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The use of vocational rehabilitation for injured workers has dramatically increased in Australia over the last twenty years, leading to increasing money spent on vocational rehabilitation. Surprisingly, this has not led to an overall decrease in injury-related costs.

Vocational rehabilitation was initially developed to address not only physical problems, but also the social, emotional and workplace needs of sick or injured workers. However, over time financial concerns have influenced the approach to rehabilitation and this may be compromising outcomes.

While rehabilitation programs must be cost-effective, it is important that financial considerations are not placed above the overall well-being—physical, social and emotional—of the worker.

Why the research matters

Vocational rehabilitation models have undergone changes in response to financial pressures.  It is important that the implications of these changes are explored so that programs continue to be both cost-effective and produce the best possible outcomes for injured workers.

What the research involved

This article looks at how the approach to vocational rehabilitation has been influenced by financial pressures, and investigates the implications of these changes.

Summary of research findings

Vocational rehabilitation has undergone significant changes over the last two decades. Non-profit and socially-based rehabilitation models have been replaced with fixed funding models (e.g., managed care or case-base funding), with a greater importance being placed on reducing injury-related costs.

While the use of vocational rehabilitation for injured workers has dramatically increased, leading to increasing money spent on vocational rehabilitation, this surprisingly has not led to an overall decrease in injury-related costs.

Vocational rehabilitation was initially developed to address not only physical problems, but also the social, emotional and workplace needs of sick or injured workers. However, over time financial concerns have influenced the approach to rehabilitation.  The focus of rehabilitation programs has now shifted towards:

• Self-management, where the person is empowered to take responsibility for their own well-being;
• Coordinated care, which entails the creation of individual care plans to provide the worker with access to the necessary services and supports to achieve specific goals;
• Community rehabilitation; and
• Welfare-to-work incentives, which involves providing injured workers or workers with a disability with incentives to return to work rather than becoming dependent on welfare payments.

While these changes may be more financially cost-effective, there is a danger of placing too much emphasis on financial expenditure at the expense of the overall well-being of workers.  Successful outcomes should not be defined only based on financial costs, but also based on physical, social and emotional outcomes for workers.

Original research

Trends in Australian rehabilitation: reviving its humanitarian core.
Kendall E, Muenchberger H, Clapton J.
Disabil Rehabil. 2007 May 30;29(10):817-23. Review.

Link to PubMed abstract