  • links between the worker and workplace continue
  • worker motivation is enhanced
  • workers maintain their salary

Links

What are suitable duties?

"Suitable duties" are:

  • medically safe duties the injured worker can carry out while s/he is recovering
  • meant to be a short term transitional arrangement towards pre-injury duties

Providing suitable duties may involve:

  • parts of the pre-injury job
  • the pre-injury job on reduced hours
  • a completely different job

Suitable duties are NOT:

  • token duties which are not useful for our organisation
  • demeaning to the worker

Developing Suitable Duties

Suitable duties can be anticipated and identified in position descriptions before an injury occurs.

When a specific injury occurs, we may use the following process to develop suitable duties:

(Q-COMP: Ideas for suitable duties)

 

Suitable duties - checklist for employers

  • Consider the listed duties of the injured worker's current job (should already be contained in the "job analysis")
  • Let the doctor know you are aware of the benefits to the worker of RTW as soon as possible, and that you will offer suitable duties to facilitate this.
  • Ask the worker and doctor about employee capabilities and restrictions
  • Read the medical certificate and evaluate how restrictions prevent normal duties
  • Include suitable duties in the return to work plan; ensure they are agreed to by all parties
  • Keeping in mind confidentiality requirements, ask other staff for their input to the written return to work plan. What duties do they recommend for the injured worker? How can they be supportive during the rehabilitation process?
  • Consider how other workers may be affected by restricted duties and hours
  • Review the worker's progress as required
  • Consult with the employee, doctor and rehabilitation provider to revise the plan as the employee's health and capabilities improve

(WorkCover: Suitable duties: Information for employers and injured workers)

 

3.2.7: Rehabilitation meetings and reports

Rehabilitation meetings are attended by the injured worker, supervisor, case manager (insurer), RTW coordinator (if the CMO has one) or line manager, and if possible, the treating doctor.

At rehabilitation meetings the worker's RTW goals are developed, monitored and reviewed.

Rehabilitation reports inform all key stakeholders on the rehabilitation and progress of the injured worker towards the RTW goals.

Training the injured worker for another job

Training for another job should be considered as soon as it is known that the injury will prevent the injured worker from permanently returning to their pre-injury duties position and hours.

3.2.8: Improving the way return to work is managed in our workplace

We choose measurable against indicators of return-to-work performance.

  • To measure return to work performance, we:
    • seek staff perspectives (injured workers, co-workers, other staff)
    • calculate the average compensation per injured worker
    • calculate the percentage of workers who return to work
    • investigate whether the worker is still working 12 months after their return
  • We compare our organisation's performance to sector averages
  • We review our return to work strategies and develop improvement plans
  • We investigate the cause of the injury and taking steps to prevent a recurrence
    • let the injured worker know that we have taken steps to prevent a recurrence
  • We follow up prevention strategies regularly to make sure they are effective.

(Adapted from Q-COMP: Return to Work: a 5 stage process)

 

Fostering a workplace culture which promotes early return to work

Immediate (within eg 3-days), safe return to work and provision of suitable duties following injury or illness are high priorities.

Return to work is naturally seen as a staged return to pre-injury duties

Job analysis documents are developed before injuries occur and include suitable duties modifications

We educate our staff …

… managers and supervisors:

  • effective injury management principles (e.g. early intervention),
  • the importance of suitable duties
  • why early return to productive work is vital

… all staff:

  • what they can expect if they sustain a work related injury or illness
  • how early return to work will support staff recovery mentally, physically and financially

  • refresher Injury Management training for all every two years

3.2.9: Wellbeing Initiatives

A workplace wellbeing program may include:

Organisational factors

  • improved morale
  • work team climate
  • supportive leadership
    • empathy
    • clarity
    • engagement
    • learning

Individual factors

  • ensuring job-fit to skills
  • focus on improving morale
  • encouraging healthy lifestyle choices, nutritional or exercise campaigns and initiatives
  • training and personal development opportunities