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Running head: PERCEPTIONS OF REHABILITATION PROVIDERS

The Role of the Rehabilitation Provider in Occupational Rehabilitation: Providing for

Whom? Part 2: Perceptions of Key Stakeholders

Dianna T. Kenny

The University of Sydney

Australia

In Australian Journal of Rehabilitation Counselling, 1998, 4 (2), 11-122

Key words: rehabilitation provider, occupational rehabilitation, injured worker, workers’

compensation

Correspondence and reprints: Associate Professor Dianna Kenny PhD, School of Behavioural

and Community Health Sciences, Faculty of Health Sciences, The University of Sydney, PO

Box 170, Lidcombe, NSW, AUSTRALIA 2141

This research was funded by a grant from the WorkCover Authority of NSW, Australia

(Grant No 30 303 010)

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ABSTRACT

This paper is the second part of a two part series that examines the perceived roles and

effectiveness of rehabilitation providers. The first paper examined the perceptions of

rehabilitation providers regarding their roles in, and perceived barriers to, occupational

rehabilitation. In this paper, key stakeholders’ perceptions of the role of rehabilitation

providers in the management of workplace injury were assessed via interviews and surveys.

Forty-nine injured workers were interviewed and 407 returned a survey questionnaire. Two

surveys of employers were conducted: one in the Newcastle/Hunter region of NSW,

Australia, the other a state-wide survey (N=612) of a representative sample of employers in

NSW. In addition, nine treating doctors and 14 insurers were interviewed. Results indicate

two thirds of workers were satisfied with the service they had received from the rehabilitation

provider. The major concerns of injured workers were the rehabilitation providers’ lack of

knowledge of the demands of particular workplaces, the problems associated with particular

injuries and the pressure on rehabilitation providers from employers and insurers to return the

injured worker to work.. Sixty percent of employers reported that rehabilitation providers

were effective in restoring injured workers to work. Treating doctors were generally hostile

to

rehabilitation providers, claiming that they were unprofessional, inexpert and poorly trained.

Finally, insurers complained of stereotypical case management plans, role confusion, and

over-servicing.

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An increasing number of injured workers are referred to rehabilitation providers to

assist them and their employers to achieve a safe, timely and durable return to work. In the

previous paper in this series, the perceptions of rehabilitation providers were canvassed via in

depth semi-structured interviews to elucidate the major barriers to occupational rehabilitation

and their possible solutions. Three major barriers to occupational rehabilitation that were

identified by rehabilitation providers. These were: (i) problems associated with defining their

core business and client group; (ii) misconceptions, lack of information and failure of

communication; and (iii) lack of co-operation and overt and covert obstruction to the

rehabilitation process by other key stakeholders. Each of these barriers were experienced

with each of the nominated stakeholder groups. Solutions offered included: i) forming a

trusting relationship with the injured worker; ii) enhancing employer knowledge of, and

commitment to rehabilitation; iii) enlisting the support of treating doctors as team players in

the injury management process; iv) early referral of the injured worker to rehabilitation; and

v) finding better ways to resolve disputes between insurers and injured workers.

In this paper, using both data (ie using a variety of data sources) and methodological

(using qualitative data, content analysis and statistical analyses of survey questionnaires)

triangulation (Patton, 1990), the perceptions of key stakeholders about the practices and

effectiveness of rehabilitation providers are reported. The aim of this study is to determine

the degree of concurrence between the self-perceptions of rehabilitation providers and the

perceptions of stakeholders who use their services. This process is a necessary precursor to

improving the management of occupational injury.

METHOD

Participants

The stakeholders who provided commentary on the practices of rehabilitation

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providers included 456 injured workers, 49 of whom were interviewed and 407 of whom

responded to a survey; and two groups of employers (N=93 and N=614) who responded to

surveys. In addition, the views of nine general practitioners and 14 insurers who participated

in in-depth semi-structured interviews are also presented. The demographic characteristics of

the sample have been described in detail elsewhere (see Kenny, 1994; 1995a; 1996), but are

briefly summarised for each sub-sample in the subsequent sections.

Procedure and Instruments

Interviews

All interviews were conducted by the author and trained interviewers, and were

recorded and transcribed verbatim for coding (for details, see Kenny, 1995a). The semi-

structured interview protocols for each stakeholder can be found in Kenny (1995). Interviews

for injured workers were conducted in their homes, and interviews for the other stakeholders

were conducted at their workplaces. The interviews were between one and two hours long.

In the interview protocols of all stakeholders, two open-ended questions ie "What are

the major barriers to the return to work and occupational rehabilitation of injured workers?"

and "How might these barriers be overcome?" formed the basis of a coding scheme designed

to elucidate the roles that each stakeholder played as perceived by the other stakeholders.

