X
GO

Work Options News

rss

Information of interest to our Clients and for the industry


Understanding How Psychosocial Barriers to Pain Affect RTW Outcomes

Have you ever been for a routine chiropractic appointment and met with, ‘Oh wow, you’re back is really out of alignment’ before a click and a crack has you sorted? But then in another week or two your back starts to ache and you automatically think ‘my Chiropractor said my back is out and it’s hurting again so I obviously have a bad back.’ Think about it… have you actually always had a bad back and since your Chiropractor has pointed it out, you’re more sensitive to back pain? Or have you just been sitting for a long time and need to stretch out, or lifted a heavy box from an awkward position? Perhaps there are a range of other factors that are impacting your perception of pain…

The psychosocial approach to pain looks at the combined influences of factors – or barriers – within a social environment, and determines the effects they have on physical and mental wellness. Beliefs, values and behaviours are examples of these barriers which can impact on an individual’s pain threshold and perceived pain tolerance.

Pain threshold refers to the point at which a stimulus causes pain that can no longer be tolerated, whereas pain tolerance refers to putting up with pain day to day. In order to recover, an individual must tolerate pain in order to increase physical capabilities, which ultimately then increases pain threshold.

So how does this all relate to return to work outcomes? Often an injured person will tell themselves that they can’t do something, or they can’t function at full capacity, because of their injury. As a result, they start to move less in fear of making their injury worse, which is the opposite of what they need to do to make it better, slowing down their recovery time. Their thought process goes something like this:

Injury Management Specialists will tell you that a fast and efficient recovery and return to work is about increasing physical capabilities which will therefore increase pain threshold, and reduce reliance on passive treatment and medications, in order to gain a sense of empowerment and return to their pre-injury state.

Here’s how an Injury Management Specialist will assist an injured worker reduce the impact of psychosocial barriers, and get back to work sooner:

  • Provide rehabilitation services, recovery strategies and mediation between doctors and specialists to manage pain, with sustainable upgrades in capacity to increase function
  • Set personal goals for increases in self-efficacy, improved relationships, mood and reduction in pain through personal, domestic, work and community
  • Provide pain education and encourage shifting beliefs about pain:
    • Provide valuable and educational resources beyond Google
    • Listen to what the worker hears, rather than what they are told
    • Checks in to identify what they’ve learnt and put ideas into practice
  • Focus on reducing pain by encouraging the worker to reduce reliance on passive treatment, reduce pain medication and home help, and take control of their pain

Pain is a subjective experience; everyone has personal barriers when it comes to pain, which is often reflected in our actions. But what is important to understand is that psychosocial barriers to pain, and the fear of making an injury worse, can sometimes mean that pain gets worse anyway, or an individual develops chronic pain as a result. Defusion – changing the relationships with thoughts – and acceptance – turning off the struggle switch – are key factors in the psychosocial approach to pain and recovery. An Injury Management Specialist will use these tools, and others, to create a placebo affect, and shift pain beliefs by allowing increased confidence to function, the resolution of the cause of pain, and ultimately allow improvement in life and return to work as quickly as possible.

Consult an Injury Management Specialist or Return to Work Provider.

 

5 Common Workers Comp Questions Answered

Our Senior Injury Management Specialist Diana Hurst guides you through our most common questions regarding Workers Compensation claims.

The importance of critical incident debriefing in preventing psychological injuries

SafeWork NSW has recently circulated information highlighting the risk of crush injuries, as a result of two fatal incidents where truck drivers have died while working on or near their trucks. And it got us thinking… what about the psychological injuries caused to others who are unfortunate enough to witness incidents like these?

 

History tells us that high risk industries are almost guaranteed to succumb to a worker fatality at some point.

 

As of the 6th of June there had been 64 Australian workers killed at work in 2019. In 2018, that number totalled 157.

 

What history also tells us, is that for those who are exposed to or involved in a workplace incident, the first two hours are critical in assisting workers deal with their physical and emotional reactions.

And the reason being is because exposure to critical incidents can lead to significant distress; recurrent thoughts, anxiousness, mood changes, restlessness and shock. And gone untreated, distress can lead to long-term physiological issues such as Acute Stress Disorder or Post Traumatic Stress Disorder.

