Return To Work Compliance. Does anyone Care?

I can only chuckle at the WorkSafe ads.  You know, the one with the overly happy injured employee and the supportive GP that encourages a return to work; the willing employer and the celebration and welcome that occurs upon their successful return to work.

Does this really happen? Really?

I’m all for all parties cooperating to achieve a common goal but this promotion of return to work is far from what really occurs.  Do I really need to be telling you this?

Employers, more often than not, are faced with a frustrating and unsupported return to work process involving employees with one or more of the following: –

  • No interest in returning to anything other than their normal role;
  • Ignorance towards the return to work process and their obligations under WorkCover;
  • Poor attitude – external or internal factors contributing to the process;
  • Uncooperative or constantly changing treating doctor;
  • No change in capacity regardless of the position being offered or the effort to obtain agreement;
  • Failed attempts to return to work resulting in time lost and a disrupted program.

 

When this occurs do employers get the support they should from their WorkCover Agent?

Does anyone actually care?

Creating a dispute around return to work is mostly a fruitless exercise but it is sometimes a necessity.  An employee who is not cooperating or meeting their requirements should not, in my view, simply continue to be entitled to benefits.  The entire scheme is based around return to work yet, when it comes to enforcing a workers obligations, the scheme is letting employers down.

 

The Compliance Process

 

The first step in the process is to issue a warning for non-compliance; some Agents insist on providing a verbal warning before the written warning – the idea being that the employee is provided with the opportunity to comply without any ramifications.

So, the initial failure to comply with a return to work program has already been let slide.  This sends the wrong message as to what the workers obligations are.

Keep in mind the ‘warning’ doesn’t do anything other than allow the second part of the process to be considered; the ‘suspension’.  This can occur, at a minimum, after a further two weeks following the warning being issued.

This involves the suspension of weekly benefits with the worker being provided another 28 days to comply with the return to work before the third part of the process, the termination, is considered.

This process is exhausting and there is actually more to it that I have outlined here. 

Whilst I do not support simply denying a worker their entitlements on a whim, the scheme is not providing any support at all.  Even when a decision around compliance is made, the inevitable outcome is not favourable.

 

What can you do?

 

This exhaustive process as it stands can result in employers getting frustrated and can put the entire return to work process in jeopardy.

I say this with an understanding of the cost involved in managing a return to work – on top of any premium impact the claim may have already had.

  • Keep the return to work program up to date and current
  • Continue to communicate with the worker and their GP – even if no-one is listening
  • Be flexible and try to accommodate any changes to the program – initially…
  • Provide updates to other staff where required – let them know what is happening.
  • Challenge the approach your WorkCover Agent is taking
  • Document everything and be realistic about the outcome.

 

There are no winners in a dispute about return to work…

 

If you are not getting the support you need or require advice regarding a complex or difficult return to work please give us a call.  An independent opinion can be an invaluable tool and may provide you with a solution to move a program forward.

 

Help Me!! Help You.

Channelling Jerry McGuire, “Help Me!! Help You, Heeeelp Me!! Help You”, has become all too common in our workplace. We see it time and time again; injured employees that instantly believe the management of their injury and their recovery is someone else’s problem or responsibility.

WorkCover is a no-fault system and any injury occurring at work is unfortunate as no-one sets out to hurt or injure their staff, however individuals must take responsibility for their treatment and recovery. Sure, we can provide advice and guidance but you can only lead a horse to water…

It is concerning to see the attitudes of some employees following a workplace injury. We do not doubt that it can be tough managing any injury and fully appreciate the impact this can have on general day to day activities. What doesn’t make sense is how this is made any easier to deal with if there is minimal personal responsibility.

It is fair to say that the medical fraternity have a lot to answer for when dealing with this type of attitude. In a lot of ways, they actually promote it via a lack of ‘tough love’ or general honesty regarding an individual’s situation. Any person who is injured needs to be encouraged and provided with direction. Enabling their lack of motivation to get better does not benefit anyone and is a ‘soft’ but often too common option.

We cannot and do not ignore the psychological overlay that can come with any physical injury and, whilst this is becoming more and more prevalent, the actions taken by employers and support personnel immediately following any workplace injury can dictate the attitude toward their recovery that then occurs.

Take the time, spend a minute, provide some help and reinforce your approach to the health and wellbeing of your employees. Give them the ability and knowledge to ask the right questions of their medical providers and guide and assist them to drive their own recovery. Promote and support an early return to work and help to challenge medical opinion if there is no progress. Keep it positive and continue to encourage…

WorkCover is unlimited when to comes to treatment options; essentially anything and everything is on offer and will, in most cases be paid for. Identify and manage the attitude early; don’t be afraid of the tough love approach – people must take some responsibility. There really is no excuse…

Pre-Injury Average Weekly Earnings for Casual employees

We have had much debate and conjecture over many years regarding the view of WorkSafe in calculating the pre-injury average weekly earnings (PIAWE) for casual employees.

