Suitable duties programs
This Workers' Compensation Regulator webinar will enlighten return to work coordinators about the purpose of suitable duties programs and how they can assist with getting better return to work outcomes.
Chris Foley, Managing Director of Strive Occupational Rehabilitation, shares his insights about how keeping people engaged in the workplace assists with self-fulfilment. He also discusses how educating employers about accommodating injured workers is beneficial for all stakeholders, including promoting high social engagement, workplace moral and better productivity.
In the webinar Chris discusses:
- the purpose of suitable duties programs
- barriers, both evident and unknown
- achieving milestones in suitable duties programs.
Watch the webinar, or download the presentation. This content is protected under copyright.
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- Getting back to Work Series
Suitable Duties Program
with Chris Foley, Managing Director, Strive Occupational Rehabilitation
Good afternoon and welcome to today's webinar on Suitable Duty Programs. My name is Natalie McSweeney and I will be your Facilitator for today. Before I introduce you to Chris Foley our Presenter for today we have some tips on making the most of your webinar experience.
Firstly, the presentation will go for approximately 40 minutes. At the end of the presentation there will be an opportunity to answer your questions. You can ask your questions at any time using the Q&A on the right hand side of your screen and we will collate and answer as many as we can towards the end of the presentation.
A copy of this webinar will be emailed through to you shortly and available on our website. If you have some trouble with audio issues please use the chat box on the right hand side of your screen and we will have our IT expert assist you.
Chris Foley your expert presenter for today, Chris is Managing Director of Strive Occupational Rehabilitation and holds qualifications in occupational therapy, family therapy, working in ethnic communities, Scott Works International Negotiation, mediation, conflict coaching, organisational behaviour and has an MBA in organisational dynamics and leaderships. With an extensive background spanning over 25 years in the field Chris feels that the experience of working with injured workers and employers to overcome barriers to work and find solutions to injury, disability and engagement is useful and meaningful work and has become a continuous passion.
Keeping people engaged at work has meant their sense of self worth has remained in tact and employers who once did not know how to accommodate injuries and disabilities had a way of finding solutions for people. The benefits of being high social engagement and workplace moral leads to better productivity. During the webinar Chris will discuss the purpose of suitable duty programs, barriers – both obvious and hidden – and milestones.
Thank you Chris.
Thank you for that. Welcome everybody and thank you for inviting me along here today. It's all a bit daunting this webinar stuff. I'm used to being on stage and seeing everyone poking their tongue out at me rather than in this circumstance.
So today we're going to cover off the following things. We're going to look at it by definition, the assessment, what are some of the barriers, how we go about monitoring, how you might evaluate it at the end and last but not least is about looking after yourself.
Before I go into it in great depth I thought it's useful to also just talk a little bit more about why I have that passion. So many years ago I worked with young people with schizophrenia and a young fellow – we'll call him John – was coming in and out of hospital and he was – the staff were getting quite distressed by it. He would go out, he'd go to work, he'd get to about three days' work and then he would have a breakdown and end up back in hospital. So they asked me to sit down with him and we worked through what was going on. And I remember the question quite clearly saying to him "John why do you try to work beyond three days? It's very clear now that when you get to that fourth day it becomes too much and you break down," and he turned to me and he looked at me very seriously and he said "Chris you have a job that takes you over five days. You've got a house, a car, a family. You go to the pictures. On three days of my wages I can only pay rent and feed myself. All of those other things are just a dream." And so with that in mind I've certainly found something in terms of the connection to the world of work for people has a lot more meaning than just getting money.
So what are suitable duties? So they're basically short-term work duties that are agreed between the employer and the injured worker and the treaters. They're to assist in the person's return to work. Parts of the job may be used that the worker was doing before they went off. It may be the same job on reduced hours or it might be different duties. It could be opportunities for training or it can be a combination of all of those. So certainly we're only limited by our imagination.
Where can they be used? Now certainly what I've found over the years is people and I'm aware that people here are probably looking at it from the point of view of compensation systems but its use is much broader than that. So certainly when we're thinking about people with disabilities entering the workforce or remaining in the workforce we're finding with the ageing population that we have a lot of secondary health issues that are starting to impact upon workplaces and for those employers who are enlightened about the need for keeping people engaged in their work, we certainly find that people are using suitable duties much broadly than just the compensation arena. We find that people use them for things like people coming back from cancer operations, heart attack, stroke, multiple sclerosis, diabetes – the whole range of things that are impacting upon people. Obviously things like workers' compensation and also people from income protection. So it has the use that's much broader than simply just the compensation arena.
