Worker’s Compensation & Exercise Physiology

Workers compensation insurance provides support for workers with a work-related injury. Most employers in New South Wales are legally required to have a workers compensation policy to protect them for costs of claims. Workers compensation assists with the costs of weekly benefits, medical and hospital expenses and a range of other benefits to help the worker recover and return to work.

Workers compensation can also provide the injured worker with:

• Assistance around the home
• New employment assistance payments
• Education or training assistance payments
• Property damage claims
• Lump sum compensation for permanent impairment
• Hearing impairment claims
• Payments in the event of death

Factors influencing return to work outcomes

There are several factors across four main domains that work together to influence return to work outcomes for an individual worker.

Personal domain

Modifiable factors known to influence return to work include:

• Self-efficacy
• Recovery expectations
• Perceived work ability
• Pain catastrophising/fear avoidance
• Concern about making a claim

Workplace domain

The work environment is characterised by an employer's commitment to physical and psychological health & safety, positive relationships and a supportive recovery environment. Employers can influence return to work outcomes before an injury even occurs by:

• Promoting the health benefits of good work
• Put in place expectations of recovery following a work injury
• Evolving successful systems to prepare for, respond to and manage injuries
• Making sure all workers understand their rights and responsibilities

Returning to work improves when the process is planned and the actions of all parties are coordinated. A written return to work plan increases the likelihood of return to work by 1.7 times. After 30 days, a plan becomes more critical, increasing the likelihood of returning to work by more than 3 times.

Insurance and compensation domain

This area includes claims agents, insurers, regulatory authorities and other government/non-government agencies. Current evidence-informed claims management frameworks promote modified, person-centered claims management characterised by:

• A biopsychosocial approach 
• The worker having ownership of return to work goals and outcomes
• Attempt to make sure expectations are aligned throughout the return to work process

Health care domain

This includes treatment and rehabilitation to promote recovery. In this area:

• Treatment that focuses on returning to work improves return to work outcomes
• Workers with a mental health condition, work-focused cognitive behavioural therapy (CBT) can reduce time away from work, and the costs associated with work disability. Evidence does not support traditional CBT as being effective in improving RTW outcomes
• RTW is improved by contact between the healthcare provider and the workplace

Facts

• 10,947 claims reported for January 2022
• $304.8M of payments made during the month
• 1.52% of reported NSW wages goes to premiums
• $4.4B of premiums collected annually
• 72% expenditure paid to and for workers 2019/2020

Return to work rates as of January 2022

• 63% at 4 weeks
• 78% at 13 weeks
• 83% at 26 weeks
• 87% at 52 weeks
• 89% at 104 weeks

Exercise Physiology used for treatment

Exercise physiologists prescribe functional exercise for the purpose of increasing a worker’s capacity for employment. They also provide guidance to assist workers transition to a self-managed exercise program.

All allied health practitioners requesting approval to provide treatment are required to complete this form and submit it to the insurer. The AHRR aims to:

• establish clear treatment goals and expectations with your client
• improve the relevance of information provided to insurer case managers to guide decisions regarding treatment
• enable allied health practitioners to contribute valuable information to assist in your client's recovery at work/return to work planning
• simplify processes by increasing consistency across allied health practitioner groups.

References

Factors influencing return to work outcomes. (2022, February 17). SIRA. https://www.sira.nsw.gov.au/theres-been-an-injury/factors-influencing-return-to-work-outcomes

Open data analytics tool. (2022, May 24). SIRA. https://www.sira.nsw.gov.au/open-data/system-overview#viability

What is workers compensation? (2022, February 2). SIRA. https://www.sira.nsw.gov.au/insurance-coverage/workers-compensation-insurance/what-is-workers-compensation