The breadth of RTW activities

It has been said that the job of a return to work professional is like being the meat among ingredients that don't want to become a sandwich. The role requires an approach that brings people together, develops cohesion from disparate interests and provides an ongoing bond.

The activities of a return to work coordinator vary. Factors that influence the job make-up include:

1.	The number of cases being managed

2.	The background and expertise of the person in the role

3.	The types of cases

4.	The availability of other people and resources

5.	Other roles the RTW Co-coordinator may have, such as payroll, health & safety etc.

Return to work professionals assist return to work through one or many of the following activities: 1

Employee support

Communication with the employee can occur by phone or in person. Conversations may be brief and to the point, or long and involve getting to know the person, their beliefs and their situation and motivations.

The quality of the relationship between the RTW professional and employee is paramount. If the employee does not trust the RTW professional, success is less likely and communication will be thwarted. If the employee has confidence the relationship is frank and for their benefit, communication will be more open.

Effective RTW Co-coordinators may provide employee support by:

Clarifying the role of RTW Co-coordinator to the worker

Meet face-to-face with the worker early on

Respond to individual concerns of the worker

Discuss the possibility of modified work with the worker

Assessment of workplace psychosocial stressors

Review pain and function diary with the worker

Advocate and express concern for the worker's well-being

Ensure the administration of any claim progresses without delay

Facilitate resolution of pay concerns or problems

Educate the employee about the compensation system: pay rates, system requirements, the need to attend appointments

Assist to provide the worker with training and instruction at the worksite

Assist with return to work on restricted duties

One of the core roles of the RTW professional is to assist the employee to be at work on appropriate duties. Setting up a productive return to work may be simple or difficult. Much depends on the attitude of those involved. Appropriate duties are productive and meaningful tasks, supported by good levels of communication between all parties. Some flexibility with the tasks make a major difference to outcomes.

Effective RTW Co-coordinators may assist return to work on restricted duties by:

Discussing accommodation requests with supervisor

Review physician restrictions with the worker

Query supervisor on specific job tasks and activities

Query worker about ways he/she performs job tasks

Direct observation of work tasks

Brief ergonomic assessment of physical risk factors

Conduct a formal ergonomic job analysis

Facilitate agreement on acceptable accommodations

Develop a plan for work modifications

Develop a return to work plan

Resolve differences in plans from multiple providers

Obtain organisational support for job modifications

Follow-up or post the RTW ergonomic evaluation

Assign responsibilities to implement job modifications

Communication with others

Reliable and effective lines of communication between the employee and employer are key elements of success in return to work

Communication styles and activities play a large part in return to work outcomes. Certain circumstances call for a simple brief conversation. Other circumstances require the RTW professional to deal with difficult people, difficult times, engage senior managers and work to influence health professionals. The RTW professional may need to talk to the supervisor to achieve a dramatic change in approach.

RTW Co-coordinators communicate effectively through:

Enhancing positive communication that influences and brings people together.

•	A conversation about an action, such as arranging an appointment

•

Listening

•	Developing trust

•	Influencing

•	Coordinating

•	Seeking input or providing feedback

Activities to improve communication between those involved in return to work:

•	Reliable and effective lines of communication between the employee and employer are key elements of success in return to work

•	Meet on-site with the worker, supervisor, and stakeholders

•	Meet with health & safety personnel to discuss case

•	Collective brainstorm of possible solutions

•	List/prioritise perceived problems or barriers

•	Generate written report with recommendations

Treatment

A proportion of RTW professionals get involved with the employee's treatment. The RTW professional is NOT the person's treater, but can work to ensure the employee is confident in their treatment, is receiving quality evidence-based care and delays are avoided.

Effective RTW Co-coordinators may assist the employee to receive treatment by:

•	Facilitating early access to high quality medical care

•	Ensuring delays in treatment are avoided

•	Encouraging the employee to be an active participant in their own health care

•	Arranging access to on-site physiotherapy in the workplace

•	Facilitating access to on-site physician

1 Modified from Shaw W, Hong Q-n, Pranksy G, Loisel P. A Literature Review Describing the Role of Return-to-Work Coordinators in Trial Programs and Interventions Designed to Prevent Workplace Disability. Journal of Occupational Rehabilitation. 2008;18:2-15