Again one of the things that AHRI identified – that's the Institute of Human Resources - is to lose an employee is the equivalent of losing three times their salary in terms of replacing them, so their salary and on-cost. So the costs are fairly high. What's considered to determine suitable duties? Well certainly we need to think about the person's disability, their incapacity, any relevant medical information is important as well. We often fall into the trap of just thinking about "This is the injury that's presenting to us," rather than thinking about the rehabilitation plan of the worker and any other conditions that might be there.
So a good example might be a young person with – an 18-year-old with a broken arm. We can expect that they will be back fully able to utilise their broken limb within six weeks. Yet a person at 55 years of age – this makes me a bit frightened – that has the same injury it's going to take them three months. If we add to that things like Type 2 diabetes or some other medical conditions then that extensive period of time can actually run out to 12 months. So we should consider the rehabilitation plan. We should consider the workplace itself. Does the workplace have a policy? If you don't have a policy one of the things I would suggest that is useful is in terms of getting it and promoting it to people. One of the things we find is that often when an employee gets injured the first thing they do is to find out "Well what is it that's going to happen to me?" and in the absence of something they start to fill in those things.
We need to consider the worker's age, their education, their skills and their work experience as well and any other relevant matters. And I'm reminded from some experience some time ago where I worked in a factory where there was an older gentleman who had injured himself and everyone was struggling to actually get him back. There were reasons for that quite clearly but whenever we got into the suitable duties of it there seemed to be some sort of a resistance, something going on that we needed to uncover and in the discussion eventually once we'd got his trust we found that he was actually illiterate. So he'd worked in the one job for a long period of time and had managed to get away from letting people know that he couldn't read or write. But upon being injured suddenly he was fearful of all of those experiences as a child where people would see him as dumb or stupid and he certainly wasn't that but certainly in identifying that, that became a barrier that we suddenly realised we had to overcome.
We have to think about the location as well. Sometimes the person may be perfectly able to do their work but the ability to get to and from work is there. I've got a client at the present point in time who's had a shoulder reconstruction, absolutely nothing wrong in the way in which he does work but getting to and from work is a real problem because he's reliant on public transport and certainly peak hour traffic is something – or peak hour train travel is not something you want when you've just had a shoulder reconstruction. Everybody seems to want to pat you on that shoulder.
Chris we have our first question from our audience. What's the best way to find out age, education skills and work experience of a worker?
Yeah. Look I guess the underlying thing that I'd like people to take away from all of this is really about how we connect with people. So having a discussion with a person and making sure that we really understand where they're coming from is really important and certainly that conversation gives you the opportunity to start eliciting that information for that person to feel comfortable and that you've actually got their holistic view in mind.
I guess one of the things that we should be thinking about is how we connect. There's some good reason for managing or why to develop a suitable duties plan. Certainly the maintenance of a person at work is particularly important. We know that as I said before, if you lose an employee the longer they're away from work the harder it is for them to come back to work and so if we can find ways of keeping them engaged they have less time to sit on the couch and think of all the evil things that might happen to them rather than the things that actually will. But there's some other reasons as well.
Just in the last two or three years Mansel Aylward and Dame Carol Black identified the health benefits of work. So they did a longitudinal study based on people's worklesness and what they found is that people who are workless, i.e. that are not working for a period of six months, that the health outcomes for that person become the equivalent to a person smoking 10 packets of cigarettes a day. Yeah that's correct – 10 packets – and being workless for 12 months results on average - what they found is that the results of being workless for 12 months actually takes a person's life expectancy down by 10 years. So it's fairly startling this research that's coming out and certainly Dame Carol Black has been out here in Australia a number of times promoting this research and I'd encourage people to sort of grab hold of that and have a look at it.
Equally some years ago Macquarie University was engaged to look at the cost of social security on the tax payer. What they found is for every $1 of money that is spent on a person who is unemployed it costs us the tax payer $54 which is a huge impost upon our economy and the productivity of our nation. So done well, suitable duties actually reduces the cost of business for workers. It reduces the cost of workers' compensation premium. It reduces the social cost to the individuals and certainly has a social benefit I think for our society.
So why develop? Further it can provide extra assistance to an area. When we're thinking about it there may be something that can be assistant for others. It may be off budget. It may be something that other people need some assistance in and as I said keeps connection.
It is a positive human resource initiative. I know that in working now for over 20 years that workplaces that actually don't differentiate between workers' compensation and others and do the same thing for a person regardless of how they're injured their workplace morale is higher, people's willingness to actually report injury is greater and the sense of people feeling that the workplace has connected with them is huge.
What do we need to consider? Well certainly the medical certificate is important. The treating doctor is the person who's going to actually determine what it is the person can and can't do and they will have information that may not be privy to an employer. The age and education of a workers is there, where they live. As I said before a person travelling long distances where the injury might not preclude it but the possibility of reinjury is there is something that we need to think about it.
