Australia is moving towards harmonising our eleven different sets of workers’ compensation and return to work legislation. One benefit would be the elimination of confusing inconsistencies in the different rules and terminologies between the states and territories.

Imagine the frustration in the United States, which has 50 states each with its unique complexities.

In the US there are 4.1 million workplace injuries and 1.2 million people losing time from work per year, Last year’s GDP Report showed the US spends around $160 billion due to injury-related lost work time.

It’s plain to see that return to work is an issue that needs addressing. US occupational medicine doctor Dr Jennifer Christian is doing just that.

She leads the 60 Summits Project, a project aimed at bringing people from different sectors of society together to build team approaches to return to work.

In the midst of a recession, when employers fear that lost productivity will cause their business to fail, and chronically ill, injured and aging employees fear that they  will lose their jobs, the highlighting of return to work issues becomes even more important.

One of the biggest challenges of return to work in the US is getting doctors to understand the workers’ compensation system and to play a constructive role in helping  injured employees get their lives back on track and keep their jobs – instead of creating needless absence, needless work disability, and needless job loss.

In the US, as in Australia, there is the problem of doctors giving employees job restrictions without a full understanding of their workplace and therefore of the varied roles they could be undertaking.  Both employee and employer take the restriction as written in stone, and the employee can actually end up being held back from recovery and from eventually building back up to their normal roles.

There is also the awkward underlying truth that the science behind almost all work restrictions simply doesn’t exist.  As Dr Christian says, “This particular emperor has no clothes.  The reality is that doctors are actually the ‘designated guessers’ so everyone should pitch in to help the doctor give the best possible guidance.” 

Often doctors lack understanding of the mechanics of the injured worker’s job, while employers are unaware that it is important to keep employee engaged in the workplace during recovery, and don’t know how to adjust work to fit temporary changes in work capacity.

Many people in different types of organisations and disciplines are called on to respond when injury, illness or aging is affecting someone’s ability to work. The group includes doctors, rehabilitation providers, workplace supervisors, human resources and return to work coordinators, claims handlers, benefits administrators, union stewards, lawyers, adjudicators, etc. 

They are usually unfamiliar with how each other sees these situations and what each other is doing. They often blame one another for bad outcomes – when the fundamental cause is really the lack of a shared positive vision of what should happen coupled with the lack of a collaborative and problem-solving approach to the stay-at-work and return-to-work (SAW/RTW) process.

In fact, Dr. Christian said, “to be successful, the SAW/RTW process often requires a team approach. I often say it’s a team sport in which today the members of the team don’t know each other, don’t realise that they are on the same team, don’t know there is a game going on, or what the point of it is!” 

The 60 Summits Project is promoting a new model for the SAW/RTW process and sixteen specific recommendations for how to improve it laid out in report entitled Preventing Needless Work Disability by Helping People Stay Employed.  

The report was produced by the American College of Occupational and Environmental Medicine (ACOEM). Dr Christian, who led the group that developed the ACOEM report, founded the independent non-profit 60 Summits Project in order to “catalyse positive change in workplaces as well as disability benefits and workers’ compensation systems throughout North America”. 

The name 60 Summits comes from her original commitment to hold multi-stakeholder Summit-type workshops that use the ACOEM report as the framework for dialogue in all 50 US states and 10 Canadian provinces.

Dr Jennifer Christian and RTW Matters Editor Dr Mary Wyatt will appear at the Fresh Ideas for Injury Management Conference in Sydney, 26 August and in Melbourne, 28 August 2009. Click here for the conference program.