Finally, there has been a positive outcome for any injured casual employee.  The casual loading they receive as part of their employment status is now being included in their PIAWE calculation.

This eliminates the unfair and unjust approach that was being taken by some WorkCover Agents when calculating the PIAWE for casual staff.  Their position prior to this was to deny the casual loading and therefore deny an injured employee a significant component of the normal earnings.  Why?  Because the WIRC Act excludes ‘loadings’ under the definition of PIAWE.

This is one of those scenarios where common sense failed to surface for many, many years.  The scheme is not designed, nor is it intended, for a worker to be worse off financially than they would if they were not injured at work.

It’s a taken a long time but this argument no longer needs to be had.  Casual employees will receive a PIAWE that is based on their true rate of pay.

Employees who are currently being disadvantaged can apply for a review of their PIAWE and may be entitled to ‘top-up’ payments with interest.

PIAWE is a key cost component to your overall claims costs and the premium you pay. If you are having any difficulties or have concerns that the PIAWE for your employees is not accurate, for whatever reason, please give us a call.

 

Getting back to work….. Is it too soon?

You cannot avoid the relentless message spruiked by WorkSafe about getting injured employees back to work and a significant part of our role in representing employers involves exactly that.  An early return to work helps with recovery and keeps WorkCover premiums low – it’s a no brainer.

However, do we sometimes need to back off and let the employee recover sufficiently to support and enhance their return to work prospects?

The insistent push to achieve a return to work can sometimes be to the detriment of all parties, as returning employees too early can ruin relationships, jeopardise a positive claims outcome and impact recovery.

Balance is the key

Finding the right balance is certainly a skill of its own. Every injury is different and every period of incapacity comes with a different approach, tolerance and, dare I say it, agenda.

You then add the work environment, impacting external factors, workplace culture, work performance issues and general attitude and you have a cocktail of elements that will influence any return to work opportunity.

All these factors must be considered.  Any return to work must be managed considering all these factors and there is a fine line between not doing enough and pushing too hard.

Performing return to work planning (as is required legislatively) and achieving a return to work are two very different things and should not be confused.  Many employers feel pressured to offer suitable employment forgetting the impact this will have on the employee.

The requirement to conduct return to work planning is exactly that – planning for an appropriate and suitable return to work.

It is not intended to push employers to create made up positions or unproductive, supernumerary jobs that provide no value or benefit.

Ask Yourself…

  • Should an injured employee who is immobile due to their injury be forced to get to work?
  • Should an employee be forced to work in an environment performing tasks that are a world apart from their normal job?
  • What is the injury and is a return to work appropriate? Should your plan involve appropriate recovery time and the support and guidance from the worker and their GP before it is implemented?

You might find it unusual that this message comes from a consultancy firm that prides itself on the claims outcomes it can achieve for its clients.

Return to work is a key component of our success but getting it wrong comes with massive ramifications via the potential premium impact, cultural effect and the hurt to professional or personal relationships.

Following any workplace injury, you will be hounded to provide your WorkCover Agent with a return to work plan and will be reminded of your obligations to offer suitable employment.

The common phrase ‘do unto others as you would have them do unto you’ does come into play with any return to work.  You only get one chance to get it right so don’t feel pressured to get it wrong…

If you are having difficulty managing a return to work or if you are struggling to get the balance right then please give us a call on 0418998106 – sometimes it’s as simple as a different set of eyes and an independent view that can help. 

 

Hazards, What Hazards?

Incident reporting. Seems pretty straight forward doesn’t it?

Have an incident; report it. Have an injury; fill out an injury report form. Straight forward.

So what about hazards and near misses?

How does your business go about reporting these?

In my opinion, they’re a really important part of incident reporting. I feel like I’m constantly asking people to report their hazards and/ or near misses; because we don’t know what we don’t know.

You’re the person working your job, if there’s a hazard  that might cause you or someone else to be injured, your employer needs to know about it in order to fix it, and to hopefully ensure  no-one is injured.

