The workers compensation framework in Australia is complex, highly regulated and constantly evolving. It can be a difficult proposition for some employers to navigate. The impact of workplace injury and workers compensation claims on business is rarely limited to the premiums payable and it can consume considerable resources for an employer.
Successful workers compensation claim outcomes rely on effective return to work case management; the practice of optimally managing the multiple dimensions of rehabilitation and return to work. This process of centrally managing a claim in a flexible and tailored way can be onerous, however when implemented well the benefits are clear. These benefits are evident in reduced time lost, reduction in cases that progress to workers compensation claims, reduction in claims and durations where claims do occur, reduced workers compensation premiums, and increased productivity.
Best practice return to work case management principles from current research can be summarised into the following categories1:
1. Timeliness – in relation to:
- Early incident reporting – this triggers early intervention activities which can sustain an individual at work rather than leading to an absence
- Early risk assessment of claim – research suggests that identifying individual claim and psychosocial factors are very predictive of claim duration and/or outcomes
- Early medical intervention – this has been shown to promote physical recovery
- Early contact with the injured person, supervisor and doctor (preferably within 24 hours) and implementation of early intervention strategies prior to determination of liability
- Early return to work or continued duties – despite the possible presence of pain, these have been shown to be associated with improved outcomes
2. Multi-disciplinary management
A coordinated, collaborative approach between the disciplines involved in treatment and stakeholders such as the agent, employer and rehabilitation provider (where engaged) is essential. Effective case management should facilitate communication between all involved to openly discuss and determine strategies throughout the duration of the claim. This is vital in overcoming identified return to work barriers.
3. Multi-dimensional management
In addition to appropriate clinical management, effective return to work case management requires addressing the multiple dimensions of injury. These include individual physical and psychological characteristics (such as expectations about injury and return to work) and social and workplace factors (such as job design and workplace support).
4. Best practice clinical management
There is an increasing body of research on best practice clinical management of various injuries and work related conditions that should be incorporated into practice guidelines and protocols for clinicians working with accident compensation clients.
5. Rehabilitation tailored to an individual’s needs and stage of injury and work absence
Increasing evidence shows that rehabilitation and return-to-work interventions should
be tailored to an individual’s physical and psychosocial characteristics. In addition, the emphasis and content of interventions should change as these characteristics change and depending on time since injury and duration of work absence.
6. Comprehensive outcome measurement
Monitoring the effectiveness of case management activity is a crucial part of successful and sustainable return to work. Unless this monitoring and measurement is undertaken, it is very difficult to know whether strategies and practice are benefiting both the injured person and the organisation.
The above principles are well known and evidence-based, however putting them into practice can be challenging with appointed return to work coordinators often required to undertake this role in conjunction with several other operational duties. Outsourcing the function of return to work and/or workers compensation claims management allows for flexible deployment of resources and ensures that experienced return to work and claims management professionals are engaged to achieve the best outcome for all parties. In addition, employers save costs of recruiting and training staff to undertake these core workplace duties.
Konekt’s Professional Services Group delivers holistic incident, claims and injury management consulting services to provide organisations with a high quality and cost effective solution. By engaging Konekt to assist with their return to work coordination function, employers receive a tailored and outcome focussed service delivered by experienced return to work and claims management professionals. Konekt are able to provide these services in a flexible manner to achieve optimal outcomes; this may be via remote telephone support or on-site assistance as required.
Konekt’s outsourced workers compensation and return to work coordination function is able to manage all incidents from date of injury through to resolution of claim. Services may include:
- Initial triage and early intervention of incidents
- Oversight and proactive management of active/premium impacting workers compensation claims
- Remote case management and intensive advisory support to site-based RTW Coordinators
- Participation in Claims Reviews and Performance Reviews with agents and insurers
- Claims agent liaison and attendance at quarterly claims reviews for the driving of favourable claim outcomes
In addition to return to work and claims management support services, Konekt’s Professional Services Group are able to provide:
- Development and review of injury management and rehabilitation documentation including policies, procedures, manuals, templates and letters
- Workplace Health and Safety (WHS) System Audits; identifying gaps and priorities within an organisation’s WHS management system using AS 4801 as benchmark (usually done remotely initially followed by on-site review)
- WHS Inspections; on-site visitation to evaluate all risks and identify non-conformances of state based legislation and develop an action plan
- WHS System Development and Implementation; developing a tailored system (or amendment of existing material) to ensure inherent risks of an organisation are addressed in accordance with legislative duty
- Work Health and Safety Awareness for Supervisors & Managers
- Risk Management
- Ergonomics and manual handling
- Bullying and harassment awareness
- Return To Work Coordinator training
For more information about how Konekt can help improve your return to work processes and outcomes please contact the Professional Services Group on email@example.com or speak to your local Konekt representative.
Did you know?
Did you know that Safe Work Australia has a YouTube channel dedicated to providing virtual seminars relative to health, safety and leadership.
1 Murphy G, Foremen P. Facilitators and Barriers to RTW: Report. Institute of Actuaries Australia’s XIth Accident Compensation Seminar 2009. Melbourne Australia: Institute of Actuaries Australia, 2006.