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 final one in our series with Star Injury Management WA Manager, Naomi Goods, that focuses on the strategies and tips to help manage an injured employee return to work.
A transcript of the interview with Star Injury Management is below. The complete EBM Insights podcast series is available here.
Introduction:
Our final podcast in our series with STAR Injury Management is now available.
Naomi Goods closes out this series and provide information on when to get help from a workplace rehabilitation provider to assist your employee with their Return-to-Work plan
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. This podcast is the final one in our series with Star Injury Management that focuses on the strategies and tips to help manage an injured employee return to work.
Last time we discussed the different treating parties involved in supporting an injured worker in developing their return to work.
Today we will cover off when to get help from a workplace rehabilitation provider. Joining me from Star Injury Management is there WA Manager, Naomi Goods. Naomi has worked in injury prevention and workplace health, and has a specific interest in complex ergonomic assessments, industrial ergonomics and work site assessments.
Also joining us again is Mary Zlnay from EBM Insurance and Risk’s Injury Management team. Welcome to you both.
00:00:59 Speaker 3
Thanks, happy to be here.
00:01:01 Speaker 4
Thanks for having me.
00:01:03 Speaker 2
To recap what we’ve discussed in the previous episodes of our series with Star Injury Management, can you provide your top tips to assist in managing any injuries in the workplace?
00:01:14 Speaker 4
Yeah, definitely. So where possible, and this is probably one of the key things that makes a person return to work. The easiest is having a treating doctor that’s familiar with the workers compensation scheme.
A doctor who will know how to proactively manage a claim and understands the implications of a lot of their decisions.
The other key thing is making sure you’ve got a list of suitable duties or options for what the doctor can certify someone.
So not just saying office duties, but it might be like one hand at work or a particular project or something like that the injured worker can do.
When they are fit for work, are also trying to make sure you’ve got an aligned preferred provider, so a specific workplace rehab provider that knows your company really well. They know the shared processes so they can work with you proactively to manage your return to work as quickly as possible, as early as possible.
00:02:18 Speaker 3
So, when do you recommend an Employer should have a discussion with their insurer about the engagement of a workplace rehabilitation provider and what are the benefits to early engagement?
00:02:29 Speaker 4
So, there’s been a lot of research in this area more recently. Generally speaking, having someone engaged with a rehab provider if they’ve been unfit for more than two or four weeks is a really strong indication that someone needs a rehab provider. That’s probably the key take home point with when you definitely need a rehab provider.
If your certification from the doctor keeps stating unfit and there’s not really any reason for the person to be unfit.
Also, if you don’t have any options for suitable duties, so a common one we come across is if all the duties are on a remote mine site and you don’t have an option for them to do a light or restricted return to work programme.
You’re likely to need an external work trial programme, which is something a rehab provider can assist in setting up. If the injury is really complex and requires surgery, it’s likely that there’s going to be a lot more parties involved.
So having a provider is really helpful then, and more generally, any kind of indication of some psychosocial issues, so there might be some things that aren’t necessarily related to their injury. They might have some family problems that you’re aware of or some personal non-related health issues. Those kinds of things.
But generally, the earlier a rehab provider is appointed, the more likely it is that you’re going to get positive outcomes for return to work. I think there is some indication from some New South Wales studies that we’ve done that show that for each dollar you spend, the return on investment for that early involvement is quite significant.
00:04:19 Speaker 3
So, what are the steps to appointing a workplace rehabilitation provider and who is responsible for discussing it with the worker.
00:04:27 Speaker 4
So, anyone can refer to a workplace rehab provider, they just need to provide what’s called a form 310. Our referral form in terms of who can activate can come from the injured worker, the treating doctor, the employer representative, or the insurer.
You will generally always need to seek insurer approval for it so we can chase that up as a workplace rehab provider.
In terms of who should discuss that with the injured worker, it’s always better if that discussion comes from the workplace representative just so that you’re explaining to them why you want that extra help for them, and it should be seen as an extra help that you’re trying to give them more support, not as another thing you’re making them do is usually when it’s best received.
00:05:17 Speaker 3
Are there any costs associated for their rehabilitation services?
00:05:21 Speaker 4
So, workplace rehab providers return to work services are gazetted under the Workcover WA scheme. So, the insurance company funds the costs of our involvement with the return to work process under the gazetted rates and some workplace rehab providers will also have several service level agreements with certain insurance companies as well to keep the costs at a minimum, but still provide those services.
00:05:48 Speaker 2
OK, great. And is the worker able to choose their own workplace rehabilitation provider?
