When managed effectively, injury management and return to work (IM/RTW) initiatives benefit employers, workers, and the industry overall by reducing and even eliminating lost time due to accidents.
A key reason for this is that they greatly reduce the ‘white space’ that surrounds workplace injuries — the time between when an accident occurs and when the compensation claim is accepted. Without an effective intervention plan, this white space can delay the return to work by weeks or even months, depending on the extent of the injury.
Consider, for example, the following scenario: A worker is injured and sent home with instructions to see his or her doctor. During the appointment, the doctor makes an initial diagnosis (sprained ankle), tells the worker to take two weeks off and recommends physiotherapy to assist the healing process. He then files various compensation-related forms with WorkSafeBC.
One-to-two weeks later, the claim is accepted and the worker makes an appointment to see a physiotherapist. The therapist is concerned about the level of tenderness and swelling, and tells the worker to make another appointment with the doctor. The doctor agrees that there might be more going on and orders an x-ray. A week later, the results are in: the worker has badly torn ligaments. The doctor tells the worker to take another three-to-four weeks off and to continue with physiotherapy. He updates the compensation claim, and WorkSafeBC signs off on the revised claim one week later.
It has now been three-to-four weeks since the injury occurred. The worker has spent most of this time at home, disconnected from the workplace. The employer, who has been without an important member of his or her team, will have to wait even longer for the injured worker to return to previous duties. It could be even worse if the injury is even more complex and requires additional work, like a CT scan, to properly diagnose. The more layers there are to an injury, the more white space.
While the scenario described is common, there are ways to minimize or even eliminate the white space, and this is where IM/RTW programs can play such an important role.
At the company level, having a program means that an employee with a sprained ankle or torn ligaments might miss a few days rather than a few weeks. This is because everything will be in place for him or her to safely return to the same duties, or to modified or alternative duties that are acceptable to him, his doctor, and the employer. Rather than leave it up to the system, the employer has decided to become actively involved in injury management and has put in place a program that is supported by all parties.
On an industry-wide level, clinics and facilities that either are dedicated to IM/RTW or include an IM/RTW component can also make a significant difference. Such approaches are beginning via initiatives such as WorkSafeBC’s Stay at Work (SAW) centres, which are being utilized at a number of Lower Mainland sites.
Developed in consultation with employers and worker representatives, the centres offer on-site diagnosis and treatment, assistance with claims, and other services designed to help injured workers return to current or modified duties as soon — and as safely — as possible.
However, while it is making a valuable contribution, the SAW initiative is best suited to mines and other workplaces with large, stationary workforces; it is not effective with small, mobile employers, who comprise the majority of construction employers.
There are also a few private medical clinics that include an IM/RTW component. They are able to provide same-day diagnosis and assist workers with the claims process. But their reach is also limited.
The ideal solution would be a network of regional facilities that are dedicated to injury management and return to work. These facilities would:
• be open to all workers and employers;
• have the staff and equipment required to provide same-day diagnosis and treatment;
• manage the claims process;
• offer RTW options, and work closely with employers who do not have a formal IM/RTW program in place and co-ordinate with those employers who do; and
• provide physiotherapy and other rehabilitation services.
This kind of centralized, under-one-roof approach would also help to remove some of the pressures currently experienced by hospital emergency rooms, doctors’ offices, and walk-in clinics that represent the first stop for injured workers.
While it will take considerable planning and co-ordination, the hope is that such a network will be built for British Columbia.
Michael McKenna is executive director of the B.C. Construction Safety Alliance. For further information, contact a safety and injury management advisor at 1-877-860-3675 or email info@bccsa.ca.
