This article by Dr Kevin Sleigh was originally published by WorkSafe Victoria.

HEALTH BENEFITS OF WORK

• Strong evidence base that work is generally good for physical and mental health and wellbeing
• Worklessness is associated with poorer physical and mental health
• Work can be therapeutic and can reverse the adverse health effects of unemployment

ASSISTING WORKERS WITH BACK INJURIES TO RTW

• Workplace back injuries are common ~ 20% of all WorkSafe Victoria claims
• More likely to result in prolonged incapacity than other types of physical injuries
• Back injuries range in severity from minor muscle strain to serious spinal disruption
• Difficult to accurately diagnose exact cause of the pain in many cases
• Usually is constant with intermittent peaks
• Reoccurrences common

What you can do as a coordinator to assist a worker with a back injury to RTW:

• Be positive and supportive of your injured worker and don’t assume your experience of back injuries will be the same as theirs
• Think about what your worker can do, not what they cannot
• Ask your worker what they think they can do
• Monitor them and support them throughout the RTW process – its almost certain they will have reoccurrences and these are sometimes tough to physically and psychologically deal with
• Take into consideration medication the worker may be taking
• In RTW arrangements - look for duties which allow graded duties as the worker recovers
• In general movement is good – staying still is bad. Duties which allow the worker to sit, stand and move around as they wish are more suitable than static postures or strict routines.
• Bending and twisting are best avoided are that are most likely to be pain aggravators.
• Restrict manual handling to 5kg close to body and 2kg away from body to begin with and increase as tolerated (be guided by THP)
• Be patient – some workers will take many months or even years to recover. Some injuries never fully resolve.
• Be prepared to have a list of suitable duties prepared in case of back injury in your workplace and forward these to the THP for consideration with letter via worker or attend in person.
• Use your Agent to assist in more difficult cases. They can assist with case conferencing or Medical Advisor contact.

Key messages for workers with back injuries

• You don’t have to wait until you are 100% recovered to return to work. The sooner you start planning to return, the better your chances of getting back earlier.
• It is important to stay positive and motivated-focus on what you can do rather than on what you can’t.
• Getting back to work after a back injury isn’t always easy but it can help you recover and gain a normal life more quickly.

PREDICTIVE RTW FACTORS

Worker predictive RTW factors

• Worker with low back pain who have good expectations about their recovery return to work after fewer days than those with poor expectations about recovery.

Doctor predictive RTW factors

• The patients of doctors who give their patients a date after which they could return to work, were more than three times as likely to return to work soon after injury.
• The patients of doctors who give guidance on how to prevent recurrence and re-injury they were more than twice as likely to return to work.
• If the doctor contacts their patient's workplace that worker is about twice as likely to return to work early.

GP RESEARCH

A recent WorkSafe survey of a large number of GPs revealed some interesting facts that you can use to improve your interactions with GPs:

General attitudes towards Return to Work (RTh5>
 

Approximately 3% of your average doctor’s patient list is made up of worker’s with workers compensation claims and doctors don’t typically receive any training on assisting their patients back to work. So, don’t assume doctors know what you need/want, and make things as easy and clear for them as you can!

GPs’ perception of employer RTW attitudes/behaviour

 

 

Based on these perceptions as a coordinator you should be:

• Reassuring your worker’s doctor that:
  • their patient is a vital part of your workplace and you want to help them in any way you can with their recovery
  • your workplace is safe (issues that caused the injury have been resolved, if appropriate)
  • you have suitable duties available for them as soon as they are ready
  • their patient will be supported and monitored throughout their recovery
  • you will stick to the restrictions they outline in their certificates and monitor and support their patients throughout their recovery and RTW
     
• Making sure you are prepared before any contact with the GP – your conversations/communications need to reassure the GP that you are capable and trustworthy and that you know the limits of yourexpertise (that you will ask for help when you need it and not make assumptions about their patients capabilities)
   
• Show the GP that you want to support their patient and be proactive, don’t wait for them to call you

COMMUNICATING WITH GPs

Getting through to the doctor:

• The way to a doctor is through the reception desk
• The Practice Manager manages “Practice Policy”

Treating doctor contact made easier - acute back injury

Be prepared:

• Accompany injured worker to GP (with your worker’s consent and where appropriate)
• Have standard letter of referral to go with worker to GP
• Be sure that GP knows that you have range of suitable duties available. Speak to GP if you can.
• Know your workplace and duties available
• Provide GP with pictures, videos etc, of workplace and be able to describe the physical requirements of duties
• Assure GP that worker will be appropriately supervised, monitored and supported while on restricted duties and will comply with any restrictions.
• Afterwards, remain in touch with GP even if you don’t always get through.

Treating doctor contact made easier - ongoing back injury

• Prepare for contact with introductory fax or letter
• Include copy of Worker’s Medical Authority
• Include a short list of key issues you wish to discuss
• Ask for a suitable time for the doctor to be available
• Be prepared to address payment issues
• Keep your appointment time
• Key questions to workers with back injuries
• What do you understand is the problem?
• What has you doctor told you that you should do to recover?
• How can I (we) (employer) assist recovery?
• When does your doctor think you might be able to return to some work?
• What are you doing at present? (activity level)
• AVOID: Any emphasis on words like injury, hurt harm, rest, disability, don’t hurry back

Key questions to ask your worker’s doctor

• What is the injury? (Diagnosis in layman’s terms)?
• What is the treatment plan?
• How can I (employer) assist recovery?
• When do you think patient could be able to do …..?
• What is patient doing at present? i.e. what is the current activity level?
• Is a referral to … likely to be required?

Where to get more information:

• Call your WorkSafe Agent
• Call WorkSafe’s Advisory service - 1800 136 089
• Join WorkSafe’s RTW Network
• Register for and attend WorkSafe RTW events and workshops
• Access AFOEM’s Health Benefits of Work Consensus Statement and view signatories
• Call your employer association(s)