Central West Health & Rehabilitation
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What should you do if a worker claims their work is unsafe to perform? Oct 15th, 2014
A worker who refuses to perform work because of genuine safety concerns cannot be liable for industrial action.

If a worker complains of a safety risk in the work they perform, undertake the following steps:

  1. Ask the worker to identify the hazard and the risk it poses;

  2. Control the risk by eliminating the hazard or implementing risk controls; and

  3. Ensure workers are fully trained in the new work procedures.

If the hazard can’t be controlled, stop the process if possible and consider what alternative safe work you can offer workers.

If a union threatens industrial action in relation to a health and safety concern, notify the union of the steps you have taken and engage them in any dispute resolution processes you take.

If the worker has a health and safety representative or if your workplace has a health and safety committee, they must also be included in the dispute resolution process.


Next- What if the issue is difficult to fix?

Work debate spaces: Improve safety practices with employee input. Oct 15th, 2014
In daily work, there will always be situations that are either not covered by the rules or in which the rules are locally inapplicable. To foster participatory approaches in safety it is necessary to develop means to consider the actual organization and interactions among workers.

Safety relies on the ability of workers to assess the applicability of procedures and adaptations to carry them out. In order to progress, it is necessary to consider the safety approach as adaptive, dynamic, and developmental. Although the concepts around the development of a safety and safety culture are well developed, tools and methods that enable practitioners to ensure that the system in which they work are resilient and able to bounce back quickly to errors or other unexpected events are required.

Participatory approaches may play a key role. But how to develop participatory approaches that articulate the formal and the living organization? A possible way is the discussion and confrontation of points of view between different stakeholders of the organization around elements of the real work.

Work debate spaces (WDS)

To foster participatory approaches in safety it is necessary to develop means to consider the actual organization and interactions among workers. These are concepts developed by the approaches ‘Strategizing’ and ‘Work of Organization’.

Strategizing: This approach integrates the routines of meetings, discussions, or data processing in the definition and implementation of a ‘strategy’. It is important that the strategic issues of the organization are not decided and imposed by the leaders, but rather are the result of a daily construction with all stakeholders of the organization.

Work of Organization: This approach describes a living organization: occupational rules are developed by the employees in order to mitigate the defects of the formal organization, and to develop safety.

Both approaches consider an organization defined simultaneously by the leaders and by local and temporary regulations constructed by employees in the field. The questions they raise are needed to feed the managerial and strategic levels of the organization.

Articulating safety challenges is only possible with a working group to identify the situations that are particularly difficult to manage, to discuss them within the organizations and to propose changes.

WDS's are a time for discussion. The group advocates the discussion of work on a regular and protected basis, coordinated by a manager who does not belong to the direct hierarchy (e.g. Health and Safety Representatives). This method acts as a medium that deals with all the arrangements, compromises and adaptations that are required for safety system changes.

WDS permit not only the improvement of safety, but also help develop the competences of the employees, management and HR department with the bigger picture realities of health and safety. It allows safety to move beyond the traditional perimeter of the retrospective analysis of dysfunctions, and enter in learning dynamic starting with field situations. It allows the development of safety by different levels in the company, and progresses the organization beginning with experiences within the organization itself. This permits the development of an enabling environment for safety

It is necessary that the executive committee be engaged in the process by supplying the technical, organizational, and human means so that the WDS can be instigated. A preliminary phase is necessary, based on observations and interviews with workers, to engage the elements for the development of the WDS. Within these spaces, some conditions are defined so that people can experience the improvement proposals: a discussion based on real work activity, a joint elaboration and evaluation of solutions based on a dynamics of confrontation. 


Sick leave patterns in common musculoskeletal disorders Oct 14th, 2014
Musculoskeletal disorders (MSDs) are the most common causes of severe long-term pain and physical disability and have a major impact on society.

Sick leave is an important public health problem with both social, economic and health related consequences for the individual as well as social and economic consequences for society, and MSD’s are one of the most common reasons for work disability and sick leave.

20 251 sick leave periods were issued for 16, 673 with a mean (SD) age of 43. The main purpose was to give a descriptive overview of sick leave patterns in different diseases within the group of MSDs, including all doctors prescribed sick leave. The aim was to get comparable estimates of duration, age and sex distribution and patterns of recurrent sick leave for the different subgroups.