A prime example: some time ago, I received a claim and after contacting the injured worker to find out what happened, she advised me that the equipment she was working on was broken. Apparently everyone knew about it and yet they continued to use it! Then she was injured (surely this shouldn’t really be surprising?). The injured worker ended up losing some time off work, required medical treatment and was on a return to work plan for a couple of months. The impact of such injuries is often unseen until you’re in that position; and it’s not just the work stuff. It’s all of the stuff outside of work; things like being able to attend to your own personal care (have a shower, use the bathroom, getting dressed etc), picking up or playing with your child, getting upstairs to your home, driving your car, playing soccer on Saturday. As well as being away from your workmates who you see regularly, it’s those things that have the biggest impact for you as an injured worker.

Let’s look at a current event for example; Dream World on the Gold Coast. They’ve recently had a significant and devastating incident occur which resulted in the death of four people. Death.

2016-11-dreamworld-picture1

 

It’s since come to light that (at least) one person identified some issues and reported it to staff approximately and management and via social media two weeks before the incident. How’s the final line: “Someone will get seriously injured or killed one day!”. And within two weeks this exact thing had happened.

At the present time, it seems that the investigation has concluded that it was a freak chain of events which led to this incident, but none the less, a hazard was reported and people died. This just isn’t good enough in any workplace.

Report your incidents; report your injuries; but also report hazards and near-misses.

Tips on how to encourage a reporting culture:

  • Make sure you’ve got your register of injuries available and that staff know where it is – a reminder might be timely. Consider how you’re making it readily available;
  • If staff verbally report something to you, request that they follow it up in writing – assist and support them to do it if necessary. A training session on incident reporting may also be a good idea;
  • Follow up your staff to make sure they’re ok. This helps staff to realise that the time and effort they have taken to complete an incident report was not wasted as someone is looking at it;
  • Rectify the issue and (if possible) provide feedback to the person who reported it. The positive flow-on effect of staff knowing that reported issue and that it’s been addressed leads to positive culture change.

 

Contact NewCare on 9650 8610 or email us at hello@newcare.com.au if you’d like more help

Conciliation – To Fear or Not to Fear

Common scenario – You’ve  just received a letter advising that an employee has lodged a request for conciliation. You read through it and it tells you the nature of the dispute, when it was lodged and who is involved – the Agent, employee and the employee’s representatives (often this is a legal firm).

At this point many employers may feel a sense of unease – What is conciliation? How did this happen? The employee is represented, who is representing us? Do I need legal representation?

Well, you can relax because we understand and are here to help.

Conciliation is not to be feared. It is an informal meeting between the parties of the dispute to discuss the decision that has been made and where possible resolve the matter before it goes down the litigation pathway.

Typically, the types of disputes that find their way to conciliation mainly include rejection of liability and termination of weekly payments and/or medical expenses. Importantly, you may not agree with the decision that has brought you to this point. The Agent is there to defend their decision. Therefore your attendance and having appropriate representation at Conciliation can be vital in making sure that an outcome can be achieved to the benefit of all parties. After all, the employer – employee relationship still needs to be managed and maintained, regardless of the outcome.

You’re at Conciliation, so what happens now?

A conciliator chairs the meeting, ensuring that the Agent, employee, employee representative (a solicitor can only attend if all parties agree), employer or employer representative have an opportunity to discuss the decision that has been made and why they agree or disagree with it. Private discussions are then held and this is the perfect opportunity to consider all the information available and put forward an offer(s) to try and resolve the matter.  This is a really important part of the process. Keep an open mind and giving a little here to resolve the matter may be the best outcome in the long run.

The conciliator will then discuss offers or counter-offers with the parties in an attempt to gain agreement. One of the following outcomes will be achieved at the conclusion of these discussions:

  1. The Agent may Withdraw their decision;
  2. A Recommendation is proposed to resolve the dispute and is agreed to by all parties;
  3. The matter is referred to the Medical Panel (if the dispute relates to medical questions);
  4. The conciliator issues a Direction that weekly payments and/or medical expenses be paid for a limited period;
  5. A Genuine Dispute is found allowing the matter to proceed to court to determine the matter.

Do not fear the conciliation process. You do not require legal representation, however having someone with sound worker’s compensation knowledge representing you will help in achieving the best possible outcome for you and your employee.

Call NewCare now!

And Hear it is

One of our client’s injured workers has been offered over $20k for a hearing loss claim. I’m wondering how they could have managed this better and what we can learn.

Clearly you need to begin with noise level testing at all workplaces, and then undertake health monitoring for all employees. Pre-employment hearing testing is critical. You also need to consider appropriate PPE (Personal Protective Equipment). It probably would also be a good idea to have a tool-box talk about incident notification as well, just to reiterate the point that if someone is having problems with something at work, whether it’s a near miss, hazard, incident or injury, they need to report it.