It must be useful to the employer's trade or business. So you know, essentially there is no point in giving a person a task that is outside of what the organisation does. I'm reminded - just recently I was asked to come in and assist an employer post someone going in and doing suitable duties programs with a teacher that was returning to work and that suitable duties program had in it "Making cups of tea for their colleagues." That doesn't sound too bad except if you think about it as being something in the culture of that organisation, certainly that teacher felt that the workplace was being – was getting at them and that they felt belittled and shamed in front of their employees.
Fortunately the rehab coordinator recognised that and put a stop on it very quickly and said "No, no, no. Let's get a bit serious about it. Let's think about what is actually meaningful work," and that's particularly important because remember if we're talking about connection people gather meaning and if we give them the meaning that they're not worthy or they're dumb or something like that then we're battling on two fronts.
It must comply with an injury management plan. So we need to be thinking about how people – what's the plan in there. It's easy to actually – to think about what it is we're asking the person to do that's actually going against some sort of treatment plan that's being operated. We've got to understand the actual demands of the job both physical and mental. So certainly – sorry. I've lost my track here. Certainly one of the things that we need to be clear about is the genuineness of the conversations that we're having.
So what are the things that we need to do in terms of developing up these treatments, these plans? We need to list the duties of what the person is doing and we do that by talking to the injured worker, to the supervisor and getting it from their job description. A bit of a cautionary note here. There wouldn't be too many times in a year where I'd go into a place where the person's job description bears no resemblance to the work that they're actually doing and I'm finding that particularly so in white collar areas. Often people working in factories and that sort of thing, the duties are clearer but in terms of them being clearly designated for the doctor and what have you, often we find that they're a bit blurred.
I am reminded of some years ago working in Melbourne at the Australian Paper Mills. I went along to a doctor who said it was outrageous that the employer was getting the worker to move – it was outrageous that the employer was getting the person to move something like one and a half tonnes of paper along a process line. And I asked the doctor, I said "Well how do you think that's done?" He said "Well this guy's got to move it from one end of the factory floor to the other?" and I said "Yeah but he sits in a booth with a crane and a joystick," and the doctor's gone "Oh. Oh I never bothered to ask that." So the doctor recognised that perhaps he didn't know as much about the detail of work that was in there.
Making sure that we're clear about the restrictions and what they actually mean it's important that we consider everybody's input to it. Time and time again we find that because the physio hasn't been included in understanding what the suitable duties are or the doctor or the psychiatrist or the employer or even the family for that matter, without them knowing and understanding it they become barriers to actually a successful return to work.
Certainly a suitable duties plan that says "Do it because I say so," has pretty much a guaranteed chance of failing. A number of times that I've come in and people have basically just demanded that the person follow willy-nilly and blindly because "This is what I do," really ends up in tears for all.
We should determine the maximum number of hours that the injured worker can work and often the person may overstate it particularly people who've been off work for long periods of time. I often say to them, you know, "On the first day back you are going to be very, very tired," and this is regardless of whether it's physical or psychological. And they say "No, I'll be right. I've done this before," and they don't recognise that in fact that return is impacting upon their – their ability to – or their stamina in fact. So often people are hypervigilant because they're worried about what the workplace is thinking about them. And so those hours need to be considered around what would normally be expected. So often a psychological return to work plan might have a day between to allow the person to recuperate in the early stages.
We also need to be considering how it impacts upon the workplace. So having someone slowing down a work line or having duties that are impacting upon other people really needs to be considered very carefully.
Chris I've just got a question. When it comes to determining the hours of an injured worker where do you start?
Yeah look that's a good question and certainly my experience would say that that is part of the discussion that you have. You start off with the principle I think of saying to people "Look we think that this person might be able to get back to their normal duties within two months or three months or one week or whatever it is. So you start with a "What do we need to do in order to get this person across the line at the time that we've determined?" Not to say that it's hard and fast but if we've got that timeline we've got the opportunity to say to people "Look for a period of time the person is working reduced hours," and "What would impact upon the workplace less?", "What could we do to make these duties such that it doesn't impact negatively on the workplace and the workers around there?" and that's particularly important. So there's no hard and fast rule. It is about making sure that you're covering off everyone's opinion but starting from the premise of "This is when we're going to get the person back," and sometimes that requires probably a little bit of guess time on everyone's part but at least by having identified that we're going to have this done by X amount of time it gives us an opportunity to say "Well how are we going along this road?", "Do we need to increase it, slow it down?" and always you've got the opportunity to come back to it and actually increase it as the time goes or reduce it as the need may be.