Adjusted for age, the mean number of days per sick leave period was 26 days for low back pain and 27 days for myalgia (i.e. other soft tissue disorders not classified elsewhere). Disc disorders and rheumatoid arthritis had the longest periods with a mean of 150 and 147 days respectively. For hip and knee osteoarthritis the mean was 81 and 116 days respectively

The distribution of number of sick leave periods, over age categories, and between men and women, was different for the different disease groups. For back disorders, the total number of sick leave periods was highest in the age groups 40–44 and 45–49, with a similar pattern for women and men. The number of sick leave periods for knee and hip osteoarthritis peaked in the older age groups with a predominance of men in the hip osteoarthritis group.  Myalgia had a more even distribution over the age categories with similar patterns for men and women.

25% had more than one sick leave period during the two years. Out of the six studied disease groups, individuals with rheumatoid arthritis had the greatest share of recurrent sick leave periods (34%) despite also having a greater share of long sick leave periods. The other conditions with typically long sick leave periods, e.g., disc disorders and hip osteoarthritis, had less recurrent sick leave (15 and 18% respectively), while typical conditions with short sick leave periods, e.g., back pain and myalgia, had more episodes of recurrent sick leave.


Exercise and start talking: tips to help improve FIFO workers’ mental health Oct 13th, 2014
FIFO workers are being urged to implement six simple strategies in order to stay mentally healthy.

Avoiding the wages trap, keeping the lines of communication open and staying physically fit are among the steps workers can take to improve their mental health, according to industry support group Mining Family Matters.

Numerous studies into the wellbeing of FIFO workers has found stress, anxiety, divorce, drug and alcohol use and a sense of helplessness are prevalent among the workforce.

A study last year by Lifeline WA and Edith Cowan University psychologists, found a number of issues affecting FIFO workers’ mental health. In August the West Australian parliament unanimously backed an inquiry into the link between FIFO mining rosters and suicide.


Mining Family Matters has suggested the following strategies:

  1. Be honest about how you're feeling and tackle problems as a team. Many problems that arise are symptoms of the FIFO lifestyle, rather than relationship problems.

  2. Set shared goals.

  3. Don't assume that your life is tougher than your partner's. (Life is not a competition - you're both exhausted.)

  4. Get financial advice to ensure good wages are saved and invested wisely, instead of being trapped by large debt.

  5. Exercise regularly - it will improve the health of both body and mind.

  6. Try to keep the lines of communication open when you're apart (and if you don't feel like talking, explain why in a loving way).


Video - Wheelchair Basketball Fitness Circuit Oct 11th, 2014

Video - Diabetes ABCs Oct 9th, 2014

So what can we include in a worksite health promotion program? Oct 9th, 2014
Worksite health promotion programs should be developed to suit the nature of your business and the needs of your workers. Therefore, a health promotion program that fits one company will not necessarily fit the next.

So what can you include in your health promotion program?

Some options are easy to implement, others take more time and resources. Here are a few examples of what you could do in your workplace:

  • develop health and safety policies and procedures that have a commitment to the wellbeing of your workers at their core;

  • create a supportive working environment where a work/life balance is promoted;

  • encourage positive social interaction and personal skill building in your workers through social events and participation;

  • always provide non-alcoholic options at work-related functions and educate your workers on alcohol and drug misuse;

  • inspire your workers and encourage learning with workshops and guest speakers during lunch breaks;

  • provide health services to workers such as physical health checks, eye tests, flu vaccination,  

  • provide access to a range of health resources, including specialist information from external agencies;

  • create awareness by holding seminars on issues such as stress management, healthy eating or quitting smoking;

  • provide showers, changing rooms and bicycle racks to aid and encourage a physical activity for your workers' commute;

  • organise a corporate rate for your workers to join the local gym;

  • provide filtered water and facilities for preparing healthy lunches;

  • provide access to counselling for smokers who want to quit; and

  • encourage participation in a organised community events such as fun runs.

Remember, the level of resource commitment your business makes to these kinds of programs is up to you – there is no right or wrong answer but the most important thing to remember is that when your workers are feeling good they will be performing well and that has many benefits for your business.


The most effective worksite health promotion program Oct 9th, 2014
These are tips that will assist you in making the most effective worksite health promotion program you can. Use them alongside the 8 steps to an effective health promotion program, and you will be halfway there!

An effective health promotion program will do the following:

  • Be coordinated by a person with the necessary skills and resources to commit to the project.

  • Have the long-term commitment of the company (workers, management, directors) to achieve long-term results.