Only stakeholder comments related to the role of rehabilitation providers are reported in this

paper.

The purpose of the interviews was to identify the major themes relating to the

perceived role and effectiveness of rehabilitation providers and to assess the commonality of

emergent themes across the stakeholder groups. In the following results section, issues were

identified as common themes if they were present in 50% or more of the interview responses

for each of the stakeholder groups. The surveys of injured workers and employers assessed

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the degree to which the results of the interview studies were representative of injured workers

and employers who use rehabilitation services.

Injured worker questionnaire

Questions for the injured workers’ survey questionnaire were developed from

discussions with rehabilitation personnel from the WorkCover Authority of New South

Wales and from detailed analyses of in-depth semi-structured interviews of 49 injured

workers who had been purposefully sampled from the original sample of 3 041 workers (see

Kenny, 1995a for details of sampling). These interviews identified what workers perceived to

be the major barriers to occupational rehabilitation following a workplace injury or illness.

The questionnaire comprised 6 sections as follows: Demographic information, nature and

outcome of injury, job and workplace characteristics, the claim for workers compensation,

injury management and personnel involved, and an open-ended section inviting workers'

comments about what was most helpful and what was least helpful in assisting them to return

to work following their injuries. The survey was pilot tested on 30 injured workers who did

not form part of the study population, and modified according to feedback from this group

before distribution to the study sample.

Employer Questionnaires

Questions for the initial survey [Work and Rehabilitation Survey for Employers

(Kenny, 1996)] were developed from discussions with rehabilitation personnel from the

WorkCover Authority of New South Wales and from detailed analyses of in-depth semi-

structured interviews of the 23 employers of the 49 injured workers described above. These

in-depth interviews assessed employer knowledge about occupational rehabilitation,

workplace practices and perceived barriers to occupational rehabilitation following a

workplace injury or illness. The Work and Rehabilitation Survey consisted of 45 questions

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distributed among seven sections as follows: industry demographics, injury characteristics,

occupational health and safety and rehabilitation policies, policies and practices regarding

suitable duties, workers' compensation, injury management and personnel involved, and an

open-ended section inviting employers' comments about what was most helpful and what was

least helpful in assisting their injured workers to return to work following their injuries.

Questions for the statewide survey were based on questions used in the Work and

Rehabilitation Survey for Employers (Kenny, 1996).

Treating doctor interview protocols

The interview protocol for general practitioners covered issues related to their

perceived roles and responsibilities in treating workers' compensation claimants, the

difficulties they encountered, their perceptions of other stakeholders, and of the workers'

compensation system and their views regarding the role of worker and workplace

characteristics in contributing to the outcome of the injury.

Insurer interview protocols

The interview protocol for insurers covered issues related to workers’ compensation

in general, their perceived role in the injury management process, communication with

stakeholders and the criteria they used to select rehabilitation providers and medical

practitioners to whom they referred injured workers.

RESULTS AND DISCUSSION

Stakeholders’ Perceptions of Rehabilitation Providers

Injured Workers (N=49 interviewed)

The 49 injured workers who were interviewed were selected using a stratified

purposeful sampling technique of an original population of 3,041 workers to adequately

represent sex, industry, injury type, amount of time lost (all exceeding one week), and

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employer size. Back injuries (34%) sprains and strains (21%) and occupational overuse

(17%) accounted for 72% of all injuries. Twenty six (53%) of these workers had been

referred to a rehabilitation provider. Of these, 18 (69.2%) had a back injury, five had a sprain

or strain, and three had an overuse injury. Data presented in this section refer only to this sub-

group of 26 workers.

Rehabilitation providers offer a range of services to injured workers that are codified

by the WorkCover Authority. Table 1 sets out the type of service offered, the number and

percentage of workers who received each service and their satisfaction rating of the service

provided.

____________________________________________________

Insert Table 1 here

_____________________________________________________

The most frequently offered services to this group were rehabilitation assessments,

functional assessments, workplace assessments, and the preparation of rehabilitation plans.

Rehabilitation providers were perceived to perform some of their functions well and others

poorly. Satisfaction ratings for all services ranged from 80% very satisfied/satisfied for

functional assessments and work conditioning, to 37.5% - 40% very satisfied/satisfied for

advice concerning job modification, and advice or assistance concerning job seeking. The

numbers are small and should be interpreted cautiously, and used only as a basis for seeking

further feedback from users of these services. Below are examples of satisfied and

dissatisfied injured workers’ responses to the role of the rehabilitation provider in injury

management. Positive experiences with the rehabilitation provider were often juxtaposed

with negative experiences with other stakeholders, as exemplified in the scenarios below.