By providing really early intervention to a fatality or major incident on site, psychologists can counsel workers to assess their current state of mind, diagnose shock and determine if they are at risk of developing long-term psychological injuries.

Here are five critical incident management tools to assist in supporting workers:

1. If you’re in a high risk industry, prepare workers for a possible critical incident:
• Develop procedures for responding to and identifying critical incidents and ensure staff are educated and aware of procedures
• Contract suitably qualified safety consultants with experience in critical incidents and critical incident management
• Asses the workplace for safety hazards and ensure all necessary PPE is available

2. Demobilisation (rest, information and time out) is the best way to calm workers following a critical incident, ensuring their immediate needs are met as soon as possible:
• Convene with all workers, summarising the incident and clarify any uncertainties (ensure all workers have the opportunity to ask questions)
• Provide Psychological First Aid (supportive and practical assistance via assessing needs and concerns, ensuring basic needs are met and connecting people with information)
• Provide a course of action moving forward, and alter workplace responsibilities and roles where necessary

3. Defusing (immediate small group support) should be conducted by a qualified employee or external contractor and is an opportunity for workers to review the event, talk about what happened, receive advice and support. Defusing should take place within 12 hours of the critical incident occurring.

4. Debriefing as a group should take place approximately one week after the critical incident. It is an opportunity for workers to put things into perspective once they’ve had a chance to process what has happened. Often a knee-jerk reaction to a critical incident will be that ‘I don’t need to talk about it’, but often within a few days the worker may find that they are now experiencing other psychological or physical issues as a result. Debriefing allows a qualified counsellor or safety expert to assess the risk of long-term psychological injuries, determine if acute stress is present for individual workers, and can provide management techniques and tools to handle emotional reactions.

5. Follow-up support is key in psychological injuries; shock around trauma is known to manifest over time and can worsen if not addressed or spoken about. If workers find that their shock builds momentum, they are losing sleep, having recurring thoughts of the incident and are struggling to move on with every day duties, this may be a sign of a psychological injury such as acute PTSD. Workers who expressed significant concerns at earlier stages of the critical incident management process should have continual follow up support with a trained professional.

When it comes to preventing the onset of shock, and potentially acute stress or PTSD, after a critical incident, it’s recommended that all workers be involved in the critical incident debriefing process. Although many workers will be able to return to normal duties within a short time frame, if not immediately, it’s important to note that serious accidents are one of the leading causes of PTSD in Australia. But more importantly, it’s treatable and, with the right help, avoidable.

For more information or help with regards to critical incidents and psychological injuries, see our Work Health Safety Services or call 02 9957 1300.

Common Injury Management Mistakes Guaranteed to Rise Insurance Premiums

As an employer, you have a lot on your mind when a worker gets injured… I’m not going to meet the deadline; how will I get the job done now; what will this cost me; should I hire a temporary replacement?

The last thing you need to add to the stress is the cost of your insurance premiums rising because you haven’t followed the correct procedure or not acted quickly enough.

At Work Options, we see a lot of situations where an employer’s insurance premiums rise because of common injury management mistakes. Here are the top 6:

Not offering suitable duties
Offering suitable work duties is critical to the return to work process and keeping your insurance premiums down. How? Returning to work in some capacity is proven to significantly increase the chance of the worker returning to a pre-injury capacity, assisting their physical and mental recovery, in a much faster timeframe than doing nothing at all. In turn, there are less costs for medical, legal and wages.

Not acting soon enough
It’s pretty simple really… failure to report the injury will result in delays in the claim, treatment approvals and actions taken by the insurer to start the process; all costing valuable time and money, lost wages, and ultimately a slower return to work. You should notify the insurer within 48 hours of a workplace accident or injury.

Not being active in the process
We hear it from workers all the time… “My manager acts differently towards me since my injury”. Unfortunately some employers don’t take an active part in a worker’s recovery and return to work until they notice a jump in their premiums. Not only does this often lead to conflict between the two parties, but workers will feel undervalued and employers forfeit any control they have over the direction of the claim, ultimately resulting in rising premiums.