  • Be integrated with the operations of the company.

  • Have the capacity to adapt when the needs of the business or its workforce change.

  • Be available to everyone in the company.

  • Involve consultation between managers and workers to guide the direction of the program.

  • Use resources within the workplace, as well as those available outside the workplace (such as community resources), to reduce the cost of the program.

  • Be a mix of low-cost strategies with higher-cost and commitment strategies.  

  • Reinforce and support the company health and safety plan.

  • Use external experts and agencies for addressing specific problem areas within your business, e.g. quitting smoking.

  • Involve senior management participation in the activities, exercises and strategies that make up the program.

  • Be promoted to workers to:

  • encourage participation voluntarily;

  • increase understanding of the program and its advantages; and

  • increase awareness and involvement in improving the program.

  • Demonstrate the benefits of working with the company to potential workers.

  • Not look down upon workers for not participating.

  • Be reviewed regularly and reported back to senior management.

Remember, there are many factors that can affect a person’s health and well-being, both physically and psychologically. Some of these factors will exist within the workplace, e.g. relationships with colleagues, working environment, level of job satisfaction, and some of these factors will exist outside the workplace, e.g. personal relationships, living conditions, lifestyle choices.


Central West Health and Rehabilitation can provide cost effective assistance. Contacts


Work disability among workers with knee arthritis Sep 22nd, 2014
The prevalence of knee osteoarthritis (OA) among individuals active in the workforce will increase considerably in the next generation and a significant percentage of these individuals are expected to experience work disability because of this disease.

Knee OA is responsible for prolonged sick leaves and early retirement in a small percentage of workers; however, many workers will have the disease for a long time and remain active in the workforce, not achieving their optimal productivity. Knee OA seems to affect partial work disability or ‘presenteeism’, defined as the loss of work productivity in terms of quantity or quality because of an illness or an injury in individuals who are present at their job, rather than absenteeism.


The above review was to summarize the existing knowledge on:

(a) work disability risk factors;

(b) efficient interventions to reduce work disability in individuals with knee OA.


Risk factors

The only study (Bieleman et al., 2013) that answered the research question on work disability risk factors provided data from a large-scale prospective cohort of good quality. On the basis of this study, age and previous work absence episodes can be viewed as predictors of work disability for OA patients. Bieleman et al. mainly focused on physical personal factors; however, it is now well established that psychological factors such as perceived job strain, social support from co-workers and supervisors, job satisfaction, and self-efficacy influence work participation among individuals with RA and other MSK disorders. Work environment (physical work demands, work adaptation) could also play a major role.



Only two studies on work disability intervention were found, the results of these studies converged to conclude that compared with standard care interventions, education-based interventions seemed to be more effective in reducing work disability.


Excessive occupational sitting is not a “safe system of work” - Is it time to implement risk control strategies Aug 29th, 2014
graphicBeing able to work usually has a positive impact on health. However, changes in the physical demands of work and increased use of computers have led to many workers now being employed in sedentary jobs. While these have traditionally been thought of as safe work environments, recent evidence suggests this mode of work — often involving long uninterrupted periods of sitting — may be hazardous, contributing substantially to the growing chronic disease burden associated with obesity, diabetes, cardiovascular disease and cancer.

Importantly, being sedentary (ie, too much sitting) is not the same as being physically inactive. Insufficient client physical activity is defined in the public health context as not meeting the guidelines to accumulate at least 2.5 to 5 hours of moderate-intensity physical activity per week. Both physical inactivity and sedentary time have an impact on health: physical inactivity is estimated to account for 5.5% of all-cause premature mortality, and excessive sitting time, after adjusting for physical activity, accounts for 5.9%.

Even if workers meet physical activity guidelines (i.e. are physically active), they can still have high exposure to sedentary time!

Work health and safety laws in Australia and other jurisdictions require employers to provide a "safe system of work". For example, section 19 of the Work Health and Safety Act 2011 states that the "primary duty of care" is to "ensure, so far as is reasonably practicable, the health and safety of workers" by, among other things, "provision and maintenance of safe systems of work".

This has lead a number of experts voice the following (Straker et al, 2014):

a) the systems of work commonly observed in contemporary offices demonstrate a high likelihood of excessive sitting hazard;

b) the degree of harm associated with this hazard is likely to be substantial;

c) the evidence for this is now widely known;

d) there are available ways to minimise the risk; and

e) the cost of these strategies is proportionate to the risk.

