Mr S works in quality control. His job requires expertise and an understanding of the production line process.  He has worked with his most recent employer for four years and has been regarded as a good employee.

About 18 months ago the workplace had a high production run of specialised material to be checked and Mr S felt under pressure to get the job done.  Whereas he generally checked a variety of goods, this job involved checking only one product. In order to check the product properly, Mr S had to maintain an awkward position and his back became sore. He mentioned this problem to a supervisor but, given the pressing production requirements, the supervisor did not take a great deal of notice.

Over the next few days the soreness got significantly worse and Mr S had difficulty moving.  As well as the low back problem, he developed anxiety and was constantly fretful.  He worried about whether he was doing a good job and did not feel that he was working fast enough.

Within a couple of days of completing the high production job, Mr S had a full-blown anxiety or panic attack.  He had palpitations of the heart, difficulty breathing, and numbness and pins and needles in his fingers and around his mouth.  Mr S associated these symptoms with heart problems and thought he was going to die.  His wife rushed him to the emergency department and he was checked and given the all-clear.

Over the next week Mr S remained off work.  His employer, generally responsive to these types of problems, called to see how he was going.  At that stage it was not recognised that the problem was a work-related one; they simply knew he was off work having heart investigations.

Through discussion it became apparent how the problem had developed and its relation to the high level production job.

The company, recognising the issues, became proactive.  Mr S's supervisor, who had contacted Mr S after his panic attack, discussed the issues with HR.  HR got in contact with Mr S's doctor and a return to work program was developed.

Internally, the company talked about anxiety and how Mr S's situation could be managed in order to provide a good outcome.  Mr S was invited back to the workplace for a discussion, and in that discussion:

• His high level of service was acknowledged and the company voiced their appreciation for his commitment to his work;  
• The company expressed their desire to help him through this period;  
• The company asked what they could do to assist; and  
• Mr S was offered return to work in quality control, with the proviso that he would not be required to do high level output.

The company asked Mr S to allow them to raise the situation with his colleagues and Mr S agreed.  Mr S's immediate work colleagues were then given information about what they could do to help when Mr S returned to work—ie, treating him normally but providing support and being responsive to his needs.

The following week Mr S returned to work.  He had continued back pain but was able to do the quality control work without a lot of bending.  He continued to have problems with anxiety and the company encouraged him to see a psychologist.  The psychologist gave Mr S clear advice about what he could do to manage anxiety. With Mr S's permission, his psychologist came to his workplace and spoke to his supervisor about workflow and what could be done to improve the work environment.

The return to work coordinator made contact with Mr S's wife to ensure that she understood the organisation's approach.

Pay issues were managed quickly.  Mr S was encouraged not to work overtime for the first six weeks of his return to work.  Despite his anxiety, he then felt ready to increase his hours of work, which he did.

Down the track Mr S continues to do his normal job, but continues to experience significant anxiety.  He has difficulty going out into crowded places and being around a lot of people and has occasional anxiety attacks.  However, he knows how to manage them and with his psychologist's help is gradually returning to everyday activities.

Key Messages

A co-ordinated approach helps manage significant health issues.

Anxiety and stress-related problems are common causes of significant disability.

Key aspects of good management included early contact, positive support, and strong levels of communication with the absent employee.

Involving the employee's family, treating practitioner and psychologist have a positive impact on return to work outcomes.

In a poorly managed return to work, this claim would have cost in excess of $100,000.  The organisation spent $1,800 on services to proactively manage the situation, resulting in a much better outcome for Mr S and significantly reduced costs for the organisation.