Claims / Injury Management and Rehabilitation for Injured Workers: Initial Results of a Partnership Approach

Abstract

Acritical life event such as a significant work injury imposes on the individual a heavy burden in terms of suffering, social exclusion, stigmatisation, negative role transition, and emotional, and financial costs. Such events, therefore, have multi-level implications relating to the functional restoration of workers, the professional efficacy of their service providers, industry productivity and economic viability at individual, organisational, community and state levels. In accord with this viewpoint, discussions have been held with a range of the key stakeholders, including employers, workers, case managers, WorkCover personnel and vocational and medical providers from which a larger research study has been designed. This paper sets the scene for an investigation into a learning partnership approach to claims / injury management and rehabilitation that is pragmatic, timely and consistent in fundamental principles, and which links well with the treating medical experts, employers, insuring agents, workers and close family members involved.

Promoting Excellence: A Learning Partnership Approach to Workplace Claims/Injury Management and Rehabilitation in South Australia

“…The researcher's familiarity with the area allowed effective management of the high volume of data in relation to the key issues. The distinct perspectives of different stakeholders can be seen in the resulting publications (see Roberts-Yates 2002a, 2002b, 2003a, 2003b, 2003c, 2004. The comments quoted in the introductory material above also come from this source.…”

“…It is clear that there is a need for an overall assessment of future possibilities in the delivery of improved responses in relation to claims/injury management and rehabilitation in South Australia. Recent publications have outlined concerns and issues in claims/injury management and rehabilitation (Roberts-Yates 2002a, 2002b, 2003a, 2003b, 2003c, 2004a. This article addresses the issue of identifying the key aspects of the situation to which attention should be paid immediately.…”

“…When occupational injuries and illnesses have been sustained in South Austtalia, the workers are entitled to claim compensation under the South Australian Workers' Rehabilitation and Compensation Act 1986 and, as a result, they are obliged to participate in the rehabilitation and return-to-work process. This initiates a range of multidisciplinary intetactions involving treating medical practitioners, allied health professionals, vocational rehabilitation providers, case managers and employers; the latter having the responsibility to identify and provide suitable alternative duties for the injured workers (Roberts-Yates 2002a). Although the current wotkers' compensation scheme is a no-fault system, the adoption of an adversarial approach by some of the key players and the inflexible behaviour demonstrated by some claimants and service providers all too often denies any opportunity for cohesive service provision across the professional stakeholders.…”

The Dilemma of the Case Manager in Workers' Compensation: Decision-Maker, System Player, Para Legal/Medical Specialist, Mediator or Enemy?

“…Assumptions were identified from the researcher's prior experience and knowledge of the field, and anecdotal evidence was acquired from the key stakeholders. The stakeholder groups were invited to comment, validate and modify the prepared list of assumptions resulting in a series of key perceptions from which the key research questions were identified (see Roberts-Yates, 2002a). The interviews were guided by semi-structured questions where appropriate and at other times prompts were constructed to encourage narrative and discussion.…”

Factors influencing return-to-work following upper extremity surgery

“…(7,222,350) Workers in these systems felt they lacked information explaining the compensation process, or the information was provided in language that was difficult to understand. (222,414) Using a framework of loss may be a way of considering some of the key psychosocial, emotional and physical aspects that impact on a workers' recovery and cause barriers to returning to work. Hence, a worker-centric paradigm has been proposed as one method to improve workers' experiences in their RTW journey.…”