For these reasons many advanced organisations are implementing risk control strategies. Some risk reduction strategies, such as introducing standing meetings, are costless, while other strategies have a cost. Changes to work systems can reduce sedentary time. Alterations to the individual physical environment (eg, sit–stand workstations or active workstations) and combined approaches (including individual, environmental and organisational changes) have achieved substantial reductions in total occupational sitting time and prolonged unbroken sitting time.

In an aging population, those organisations that don’t may find themselves having to catch up as legislation and Health Professionals start to recognise available evidence suggesting contemporary offices are failing to provide a “safe system of work” for their patients.

For example, Doctors should be prescribing behaviour to reduce occupational sedentary exposure where this may exacerbate, or be exacerbated by, an existing medical condition. A doctor who is aware that a patient has a prolapsed disc in the spine would require the patient to refrain from lifting heavy objects at work. In the same way, a doctor who is aware that a patient’s cardiovascular condition necessitates remaining active and avoiding excessive sedentary exposure should inform the patient and employer of the need for the patient to regularly move to maintain wellbeing!


Strategies to help you stand up, sit less and move more Aug 29th, 2014
Many advanced organisations are implementing strategies to reduce prolonged sitting. Some risk reduction strategies, such as introducing standing meetings, are costless, while other strategies have a cost. Changes to work systems can reduce sedentary time. Alterations to the individual physical environment (eg, sit–stand workstations or active workstations) and combined approaches (including individual, environmental and organisational changes) have achieved substantial reductions in total occupational sitting time and prolonged unbroken sitting time.


Here are 12 strategies to help you stand up, sit less and move more

  1. Walk over and talk to colleagues instead of emailing them.

  2. Remove bins and/or printers from your office and use central ones.

  3. Dispose of waste and/or collect printing more frequently.

  4. Drink more water so you have to go to the water cooler (and bathroom) more often.

  5. Use a bathroom that is further away.

  6. Step outside for fresh air.

  7. Use the stairs instead of the lift.

  8. Use an active way of commuting to work (walk or ride a bike, stand up in the train, or stand up to wait for your train/bus).

  9. Park your car further away from your workplace and have a short walk, or park in short-term parking so you have to walk back to move your car.

  10. Have lunch away from your desk.

  11. Walk laps of the floor at regular intervals to break up the day.

  12. Walk around the neighbourhood at lunch. You can mark out two or three timed walking routes to fit into your working day and promote variety.


Scientists Discover Area of Brain Responsible for Exercise Motivation Aug 27th, 2014

Scientists at Seattle Children’s Research Institute have discovered an area of the brain that could control a person’s motivation to exercise and participate in other rewarding activities – potentially leading to improved treatments for depression.

Researchers have discovered that a tiny region of the brain – the dorsal medial habenula – controls the desire to exercise in mice. The structure of the habenula is similar in humans and rodents and these basic functions in mood regulation and motivation are likely to be the same across species.

Exercise is one of the most effective non-pharmacological therapies for depression. Determining that such a specific area of the brain may be responsible for motivation to exercise could help researchers develop more targeted, effective treatments for depression.

Changes in physical activity and the inability to enjoy rewarding or pleasurable experiences are two hallmarks of major depression. But the brain pathways responsible for exercise motivation have not been well understood. 

The study used mouse models that were genetically engineered to block signals from the dorsal medial habenula. Compared to typical mice, who love to run in their exercise wheels, the genetically engineered mice were lethargic and ran far less.

In a second part of the studye, the mice could “choose” to activate this area of the brain by turning one of two response wheels with their paws. The mice strongly preferred turning the wheel that stimulated the dorsal medial habenula, demonstrating that this area of the brain is tied to rewarding behaviour.

Factors influencing return to work after hip and knee replacement Aug 27th, 2014
Hip and knee arthritis causes significant problems in the working-age population and can lead to a reduced quality of life, change in employment or unemployment. The 10th National Joint Registry reported that 18–20% of patients undergoing hip and knee replacement in England and Wales were under the age of 60 years (NJR. National Joint Registry for England and Wales 10th Annual Report, 2013. www.njrcentre.org.uk)

Heavy lifting and bending have been reported as important factors in the development and progression of arthritis. The effect of arthritis on employment depends on the type of work usually performed, with manual or lifting jobs associated with increased levels of unemployment due to arthritis. In addition to a loss of employment, arthritis has also been associated with a prolonged sickness absence or a change in the type of work performed.