It's really important again that everyone is supportive and I'm reminded many years ago of working with a person who was a boat person in fact, a Vietnamese guy who was working in a sausage factory of all places. We had a suitable duties program there and he was really resistant to doing it. He was finding it very difficult to – he was finding it very difficult to find a path back. He was making excuses, not turning up and it wasn't until we looked into it a bit closer, so the supervisor was saying "Yep it's all good," the manager was saying it was all good and it was all happening fine from their perspective but what we found was that the local workplace were putting signs on his back saying "Kick me. I'm a broken individual," and things like that. So he was being bullied in the workplace subtly or not so subtly in this instance but no one was doing anything about it. So whilst his injury was physical the social barriers were becoming extraordinary and that didn't end well for anyone I might say too. Obviously there was a number of consequences for everyone around that – the worker, the workplace and the financial viability of that business.
So we need to consider about what the treating practitioner is going to say. So what's the capacity the person has? We need to consider is there an adequate assessment of the inherent requirements of the job. Now I use those terms advisedly because just to say "The person can do something like pick and pack," really doesn't provide enough information to the doctor to actually say "Yes. I know what to do here," because pick and pack in this day and age can mean lifting from above shoulders. It can be working at heights. It can be driving forklifts. It can be a whole range of things that are left to either the doctor's imagination or to allow the worker to describe to the doctor what's going on.
And certainly just recently I had an occasion with a person who was psychologically injured. A person with genuine depression and what have you told his doctor that the workplace was treating him badly and wouldn't do anything and that he needed to stay home. And the doctor felt that that was outrageous. But in talking with the doctor about what the duties were and how the duties could be modified to allow for this person's inability to get up and what have you actually gave the doctor a different view of how and what was going on. Or if we use the example of pick and pack, you know, the person may be able to flex their arm but not actually extend it. And so if we have things like a suitable duties register or a task register that actually is detailed that is very helpful for the doctor to say "Okay. I can recognise what the person needs to do, what are the psychological components of the job, what are the physical components of the job. I think the person can do this," or "We need to be careful about this."
We also need to ensure that there has been close communication with the treating practitioners to really give them those broader options that might be available in the workplace because again the doctor is reliant on – otherwise just on the injured worker's information. And the injured worker may have a whole lot of other things going on that are not necessarily dishonest in intent but they genuinely believe that somehow this is sent to upset them.
So certainly if you're not clear on how to do that, you know, obviously you can get a specialist occ rehab provider to come in and provide those duties and particularly in those instances where you might have difficulty in communicating with the practitioner. And that should be done not over the phone. I actually believe face-to-face is one of those things that's important in those circumstances because through that communication we get better outcomes.
Sorry Chris. We just have a question. Do you have any tips for how to actively enable or encourage doctors to complete the medical certificate in full including restrictions? Example providing job task register.
Yes. Sorry – could you ask – sorry. Could you ask the question again? Sorry I'm…
Certainly. So do you have any tips on how to actively enable or encourage doctors to complete the medical certificate including full restrictions? Example like the job task register?
Sure. Yep. So having all of the information in front of the doctor is really important. But one of the things that's also important is to actually think about the doctor's life. For many doctors their life is turning up to work and then five minute blocks of meeting with people. And so expecting them to actually concentrate on a one minute phone call is really asking anyone a bit too much. So being able to ring up and talk to the receptionist and say "Is there a time where I could have a discussion about our suitable duties for the injured worker?" is a useful time. A) it gives the message to the doctor that you're genuine and serious about his opinion and B) it gives him an opportunity to actually think about it before he has the discussion. So having that detailed task analysis sheet and what have you is something that he can then look at and it should include, you know, rates of lifting, volume of work, weights, all the reaches, the psychological components of it and things like that. So again he can actually spend his time giving that.
We also need to consider about whether the person needs a functional capacity done. Now functional capacity these days means a lot of things to different people. For me I think it needs to be considered around what's the actual workplace. So functional capacity that's actually conducted in the workplace is better than doing it off site. Again because there are so many nuances as to how people do things it's easy in, you know, practice to get a functional capacity going – assessment going where you've got all the weights in the correct containers and all at the correct heights and all of those sorts of space but when you get to the workplace find they're working in cramped conditions etc. etc.
There may be a need to consider adjustment to injury. Many times people actually believe that their injuries are such that they're greater than actually they are. Often I'll talk to people who will say I'm, you know, "I'm not 100% fit," and the truth of it is the person hasn't been 100% fit for so many years. Or that, you know, I can give the example of myself. You know, if I was to step on a pin at home there'd be an ambulance at the front door. If my wife was to step on it she'd pull it out and get on with the business. So people have different thresholds and people need to explore what their injury means to them. I'm reminded of a man who was injured and really struggling because his whole role had changed from it. He was no longer the provider. He couldn't take his son to football. All of these things started to impact upon his psychological wellbeing because of his physical – his physical condition.