00:05:55 Speaker 4
Yes, they can, so they can choose their provider under the work cover legislation and they can also choose their treating parties as well, which extends out to their GP and physio’s.
00:06:11 Speaker 2
And are they able to change providers during the life of their workers compensation claim?
00:06:17 Speaker 4
Yes, they can, which is why it’s really important for workplace rehab providers to be neutral and transparent in terms of their processes and what they’re trying to do with the return to work.
Our goal is always very transparent we’ll always let workers know that our aim is to try and help them get back into work and get back to work.
So that needs to be clear and transparent to make sure that we maintain that relationship with an injured worker.
00:06:46 Speaker 3
What happens if the worker has indicated that they don’t wish to be involved in the process and or they have failed to participate in the return to work process?
00:06:55 Speaker 4
So, this is quite a complex issue and can depend on quite a few different factors, and so it can depend a little bit on the reasoning. The injured worker doesn’t want to participate, so it’s usually important to get an understanding of that as the initial first step.
Workers at certain points in the claim aren’t obligated to participate, so one of the most common ones is if they’re totally unfit for work. They’re obviously not required to participate in a return to work programme and if they do have a capacity for work and they’re just not wanting to participate in work, then that’s really when you need to have that discussion to confirm why that is.
There may be other options that the insurer representative can discuss with the injured worker to confirm in terms of how to progress from there, whether it’s a non-compliance or whether they want to look at another pathway for their claim.
00:07:48 Speaker 3
Alright, can the workers treating Doctor refuse to participate in their return to work process?
00:07:54 Speaker 4
So again, that can be quite a complex one as well. So technically the treating doctors not necessarily participating directly in the return to work process but it can be common for some GPs to not want to be involved in workers compensation work which will impact them, certifying the worker under the Workcover request.
If this is the case, then often the injured worker actually needs to see a new treating doctor to be able to get those certificates, and the doctor can also decline participating in case conferences and things like that.
Generally, in those circumstances, that’s when we’d encourage the injured worker to see a treating doctor that will participate more actively in the process to support them in returning.
00:08:42 Speaker 2
OK, and what are some of the key areas you would cover off with an injured worker in the initial stages of engagement?
00:08:50 Speaker 4
So, the main thing we’ll do is sit down and communicate with them to explain our role in the system and what we can do to assist to get an idea of where they’re up to in their recovery and their treatment, and make sure we communicate what our plan is for their return to work. We’d also try and review what the duties options for them to get an idea of if they’re in work, what they can progress to, where they can start, or if there’s even suitable duties available, and talk to their treating parties to get an idea of where they’re up to in their recovery.
What they might need to help progress their recovery and try and bring everyone together to get them on the same page.
00:09:32 Speaker 3
Can a workplace rehab provider be used just for parts of the workplace rehab process? For example, if we only need them to go to medical appointment or if we only need them to write up the return to work programmes? Or do they need to have the whole service?
00:09:47 Speaker 4
So, they can be used for just small parts of the service under the Workcover scheme. You can refer for what’s called a Specific Service Referral. These usually are very prescriptive in terms of it might just be a vocational assessment to identify alternative duties that a worker can do if they can’t return to their pre-injury role or a work site assessment which might involve recommendations.
For return to work or an ergonomic review if you’re just wanting someone to attend a GP appointment as a one off that’s not currently a specific service option under the scheme that would need to be a full referral for returns to work.
Having said that, there are other services that some employers will fund directly rather than through the scheme that might involve just a one off case conference appointment and assistance with developing a return to work so that they can then manage the claim themselves internally.
00:10:49 Speaker 2
And to close out this series, what are some key takeaways in when to get help from a workplace rehabilitation provider?
00:10:58 Speaker 4
So, when someone is unfit for more than two to four weeks is the main one that you don’t want assistance.
Yeah, if you can’t identify any suitable duties or you know that they need to be able to fly to a mine site to participate in any kind of work duties. If you’ve got no one inhouse that’s responsible for overseeing return to work or no one that has time and if there’s generally any kind of indication of a breakdown in the relationship with either the injured worker or just the workplace in general and the injured worker are probably the main points.
We definitely need a rehab provider involved.
00:11:41 Speaker 2
Thanks to Naomi and Mary for joining us today and also a big thank you again to Star Injury Management for joining us in this special podcast series.
I’m sure our listeners will find this information very interesting and will be better equipped with any return to work plans.
For fact sheets on what we’ve discussed, please go to Star Injury Management’s website which is starims.com.au. 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 to Mary and Naomi.