Studies have quantitatively assessed the role of surgery in returning the patient to work after joint replacement. Joint replacement may enable patients to continue working, which may be more cost-effective in the long term as patients remain economically productive members of the society. However literature is sparse regarding factors affecting return to work after knee or hip replacement.

The above review of qualitative and quantitative literature aimed to address the following questions (See table 2):

1) What are the employed patient’s expectations from a joint replacement before and after surgery?

2) Who is most at risk of not returning to work after joint replacement surgery?

3) What external factors are important to help patients return to work?

4) Does age of the patient determine their ability/motivation to return to work?

5) Are patients able to return to work at the same level? 

Infographic - Sitting and Injury Aug 24th, 2014

Infographic - Coffee, Alcohol, Water Aug 22nd, 2014

Infographic - Injury First Aid Aug 18th, 2014

Hypoglycemia Aug 5th, 2014
handoutgraphicHypoglycemia is a condition that occurs when the blood glucose level has dropped too low, usually below 4mmol/L, although some people may have symptoms at a slightly higher level. Hypoglycaemia is commonly referred to as a ‘hypo’, low blood glucose or insulin reaction. It is important to treat hypoglycaemia quickly to stop the blood glucose level from falling even lower.

Hypoglycaemia is most common in people who inject insulin or are taking tablets to manage their diabetes. It is not a problem for those who do not take medication to manage their diabetes. Talk to your doctor or trusted health professional (diabetes educator, exercise physiologist, pharmacist etc) to find out your risk.


Video - Blood Presure Aug 4th, 2014

One in five serious workplace injuries involve a tradie Aug 2nd, 2014
graphicAustralia's hundreds of thousands of tradies may enjoy the outdoors, but it does come at a price with one in five of all serious workplace injuries involving a tradie.

Startling figures from the Australian Physiotherapy Association's latest health report, released today, show tradies have among the highest number of injuries, musculoskeletal conditions and other health and safety risks of any profession. Many from smaller businesses who are harder for national health and safety initiatives to reach.  

Released as part of Tradies National Health Month, the Stop Trading Your Health Away report shows nearly one in five serious workplace-related injuries involve a tradie, making them one of the most affected professions in Australia.

Musculoskeletal health costs $20.9 billion annually in direct health and lost productivity costs in Australia.

Within the industry, construction workers are currently claiming 34 per cent of workers’ compensation claims. More than half of these claims were related to muscular stress while handling a range of materials, tools or other equipment.

Tradies are also among one of the largest proportions of occupations with the highest incidence of early retirement. Statistics show that tradies are 35 per cent to 50 per cent more likely to retire before the age of 60 compared to professional workers.



Is Manual Handling Training Worth it?

Video - Nerve Pain Aug 1st, 2014

Video - Phases of Pain Jul 31st, 2014

Case Study - Concord General Hospital, Sydney Jul 27th, 2014
grphicEmployers, insurers and workers’ groups have expressed a growing interest in return-to-work (RTW) interventions after injury or illness. As disability management is increasingly being integrated into employers’ and insurers’ mandates, there has been a focus on workplace-based RTW interventions.

Some injuries take longer to heal due to the nature of the injury and management. We have generally found three types of disability groups have come to light over the years.

The first is the short duration claim where the patient has a well-defined acute episode (i.e. flu, strain or sprain). These cases will return to work often with minimal intervention.

The second (and often most difficult) group represents the patients with sub-acute or progressive diseases or injuries. This population often needs help with ensuring the medical interventions are enough to progress back to health. They may need help in finding their way through the health care maze and psychosocial issues can be a major barrier to RTW.

The third group are those with terminal or debilitating diseases, such as Chronic Pain, Cancer or Multiple Sclerosis, that may eventually prevent return to work.

Concord General Hospital in Sydney is a self insurer, who in 2003-4 found themselves with a huge number of open claims (~300), and a spate of very difficult cases who went on to have chronic pain syndromes. The organisation felt they were failing injured workers and that something needed to change.

The initial step was to change their existing rehabilitation policy. They developed a database to track workers from notification to finalisation. They developed resources such as suitable duties lists for a majority of departments, and increased the role of managers in the rehabilitation process. They also took steps to increase the level of communication by having regular meetings between supervisors and managers of major departments to review claims and provide comparative data.

