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Information of interest to our Clients and for the industry


Why work is the best treatment for injury recovery

The statistics are proof: work, wellbeing and general health are mutually beneficial. But a common belief among injured workers (and employers) is that ‘I need to be totally fit, well and completely recovered before returning to work’. Not true; good return to work outcomes are more likely when workers and employers understand the health benefits of work, and are empowered to return to work to aid their recovery.

Australian and New Zealand healthcare professionals, along with Government agencies, have been researching the topic since 2011 and have committed to a consensus statement regarding the positive relationship between health and work, and the negative consequences of long-term work absences.

Let’s hash it out.

Impacts of worklessness

Of all people who sustained an injury at work in 2018, 30% ended up leaving the workplace as a result of their injury or illness, and 16% were no longer working in the role in which the work-related injury occurred.

Numerous studies within Australia and globally have discovered that long-term worklessness leads to:

  • A loss of self-esteem and identity within the community
  • A halt to social participation and fulfillment
  • 2 to 3 times poorer physical and mental health, as well as delayed recovery
  • Financial stress and difficulties
  • Higher hospital admission rates
  • In extreme circumstances, increased mortality rates

If a person is off work for 20 days, their chance of returning is 70%; if they’re off work for 45 days, their chance of returning is 50%; and if they’re off work for 70 days, their chance of returning is only 35%. It’s fair to say that the associated costs of worklessness are substantial and often severe. But so too are the potential benefits for change.

Health benefits of work

Employer-supported, early return to work helps recovery, prevents de-conditioning and helps provide people with appropriate social contacts and support.

Rehabilitation is part of the recovery process, as is work; the challenge is changing perceptions to view it that way. But when listing the benefits of early return to work, it’s hard to ignore the advantages:

  • Faster physical recovery and function as a result of movement
  • Workers feel as though they are making a contribution to society, their family and community
  • Provides a sense of pride, identity and personal achievement
  • Enables workers to take part in social activities, build relationships and gain support
  • Provides financial security and therefore independence
  • Gives structure to days and weeks
  • Improves self-esteem, self-satisfaction and gives workers the means to challenge and develop themselves
  • Reduces psychological stress and improves mental health
  • Decreases the likelihood that workers will engage in antisocial behaviours
  • Leads to lower morbidity rates

So how do we (employers, workers, legislative bodies, Government) collectively promote the necessary shifts in understanding that work, in general, is good for return to work outcomes? Here are 7 simple steps for employers:

  1. Leadership – fostering and consistently demonstrating that safety in the workplace is crucial, will allow the adoption of a positive workplace culture from the top down.
  2. Policies and Procedures – ensure that the company has written Policies and Procedures in place to prevent workplace injuries and illness, which go beyond legislative requirements, and are specific to the business and industry. Embrace inclusive WHS best practices. And if you have existing Policies and Procedures in place, give them an audit to ensure they’re up to scratch.
  3. Safety Training – all safety training needs to be consistently reiterated, educated and implemented.
  4. Encouragement – offer encouragement and support to employees who are interested in staying fit and healthy. Provide some small health incentives or offer Corporate Wellness Programs where possible.
  5. Consult a Return to Work Provider – an industry expert will provide individual case management, assist employees to access medical care and treatment providers, provide progress reports and assist in an efficient return to work of the employee. They’ll also ensure that restoration of working life is closely alligned to clinical goals.
  6. Offer Suitable Duties – an injured worker may not be able to return to work in their full capacity straight away. Provide altered or alternate duties to get them back to work sooner, aid in recovery and improve productivity.
  7. Communication, communication, communication – keep lines of  communication and support open for any injured worker and ensure you’re receiving regular updates from the Return to Work provider. The more active you are ensuring the worker still feels valued throughout the process, the faster their recovery and return to work is likely to be.

As Rehabilitation Providers and Return to Work Specialists, we know that most common health conditions will not be cured by treatment alone; work is a therapeutic intervention and should always be a part of the treatment process. We also know that employers play a big part in the return to work process; employer-supported return to work, positive communication and support is the best way forward to shift beliefs around recovery and work, and ultimately getting injured workers back to work sooner.