A conditioning program – again my preference is if it's safe, is to have that in the workplace again because we need to be thinking about the simulation of work in the workplace is more real to the person. We can set up a gym program and have the person going off to a gym where the gym instructor's supervising it round the clock and, you know, helping the person go through. But that's not how workplaces are these days. People are often working together in teams and things like that and the expertise of the supervisor to know what to do is not there. So having some sort of program built in the workplace and again I emphasise where it's safe, is much more efficacious and it also keeps the person connected to their workmates and what have you.
Sometimes a vocational assessment is needed and again that may be a transferrable skills assessment as opposed to a vocational and that's really to identify how the person might use their skills in a different way. You know, I'm thinking back to some of the disasters in my life around suitable duties. I had a guy and he was willing to come and work in an office. He was a plumber and so here he was working 9:00 to 5:00 in the office, inside in amongst a whole group of women and he was just not doing so well. And of course one of the things I didn't realise and I certainly think about these things now is that his life choice was to actually work outdoors and being indoors was something he couldn't really abide by. He found it claustrophobic. He was finding it difficult working out in building sites. There was a lot freer language than there was in the office and so for him the vocational assessment was really about "Well how can we use your skills in a different way?"
So what are some of the barriers? Barriers to getting – getting back to work are often there because we haven't stopped and had that conversation that I talked about earlier. You know, "What is it that I know about the person?" and having that conversation with the person to really understand what's going on with them. Workplaces where supervisors and what have you understand that the person's son is going to university or there's trouble at home and things like that actually do a lot better than the ones it's really just matter of fact. Asking the person how it is that they think that we can be of help. "Is there anything else that we should know about?" The person may be needing to pick children up and so we're cutting across that sort of thing.
I'm thinking also about a case again where the injury occurred where a man from an Islamic background was working in a factory in Melbourne and he was working as a – in a metal pressing area and he got his hand caught in the press, lost the tip of his middle finger and basically from that time onwards refused to come back to work. Or appeared to refuse to come back from work. The insurer was getting more and more cranky with him. The independent medical assessments identified that he was capable of working.
More and more people were getting on the side of "This guy is ripping us off," when in fact the HR manager actually was the person who actually saved this fellow from what was an inevitable clash with the law and what have you because she came into the meeting. And we had a case conference where everybody was talking about the "What's going on here?", "Why is he not following these duties?", "What's happening?" and she said "I do not believe that this man who has brought food into the place, who's done shifts without pay, who's helped other people when things have happened to them is not wanting to come back to work. There has got to be something here that we don't know about." And as an act of desperation from myself was I'd basically said "Well look I will get to a home visit if you're happy and we'll talk about suitable duties and why they're not happening but we'll take an interpreter."
So we travelled to the person's home, made an appointment to see them and it was a whole new world for me. I got to the front door, I had to take my shoes off. We were carried into the – or travelled – conveyed into the lounge room which didn't have the traditional couches. There were cushions on the floor. There were various paintings on the walls and that were clearly of the Middle-Eastern origin. And so we did the interview and we had to sit down and eat food and all that sort of thing before we got down to business. When we did get down to business we started talking and things like that and you could see the frustration on this man and the tears rolling down his face and I was thinking "Gosh I don't know what's going on here. I really don't know." And the interpreter turned to me and said "Chris I know I'm not supposed to do this but can we talk?" I said "Sure."
So he talked for – with the fellow it's called an Iman for a period of time and he said "Chris can we go outside and talk for a second?" So I went outside and I said "What's…" Halouse was the interpreter's name. I said "Halouse what's the problem?" and he said "We've missed something. You've missed something. There's something going on here." I said "What's that?" He said "Well he's a very simple man. He comes from a peasant background. He's got a very strong, faithful belief in Islam and one of the tenants of Islam when you've done something wrong in the eyes of the law is that you, for instance if you thieve something you can lose your right hand and the law says 'That's what happens but god does it to you,'" and he said "This man believes that somehow his hand is a symbol that god is punishing him for something." I said "Well gosh I don't know what to do here Halouse. What should we do?" And he said "Look I'm not sure either but I think the way to go is to actually talk to the Iman of the local church.
So we went back to the fellow and said – we asked him whether that's what we could do. So this is after three months of trying to get the fellow back to all sorts of suitable duties, light duties, anything that we could do. He was more than happy. Halouse rang the Iman of the church, spoke to him there, put the fellow on. The fellow went to see the Iman on the Friday and he was back full time on the Monday. Basically the Iman's treatment was "This is not god. It was an accident," and that's all he needed to hear.