The consensus was that the first 4 weeks after an incident/injury was the answer, – after that you start to lose control! They instigated a rapid assessment and early intervention process, which included an assessment psychosocial risk (i.e. Yellow Flags). The idea was that high risk individuals needed to be identified in the first week/s. Nothing different needed to be done; only it needed to be done earlier. It was also important that the GP was in control of the whole process through consultation and approval.

The first question to answer was; “can these high risk individuals be found early, and if so, do they actually costs more?” Injured workers filled out a psychosocial risk questionnaire and were followed through until they returned to work with a final certificate. Each injured worker was categorised and claim costs were reviewed and compared across the high, medium and low risk groups.

The answer to Question 1 appeared to be a resounding YES! (see image)

The next question was then “what can be done about it?” Concord’s approach was to; (a) activate an independent Vocational Rehab Provider within first 2 weeks; (b) complete an independent psychological assessment, and subsequent treatment within 2 weeks; (c) complete an independent Medical Consultation within 4 weeks; (d) have the file reviewed if not returned to work within 4-6 weeks.

The emphasise of the above approach did not appear to do anything different to what usually happens, it simply did it much earlier in the management process.

The results were quite impressive; primarily there was a 25% reduction in the costs of each ‘high risk’ claim. This equated to a $4331.00 saving per high risk claim. (see image)


There is a significant difference between the 20% in the “high risk” category and the other 80% who manage pretty well with ‘usual care’.

Psychosocial risk factors (i.e. ‘Yellow Flags’) predict the cost of a workers compensation claim within 48 hours regardless of what or where the injury occurs.

The provision of an early and aggressive assessment and intervention, lead by a trusted GP can reduce costs in high risk claims.

Vocational Rehabilitation - What do they do? Jul 26th, 2014
Approved Vocational Rehabilitation Providers (Voc Rehab) can assist an injured worker if there are problems with the return to work process. Voc Rehab providers are commonly health professionals such as occupational therapists, physiotherapists, exercise physiologists or psychologists who ‘generally’ have expertise in addressing the physical, psychological and/or workplace barriers that may prevent an injured worker returning to work.

Workplace rehabilitation providers are approved by WorkCover WA and have the qualifications, experience and expertise appropriate to provide timely intervention with services based on the assessed need of the worker and the workplace.

GraphicWhat does a workplace rehabilitation provider do?

A voc rehab provider is essentially an injury management co-ordinator. Voc Rehab will attempt to deliver an appropriate professional return to work program when the situation requires an external provider (see below).

If an initial assessment indicates that rehabilitation services are recommended, the rehabilitation provider must discuss the findings of the assessment with the employer, the injured worker and the treating medical practitioner.

The rehabilitation provider should give a copy of their plan to the injured worker, employer and treating medical practitioner. The insurer should also receive a copy of the service plan; in most instances, the insurer will provide approval for payment of rehabilitation expenses as part of the claim.

In all circumstances, employers should remain the workplace decision maker regarding return to work activities.

What rehabilitation services may be recommended?

Rehabilitation providers can provide any of the following services in helping workers return to work:

- support counselling

- vocational counselling

- purchase of aids and appliances

- case management

- retraining criteria assistance

- specialised retraining program assistance

- training and education

- workplace activities

- placement activities

- assessments (functional capacity, vocational, ergonomic, job demands, workplace and aids and appliances)

- general reports

When should a workplace rehabilitation provider be engaged?

The worker is unable to carry out pre-injury duties and there is a need to identify alternative or modified duties with either the same employer, or with a new employer.

There is a need to complete a practical assessment of a worker’s capacity to return to work (for example, when there are conflicting opinions of the worker’s physical or psychological capacity to return to work; or there are reports of ongoing symptoms when the worker is at work).

The worker is experiencing problems associated with returning to work (for example, personality clashes with worksite injury management staff.).

Modifidations are required to the workplace are being considered to assist the workers return to work (for example, special lifting equipment or special seating arrangements).

There is a need to assess the suitability of a return to work program with a new employer if this is identified by the injured worker, employer and treating medical practitioner as the new rehabilitation goal.

There is a need to determine whether retraining is likely required. (back)

Case Study: Concord Hospital

Who pays for a workplace rehabilitation provider?

Vocational rehabilitation providers are approved by WorkCover WA and their costs are covered by the Prescribed Amount in every workers’ compensation claim. Costs may vary according to the services they provide, but the maximum amount they can charge is determined by WorkCover WA and reviewed annually. These costs will add to your yearly claim costs, used to determine your insurance premiums.

