Articles

Navigating RTW Coordination

Gabrielle Lis

From managing interactions with doctors, to writing useful and appropriate file notes, new RTWCs face many challenges. How can organisations help them get their bearings?

In Australia, return to work coordinators (RTWCs) are obliged to undertake two or three days of formal training, depending on jurisdiction. Whilst such training gives people a good grounding in the administrative and legislative requirements of the role, the brevity of the courses means that the majority of learning occurs on the job.

Andrea Jack is the national RTWC at Mirvac, an Australia-wide real estate group involved in investment and development. (She is also responsible for the Health & Safety Environment.) She oversees approximately 40 RTWCs who work in a variety of contexts, including construction sites and office spaces, and has supervised many fledgling RTWCs.

As part of their general return to work approach Mirvac:

  • Recruits RTWCs carefully, looking for individuals with on-the-job experience, a health and safety background, and good interpersonal skills; and
  • Ensures that claims cost is NOT a concern for individual RTWCs, thus freeing them up to focus on the human side of the job. (The financial aspects of RTW / workers’ comp are the responsibility of those who manage the RTWCs.)

Andrea subscribes to RTWMatters, and recently she agreed to speak with us about the challenges fresh-out-of-training RTWCs face. Some common mistakes, along with some sensible solutions, are described below:

  • Alienating doctors;
  • Fudging file notes; and
  • Mishandling psych claims.
 
PAPERWORK JUNKIES VERSUS THE DOC

New RTWCs are often very focused on administrative matters, perhaps because they are confident that they have the necessary skills to handle this aspect of their job. Sometimes, this leads them to prioritise claims’ forms and other paperwork over the human side of RTW coordination.

However, an admin-centric approach is rarely helpful. For successful RTW coordination, people skills are more important than paperwork.

Andrea feels that new RTWCs are more likely to struggle in their communications with doctors than claimants.

Beginning RTWCs (and many more experienced ones too!) frequently feel that GPs and other treating practitioners obstruct, rather than facilitate, return to work.

In some cases, these frustrations may be valid, but RTWCs should bear in mind that doctors see their main responsibility as looking after patients, not employers. An early return to work is not incompatible with patient advocacy, however, doctors are unlikely to respond well to demands.

In fact, a RTWC who takes their frustrations about delayed RTW out on the treating practitioner might reflect poorly on the workplace culture overall, thus making it less likely that the doctor will advocate for return to work.

Andrea identified some specific missteps RTWCs might take in their dealings with doctors, including:

  • Telling doctors how to do their job;
  • Being demanding and directive;
  • Comparing cases, and assuming that workers with seemingly similar injuries will also have a similar timeframe for return to usual duties;
  • Using industry jargon in their communication with the doctor, that the doctor does not understand (just as doctors might use mystifying medical terminology that RTWCs don’t understand); and
  • Writing RTW plans that do not clearly describe the working environment to someone unfamiliar with it, thus reducing the chance that doctors will feel confident in signing them off.

Rather than letting frustration dictate doctor / RTWC communication, it is more helpful to:

  • Be respectful of the treating practitioner’s expertise;
  • Be polite and professional at all times;
  • Use simple, everyday language; and
  • Run RTW plans by a manager or colleague, to ensure that they are clear and adequate.
“HORRENDOUS” FILE NOTES

File notes, Andrea told us, can be “horrendously difficult for people starting out”.

Common mistakes include:

  • Incorporating too much subjective content. For example, “I saw Worker X arrive at work this morning, limping past the supervisor station, but when I saw him later on his break he wasn’t limping at all.”
  • Being too brief. For example, a RTWC might limit file notes to sentence fragments and bullet points. These don’t allow anyone else reading them to get a clear picture of what is going on, and might leave out important information.
  • Using inappropriate language. For example, while it is appropriate to observe “Worker X presented with a low mood today” it is not appropriate to say “Worker X was sulky”.

The tone and content of file notes should reflect the fact that workers are permitted to access their own file. Therefore, file notes should be free of:

  • Opinions;
  • Jokes; and
  • Inappropriate / irrelevant observations.

Observations about emotional states are relevant, however care must be taken to phrase these in a professional and appropriate manner.

PSYCH CLAIMS

Even experienced RTWCs can struggle with the management of psychological injury claims, or instances when psychological difficulties arise as a consequence of a physical problem.

Common difficulties new RTWCs face include:

  • An insufficient understanding of the psychological condition in question, for example simply categorising a worker as “stressed”;
  • Managers / supervisors with responsibility for the injured worker attempting to shift this onto the RTWC, for example, expecting the RTWC to discuss performance issues with the worker; and
  • Feeling reticent about asking for help with a psych claim, even when they know themselves to be out of their depth.

If a RTWC is struggling with a psych claim, they should:

  • Recognise that their uncertainty will show through and that under these circumstances, they are unlikely to achieve good outcomes.
  • Discuss their difficulties with their manager. It may be possible to:
    • Refer the case upwards, to someone more experienced, or outsource it to a rehab provider;
    • Get guidance about appropriate methods for supporting the worker, given the psychological condition he or she is suffering from; or
    • Be given assistance in approaching the worker’s supervisor, to ensure that inappropriate responsibilities are not hoisted on the RTWC.

This article on juggling RTW and performance issues may also be of use.

Thanks to Andrea Jack, for sharing her time and expertise!

Published 04 October, 2010 | Updated 23 June, 2015