Consider the following in your workplace/s

  • Assess noise at all of the sites.
  • Review & provide appropriate PPE and ensure that the PPE is worn.
  • Arrange audiometric testing for employees to measure their starting point (and get it checked at least every 2 years).
  • Record and monitor results of audiometric testing – if there’s a significant decrease, we’ll need to arrange an audiological examination.
  • Review induction process – ensure that audiometric testing is undertaken within 3 months of commencing employment.
  • Review procedure documents related to PPE and to noise management.
  • Reiterate the need to report near misses, hazards, incident and injuries.

Hearing loss claims are difficult to deny and can come at a significant cost – you inherit an employee’s hearing loss as soon as you employ them. If it deteriorates in any way under your employ, you can pay for an entire working life of noise induced deafness.

Don’t just pay your premium invoice!

Premium notices have been flooding into the office over the last few months and I’m continually surprised with the information, or lack thereof, that is provided to employers to allow them to actually understand what it is they are paying and why.

There seems to have been a conscious decision to provide as little information as possible, as these notices do not allow employers to assess or understand their performance, review their industry classification or develop goals to assist in premium reduction for the year ahead.

So what do you need to know?

The key factors that drive the premium you are paying, or have just paid, are as follows: –

  • Employer claims cost rate and Industry claims cost rate (an assessment of your claims performance).
  • Premium claims costs – rolling three years from 2017/18 (key factor, and the most controllable, within the premium calculation).
  • Weighted Industry rate and industry classification/s (supporting your predominant business activity).
  • Employer performance rate (dictates whether you are paying above or below the industry average).

Understanding these factors allows employers to develop strategies and targets around claims costs and ensures the relevance and accuracy of industry classifications.

All this information is available to you but you need to ask for it. Opportunities for improvement can then be assessed and modelled based on this information, and informed decisions made about future claim strategies and outcomes.

Don’t just pay your premium invoice – use it as an opportunity to better understand what, how and why.

Medical Certification – GP v Physiotherapist

When it comes to RTW where do the best results come from?

My role requires me to attend many “fitness for work reviews” (FFWR) with injured workers who see both a GP and Physiotherapist regularly. Many of these injured workers only see their GP to obtain their certificate of capacity (COC).

I have left many FFWR conducted with GP’s feeling a little underwhelmed with the lack of constructive conversation and lack of movement on the worker’s capacity to undertake suitable employment. It has resulted in me asking myself the following questions;

1. Is the GP the best person to be talking to about RTW?

2. Is the GP the best person to be issuing the COC’s?

Sure, a GP might have the injured worker’s medical history and a long term relationship, but what clinical based exercises or daily physical function tests is the GP carrying out? From my experience none.

When it comes to being asked if the RTW arrangement is suitable for the injured worker, a conversation not to dissimilar to this follows;

GP – What do you think you have capacity for?
IW – I’ll be guided by you as to what I can or cannot do?
GP – Do you think you could lift 5kgs?
IW – Yeah I guess so? I’m happy to give it a try.
GP – Hmm, what does your physio have you doing at the moment?
IW – They work on my shoulder when I am there, along with checking how high I can lift my arm and has me doing some light weights. I also have home based exercises.
GP – Ok, I’m going to get in contact with the physio to discuss the arrangement and see what they have to say in regards to the matter.

If we were to flip this on its head and look at our recent outcomes when we have engaged the physiotherapist; asking them if they would be willing to take over certification of the injured workers’ capacity, the conversation goes something like this;

Physio – What do you think you have capacity for?
IW – I’ll be guided by you as to what I can or cannot do?
Physio – Well we have you lifting 5kgs in here, your mobility has increased in the last few weeks along with your range of motion. I think that most of these duties are within your limitations.
IW- My only concern is with ………… (specific task).

The conversation moves quickly to a more flavorsome conversation about tasks, hours, days and timeframes.

Why the difference I hear you asking. Well a physiotherapist is much more accountable when it comes to treatment and the payment of that treatment.

Physiotherapists are required to provide a treatment plan, with outcome measures and detail where a worker should be at specific points in time, based on the treatment they are providing. This plan allows questions to be asked of the Physio. and makes them more accountable regarding the injured workers progress.

So is the GP always the best person to be involved?

In my opinion, no, probably not.

Should we always engage the Physio in the RTW process?

Absolutely. They don’t always have to be the one issuing the certificates or even the one at the “fitness for work review” but if they are not present at the review, engaging them prior to meeting with the GP can only enhance our conversation when discussing return to work opportunities.

Note – a GP is not required to provide outcome measures or clinical rational to continue to certify an injured worker. A physiotherapist is asked to provide a treatment plan with clearly set out outcome measures. WorkSafe Agents can review and possibly cease Physio. if there is no progression.