EBM Insights podcast series is a deep dive into current issues surrounding insurance and risk management in today’s ever-changing world.
This podcast is the 2nd in our series with Chris Mather from Star Injury Management as well as Mary Zlnay from EBM Insurance & Risk’s Injury Management team. We dive deeper into the medical side of a return to work plan.
A transcript of the interview with Star Injury Management is below. The complete EBM Insights podcast series is available here.
Introduction:
The second part of our podcast series with STAR Injury Management is now available.
This episode features Chris Mather discussing the different medical treating parties involved in helping an employee Return-to-Work.
Disclaimer:
In this podcast, we have provided general advice only and not personal advice. In giving this advice, we have not considered your personal circumstances.
00:00:00 Disclaimer – Speaker 1
In this podcast, we have provided general advice only and not personal advice in giving this advice. We have not considered your personal circumstances.
00:00:13 Speaker 2
Welcome to EBM insights. Today’s podcast is the 2nd in our series with Star Injury Management that focuses on strategies and tips to help manage an injured employee return-to-work.
Last time we discussed how to involve an injured worker in developing their return-to-work plan and how to identify suitable duties for them to perform. Today we look at the medical treating parties that contribute to helping the employee return-to-work.
Joining me again for this episode is Chris Mather from Star Injury Management. Also joining us again is Mary Zlnay from EBM insurance & Risk’s Injury Management team. Welcome to Chris and Mary.
So, Chris, when developing the return-to-work plan with and for the employee, who are some of the medical professionals that an employer may need to engage with.
00:00:59 Speaker 4
So primarily, the treating doctor and all the specialists are the primary decision makers in the workers comp scheme. Here it is important to get feedback from allied health professionals such as physiotherapists, psychologists, exercise physiologists or occupational therapist but ultimately under the Workcover WA, the medical practitioner and the surgeon have basically the final say on on that.
00:01:20 Speaker 2
Are employers able to attend medical appointments with injured workers? Can the employer choose their treating medical provider?
00:01:29 Speaker 4
Uh, yes and no. For both of those the employer can attend if the worker is agreeable to an employer representative or potentially a web-based rehabilitation provider attending medical appointments, but there’s no obligation on the actual worker to agree to that. Potentially, they may be in the rewrite of the ACT which I’m sure you’re both aware of.
Medical practitioners can be selected if the injured worker is in agreement as well. But the worker ultimately has the right to elect their own medical practitioner under the ACT.
00:01:55 Speaker 3
OK, so from reading your notes on this topic, which are great by the way, you mentioned the importance of an early case conference with all treating parties, what would you recommend be covered off during this initial session?
00:02:07 Speaker 4
First and foremost, discussing the diagnosis, treatment plan, barriers, and potentially referrals to specialists or allied health practitioners. It is always important to get a clear picture of what the condition is and also getting the right treatment in place.
From there you can provide a suitable duties list to help with return-to-work planning. Make sure that those are physical demands of tasks.
If task is complex or unusual, take a video of it for the doctor at the appointment. Make sure the Allied health professional has information on available duties and return to work so they can tailor their treatment and recommendations to return to the tasks.
I find this one can be difficult, sometimes you implement, and I do tend to find allied health professionals are much more conservative than the GP or a specialist when it comes to return-to-work recommendations. So, this one can be beneficial as the Allied health professional often directly communicate with the GP or specialist particularly if they’ve been referred to.
Then by the GP or specialist. A specialist physiotherapist reviews can assist with earlier diagnosis or adjustment of treatment plans to improve recovery, particularly recovery stalls, or the diagnosis is unclear.
This can help the treating parties adjust the treatment plans. It’s potentially not so much early on, but more so after a period of no improvement, or diagnosis remains unclear.
With the assistance of treating parties, set recovery timeframe expectations as early as possible, this in particular help the injured worker to know the expected duration of when they’ll be back to normal and helps everyone to keep track, particularly the recovery stalls.
