Thoughts on SIRA's return to work action plan
These are my thoughts about SIRA's plan to address poor return to work performance in the NSW workers compensation scheme which is titled "Turning around poor return to work performance"
What about the medical team? SIRA must ensure the medical team provide appropriate, timely and ethical service to reduce the detrimental effects of dishonest, misguided and biased treatments on the return to work rates.
Treatment providers and nominated Doctors have excessive influence on a person's return to work. Decisions are often based on circumstance and perception rather than medical evidence or sound clinical judgement. As a result, there is constant failure by medical teams to support graduated recovery and improvements in function.
Too often within the compensable schemes we see medical professionals misunderstanding their role in a person's recovery. Practically and ethically, the medical management of compensable and non-compensable injuries with similar diagnosis should be near identical. But we know this is not the case. We need to hold medical professionals accountable.
Decisions should be made based on clinical judgement with the goal of recovery and returning to life (work being one part of that life). Additionally, answering questions about a patient's care and treatment should not be seen as an inconvenience. An inconvenience which elicits either no response, an apathetic response, or a $200 invoice.
Then there are medical decisions made as a form of power play or negotiation tactic to "get what they want" or to "force a response". There is too much animosity in the compensable scheme which usually begins from the initial points of contact.
Before all these steps and strategies, we must encourage compassionate conversations. We must first listen to those who are the most affected by these decisions. The people who have sustained an injury.
There seems to be a lot of people sitting in their offices making lists and checking them twice, writing business plans, identifying risk factors, developing strategic plans, reviewing best practice and work performance. SIRA's plan suggests making "outbound calls to workers", how about answering inbound calls? While yes, it would be helpful to educate workers on the health benefits of good work, we must also educate them on how to navigate the system so there is a clear understanding of expectations.
Moving onto the workplace rehabilitation providers. Yes, I am one. To my peers, I say this – be better.
My personal caseload is filled with workers who have been misguided, deceived, ignored, and forgotten, not by the claim mangers (whom we often like to blame) but by their previous rehabilitation consultants. Our job is not hard, stop pretending that it is. Our job is to help someone navigate through the system by providing them with the right resources at the right time.
I'm frustrated by a system which does a lot of planning. There are people in the industry who are in motion, doing great work and genuinely supporting the return to work process. SIRA, take the time to talk with them. Their voices are not very loud though, so you might have to listen closely.
It's because of these people, I remain intelligently optimistic. I believe in The Spirit of the System. I believe the system can help people. I've witnessed the positive effects. It just relies on each and every person within the system to be compassionate, collaborative, ethical and to acknowledge their own biases.
These are my opinions, strong but held loosely. I do not represent any organisation other than my own. It's time to start having collaborative and honest discussions about the state our the system with those who live it every single day.
Rhea Mercado | The Intelligent Rebellion Podcast
16 December 2021.