So you can see that – that part of what I'm saying here is about suitable duties are about understanding the players, understanding the people, understanding that it may be something much broader than what's presenting to you as a broken finger or a person who's unwell.
It's really important not to be over promising things as well. So really being clear about what it is that we can and can't do.
Often some of the barriers – "I'm not well and should be left alone to feel I'm better." As I said before often people feel the first time they actually get injured since they've been injured on the football field some 25 years later. And so they actually have an expectation that they're going to be just as good as they were then.
"I don't understand very well what's happening to me." I would love a cent for every time I've spoken to a worker where there's problems getting them back to work, where they've said things like "I stayed at home for three months. No one contacted me, no one said anything to me and now they're wanting me to come back to work. They didn't listen to me. They're not listening to me now," I'd be a rich man. And the second most rich making thing would be where a manager or a person turns to the injured worker and says "I've had a frozen shoulder too. It's not so bad. You do this, this and this and away we go. So just get on with it." Again it's not actually acknowledging where the person is themself.
Injuries are different to everybody. They have different meanings and in terms of return to work and suitable duties programs we need to really be meeting the person where they're at hopefully without some sort of value that's driving it in our background.
Chris just a question in regards to that. How do you put your personal view to the side and just listen to the worker?
Yeah. Look that's an interesting question. I've worked in this industry now for as I said over 25 years and we have a number of staff at work. One of the things that's really important is to say "This is not about me. This is about the person," and you've – I think you've got to have a natural curiosity about what's making people tick. We do have conversations amongst our consultants and one of the questions I will often ask them is "Do you like this person?" because if we don't like the person we need to then say "Well why is it that we don't like them?" and then determine what it is that we can do to overcome that barrier. Sometimes just in asking that question and working it through we identify that "Actually I don't like them, I'll never like them and I actually don't want to like them," and in that instance it's much better to actually change who's dealing with them because you just can't get over that. That doesn't happen often but certainly having that conversation and making sure there is some connection is really important.
Employers – barriers can be "I want the person 100% productive before they come back." Well often my experience is that the person wasn't 100% productive before they got injured. So we're actually asking something impossible of them. The employer that does the "Yeah I've got suitable duties. Done that. Let's get on with that." So tick that off, throw it at the various people and away they go, again that's just ticking the boxes rather than thinking about what it is that we're doing.
Or for where people are not monitoring the program, not actually setting out timeframes and certainly in the beginning I think it should be weekly. I'm reminded of some time in the past probably about eight years ago or so where I was asked to go and do a work site assessment and develop up a suitable duties program which I did and then handed it back to the referrer and said "Do you want me to monitor this." "No, no. That'll be all right. We'll do. It's all good," and then six weeks later I got a phone call from the same referrer saying "Can you go along and do an upgrade of the program?" I said "Sure. Not a problem. Can you send me through what's happening?" "No. They've done everything. All good."
So I got along there and I spent the first hour of my assessment dealing with the anger of the employer who said "I've been left alone. There's been some problems. No one got back to me," and the injured worker going "Yes. I'm really outraged at this. You know, it's been difficult at home. Arguments have occurred at home and we're left in limbo." So, you know, as I said I spent an hour then trying to undo something that shouldn't have been there in the first place because if people had actually monitored it along they way they would have been able to deal with something, nip it in the bud and we would have been having a positive discussion rather than the one that was there.
The ongoing management of the person – we need to be thinking about how that is. You know, do they have a psychiatric or psychological diagnosis? Again, you know, work places – people have extraordinary views about what it means to have a psychological injury and that's just ignorance. I mean the population of Australia at large has a medical vocabulary or a medical understanding – only 40% of the population understand what the diagnosis means to them. So often we are dealing with other people's understanding of what this psychological label is and other people's understanding. So Dr Google has a lot to answer for in those sorts of things because people just jump on whatever is there and so dealing with the workplace. So sometimes the plan might be to educate workers in the workplace about mental health and certainly a number of really successful organisations that we've worked with will spend the money to have someone come in and talk to them about resilience, about mental health, about looking after each other, about, you know, doing things like "Are you okay?" day and things like that. But certainly the number one is where people just don't connect with the employer.
We've just got another question in regards to that. We've got a worker who has issues with a fellow worker and they won't come back to work until that's been sorted. But the issue hasn't been identified. How could you go about sorting that one?
Yeah look that's a – that's an interesting one. We come across that quite a bit. Often people have some fears and they feel that if they actually are exposing that to their line managers or people within the organisation then that impacts – will somehow impact or come back to bite them. One of the things that we often do and I know other providers do as well is to come along as an independent party to actually talk independently to the people confidentially and then getting the information together in a way that actually protects people's privacy or that actually helps the person deal with those issues before they come back. So the example that you've used certainly I think of recently where part of the problem of getting them to come back on suitable duties was that they had had a big barney with their supervisor and that was the issue that was driving in the background. And until such time as that supervisor and the person had addressed the issues there then they weren't going to have a conversation around how to get back to work.
