It pays to care in the workplace.
Workplace factors have a significant influence on RTW outcomes – more influential, according to research and stakeholders, than scheme operation, case management, and the individual characteristics of the worker.
Many important claim milestones occur at work. The workplace is usually the site of injury and injury prevention, first response, injury reporting, claims submission, and injury management activities, including sick leave coordination, identifying modified duties/work accommodations and on-the-job recovery.
Workplaces empower successful recovery journeys when they respond to injuries in a fair, constructive, and supportive way. Improving workplace management of work injuries offers significant opportunities to enhance wellbeing and productivity of all workers. A positive psychosocial work environment is associated with stronger recovery and earlier return to work.
The Research
Australian research shows that workers who consider their employer’s response to injury to be fair and constructive have, on average, considerably higher RTW rates than those who don’t:
- 43% higher for physical injury claims; and
- 52% higher for psychological injury claims.
According to data from the 2013 and 2014 Australian RTW Surveys, disagreement between a worker and their employer or claims organisation is linked to lower RTW rates. When a difference of opinion was reported, RTW was 22% lower in physical claims and 23% lower in psychological claims.
Another project found that when supervisors and high-risk injured workers were offered collaborative training in problem-solving and communication:
- Half as many employees reported work absence due to pain, compared to treatment as usual.
- Less than a third as many days of work were lost compared to usual care.
- Half as many follow-up healthcare visits were needed, compared to usual care.
Organisational workers compensation premiums are generally based on the last three years of claims costs. Insurance premiums typically range from 0.5% to 10% of payroll, with indirect costs calculated to be 4-10 times the direct premium costs (e.g. reputation, morale, onboarding costs). Many organisations are unaware of the employee and financial benefits of streamlining and simplifying work injury management systems.
Workplace Roles in Return to Work
Key figures involved in workplace injury management are the injured worker, their supervisor, the RTW coordinator, and senior management.
Supervisors
A worker’s supervisor or line manager will express an initial response to a work injury, which can set the tone for the claim journey to come. That first response can be empathetic and supportive or angry and suspicious, which has been shown to influence recovery and overall perceptions of fairness. From that moment, the supervisor can work alongside the RTW coordinator to ensure ongoing supportive communication throughout the claim.
Building an understanding of RTW and workplace injury management can support supervisors to build their confidence in managing work injury in their teams.
Return to Work Coordinators
The RTW Coordinator acts as the bridge between the employee and the workplace. Coordinators juggle relationships with many stakeholders and must balance competing interests to promote recovery and RTW. Successful coordination requires an interplay of managerial and psychosocial skills.
RTW is more likely when the employer makes early contact with the injured worker and maintains a supportive relationship. The RTW Coordinator drives the quality, timeliness, and consistency of communication between the employer and the worker.
There are various training opportunities that could benefit RTW Coordinators, including comprehensive soft skill development to facilitate low stress encounters with workers.
Senior Management
Senior managers influence workplace culture and set organisational priorities. If senior management promote, and engage with, their organisation’s RTW processes. Senior managers can influence organisational RTW planning and policies. They can also direct the availability and flexibility of suitable duties and other work modification.
However, boards and senior management teams of many organisations lack expertise in injury management. There may be opportunities to improve understandings of:
- Psychosocial influences on recovery and RTW.
- Costs of poor management.
- Strategies and approaches that improve claims outcomes.
Action Areas
To improve injury management and return to work practices in the workplace, employers can:
- Deliver appropriate resources and skills training. There are significant opportunities for all involved roles to improve their practical understanding.
- Set a positive tone for the claim journey. Supervisors and line managers are often first to know about a work injury and their immediate response can set the tone for the claim that follows. Supervisors and RTW Coordinators are best placed to minimise adversarial approaches.
- Maintain regular, positive communication throughout claims. The best outcomes for worker health and RTW are reached when the workplace makes early contact, and follows up with regular, constructive communication. This can help an injured worker maintain optimism and overcome/avoid psychological barriers to their recovery.
- Promote good work design and proactive, inclusive prevention strategies. Good work minimises workplace injuries and assists recovery and RTW, especially when both physical and psychosocial aspects of work are emphasised.
- Gain buy-in from senior management to affect a workplace culture of care. Senior managers exert influence over numerous workplace factors that influence recovery and RTW. The support of senior management helps embed new RTW approaches into their organisation and overcome resistance to change.
- Reduce psychosocial hazards and address workplace culture. A workplace culture of psychosocial safety and worker wellbeing will improve health and RTW outcomes.
- Collaborate for continuous improvement. Consider working with your insurer to implement evidence-based improvements to your organisational RTW practices by using claims data and best-practice advice.
You can find more information on areas for employer action in It Pays to Care: Bringing evidence-informed practice to work injury schemes helps workers and their workplaces.
References
These are indicative references only. For complete reference list, please see the It Pays to Care policy paper.
- Controller and Auditor-General. Accident Compensation Corporation case management: Progress on recommendations made in 2014: Office of the Auditor-General; 2017.
- Dasinger LK, Krause N, Thompson PJ, Brand RJ & Rudolph L. Doctor proactive communication, return-to-work recommendation, and duration of disability after a workers' compensation low back injury. Journal of Occupational and Environmental Medicine. 2001;43(6):515-525.
- Ioannou LJ, Cameron PA, Gibson SJ, et al. Traumatic injury and perceived injustice: Fault attributions matter in a "no-fault" compensation state. PLoS One. 2017;12(6).
- Linton SJ, Boersma K, Traczyk M, Shaw W & Nicholas M. Early Workplace Communication and Problem Solving to Prevent Back Disability: Results of a Randomized Controlled Trial Among High-Risk Workers and Their Supervisors. Journal of Occupational Rehabilitation. 2016;26(2):150-159.
- Peters S, Coppieters M, Ross M & Johnston V. Perspectives from Employers, Insurers, Lawyers and Healthcare Providers on Factors that Influence Workers' Return-to-Work Following Surgery for Non-Traumatic Upper Extremity Conditions. Journal of Occupational Rehabilitation. 2016;27(3):343-358.
- Safe Work Australia. Australian Workers' Compensation Statistics 2018-19. Canberra 2019.
- Tompa E, Oliveira C, Dolinschi R & Irvin E. A systematic review of disability management interventions with economic evaluations. Journal of Occupational Rehabilitation. 2008;18(1):16-26.
- Wyatt M & Lane T. Return to Work: A comparison of psychological and physical injury claims: Analysis of the Return to Work Survey Results: Safe Work Australia; 2017.