Workers’ compensation insurance agents’ satisfaction with occupational therapy activities of daily living assessments

Abstract

Background and Aim:Little is known about insurance agents' (insurers) satisfaction with the services provided by occupational therapists when they assess injured workers' activities of daily living (ADL). Demonstration of accountability and provision of high-quality services are important to the occupational therapy profession. The aim of this study was to evaluate insurers' overall satisfaction with occupational therapy ADL assessments for injured workers, including communication, timeliness of reports, equipment provision, knowledge of insurers' requirements and the workers' compensation process, and provision of a professional opinion. Relationships between insurers' overall satisfaction with ADL assessments, degree of experience in their job, formal qualifications and roles within their organisation were also investigated. Method: A telephone survey was developed and administered to a sample of 40 claims officers and injury management advisors from 10 Victorian Work Cover Authority authorised agents.Results: Insurers were generally satisfied with occupational therapy ADL assessments. They were less satisfied with occupational therapists' knowledge of workers' compensation system requirements and how occupational therapists made decisions when recommending household services. Conclusion: To improve services to the insurance industry, occupational therapists need to better understand relevant legislative frameworks.

International perspective on factors influencing the performance of housework: a scoping review

“…Within the medicolegal field, occupational therapists provide an opinion that establishes the reasonable and necessary amount of paid or commercial housework assistance attributed to the compensable injury (Walker, 2011). In addition, an opinion is required about who performed the task, whether it is reasonable for other household members to perform it and if assistance would be required in the future (Harris et al., 1994; Mason et al., 2005).…”

“…Van Vuuren (2012) undertook research on legal expectations of occupational therapy reports in South Africa. Another article addressed the satisfaction of workers' compensation insurers regarding ADL assessments (Mason et al., 2005). Research has also been undertaken by occupational therapists regarding suitable ADL assessment tools both for the general population and diagnosis-specific populations such as those with Alzheimer's (Wales et al., 2017) and stroke (Cornelis et al., 2017), but there is none regarding how occupational therapists translate their assessment results into an estimate of care requirements.…”