Workplace Injury and Return To Work
"I don't want to go on WorkCover."
"I'm not a bludger."
"It will stop me from getting jobs."
"It will ruin my future."
When someone is injured at work, it is unfortunately common that one of the peak fears associated with the accident recovery pathway is that as an employee, one can be terrified of 'WorkCover' going on their employment record.
Much of my time is spent addressing the common issues quoted above to educate and demystify the Return To Work process and the negative stigma associated with it.
Join me as I discuss the workplace injury and Return To Work pathway, what it is, and why it is not the 'deal with the devil' that many seem to make it out to be.
Workplace Injury
When you sign a contract to work for a company or organisation, you would recognise if you had thoroughly read through the contract, that nowhere was written that you will be handing over any element of body integrity or functions to the employer. You would agree that you have signed purely to exchange labour and or skill in return for financial compensation. You do the work, you get paid. Thus it is not legally or ethically reasonable that you should sustain a workplace injury and not be duly compensated with a best effort to return you to your pre-injury condition.
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Generally speaking, a workplace injury is an injury sustained in the course of one's employment. This could be physical, psychological or a combination.
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Should an injury occur, one will obviously require medical assessment, investigation and treatment, services which of course cost money to render. But should the injured worker be expected to foot the cost of these expenses?
Return To Work
What is it?
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Return To Work, formerly known as WorkCover, is a type of insurance program set up by the Government to offset the costs of providing medical treatment for work related injuries away from Medicare.
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Return To Work is a pool of money into which most businesses pay, and from which an injured worker is able to utilise funds from for the purpose of medical expenses associated with their injury.
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Some larger companies instead of contributing to this pool of money, instead opt to be self insured, in which case the onus is on the company to facilitate the medical expenses of their injured workers themselves.
Early Intervention Programs
A Temporary Alternative
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Some businesses subscribe to an early intervention program which often provides funds for a small number of doctor visits and physio sessions. It is often reasonable to try this before beginning the Return To Work program. If these sessions are exceeded then Return To Work should be the next step.
Common Questions
The Return To Work program in itself is quite straight forward however there are elements that make it sound more complex. Below are some common questions that I frequently answer about the Return To Work program.
Q) Why does my GP not do Return To Work injuries?
A) It is legally more complicated and has many nuances which can be confusing for GPs. Many GPs still do Return To Work, however.
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Q) Why is an Occupational GP better than my usual GP for Return To Work?
A) Sometimes they're not, particularly if you've got a very proactive GP with a good reputation in Return To Work cases. Often though, Occupational GPs are better simply because it is an area of medicine they practice regularly, generally have reputations with many of the key stake holders involved in your claim, have a better understanding of the Return To Work process AND work in a more integrative manner with your return to work team and allied health professionals. Building your team is one of the most important steps in getting you a positive outcome.
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Q) Why are you sending me back to work? I am injured.
A) Studies consistently demonstrate that the best outcomes are achieved when a worker returns to work sooner rather than later. This aside though, it is the doctor's legal obligation under Return To Work, to provide guidance on what an injured worker can or can not do. This often is not task specific but more general and it is up to the employer whether they have any tasks for you at work that fit those restrictions.
Q) I just want some time off. Why can't I get this under Return To Work?
A) You can, but you will need to take personal sick leave to do so.
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Q) I've heard of cases remaining on WorkCover indefinitely.
A) This is no longer possible. There is a maximum time of only a short few years that someone has access to income support and medical expenses after which a claim will close
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Q) I've heard being on WorkCover gives you a bad reputation because of all the bludgers.
A) It is quite difficult to 'bludge' on Return To Work. An injured worker's treating team is usually quite aggressive in treating so as to expedite recovery. Those who try to 'bludge' will either have their claim revoked due to failure to comply with Return To Work obligations, or if they're great actors, their claim will expire eventually.
I've actually only seen a small handful, less than 10 in the thousands I've treated over the years so it is actually quite uncommon.
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Q) Why are you not taking scans?
A) Scans are usually done when it is clinically relevant to do so. We all understand how stressful it can be to have an injury, especially when you aren't 100% sure of what the injury is. Many different conditions can be treated the same and thus imaging when the results are not going to change any management is poor use of resources. Scans are rarely done for the sake of curiosity or certainty, but rather to exclude certain things that might need to be treated differently, where this exclusion can not be done with history and examination alone.
Q) My spine was scanned and they found some bulging discs/osteophytes/arthropathy/listhesis/stenosis/etc
A) This is one of the dangers of doing scans in that we're almost guaranteed to find something, and in many cases, what we find is unrelated to your injury. Everyone develops wear and tear changes over their lifetime but in most cases, they do not cause issues and in many of these cases go unnoticed for years or decades and are found only incidentally when we have a look. Negative psychology follows learning of these problems even if they are harmless and is another reason we try to avoid imaging where it is unnecessary. It is important that your symptoms can be clinically correlated with what is found on imaging, otherwise the findings are somewhat irrelevant.
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Q) I am worried my claim will prevent me getting future work
A) First of all, many jobs that require medical assessments done, are conducted by occupational doctors. Unless an injury is ongoing, a previous claim is unlikely to be of much interest to the doctor and thus a prospective employer.
Second, disclosure of previous claims is honesty based now anyway. That's not to say you should lie about it, but we can't go searching for the information like we used to be able to.
As I usually say, no one really cares about short claims. It is what Return To Work is for, just as you shouldn't be penalised for claiming something on Medicare.
Q) So can previous resolved claims affect my ability to get a job?
A) Technically it is possible but would you want to work for an employer that discriminates unfairly?
Q) Will my claim affect my employer's premiums?
A) Generally not unless you are medically required to be absent from work under Return To Work (time lost injury). Personal sick leave you may choose to take does not count as a time lost injury.
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Q) Can I just do all of this with Medicare to avoid a claim? I would rather do this.
A) You can try, but the value of Return To Work is that you can obtain gold standard care. Things like MRIs, physical therapy and some medications do not attract a Medicare or PBS rebate, or if they do, may have significant gap payments. In my experience, those trying to self fund a physical therapy regime for example, often fail to attend frequently enough due to cost. Lastly, if you need surgery, you can expect to wait 6-18+ months for this through the Medicare system.
In my opinion and experience, Return To Work achieves more and faster success though team integration and funds available for otherwise cost prohibitive investigation and treatment modalities.
Lastly, and probably most importantly, without lodging a claim, you are not protected by the Return To Work process. Specifically, income protection for lost work hours, reduced shifts offered, redundancy, etc. Your workplace is not obligated to have you onsite such as with a Return To Work Claim (further potential for lost income) And without Return To Work, you do not have a case manager ensuring that you are being treated fairly.