“Turn your sick notes into fit notes” Presentation to Goodfellow Symposium Didje Zwart,NZROT Programme Manager, Better@Work 25 March 2012
CERTIFYING CLIENTS FIT FOR WORK
Certifying to assist injured workers to remain at work or return to work as soon
as possible, following injury
TYPICAL BARRIERS
Client
Doctor
Employer
Therapist
ACC
PROCESS
GP sends referral for return to work assistance Referral is triaged by a Vocational Provider Contact is made with client and employer Onsite work assessment is completed (where possible) Return to work plan is formulated Feedback given to GP and ACC via report Certificate clearing for selected duties is essential to enable
a return to work
CASE STUDY
20 year old male Fractured 3rd metacarpal, right dominant
hand Referred by GP Non work injury Warehouse Supervisor/Assistant
WORK SITE ASSESSMENT
Job tasks assessed- picking, packing, computer work, supervisory work
Functional requirements identified Barriers noted Solutions provided Return to work plan formulated
SOLUTIONS AVAILABLE
Negotiation for light/alternative duties
Reduced hours/financial abatement
Reduced productivity
Work trials
Transport assistance
Referral to other services
Ongoing support to client, employer and GP
Discussion with ACC
OUTCOME FOR CLIENT
Returned back to work in timely manner Activities graded appropriately- four week
return to work period Reduced productivity negotiated- two
weeks Liaison with Hand Therapist and Employer Recommendations sent through to GP
CASE STUDY TWO
50 year old female Lumbar sprain Work injury, preventing an elderly resident
from falling Caregiver in a rest home with hospital wing
for palliative elderly clients
BARRIERS
Pain and decreased movement/mobility
Sitting and standing tolerance reported by client at 20 minutes before increased pain in lower lumbar region
Restricted from lifting, transferring and bending
Client worried if injury had “sinister cause” Fearful of relapse or “never getting better” Set on six week recovery period- no work
Employer adamant on full return to work/full hours
Unable to offer alternative/light duties or reduced hours - too difficult with rosters
PROCESS/SOLUTIONS ACHIEVED
Onsite assessment completed
Work tasks/shifts analysed- differences noted
Work trial offered for one - two week period with weekly onsite review by Occupational Therapist
Client agreed, less anxious at thought of work trial and being a “float”
Employer agreed to look at “lighter shifts” and “softened” around possibility of changing shifts
CONCLUSION Key element is certifying fit for work certificate Enables vocational provider to search and
negotiate for light or alternative duties Workplace assessment ideal with all parties
present to allow for open discussion where possible
Onsite follow up essential for sustainable and safe return
Clear time frames and plan set with all parties and forwarded to GP for medical consideration/clearance
Feedback and consultation with ACC