1. Good practices in the real world
Dr Mary Wyatt
www.rtwmatters.org

2. Multi-Faceted Case Management: Reducing
Compensation Costs of Musculoskeletal Work Injuries
in Australia.
Iles RA, Wyatt M, Pransky G.
J Occup Rehabil. 2012 Apr 1

3. Why talk about the study
1. We can be effective in getting people
back to work
2. Good quality early intervention is
challenging to implement (system
barriers)
3. Many policy makers rely on regulations to
prevent long term claims
4. Results in cost shifting to other systems
rather than improve quality of life

4. Setting
• Workers comp
publicly run system
• Can be a significant
cost to employers
• Claims experience
influences premium
• Centralised database
for Vic comp claims
• Intervention implemented
by private company
• Across varying industries
– health, manufacturing,
aged care etc
• Approx 12 companies,
medium to very large
• Approx 800 cases and
2500 matched controls

5. Intervention
• Day one reporting
24/7
• Case managers
coordinating
• Supervisors engaged
• Senior managers
• Early appropriate
treatment, usual GP
or company Dr
• Dealing with the
– Fears
– Difficult workplace
issues
– Delays in treatment
approvals
– The occasional
person who didn’t
wish to comply with
the spirit of RTW

6. Data from
Intervention companies
Pre-Intervention period Intervention period
Matched controls
Pre-Intervention period Intervention period

7. Average claim costs

8. Average days off work

9. Average medical costs

10. Across industry

11. Challenges
• Working against the
bureaucracy
• Working against the
adversarial approach
• Finding the right
people to be case
managers

12. Social contributors and implications
Scheme management
• In Australia, scheme
costs managed by
reducing ‘tail’ claims
• Limited length of a claim,
eg 2 years
• Many shift onto other
systems
Policy approaches to RTW
• Focus on process
• Whereas it’s more about
people
• Many barriers to effective
early intervention
• History of the schemes
play a large role

13. Impact of being out of work
• The longer someone is
off work the less likely
they are ever to return.
If the person is off work
for:
•20 days the chance of
ever getting back to work
is 70%;
•45 days the chance of
ever getting back to work
is 50%;
•70 days the chance of
ever getting back to work
is 35%.

14. AFOEM policy work

15. Contact details:
marywyatt@rtwmatters.org
Link for AFOEM policy work:
http://www.racp.edu.au/page/afoem-health-bene