That comes back to monitoring. So let's assume that we've done all the good things. We've got connection, everybody's on the same page – the doctors, the treaters, the employers, the family, the injured worker, the co-workers etc. We need to maintain how it's going. So that's why it's important to have had that goal set in there that in three months we're going to do such and such or in two weeks we're going to do such and such because that gives you something to measure it against. Making sure – and it also helps us keep in touch. That early intervention – the first time someone says "I'm having trouble doing something," you can actually attend to it.
I was working with a person with a psychological injury the other day and I just happened to say to him "How's it going?" He said "I've got a sore back." I said "What's happening?" "Nothing." So having the conversation with the employer about the "Hey should we get some sort of assessment of his chair and work station done?" and the employer said "Oh yeah we were going to do that. We just haven't got round to it." So they actually did that and the employer was so buzzed – the employee was so buzzed about that someone had actually responded to him in a short space of time that you could literally see his mood lifting.
So it's important not to underestimate the value of face-to-face contact. One of the reasons why I say that there's some strong – or there's a lot of research now around communication. Communication comes in three parts – 7% percent is what we say, 30% is in the tone in which we have and that makes 63% I think in our body language. So sending someone an email about what we're doing you have to be a pretty good writer because that's only 7% of the communication that's going to get through and again my preference always in face-to-face is I'm aware that without body language I don't know what's going on with the person at the other end. I'm not good at picking up tone over the phone. That's dependent on so many things, you know, a scratchy phone line or whatever.
It's also important in monitoring that we understand that the cost of doing something now is probably much cheaper than in the long run because to fail in terms of keeping that connection means that we end up with a person who is unhappy, disconnected with the workplace and seeking some sort of retribution.
So once the program's completed and the person's back it's all too easy just to all to walk away and go "Nope, nope. That's all good now." I always encourage and certainly within my own workplace we do evaluations of what's been done. We look at the time, the cost, the participation of people. You know, have – what were the percentage of goals that were retained along the way? Was it terminated in a timely manner? Was it too soon? Was it too late? Did all of the stakeholders actually agree with this? You know, recognising their needs and dealing with those conflicts along the way.
Again, you know, were the parties referring on at the right time? You know, there might be someone. You know, they're going to their physio but the physio doesn't have a speciality in a particular thing and you just know that if they went along and had an independent physio session with someone else that they might have actually got that golden nugget that helped them move. And if the workers express dissatisfaction really understanding why that is because that's the stuff that actually feeds back into yours and my practice. Getting that feedback helps us improve what it is that we're doing for the next time.
I come at last to the looking after yourself component of it. As I said part of this work is about immersing yourself and your own personality into the – into the task at hand and that comes at a cost often, you know. You do have to work through "What am I feeling?", "What do I think about this person?", "What messages am I giving them?" You know, "Do I have adequate professional supervision?" Certainly things like this webinar and conferences and things like that are really important to get new ideas and to recharge those batteries because it takes a lot out of people individually. Often I find that return to work coordinators, you know, that they're given the job as that extra little bit of work that's tacked onto an already busy job. You know, and so they're feeling burnt out and just crunching the numbers rather than really thinking about "How do we connect?"
Thinking about how comfortable the work environment is. You know, what do people do to recharge their own batteries? Stoping and thinking along the way, what is it that you can control and what is it that you can influence and those things that you can't control and influence needs to be recognised as "Well who has got control of that?" So that might be talking with the insurer about "Hey what can be done here?" or it's talking with the doctor about, you know, "Is there some other - something else that we can do?" If you can't do that there's no point in trying to crash through. And do you as the return to work coordinator have the power to engage someone to help? You know, again often I find people who are really frustrated because they feel that they just don't have the authority to do what's needed as it when it occurs. And again that's where the insurer can assist or perhaps others such as health providers.
So I've come to the end of skipping across the surface of suitable duties and certainly it's important at the end of the day to be able to have those conversations about what was the good, bad and ugly of it all. So thank you again for inviting me along and I'm happy to take questions either now or if people suddenly wake up in the middle of the night an email will suffice.
Thank you Chris for your very informative and enjoyable presentation. You obviously gave a lot of information throughout that presentation and answered a lot of people's questions. We do have one question though. Relating back to the slides about the suitable duty plan if conducting the conditioning program in the workplace how do you get past the stigma of someone doing rehabilitation exercises in front of colleagues?