00:03:43 Speaker 3
If the employer is unable to participate in a GP case conference, what questions should be asked to obtain key information from the GP to assist with the return-to-work process?
00:03:55 Speaker 4
Yeah, I think this one is a case-by-case question depending on the nature of the injuries. You know, sometimes it can be a very significant or severe leg fracture, arm fracture where potentially return to work is probably not going to be discussed, but if the injury does permit this and you know the employers I have to get there. I think it’s a good idea just to try and get an idea of what the broad restrictions are so the doctor will hopefully provide a medical certificate following the review, and then they provide some restrictions. So, you want to try and clarify, you know, do they need one handed duties, office, or sedentary duties. Shoulder work, any lifting limits, you know is a good place to start.
I find it’s often easy just to get broad restrictions as to what the worker can’t do as opposed to what they can do. The last thing you want the GP is trying to stipulate they can do this. They can do that, you just really want to know what they can’t do, and then you can sort of do the rest in terms of providing duties.
This should make it significantly easier to put together a list of duties following the obtaining medical restrictions, and in addition to this, Star Injury Management has developed a service to assist with employees not being able to attend case conferences, which are sort of not necessarily full workplace rehabilitation referrals, and we can be contacted for further information regarding that if any of your clients need one.
00:05:09 Speaker 3
OK, great, I I would assume that it’s best to keep all information succinct when dealing with many parties.
00:05:16 Speaker 4
Definitely, particularly dealing with medical practitioners and surgeons. The workers’ comp is just a small part of their, you know their caseload. Often, I find that if you keep it to one-page letterheads which tends to be the best for communicating information with treating parties, and yet often treating medical parties have limited administrative administrative time available, and information can be very compact and easy to try to digest, and then offline, you’ll get the information that you require following that.
00:05:48 Speaker 2
So, Chris, how is the insurer kept informed of the communication between the employer, worker, and the treating doctor?
00:05:55 Speaker 4
If there’s a work-based realisation referral in place, the injury management consultant will provide email updates following contact with these treatment parties, which will summarise the events which occurred at the GP review or Surgeon review and then the plan moving forward.
In addition to this, four to six weekly progress reports are also provided. As per Workcover WA legislation to provide formal updates in terms of progress from a chronological perspective from the last reporting period.
Other formal reports, such as return-to-work programs and work-site assessment reports can also be provided. If anything needs urgent attention WRPs are always available to call an insurer to draw their immediate attention to this information as well.
00:06:35 Speaker 2
Thank you. Alright, so to close out this session, what is the role of the treating doctor and what are the key areas they need to be across?
00:06:47 Speaker 4
So ultimately, the treating doctor is the primary caregiver and ultimately stipulates what the worker is capable of in the workplace.
So, in addition to this, we need to clarify what potential restrictions are available to be accommodated by the employer. If the focus is on restrictions rather than duties is often easier for the medical practitioners to provide input with regards to this, which we’ve touched on earlier. It’s often better to find out what the worker can’t do as opposed to what they can do.
The treating doctor is ultimately required to be an advocate for the injured worker to ensure medical restrictions allow the worker maximal ability to partake in the greater return to work program.
The treating doctor will very rarely be an advocate for the employers. Ultimately, they’re bound by their ethics to look after the injured worker.
If you have light duties available, please make it clear what they are and what their demands are. It is often easy is that the doctor to confirm a fitness. If they know what the options, you have and this was touched on earlier with job descriptors and suitable duties registers.
And we have touched on supernumerary previously as well, and it is not the doctor’s role to recommend if someone is supernumerary. However, the workplace can support this, then you can advise them and recommend the restrictions to assist with design of the return-to-work program.
00:08:03 Speaker 2
Thank you again to Mary and Chris for joining in this podcast. We have one more session to go with Star Injury Management so to our followers, make sure you listen to that one as well.
Once again, if you would like to access our entire podcast series, please head to Spotify.
Plus, we have links to each episode on ebm.com.au Thank you.