How to activate a referral to a workplace rehabilitation provider?

GraphicAn injured worker, employer or treating medical practitioner can initiate a referral to a workplace rehabilitation provider - see the list of Approved Vocational Rehabilitation Providers. However, to comply with their conditions of approval, the provider must ensure all parties agree to the referral for rehabilitation services.

A referral may be completed on the Workplace Rehabilitation Referral Form or may be made on the worker’s First or Progress Certificate of Capacity.

Note: Injured workers have the right to choose their vocational rehabilitation provider, even when the referral is made by a medical practitioner or employer.

August is Tradies National Health Month Jul 25th, 2014

Throughout the month of August the APA and Steel Blue will run Tradies National Health Month – a health awareness campaign to educate tradies on the importance of full body health and safety. The Australian Physiotherapy Association and Blue Steel have teamed up to create a month that focuses on full-body health and safety for tradies to improve awareness and support in this area.

Click the Link below to Play the Game - Pain Breaker



These organisations have also developed a wide array of great handouts and resources, which we have provided to help Tradies look after their minds and bodies. A few are provided below, many more are avaliable at the website.

graphic graphic 

graphic graphic


Return to work following Shoulder Surgery Jul 24th, 2014
shoulder imageRotator cuff tears are a common shoulder problem affecting more than half the population older than sixty years of age. Surgery may be used to treat a rotator cuff disorder if the injury is very severe or if nonsurgical treatment has failed to improve shoulder strength and movement sufficiently.

Surgery to repair a torn rotator cuff tendon usually involves; (a) removing loose fragments of tendon, bursa, and other debris from the space in the shoulder where the rotator cuff moves (debridement); (b) making more room for the rotator cuff tendon so it is not pinched or irritated. If needed, this includes shaving bone or removing bone spurs from the point of the shoulder blade (subacromial smoothing); (c) sewing the torn edges of the supraspinatus tendon together and to the top of the upper arm bone (humerus).

Acevedo etal, 2014 attempt to determine common clinical practices among 372 shoulder and elbow surgeons with regard to rotator cuff repair and management, including return to work practices. 89% of the surgeons surveyed suggested dedicating over half of their practice to the treatment of shoulder pathology.

Regards Healing Rates

Half of surgeons suggested 80% to 90% healing rate for small tears(<2cm).

70% to 43.1% of surgeons suggest 80% healing rate for large tears (2 to 4 cm).

49% of surgeons suggested 50% to 60% healing rate for massive tears (>5 cm).

70% of survey participants told their patients that their shoulder would be 'as good as it gets' one year after surgery.

A large number of surgeons (55.3%) do not allow their patients to drive a car until the arm is out of the sling full time.

91.3% of respondents reported that they would perform surgery on a current smoker despite the body of evidence showing the relationship of smoking and rotator cuff disease, and smokers having a higher retear rate. Surgeons often have a difficult time getting patients to quit smoking and smokers are still able to attain successful outcomes in most cases, albeit with higher risk of failure and longer recovery times.

Regards Lifting Restrictions

37.3% of surgeons recommended a lifting limit of 0.5kg at one month, and 29.4% allowed 4.5kg at three months. By six months and one year after surgery, a majority of respondents advised their patients to let pain be their guide as a limit to lifting (62.7% and 72.8%, respectively).

Regards Return to Work

Surgeons were asked when they allowed their patients to return to work at a sedentary job and to a manual labor job after repair of small, large, and massive rotator cuff tears.

The most common response in regard to return to a sedentary job was one to two weeks for small tears (41.2%), large tears (38.2%), and massive tears (34.3%).

For a manual labor jobs, two responses were most common; 34.7% allow patients to return to work at three months, and 35.6% allow return to work at four months after repair of small tears. Additionally, 17.8% of respondents allowed return at six months for small tears. After repair of a large tear or a massive tear, respondents most commonly allow their patients to return to manual labor at four months (29.4%) or six months (34%), respectively.

In regard to patients with Workers’ Compensations claims, a large percentage of surgeons do not allow a return to manual labor until six months postoperatively for small tears (56.6%). There was a consensus with surgeons who allow return to work after six months for large tears (68%). After repair of a massive tear, 40.2% allow return to work after at least six months, but 38.2% responded 'maybe never.'