Yeah look I think that's about educating people. The – look workplaces are difficult – can be difficult and it is about addressing the education of people round there. It's also about helping the co-workers understand that this is the best thing that people can do for it. And it does require education and it does require the supervisor to be on board. And it does require anyone who's identified as leading in that workplace to actually be on board with it. So that's where you include the union workshop representative or the significant other person in the workplace. There have been workplaces in there where you just know that the secretary to the CEO is the person who actually knows everything about everyone there and you engage them in "What do we need to do?" So again it's about being aware that that's what there and then having a strategy, even if it is outside of this particular injury of educating people about what it is that you will do and what are the benefits of having someone in the workplace returning. You know, some of the ads that you'll see from the authority coming out in the next few months really get to the heart of why it is and once people get that my experience is that most workplaces and even the toughest, blokey-est places can actually come on board and get people, you know, doing those sorts of things.
Okay. Well we've had a lot of information on creating a suitable duty plan but how do you get the doctor to agree to it especially when the role is not office based and a person has had major surgery? One of our audience feels that the doctors give employers time off without thinking about the psychological effects of that.
Yeah look that's not uncommon. Again if you think of the life of the doctor, you know the five minutes they have they're going to make some rapid discussion. So you know, sometimes it's worth having a case conference with the doctor. You know, buying his time. You know, sort of essentially saying "Look can we buy half an hour of your time? We'll pay you for your time," and things like that, "while we can talk through how we can best get the person back to work." It can be and I'm finding with some of our consultants that some of our employers for instance engage our consultants to actually do that work in terms of translating for the doctor the workplace and what the workplace is prepared to do in order to actually help the doctor engage with what's important for the workplace, what's the dynamic that's going to be addressed and how it can be safely done.
So again just recently I had a fellow who had a shoulder surgery and the surgeon said "No, no, no. I don't want him back to work for six weeks." Now fortunately the fellow said "Hang on a second. I need to be there. I've got no sick leave left. This is not a workers' compensation case. I need to be back at work," and the surgeon said "Well I'm not going to." And so the workplace said "That's not good enough. Let's see what we can do." So they paid for the surgeon and the GP to be on a case conference to discuss what could be done. And the surgeon went from "No, no, no. I'm the expert. You do what I tell you," to "All right well that's okay," and deferred to the GP around "Well if you monitor this and let me know if there's, you know, any hint that the – that there's a flare up in the surgery that I've done that you'll pull the pin then I'm happy to go along with it." So it is about just again having that conversation and thinking about what the life of the doctor is.
Thank you Chris. Well I think time's up now for today. So if your questions have not been answered as you can see Chris's number's on our screen. Alternatively you can email it to firstname.lastname@example.org and we will certainly pass those questions on to Chris.
It's been great for you to share your expert advice and tips on suitable duty programs and to all of our audience out there your feedback is important. So stay online to find out more about our other programs and complete our survey at the end. There are many resources available to assist in your roles on this subject. We have provided a list here for your convenience.
We have launched a new advertising campaign to raise awareness of the health benefits of early return to work and the importance of good communication between injured workers and employers and health professionals. The campaign commenced on Sunday the 30th of August and features television, radio, online press and billboard advertising with the main message – "There's nothing like getting back to work for getting better". The campaign is supported by online and printed resources for workers, employers and medical professionals which are available at worksafe.qld.gov.au/gettingback. Visit the website for information, tools and resources on how to improve return to work outcomes and to download or order your free promotional material.
Please help to promote 'getting back' campaign by sharing the resources available online.
On Thursday the 22nd of October, 2015 the Injury Prevention and Return To Work Conference is on at the Brisbane Convention and Exhibition Centre. It is the same great return to work conference just with an added stream for the work health safety. As we all know many of you wear both hats. You can stick with the return to work stream of speakers or mix it up with the work health safety ones as well. It's your choice. The conference starts at 8:00am and concludes with a networking function from 4:45pm. Over 500 tickets are already sold. So get your registration in by going on the Work Safe website.
Slide 30[End of Transcript]
Work Health Safety Queensland is running a Safety Leadership at Work program. Join for free and learn how to influence and build a positive safety culture in your workplace through webinars, forums and events along with film, interactive tools and case studies. You can receive updates on leading industry practices and get access to safety leaders from a range of industries as well as have the opportunity to network. To find out more visit worksafe.qld.gov.au/safety-leadership-at-work or call 1300 362 128.
That concludes our webinar for today. Again thank you to Chris Foley for his awesome presentation. On behalf of the Workers' Compensation Regulator I would like to thank you for participating. Your feedback is valuable for future webinars so be sure to take a couple of minutes to complete the survey.
Bye for now.
- Getting back to Work Series
- Last updated
- 12 January 2018
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