Injury Management

Introduction

Injury management is about ensuring the prompt, safe and durable return to work of an injured worker.  It includes treatment of the injury, rehabilitation back to work, retraining into a new skill or new job, management of the workers compensation claim and the employment practices of an employer.  You need to work closely with your insurer and your injured worker to influence the progress of the worker’s recover.  The earlier an injury is treated and managed, the sooner the worker will return to work and recover from the injury.  This means less downtime and lost productivity, as well as a saving in claims costs (and therefore lower premiums).

To assist with communicating with treating doctors a job dictionary has been developed for the Disability Sector.  This job dictionary breaks down the job into physical and psychological demands.  It allows you to select the specific role and tailor the demands for your organisation.  You can then send this to the treating doctor when making first contact to assist with discussions of suitable duties.

Return to Work Program

You must have a written return to work program.  The return to work program is your formal policy and procedures relating to how you will help injured workers with their recover and return to the workplace.  It outlines your commitment to assist injured workers to access necessary treatment and rehabilitation, and specifies the steps to be taken to achieve a safe, timely and durable return to work. 

If you are a category 1 employer (base premium exceeding $50,000, insured with a specialised insurer and have more than 20 employees, or self-insured) you must develop this in consultation with your workers and it must be consistent with your insurers injury management program.  If not a category 1 employer you can adopt the standard return to work program developed by WorkCover.

The program must be displayed at workplaces and workers must be notified of the program.  A copy of the program must be provided to any worker on request.

Return to Work Coordinator

A return to work coordinator is an employee nominated by the employer (or a contractor engaged specifically for the role) whose principal purpose is to assist injured workers with returning to work in a safe and timely manner.  Only Category 1 employers are required to have a return to work coordinator but it is recommended that other employers also have someone trained or have access to a shared coordinator or a contracted person.  A Coordinator can be shared between a group of two or more employers.  A Return to Work Coordinator must be trained (attendance at a 2 day accredited course or exemption from WorkCover if otherwise trained) and preferably have experience in the return to work process.

The Return to Work Coordinator should possess the following skills:

• Ability to develop a return to work program consistent with workplace requirements
• Ability to develop a return to work plan
• Ability to implement and explain worker compensation legislation
• Ability to identify and coordinate suitable duties for injured workers
• Case and caseload management skills, including problem solving abilities
• Excellent written and verbal communication skills, including training, negotiation and listening skills, and
• Organisational and time management skills.

Injury management plans

Developed by the insurer within 20 days of notification of a significant injury after consultation with injured worker, employer and treating doctor.  The injury management plan outlines all the services required to return the injured worker to the workplace.  It includes details about the worker and employer, information about the injury, the rehabilitation goal, and the actions required by the worker, employer, nominated treating doctor, rehabilitation provider and insurer.  A copy is provided to the employer and injured worker.

Return to work plan

The return to work plan is the written, formal offer of suitable duties by the employer to the injured worker.  It is designed to make clear what the worker can and cannot do when they return to work and when this will be reviewed.  The plan must be agreed to by all parties, worker, supervisor, nominated treating doctor, return to work coordinator, worker representative (if appropriate) and accredited rehabilitation provider (if applicable).

Suitable duties are short term work duties, which must comply with current medical certification and may include:

• Parts of the job the worker was doing before the injury
• The same job, but on reduced hours
• Different duties altogether
• Duties at a different site
• Training opportunities, or
• A combination of some or all of the above.

Suitable duties must take the following into account:

• The work capabilities listed on the medical certificate
• The age, education and work skills of the injured worker
• Where the worker lives
• The duties must be useful to the employer’s trade or business
• The duties must comply with the injury management plan
• The duties must not be demeaning or token jobs.

WorkCover funds a range of programs to help seriously injured workers who need additional assistance to return-to-work.  These include:

• Work trials, which are short periods of work experience with a host employer (ie not the workers employer  at the time of injury) to help the injured worker develop work skills, or upgrade their physical fitness in a suitable work environment.
• Assistance with formal retraining, which may be approved when an injured worker cannot return to their previous job and they do not have other marketable skills to find suitable employment
• Funds for workplace equipment or modifications to assist an injured worker to resume employment
• JobCover Placement Program, which provides a financial incentive for a different employer to employ a worker who has a work-related injury.

Achieving good outcomes

You can achieve good return to work outcomes and control your claims experience by being actively involved.  You need to:

• Notify the insurer within the statutory timeframes ie within 48 hours of the injury
• Participate and cooperate in the establishment of an injury management plan for the injured worker
• Comply with obligations imposed under the injury management plan
• Keep in touch with the worker and offer suitable duties and help the injured worker return to work as soon as possible.  By providing an injured worker with suitable duties you can lower the cost of the claim and hence the impact on your premium costs.
• Check that all claim documentation has been completed before sending it to the insurer, including attaching the accident investigation report.  Everything must be sent within seven days.
• Arrange a regular claims review meeting (eg every three months)
• Ask how claims costs and time off work will affect your premium
• Take an active interest in your claims.  You should advise the insurer which workers have returned to work, which ones have resigned and which workers have completed suitable duties
• Advise the insurer of negative feedback from workers regarding independent medical examiners
• Take steps to minimise the incidence of injuries (implement OHS systems)

Known facilitators and barriers to a successful RTW are attached.

Guidance material from a recent Workers Compensation forum including soft tissue guidelines, communicating with the insurer, overcoming barriers, successful RTW Coordination and complex claims may be helpful.

Remember that failure to provide suitable employment when you can reasonably be expected to do so, increases the cost of the claim and could also increase the premium payable and could incur a penalty under the Workplace Injury Management and Workers Compensation Act 1998.

You must display the WorkCover poster "Watching out for You"  in the workplace at a location where it will be seen by all staff.

Confidentiality of Injury Management information

Information should only be released to managers or supervisors on a need to know basis and must be maintained in a separate, confidential file.  See attached for further information.

References:

WorkCover NSW Workers Compensation and Injury Management Fact Sheet 1,2 and 6

WorkCover NSW Introduction to Return to Work Coordination Workbook for participants and trainers

WorkCover NSW: Guidelines for Workplace Return to Work Programs 2011