“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