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ON Series: Leadership in rehabilitation and return to work

Having an action plan in place which supports workers during the crucial hours and days immediately following an injury, has a strong positive impact on return to work outcomes.

In this new webcast, Leadership in rehabilitation and return to work, Jeremy Clay from McNab presents a real life case study on how employers can implement effective early intervention processes that benefit both the injured worker and the business.

We encourage you to send any questions or feedback on the information presented to

About the presenter

Jeremy Clay is the Health, Safety, Environmental and Quality Coordinator for McNab, working in a high risk construction environment with projects involving the use of subcontractors.

Jeremy was the winner of the Best demonstrated leadership in rehabilitation and return to work award in the Safe Work and Return to Work Awards 2016.

Jeremy has over 10 years' experience managing rehabilitation and return to work in blue and white collar industries across construction, mining and labour hire throughout Australia.

Jeremy is a member of the Safety Institute of Australia, and is currently completing post graduate degree in occupational health and safety at Queensland University of Technology.

Download a copy of this film (ZIP/VLC, 3MB)

ON Series webcast: Leadership in rehabilitation and return to work

On series – by Office of Industrial Relations


Welcome to today's ON Series session titled Leadership in rehabilitation and return to work. The topic and the speaker is brought to you by the Office of Industrial Relations. As a department we are committed to driving initiatives across the whole scheme that improve safety, wellbeing and return to work outcomes for both businesses and workers.

My name is Dalton Langenhoven. I am Coordinator Education and Engagement Services for the Office of Industrial Relations. I'm pleased to introduce our Presenter Jeremy Clay who was awarded for his leadership in rehabilitation and return to work at the 2016 Safe Work and Return to Work Awards.

Jeremy developed the Injured Worker Pack for the employers in McNab's supply chain for the injured workers and doctors, all to assist the stakeholders with the return to work process. He has also developed supervisor training including for subcontractors, a Corrective Actions Report Register and a job dictionary. These resources are available to managers, workers, subcontractors and their employers and anyone else in McNab's supply chain.

We are extremely pleased to have the opportunity to share Jeremy's innovative approach to rehabilitation and return to work processes with our Queensland stakeholders.

I will now hand over to Jeremy to provide an insight into his approach to facilitating positive and sustainable return to work outcomes for his organisation.

Jeremy Clay:

Thanks Dalton.

So McNab introduced a really simple system which was employer neutral. So we engaged local medical centres so that they could treat our injuries. We had some roadblocks there. So not all medical centres have all the facilities to treat the injuries that we were encountering on our sites. So for instance some local medical centres wouldn't take in walk-ins or wouldn't like to see bleeding patients or conduct say, ECGs if someone had an electric shock. So we do have a policy of anyone who does receive an inadvertent shock would go through an ECG.

So it's important for the worker to feel comfortable and sometimes they're not so comfortable if they're sitting in an emergency department waiting for a test and it may increase their already fragile sort of state. So by getting local medical centres that understand the WorkCover system, they have the treatment facilities available, they do accept walk-ins and you don't need to make an appointment. It's very important, especially if you've got a long term project. If you're a manufacturing business it would be very smart to get something very close to your manufacturing business for instance.

So we developed the systems aimed at different audiences for the worker so they've got the information they need at hand. They've got a copy of everything that we give to the doctor for instance and everything that we give to the supervisor as well.

We developed some information for the supervisors to assist them to help the worker on their journey. Not all supervisors have received the Rehabilitation Coordinator training. So it's a simple system where they can go through a checklist and say 'Have I done this?', 'What's the next thing I do?', 'Have I got all the paperwork I need, especially for the WorkCover claim?' Also explaining some of the intricacies of the insurance to the workers as well, explain the claims process and also overcoming simple roadblocks.

We also developed a job dictionary. So we spoke to a lot of experienced guys in workplace rehab, especially in the construction sector. We analysed what the jobs were, how people sort of used their bodies in different ways to find out in a clinical sort of way how much time they spend on different tasks, different weights for instance, different body mechanics. So we can focus on what people can do rather than what they can't do. So if they've injured a hand for instance, is there another aspect to their role that they can undertake?

Then we developed a simple training package for supervisors. So sometimes supervisors need to know what's in it for them. So we provided what's in it for them, provided some information about McNab's success in our injury management, the savings that we've generated and so forth, so they can get an understanding why they have to stop work and assist their worker who may have an injury.

So we learnt a few lessons on the way. So first up is planning for the worst and hoping for the best. So engaging good quality medical centres that do provide good occupational treatments and good communication. So we did have a situation where on three separate occasions we had three of our workers who suffered broken limbs and they were misdiagnosed as soft tissue injuries. That might have been for the remote location of the project and the fact that there wasn't an X-Ray close by but it did show a pattern and we subsequently changed medical centres to someone who could provide a bit better clinical support.

Also some local centres would prefer to use Medicare and may not really know the ins and outs of workers' compensation and provide things like the first medical certificate which is different to one that you go in for a general medical condition rather than an occupational one.

We treat all workers as if they're our own. So there may be some situations where we're finding that subcontractors, employees may be subcontracted themselves. So instead of investigating who's responsible the main thing is to get people the treatment they need and work out who's responsible afterwards for the ongoing treatment and care and so forth. But the initial thing is if someone needs treatment, they need treatment. They don't need to know who their employer is immediately.

We also focus on what people can do, not what they can't do. Sometimes some outcomes, you know, people think they're doing the right things by limiting people's work but sometimes it can mask some other issues and also contribute to secondary illnesses, especially mental wellbeing. You find people who get back to their peer support network actively engage in the workforce again and they get better quicker. So there's a lot of research around saying 'good work is very good for you.' So we find that people who return to work immediately we have a greater success for their long term employment.

