Global Insights: Adopting an Advocacy Approach to Workers' Compensation

Regardless of geographic location, when an injured worker is unfamiliar with the workers’ compensation journey it can be daunting to navigate on their own. It may lead to frustration, fear, disengagement, and further harm to their mental health. There is significant value in employers, regardless of size, communicating clearly and early, providing compassionate care and focusing on the individual’s experience. This proven approach, which is implemented in the United States and replicated across the Australian environment, can significantly improve recovery and return-to-work outcomes for the injured worker and prevents further harm.

Advocacy essentially means doing the right thing: simplifying the process, removing potential conflict during the claims review process, and expediting recovery and a healthy and appropriate return to work. One company may have in-house advocates or safety and wellness departments while another may look to a partner for outsourced support. Small employers may never have interacted in a workers’ compensation scheme and will require a tailored solution to navigate the system and support their employees. Regardless of the path chosen, the strategy must align with the organisation’s culture.

Navigating the pathway

Following a workplace injury there are multiple steps the employer, injured worker and their treating health practitioners must take. An integrated approach is essential to ensure the best care for the injured worker — with multidisciplinary claims, and health and recovery teams coming together. Connecting a range of services (e.g., clinical consultation, case management, pharmacy management and occupational rehabilitation) can quickly remove any barriers and frictional issues, build trust and rapport from the outset, help identify trends and create strategies to improve recovery and return-to-work outcomes in a cost effective and caring way.

Nurse triage and clinical consultation

In the United States, a 24-hours-a-day, seven days a week nurse line is available to provide immediate clinical consultation and support at the critical stage when an injury is first reported. An injury may occur when the worker is alone, or the worker’s supervisor/colleague may be unsure of how to best assist the worker and take control of the situation. A registered nurse will assess the severity and nature of the injury and provide immediate recommendations using evidence-based guidelines. This may include visiting a doctor or another health practitioner or, if appropriate, at-home treatment and self-care. Real-time connectivity allows information to be gathered and shared quickly, including to the case manager — avoiding delays and setting the injured worker and employer up for success.

Taking care of people

Our team recognises the importance of thoughtful action in moments that impact an individual’s world and their families. Ultimately, our goal is to provide the best level of support and care that leads to the best possible outcome. A carefully selected team in Australia, with a strong background and experience in workers’ compensation and injury management, has been working closely with our U.S and other global counterparts to create a tailored, comprehensive workers’ compensation solution for the Australian environment. This model incorporates best practices and proven strategies from the U.S, Australia and other countries across the world.

By Shane O'Dea

Courtesy of Sedgwick

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