Not having a rehab provider involved in the early stages

It seems pretty obvious that complex injuries require specialist advice, support and treatment… and without it, the return to work process will take longer. Simple to do – just ask your insurer to refer. Did you know that the cost of a rehab provider does NOT go onto your claim cost?

Not making WHS a priority

Prevention is ALWAYS better than a cure! Again, it seems like a simple task but unfortunately many Australian businesses don’t implement WHS initiatives because they either lack the know-how or resources. Education, appropriate PPE and tailored WHS policies and procedures are the best way to reduce the amount of injuries which occur in your workplace, keeping insurance premiums down and reducing costs in the long run. Ever wondered why workers are repeating injuries in the workplace, or how they are aggravating existing injuries? This is all avoidable when you make WHS a priority!

Termination of injured workers
Here is the biggest mistake you can make! Firstly it is illegal to terminate an injured worker within six months of a work-related injury, due to their injury; secondly by terminating an employee within three years of a claim, your premiums are likely to escalate..

It’s easy to be frustrated when an employee is injured at work, but it’s important to act quickly, offer support and provide suitable work duties, to get the worker back to work, with minimal disruption to the business. And you should know… if suitable work duties are not provided, your insurer is required to calculate an estimate for wages to be added onto the claim, and history tells us this can be somewhere between one and up to eight years of wages!

The best option? Protect your business by engaging an experienced Return to Work Provider to help you navigate through the minefield of regulations and technical information and avoid costly mistakes.

Why leadership and culture is imperative to safety

Do a couple of Google searches around risk taking in the Australian workforce and it’s easy to see that not everyone has a positive attitude towards safety and injury management. Many employees, particularly in larger businesses, tend to adopt a rule breaking approach if it’s likely to get a job done faster. So how can we as Leaders alter employee perception and, when it’s not always a simple task, should we?

 

Absolutely we should!

The latest figures show that work-related injury and disease cost the Australian economy $61.8 billion, with 77% of that worn by employers. So really, we’re mad if we don’t!

 

As Leaders it is up to us to provide the foundation for a strong culture of safety for our employees. We should enforce a top-down approach, adopting a proactive leadership style and promote a positive attitude towards safety in the workplace.

 

So how do we achieve this? Here are 8 simple steps to get you started that will make an immediate difference to your safety culture:

 

  • Commit to being risk adverse – write it into your company values if you need to but ensure that you are committing fully if you really want to be a positive safety leader
  • Walk the talk – lead by example, show your employees how to be safe, raise topics for discussion, reward safety initiatives and ideas and never break the rules!
  • Keep informed and educated on safety – talk to people, read, hire an expert… do whatever you can to ensure you are well informed around safety relating to your specific industry
  • Ensure you have a policy in place – most businesses already do, but do some benchmarking to ensure it’s up to standard
  • Communicate the policy from the top down – make sure your employees understand that their safety at work is paramount and the policy is  enforced
  • Listen to your employees – ensure they are given regular opportunities to voice their concerns and can do so in an environment and with someone they are comfortable with
  • Act on issues – what’s the point in being risk adverse if you’re not going to act on the issues, right?
  • Update employees – when an employee has had the confidence to voice a concern, ensure that you keep them updated regularly on any outcomes

So at this point, you’re either ready to start making some positive changes, or you’re waiting for the punch line. Well, here it is… remember that figure? $61.8 billion!

 

You can’t afford not to make some changes. Throw the rule-breaking approach out the window and refuse to contribute to the statistics! You might just be surprised too because there’s no doubt you’ll also profit from the additional benefits of a strong safety culture: happier employees, higher productivity, positive business relationships, less absenteeism and reduced claims costs.

Managing Employee Mental Health
Managing Employee Mental Health – ​Why It’s Good Business

Are employers responsible for the mental well-being of employees?

At some stage in their life most employees will experience some sort of personal difficulty, emotional trauma or mental health issue.

Whilst the issue may or may not be a direct result of their employment, it can have a significant impact on the employee’s ability to perform their job or, in fact, even stay in their job.

It can also affect other workers around them and impact the business in terms of decreased productivity, increased absenteeism, reduced presenteeism, loss of a skilled and valued employee, and increased recruitment costs.

For  more information see Work Options  “LightHouse Keeper – Navigating Safe Workplaces” Managing Employee Mental Health