So the Australian College of Physicians say that people who are off work for extended periods of time may never get back to work.

Also workers who are too injured to work are normally too injured to drive. So there really needs to be a plan for how that worker is going to get home from their medical treatment. So if they go there by an ambulance because they're suffering acute pain, they receive some pain medication and some other treatment, they might be ready to go home but they still need to get home. So make sure that you plan that return journey. We make it a policy that all injured workers are accompanied to their first medical appointment.

Also write it down is – consider engaging a professional to help you detail a job dictionary. So we developed a job dictionary just in-house in the first instance and then we sought some professional help in detailing that in a more clinical way from an occupational physician. So that's something that people can do. They can go and Google that and find out someone who's local for them.

It helps in having a goal what a good – someone who is fully able, what they can do. So it creates this target. You can say 'Well, this is what you need to do to fulfil your role and this is where we're going to rehabilitate you up to.' So that's good to define that in a more clinical way so the doctors can read that understanding and then suit their rehabilitation. Any allied health can use that as well.

It also helps for the supervisor to understand what they need to make sure that this worker can actually be supported in their return to work.

Education is extremely important. So educating your supply chain that no one benefits from an injury and that there are so many benefits from just a small investment in rehabilitation and return to work is - having no plan in the first instance is not a plan for success. So if you can do, seek advice from a qualified return to work coordinator. If you've got one in your supply chain you can always leverage off them. They're usually very helpful for anyone who's involved in their supply chain.

Not all businesses require them. So for high risk businesses it's a large turnover of about $3.5 million, but that changes on a regular basis according to the legislation.

So we've seen a dramatic reduction in premiums and it far outweighs any cost of our program. So when we first initiated our program from just a standard return to work program that anyone could get off the shelf and actively participated into the supply chain we saw a reduction in our own premiums. So from the industry rate which it was in 2011 to this year it's going to be one fifth of the industry rate. So we're saving a dramatic amount of money. So our five year return on investment is $1.5 million. So it's a significant amount of money that we can invest elsewhere in the business. The amount of money that went into training and other things is far outweighed by the return on that better insurance rate.

So in future we're attempting to engage our supply chain as early as possible, explain the benefits of good rehabilitation practices and sharing our job dictionary among other things, giving them advice when they need it, assisting their workers to good medical treatment is of benefit for the entire supply chain, reiterating that no one benefits when their workers are injured. Absolutely no one benefits.

Encouraging pre-employment assessment. So if you use your job dictionary you can really focus on getting your ergonomic fit right with your workers. So workers who shouldn't be doing that physical exertion as high as other people, you can limit your exposure to workplace injuries in the first place if you employ right and also select your good subcontractors as well.

Look, to encourage others I'd say plan for injuries, plan for the worst but hope for the best. Find good quality doctors that are in close proximity to where you're working. Make sure that they can actually do the treatment that is usually necessary from the injuries that you've had in the past, so that they accept walk-ins, that they know the workers' comp system, that they've got details of your injury management system so they can assist you with that rehabilitation and they provide good care. So if you notice there's a pattern that's not befitting the way you want your outcomes to be, it's always good to take that up with your practice manager.


Jeremy just following up from this point that you've just made, for people new to rehabilitation and return to work can you give some practical advice about how you, they would approach a medical centre to establish this relationship?

Jeremy Clay:

I'd encourage their return to work coordinator to go to a local medical centre near where their area is operating. We are in a construction industry, so it would be close to our construction site but if you're a manufacturing industry it would be close to where you manufacture of your delivery company. You could even get some chains that they do have a few medical doctors. One of them for instance is Sonic Health Care. If you Google them you can get some more information from there.

It's also important to engage with the practice manager because sometimes good rehabilitation is just down to the administration and having a really good relationship with the practice manager, things like information from the visit like the medical certificate and other information it makes life easier if there's a good relationship there.

Just little things like having a look at what facilities they've got available. So have a chat to the practice manager and if you do get to chat with the doctor and explain what your work is, what your past medical treatment injuries have been like and what you need services of generally can help as well. Look at the results from previous workplace injuries. If they've been successful then analyse how that's been successful and if they've been less successful you could take that information back to the medical centre and explain that the outcome wasn't what you expected and suggestions for improvement.

Also I encourage people to write down what their preferred medical centre is and explain that to people when they start with your organisation. If it's a construction site during their site induction, if it's a manufacturing environment or other environment just explain when they first start is if they do have a workplace injury is that they're welcome to use your preferred doctor and that there's usually a good relationship between your preferred doctor. Some doctors will actually come out to your work site and do some analysis of your job tasks and so forth. It's usually at a fee but sometimes you can recover those fees through better rehabilitation practices. Yeah, so I would encourage people to do that.

Going back to the encouragement I think the other aspect that you should really focus on is doing an incident investigation and considering that all injuries should be prevented, the best way to have a good outcome with workplace injuries is not to have injuries in the first instance. So really learn from your investigation. Don't immediately point to an issue with a person. Have a look at the complete system. It may surprise you what the contributing factors and the route cause are. Also engaging with other people, Workplace Health and Safety do run very good networks, like join the Facebook group etc.


Thank you Jeremy for sharing your experience and the success you have achieved with your rehab and return to work initiatives.

You can also view Jeremy's video on the Queensland Safe Work and Return to Work Awards website. We will be providing a link to that website and that video with this recording.

The Office of Industrial Relations is committed to sharing knowledge and experiences that encourage others to consider what innovations they can bring to the rehabilitation and return to work processes within their workplaces.

To that end I think today's session is incredibly valuable.

We hope you found this information valuable for your role within your business and we look forward to delivering more real life experiences for you in the future. Thank you.

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