Related reading:

Video: 5 common workers’ comp questions answered

Why leadership and culture is imperative to safety

How to promote corporate wellness when it’s not your primary role

Case study: when altering your reactions can affect RTW outcomes

Case Study: When altering your reactions can affect RTW outcomes

At Work Options we see many situations where a worker submits a claim for an injury at work, and doesn’t always have the experience they expect. In this case study, we look at a landscape labourer who was suffering from unknown mental health issues, and an employer who could have acted differently to avoid a negative and costly experience for both the employer and worker.

Case Study:

Ron* was a 38 year old labourer working for a landscaping business in New South Wales when he tripped on-site and fractured his right elbow, resulting in a worker’s compensation claim. Due to the nature of his work and the injury sustained, Ron was deemed ‘unfit’ for work and took temporary leave whilst he recovered. Whilst on leave, the employer made no attempts to communicate with Ron, until 6 weeks post-injury and post-surgery, when Ron was given the capacity to return to work in alternate duties. At that time the employer did not engage in discussion with Ron, but rather sent him a pre-drafted return to work plan outlining office-based duties.

Ron became frustrated with the lack of communication and spoke aggressively to colleagues who were contacting him via phone, the insurance agency and the Workplace Rehabilitation Consultant. The employer responded to Ron’s frustration by telling him to ‘pull himself together and understand that they were trying to support him’.

After a number of weeks of non-communication between Ron and the employer, Ron made a suicide attempt. Following this, Ron spent extended periods of time at home, not engaging in normal self-care or hygiene practices, which further isolated him from any support outside of his family. It was then discovered through Ron’s wife that there was an extensive history of mental health in his family.

Over the next several months, Ron rejected any communication attempts from the employer and insurance company, made three additional suicide attempts and was admitted to two impatient units for a combined total of 15 weeks. The employer became frustrated with Ron’s aggressive behaviour, considering it inappropriate, and elected to no longer attempt to engage with him.

After two years Ron had still not returned to work and his mental health did not improve during this time.

Recommendations:

  1. Communication is key! As soon as an employee is injured at work, it is important that the employer or a colleague checks on them regularly to ensure that they feel supported and are open to the recovery process. In this case, if communication lines were open, it would have been easier for the employer to determine that Ron was suffering from a mental health condition, which could have been managed and potentially prevented from escalating to suicide attempts.

Open communication may seem like a simple step however is often not done, particularly when mental health is concerned, for fear of making it worse for the individual.

 

  1. It is important to understand that, even when introducing positive changes, people experiencing low mental health will often react emotionally and can feel increased stress with change. This is likely how Ron felt when he received a return to work plan outlining alternate duties, without first being notified. By consulting Ron initially, he would have felt as though he had some input on the plan itself, and felt compassion from his employer.

This logic also applied when a person is still working within the workplace – businesses have a legal obligation to make reasonable adjustments to the workplace environment when a worker has disclosed low mental health, and that person needs to be a part of that discussion.

 

  1. Using language such as “we will work through it together” or “we are here to support you” shows empathy for the injured workers situation and allows them to feel valued. In this case, using language like “pull yourself together”, gave the opposite effect and caused Ron to stop communication altogether. This behaviour known as ‘avolition’ or ‘demotivation’ is typical for people experiencing low mental health, and is a sign that they often need more support to help them during these periods. It is important that if things have escalated to this point, professional advice should be sought. Suicide is fundamentally a coping strategy, a sign that a person doesn’t have a better way of coping or needs more communication around their mental health experience, and should be done professionally.

 

  1. Often people with low mental health such as Ron don’t understand why things happen unless it is explained to them; again, communication is key. Despite non-communication from Ron over the next several months as well as additional suicide attempts, although his aggressive behaviour was in fact unacceptable, reasonable attempts need to be made to explain why the employer’s communication will cease.

Although Ron’s reactions to his alternate duties were considered aggressive and unreasonable, his actions are realistic for someone suffering with a mental health condition. If your seeing signs similar to this case in your workplace, ensure that you initiate engagement, provide communication and support, and show compassion. Follow these steps, suggest and seek professional support if required, and preserve employee performance at work.

 

 

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.