RTW Flashcards
Access to financial support depends on?
MOI, employment status, where you live and where injury occurred, employer
Self-employed can access?
Income Protection, if insured
What is a compensable injury?
Work-related or road traffic crash incident
Where are compensable patients treated?
Private physio
What does the public health system manage?
Complex injuries (head injury, spinal, burns) AND acute mgmt of whiplash and fractures, but then rehab occurs in private health sector
Road traffic crashes?
Each jurisdiction of Aus has Act and Regulations to provide CTP insurance to claimants for injuries sustained by injured party only (FAULT BASED SCHEME)
What does CTP insurer pay for?
Private hospital, medical and pharmaceutical expenses
What does CTP insurer NOT pay for?
Wages, and Employer not required to keep job open
Goal from road traffic crash?
Return to function
Workers compensation injury?
Each jurisdiction of Aus has an Act and Regulations to provide workers rehab and compensation for injuries sustained at work (NOT FAULT BASED)
11 compensation systems in Aus - each state/territory has its own laws
How is workers compensation funded?
By premiums employers pay - based on industry, number of employees and claims history
Are professional sportspersons covered by Work Cover?
NO: Not a worker when
- Participating as contestant
- Training
- Performing promotional activities
- Engaging on any journey in connection with the participation, training, preparation or performance
What’s the QLD workers compensation insurer?
WorkCover (Govt owned), also self-insurers (e.g. Coles)
Why don’t all injured workers report injury?
- Fear of stigmatisation
- Fear of job loss or pressure from mgmt
- Fear of reprisals from co-workers
- Fear of reprisals from supervisors
What does the QLD workers compensation insurers pay?
- Income replacement
- Medical treatment/surgery/meds/travel/rehab/etc
- Death benefits
- Lump sum for permanent impairment
First 26wks?
Greater of 85% NWE
26wks - 2yrs?
Greater of 75% NWE or 70% QOTE
2-5yrs?
If could result in Work Related Impairment - 75% NWE or 70% QOTE or an amount equal to the single pension rate
When does workers compensation claim end?
- No med certificate
- RTW or recovered
- Medical tribunal says so
- Progress has plateaued - assessed for Permanent Impairment
- Worker not complying
- After 2yrs
Who are the stakeholders?
Injured worker, employer, rehab provider, medical provider, insurer
What is employer obliged to do?
- Keep job open for 12mths
- Keep regular contact w/ worker and insurer
- Identify and provide duties of suitable standard
- Monitor progress
- Provide supportive environment
- If impractical to provide suitable duties, must give WorkCover evidence of this
What is injured worker obliged to do?
Mitigate their loss (attend Rx)
What is insurer obligated to do?
- Provide/manage indemnity policies
- Process and manage claim
- Advise claimants/employers of acceptance of liability or otherwise, or any change to status of claim
- Payment of entitlements
- In QLD - 5 physio sessions
If more than 5 treatment sessions required?
Insurer may require Provider Management Plan
In QLD, the WC insurer will not pay for the preparation or completion of this.
Steps in planning RTW?
- Understand prognosis and functional limitations
- Understand job
- Match worker with job tasks, complete SDP, monitor weekly and update
Types of suitable duties for RWT?
Pre-injury duties with modifications, modified duties, alternative duties
Possible duty modifications?
New equipment, workstations and layouts, individuals work methods, work flows/rates
Characteristics of injured worker?
- Older
- Female
- Not married
- Lower education
- Comorbidities
Screening methods for psychosocial risk factors?
- Uni-dimensional scales
- Multi-dimensional scales (e.g. Orebro, STarT Back)
- Interviewing
Suitable duties should…
- Match capacity of worker to task
- Be meaningful and contribute
- Upgraded regularly
- Within restrictions of med cert
- Consider age, education, skills, work experience
barriers for RTW…?
- Worker related (characteristics, attitudes and beliefs, poor expectations, fear avoidant, fear of re-injury, passive coper, emotions, family members)
- Injury related
- Health care professional
- Workplace factors (job dissatisfaction, stress, can’t modify work, lack of workplace support, heavy physical demands)
- Compensation/legal context
When does compensation begin in QLD?
The day the worker assessed by:
- medical practitioner
- dentist (oral injuries)
- nurse practitioner (only in QLD)
What are the consequences of unemployment?
- Increased rates of mortality from CVD and suicide
- Poorer general health - physical and mental
- Increased rates of CVD, lung cancer, increased susceptibility to respiratory infections
- Somatic complaints
- Loss of identity and self-worth
- Disability and higher rates of medical consultation
What is the physios role in RTW?
- Outcome focused and goal-oriented services, achieve max function and safe RTW
- Consider biopsychosocial factors
- Advise and liase with treating practitioner and insurer
- Keep detailed, appropriate and up to date treatment records and information
Questions to ask patient?
- Where did injury happen?
- Do you have a med cert?
- Are you an employee or self-employed?
- What do you do for a living?
- What are the physical demands of your job?
- Does your employer have a rehab coordinator?
- If pt can’t return to usual duties - what can they do? (tell this to referring Dr)
What is the role of the treating medical practitioner?
- Gatekeeper of compensable process
- Provide med cert to activate claim
- Diagnosis, treatment and referral
- Approves RTW/Suitable duties plan
Workers compensation system is run under a medical model!
What is the role of the rehab and RTW coordinator?
Assist with claim lodgement, application for income support and statement from worker, maintain contact with worker.
Work with Dr and worker to establish rehab strategies and facilitate RTW
What are the 7 workplace interventions with scientific evidence for improving RTW?
- Contact b/w healthcare provider and workplace
- Early contact with worker by workplace
- RTW coordinator
- Offers of work accomodation
- Offered modified work
- Ergonomic work sit visits
- Supervisors trained in work disability prevention and included in RTW planning
