In a previous article, we examined problems identified by John Walsh’s review into South Australia’s vocational rehabilitation framework. Walsh offers a number of recommendations to reform rehabilitation case management, improve the state’s historically low return to work rates, and reduce the system’s financial burden on state and business budgets.

Walsh’s prescription includes a new focus on the role of return to work coordinators to streamline responsibilities and relieve pressure on rehabilitation providers.

Education on the benefits of work

Walsh draws on the position statement of Australasian Faculty of Occupational and Environmental Medicine (AFOEM), Realising the Health Benefits of Work. Drawing on a strong international body of evidence, the statement notes:

• Work, in general, is good for health and wellbeing; and
• Long term work absence, work disability and unemployment have, in general, a negative impact on health and wellbeing.

Walsh contends that greater education about work’s health and wellbeing benefits is needed among all stakeholders in the return to work process.

Building skills, building relationships

WorkCoverSA currently charges Employers Mutual Limited (EML) with management of compensation claims. EML in turn subcontracts to an assortment of 43 rehabilitation providers, where some form of rehabilitation is warranted. Walsh has recommended a number of changes to streamline the interactions between EML and rehabilitation providers:

• Reducing or consolidating the number of rehabilitation providers to make relationships between EML and providers more familiar;
• Raising employment requirements and instituting training programs for rehabilitation case managers;
• Improving EML’s existing system of specialist teams dealing with particular priorities, with a focus on expedience for high priority claims and tackling the “refer out” culture;
• Restructuring EML’s case management system with a view to a lower turnover of case managers per injured employee; and
• Renegotiating contracts between EML and rehabilitation providers to emphasise positive outcomes of rehabilitation rather than remuneration based purely on the length and number of consultations.

Previous research has noted that the likelihood of return to work diminishes with time spent out of work, and it is hoped that efforts to expedite claims will increase return to work rates and reduce the financial burden of workers compensation.

A greater role for return to work professionals

The Rann Government’s 2008 legislative reforms made return to work coordinators compulsory in all workplaces with more than 30 employees. Walsh sees an expanded role for South Australia’s return to work Coordinators to monitor the progress of injured employees reintroduced into the workplace:

• Shifting responsibility for monitoring the progress of returned employees from rehabilitation providers to return to work coordinators; and
• Improving communication between nominated treating doctors and return to work coordinators to surmise appropriate duties for returned employees.

Walsh argues that an expanded role for return to work coordinators will reduce rehabilitation costs and expedite the return to work of injured employees. Based on the experience of other states, Walsh anticipates that a greater role will improve the outcomes in a system that has suffered from a lack of employee engagement with the rehabilitation process.

Into the future

WorkCoverSA has accepted the majority of the Walsh Review’s recommendations and outlined a two year timetable for their implementation:

2011 Actions

• Require Employers Mutual to revise their case management role and function to include more effective triage arrangements
• Require Employers Mutual to deploy appropriate multi-disciplinary and rehabilitation expertise in their business to support the effective management of high risk claims
• Require Employers Mutual to undertake an appropriate procurement process to identify a limited number of vocational rehabilitation providers to be their Provider Panel, after discussions with the vocational rehabilitation industry
• Require Employers Mutual to use an audit tool to establish a benchmark of case management quality and as a ongoing quality assurance measure
• Refine vocational rehabilitation performance measurement with Employers Mutual and the vocational rehabilitation providers
• Incorporate learnings from the Walsh Report into future agent contracts and remuneration frameworks
• Support a cohort of up to 35 Employers Mutual case managers enrolling in the Certificate IV in Case Management (Personal Injury)
• Provide ongoing training and information sessions for Rehabilitation & Return to Work Coordinators and employers
• Require vocational rehabilitation consultants on Employers Mutual’s panel to undertake at least 15 hours of professional development activity per year
• Facilitate training sessions for Employers Mutual’s vocational rehabilitation providers panel
• Increase Return to Work Inspectorate visits to non complying employers
• Audit Employers Mutual’s new vocational rehabilitation panel in accordance with the Heads of Workers Compensation Australia nationally consistent framework
• Continue to support the Strategic Plan with the “Recover Better at Work” advertising campaign
• Provide additional resources to the WorkCover Vocational rehabilitation and Return to Work Inspectorate teams

2012 & Beyond Actions

• Implement an outcome based vocational rehabilitation remuneration framework supported by appropriate performance measurement
• Implement an Experience Premium Rating System for employers
• Develop Scheme Workforce Strategy for workers compensation
• Implement revised Rehabilitation & Return to Work Co-ordinator training
• Establish an overarching Training Strategy for injured workers covered by the South Australian Scheme
• Evaluate the implementation of this plan