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Workplace Factors
A look at disability management in self insured Australian companies

At a glance:
A look at return to work management in some large Australian companies shows examples of good practice and room for improvement. Some areas with room for improvement are the integration of rehabilitation
The process of helping a person back to their former abilities and quality of life (or as close as possible) after injury or a medical condition.
 and prevention programs, the involvement of senior management, and staff education and training. Disability management programs tend to work best when the workplace culture encourages injured employees to participate actively in managing their own return to work.

It's important to be as active as you can in managing your own return to work. Make sure you try to:

1. Keep in touch with your company, and update people who need to know about your progress.

2. Understand your condition. This might mean being active in your own health care, and finding a doctor you trust and understand.
3. Think about what might improve your return to work. Make suggestions to your employer and doctor.

4. If problems come up, tell people who need to know as soon as you can.

5. When you're at work, try to be as productive as the condition allows you to be.
There are a few important ways in which return to work management can often be improved:

1. Make sure the person with the illness or injury is actively involved in managing the return to work process.

2. Implement a companywide return to work policy

3. Make sure employees and management deal with the return to work process in partnership.
It's important to know how your own disability
A condition or function that leaves a person unable to do tasks that most other people can do.
 management program stacks up. One internationally recognized tool which allows employers to analyse their own program is the Consensus Based Disability Management Audit.

This assessment will allow you to compare your practice with other companies in the same industry or country, or internationally. It identifies gaps and recommends improvements.
Providing employers with feedback and advice can be helpful. If there are difficulties with communication clearly identify the problem, and any possible solutions.

It is hard for a treating practitioner
treating practitioner
A health professional that treats patients. In return to work this may include doctors, physiotherapists, chiropractors, osteopaths, psychologists, masseurs, etc.
 to be aware of the overall situation in a workplace. Many employers have well-organised return to work programs, while others have very basic systems and need clear advice on how to manage return to work. It is important not to jump to conclusions about how an organisation operates.
The best return to work outcomes are produced when a company puts in place strong policies and procedures, to which there is organisation-wide commitment. This requires ongoing staff training and input from senior management.
Original Article, Authors & Publication Details:
M. Westmorlanda and N. Buys a (2002).

Disability management in a sample of Australian self-insured companies. Disability & Rehabilitation; 24(14):746 - 754.

a School of Rehabilitation Science, McMaster University, Hamilton, Canada Centre for Human Services, Griffith University, Brisbane, Australia.
Background, Study Objectives, How It Was Done:
This paper reports on disability management in large, self insured Australian companies. Before analysing the practice of these companies, the authors note that return to work management is most successful when:

1. Organisations have active programs for preventing injury, and a system in place for managing the situation when injury does occur.

2. Responsibility for the return to work program rests with the employer, who is accountable for its outcomes.

3. Employees and employers collaborate to manage the return to work.

4. A return to work is the goal of rehabilitation.

5. Employers provide appropriately modified duties to injured workers.

6. Early intervention
A treatment or management program. Interventions often combine several approaches. In this field approaches include training in problem solving, adaptation of work duties, graded activity, an exercise and stretching program and pain relief.
 is a focus.
Having identified these factors, the authors reviewed injury management in some large self-insured Australian companies. Structured interviews were conducted with those responsible for return to work management.
Study Findings:
Interviewees included occupational health nurses, claims administrators, occupational therapists, physiotherapists, and human resources and rehabilitation professionals.

All companies had comprehensive return to work programs in place, that provided:

Early contact with employees

Follow-up contact with employees and treating practitioners

Active management of each case

Suitable modified duties and a plan for managing the return to work.
62% of participants indicated that the company was cooperative in return to work. 38% indicated that cooperation varied between company departments.
Integration of prevention and rehabilitation programs
About half the organisations studied ran separate programs for prevention and rehabilitation, and the remainder ran an integrated program.
Interviewees who worked with integrated programs were strongly supportive of the approach their organisation took. Those who worked with separate prevention and rehabilitation programs suggested that management was often poor.
Education and training
Most companies used a range of methods for providing education on injury prevention and rehabilitation. These commonly included annual newsletters, informal meetings, or annual formal training programs. One employer provided a self-guided education workbook.
 Most interviewees indicated that better training and education could be provided.
Incorporation of ergonomics
The vast majority of companies used ergonomics
Designing activities and the workplace in a way to minimize discomfort. i.e. Adapting work tasks, hours, or workstation to accommodate people. An ergonomic computer workstation allows the person to work in the best position to relieve load on the muscles of the neck and arms.
 to prevent injuries and assist the return to work.
Workplace culture
Most participants felt that the workplace culture did not encourage employees to participate in managing the return to work. Communication was mostly top-down.
One company indicated that employees were actively involved in occupational health and rehabilitation, and that this had produced good outcomes.
Union involvement in rehabilitation
There was little proactive involvement of unions in establishing systems to manage the return to work.
Even companies with good, systematic return to work management programs in place, improvements can often be made.

One area which may produce good results is improving employee education and training in return to work management. It can also be important to establish a workplace culture which encourages employees to participate in managing their own return to work.

Good communication and cooperation are important. Senior management needs to be involved in return to work, and all company departments need to operate cooperatively.

Results also tend to be best when rehabilitation and prevention programs are integrated.

PubMed Abstract

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