Get information on Stay at Work – a service designed to keep injured workers in the workplace, so they can lead their normal life – why it’s a good idea for some people who are injured to stay at work – and the team of health providers who work to ensure it all goes as planned.
Mostly, when someone is injured all it takes for them to recover in the workplace are minimal changes to their duties and perhaps physical support to enable them to get on with their job. These can usually be arranged between the injured worker and the employer.
If there are obstacles preventing this from happening, such as pain, the attitude of family members, or employer to having a partially fit person in the workplace, it can take more than that. Sometimes a ‘broker’ needs to arrange the support required to recover at work.
ACC’s Stay at Work approach provides this service. It brings together the people most involved in an injury – to work out how to help the injured worker recover in the workplace.
International research clearly shows that, particularly for musculo-skeletal disorders such as sprains and strains, staying at work promotes quicker, more effective rehabilitation for the injured worker, and financial and productivity benefits for the employer.
The nationwide Stay at Work service is delivered by multi-disciplinary providers to whom clients are referred by ACC. It uses a team approach to help people recover from injury in the workplace. The key members of the team will usually include:
- the Stay at Work service provider, eg occupational health nurse
- the client and their family/whanau
- the GP and any other health professionals, eg physiotherapists, occupational therapists, involved with the client’s recovery
- the client’s employer.
Every case is different, so there will be no ‘one size fits all’ solution. The Stay at Work service provider works with everyone involved to find solutions that help the injured worker recover at work.
Generally, the Stay at Work service provider:
- establishes a clear picture of the injury, what activities the injured worker can and cannot do safely, and whether there are barriers preventing recovery at work
- works with the team to put in place support needed by the injured worker to recover from their injury at work. This could involve:
- a period of reduced work hours
- alternative duties
- physical aids
- suitable travel options
- helping the employer make temporary modifications to the workplace – all designed to keep the injured worker in the workplace, leading their normal life.
International research shows that injured workers recover faster and more effectively if they maintain contact with their workplace and their normal working routines, where it’s possible to do so. This can bring benefits to everyone.
‘Common sense evidence abounds that keeping people productively employed is good for them and society’ - American College of Occupational and Environmental Medicine, (2006). Preventing Needless Work Disability by Helping People Stay Employed.
Benefits for the employer include:
- playing a key role in helping your employees (who are vital to your business’ success) recover faster after injury
- retaining the skills and knowledge of your injured worker in the workplace
- lowering the costs of lost productivity
- lowering the costs of training new staff to cover the role
- helping morale in your workplace by showing employees’ wellbeing is important
- lowering Work levies through the experience rating framework.
Benefits to the injured worker include:
- getting back to an everyday life faster
- having less time on reduced income
- maintaining social contacts, confidence, motivation and health.
‘For most people their work is a key factor in their self worth, family esteem and identity. So if they become sick and are not helped quickly enough, they can all too easily find themselves on a downward spiral into long term sickness and a life on benefits’ – Black, Dame. C. (2008). Working for a Healthier Tomorrow. The Stationary Office, UK
Benefits to levy payers include helping to limit scheme costs and maintaining the sustainability of the ACC Scheme.
Benefits for the treatment provider include helping patients recover faster and more effectively after injury.
‘The advice and management given in primary care has a major and lasting impact on the individual’s (and their family’s and employer’s) beliefs about the health condition and how it should be managed’ – Waddell, Burton, and Kendall (2008). What Works, for Whom, and When? Vocational Rehabilitation, The Stationary Office, London.
Musculo-skeletal disorders are one of the most common reasons for time off work due to injury. There has been a significant change in the effective treatment and management of these disorders.
Treatment approaches that emphasise rest, avoiding activity, and the role of passive treatment are outdated and no longer considered appropriate. There is now strong evidence that the most effective method to manage back pain, for example, is to maintain as much activity as possible including work (although with temporary modifications when necessary).
The following extract on stay-at-work myths and realities presents the reasoning behind the Stay at Work programme:
Workers must be able to do 100% of their job or should be 100% fit and pain free before going back to work.
People can, and do, work before they are 100% recovered; many people with musculo-skeletal disorders do not take time off work. Functional ability is regained gradually – being at work can help that process.
Workers who come back to work risk re-injury and have a longer absence/bigger claim.
There is no evidence that returning to work increases the risk of re-injury. In fact, early return to work can be therapeutic, and tends to reduce the risk of long term incapacity. In most circumstances work is beneficial for general health and wellbeing, which can aid recovery.
It’s not the employer’s problem. Healthcare providers, not employers, are responsible for getting the worker back to work.
A cooperative, integrated approach is needed, with all players (ie employee, employer, healthcare provider etc) involved.
Workers must be given ‘light duties’ on return to work.
So-called ‘light duties’ are often not needed – many people can and do return to their normal job. However some will find that too taxing and can be helped to get back by simple modification to their normal job (eg reduced hours, longer breaks or help with heavy tasks).
Modified work should be seen as temporary, with the sole purpose of helping the worker get back to normal work as soon a possible, building up to normal tasks over short set period of time (eg a week or two).
The need for modified work and its precise form must be discussed and agreed between the worker, line manager, and co-workers (perhaps with input from the health professional).
A GP’s medical certificate means that the employee can’t work in any capacity.
A medical certificate is the means for becoming eligible for sick pay or ACC weekly compensation; it is not an obligation on the individual to be off work.
Through consultation, the employer, the individual and the GP together can decide whether the individual is capable of work (with temporary modifications if necessary).
The sick note or medical certificate can be used as a ‘fit’ note – the doctor can state what the individual can do rather than what they can’t.
It’s the GP that determines whether someone can go back to work.
The GP has a key role in certifying for work readiness, but this is often a purely clinical decision without reference to the availability of broader support. Once this support is identified, which is what ACC’s Stay at Work service does, it’s possible to make good decisions about what the person can do at work, rather than what they can’t do.
Workers will always want to stay off work as long as possible.
There is no evidence that this is the case. Most people want to get back to work as fast as possible, and steps taken by the organisation to support this are generally welcomed.
The employer should not contact an individual who is absent, since it will be seen as harassment and it will have a detrimental effect on the individual’s health; total disengagement from work is needed to recover fully.
Contact with the workplace (visits, phone calls from colleagues; and phased return to work) are the best measures for ensuring full return to work, and helping people integrate back into the workplace; this is seen as the employer showing care and concern.
Source – adapted from The costs and benefits of active case management and rehabilitation for musculoskeletal disorders - Hu-Tech Associates Ltd for the Health and Safety Executive 2006, UK.
You can find more information about the benefits of workplace rehabilitation on this Australian website, which summarises the benefits for workers, employers and treatment providers: www.rtwknowledge.org.
A Stay at work fact sheet (PDF 40K) is also available.
Reviewed: 19 February 2016
Updated: 13 March 2014