It Pays to Care is an evidence-based policy that promotes a national discussion on fair and efficient ' compensation schemes.
When an injury or medical condition occurs in a compensable setting, the chance of a poor health outcome is significantly higher than for same condition in a non-compensable setting.
Work absence and long-term disability rates are higher in compensable settings.
Being out of work long term is associated with poorer physical and psychological health, and this is more likely in compensable settings. The It Pays to Care policy addresses the need to reduce work disability and to ensure work injury systems are fit for purpose.
Over the past decade, the evidence on the impact of psychosocial factors on occupational health has grown substantially. There are numerous opportunities to improve support for injured workers while reducing costs and securing benefits for taxpayers, businesses, and the broader community.
It Pays to Care is an advocacy project built around the detailed, evidence based It Pays to Care policy paper (developed by the Australasian Faculty of Occupational and Environmental Medicine). The policy paper promotes a national discussion about fair and efficient injury compensation schemes. With its supporting values paper, the policy highlights the traits and actions in the four key work insurance domains of workplaces, case management, workers’ compensation insurance and regulation, and in healthcare.
The paper collates evidence that indicates improvements will come through:
- Systems that empower the capture of psychosocial information for individual claims, with proactive management of biopsychosocial risks.
- Ensuring that scheme cultures, systems and processes don't create unnecessary barriers to recovery.
- Scheme operations that are based on the values and principles of fairness, including collaboration, timeliness, trust and reciprocity, personalised and respectful communication, and empowerment of stakeholders.
The Australasian Faculty of Occupational and Environmental Medicine (AFOEM), a faculty of the Royal Australasian College of Physicians (RACP), have developed evidence based policy material to improve health and recovery outcomes and reducing barriers to care for people experiencing work injuries.
Two key reports, authored by Occupation and Environmental Medicine physicians, precede the It Pays to Care Policy: 2001’s Compensable Injuries and Health Outcomes and 2011’s Realising the Health Benefits of Work. These two pioneering documents charted the course, highlighting the influence of psychosocial factors in long-term disability, generating awareness of the impacts of prolonged work absence, and providing a shared platform for future developments.
After a further decade of research and reflection, it was decided that the Return to Work (RTW) sector was primed for the next phase of this long-term project. In April 2022, the It Pays to Care policy was published as two complementary documents:
- Bringing evidence-informed practice to work injury schemes, presenting evidence on psychosocial factors as barriers to return to work and how these can be addressed and ways to improve scheme delivery in four domains: leadership/regulation, case management, workplace, and healthcare.
- A values and principles based approach to bringing evidence-informed practice to work injury schemes, outlining the fundamentals of healthy work injury insurance schemes.
The main message of the policy is two-fold:
- Systems should be adapted to capture psychosocial information for individual claims and proactively manage psychosocial risks by providing injured workers, workplaces, and healthcare providers with timely support according to need.
- We must ensure that scheme cultures, systems and processes do not create unnecessary barriers to recovery, but instead encourage positive psychosocial factors (those known to assist recovery and RTW), whilst reducing negative psychosocial factors (those known to slow recovery and RTW).
Workers’ compensation is a social insurance policy, designed to benefit workers, businesses, and the community at large. To secure access to ‘no-fault’ workers’ compensation benefits, workers have given up some rights (e.g. access to many common law actions). Equally, to reduce the chances of being sued, employers have accepted financial responsibility for some of the hazards of employment. Governments shape and oversee this ‘grand bargain’, as it is often known in the United States, via legislation and regulation.
Australia has 11 main schemes of workers’ compensation, most of which were established in the 1980s when biomedical explanations of injury, illness, recovery and RTW were most common. Aotearoa New Zealand has one scheme that provides no-fault personal injury cover to all residents and visitors, including those injured at work, through the Accident Compensation Corporation (ACC).
Compelling evidence has established that biomedical approaches, that influenced the foundations of Workers’ Compensation schemes, do not address many of the causes of work disability. Psychosocial factors exert a strong influence over work and health outcomes. Workers’ compensation policies and practices have been slow to respond to this important body of evidence.
This reality has driven progressive advocacy for over 20 years.
The primary author of the It Pays to Care policy paper is Dr Mary Wyatt FAFOEM, supported by Gabrielle Lis (Editor at Return to Work Matters). The authors were supported by AFOEM fellows, researchers from Monash University, the RACP Policy and Advocacy Team, and generous feedback from numerous individuals and organisations throughout the sector.
Since the paper’s publication, the It Pays to Care team has expanded to include a number of passionate advocates. The team has collective decades of experience in and around workers’ compensation and advocacy. Team members hold, or are completing, high-level qualifications in business administration, law, politics, and various health disciplines.
It Pays to Care has been socialised with, and supported by, all national workers’ compensation authorities and insurers. We are now prioritising communicating to wider parties including employers and health care providers.
RTW practices needs all players ‘on side’. Better results are achieved collaboratively. Arguably, the same applies to scheme improvements. All work injury stakeholders stand to benefit from action in the areas suggested in the paper, and contributions from all are needed to achieve the improvements suggested.