“The injury took place in a coal mine and their safety officer rang me once and asked

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how I was going. He told me he wanted to see me some time and wanted me to make

suggestions on how the accident could have been avoided and any improvements

needed to make safer working conditions. I never heard from him again. I felt my

employer and insurance company knew everything that was going on and didn't want

to tell me much at all. I felt the injured worker was the forgotten person in all that was

going on. If I didn't see a rehabilitation provider, the situation would have been a

disaster and I would have lost my job.”

“I didn’t get any decent help from anyone until I saw the rehabilitation provider. I had

tried quite a few different jobs at work after my injury, but they all put too much

strain on my knee. So we (worker and rehabilitation provider) put our heads together

and discussed what I’d like to do. She said, ‘This is what you can do and this is what

you can’t do.’ So I decided to do a business operations course at Tech, and now I am

assistant manager of a tyre place. It could easily have been the scrap heap.”

“My rehabilitation provider was an occupational therapist. I was referred about a

month after my injury (ie herniated L4/L5 disc). She was able to give me a lot of

directions as to what I was supposed to do, not just to manage my injury, but to

manage the process as well. She talked to the physiotherapist and my employer and

helped out with the paperwork. She worked out a coherent treatment plan. That took

some of the pressure off me at a time when I wasn’t coping very well.”

Negative experiences with rehabilitation providers centred around their perceived

inexperience or lack of knowledge of the demands of particular workplaces, the problems

associated with particular injuries and the pressure on rehabilitation providers from the

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employer and the insurer to return the worker to work as quickly as possible, the latter

problem clearly associated with the issue of core business and client identification

highlighted in the interviews.

“My employer was of little help to me. The rehabilitation co-ordinator had no time for

follow-up and was totally inefficient. As a result I have now exacerbated my back

injury. Also, this was due to an inexperienced rehabilitation provider who did not

realise the amount of heavy work involved in the area where I work. Good luck in

your survey. I hope some help can result. We need it.”

“The rehab provider was just a yes man. The insurer said, ‘Jump!’ and she said, ‘How

high?’ She pushed me from day one to go back to work. I was in too much pain, but

that didn’t get factored into the argument. She said that there was always something

that you could do, it didn’t matter how much pain you were in.”

“Some rehab providers have a ‘one size fits all’ policy. Our company used the same

rehab provider for all the workers on compo, and you could see that we were all

steered through the same process line, with no consideration for individual needs.”

Injured Worker Survey

Qualitative methods are ideal for identifying and specifying problems in the operation

of a system. Quantitative data are then required to assess the extent of the problems.

Accordingly, a survey based on interview and consultation data was designed and distributed

to 1,229 workers who could be located from the original population of 3,041 injured workers.

Of the 407 workers who responded to the survey questionnaire, 137 (33.7%) had been

referred to a rehabilitation provider. More than half (54%) of this group of referred workers

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had suffered a back injury, of which 72% involved disc pathology. The majority (64.7%)

were male, from labouring, machine operating, or trade occupations (70%). Half of those

referred felt permanently unable to do some (34.3%) or all (16.1%) of their pre-injury duties.

At the time of completion of the questionnaire, 53.3% had returned to work full-time, and

10.2% had returned part-time.

Employers were the source of referral for 41.6% of injured workers, treating doctors

referred 23.4%, rehabilitation co-ordinators referred 17.5%; 8.8% were self-referrals, with

the remaining 8.8% referred from other sources, including the insurer. Forty-two percent

(41.9%) were referred within four weeks of their injury, 27.9% within 12 weeks, 11% within

26 weeks and the remainder (11.8%) were referred more than 26 weeks after they were

injured or could not remember when they were referred.

There was a statistically significant association between referral to a rehabilitation

provider and return to work outcome, with those referred much less likely to have returned to

work (χ2 =17.63, df=1, p=.0003). This finding reflects the referral bias to rehabilitation

providers, with more seriously or permanently injured workers being more likely to be

referred to rehabilitation providers than those who were temporarily unable to perform their

normal work duties (Kenny, 1995d). Poor outcome of rehabilitation may also be related to

the delay in referral noted above. Of workers referred to rehabilitation providers, more than

half were not referred within four weeks of injury, a time frame currently considered to be

best practice by WorkCover and insurers. There is ample evidence in the literature supporting

early intervention and early referral to rehabilitation (Ehrmann-Feldman, et al, 1996;

Gardner, 1991; Lechner, 1994; Lusted, 1993; Ryan et al, 1995).

The failure to provide information and the presence of misinformation were major

foci of the interviews with rehabilitation providers and were perceived by them to constitute

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substantial barriers to the success of occupational rehabilitation. To assess the extent of the

perceived problem, injured workers were asked about their information source and

knowledge of the workers’ compensation system. At the time of their injury, only 13% of

workers believed that they knew everything that they needed to know about workers'

compensation; 53.3% said that they knew a little and 33.7% said that they knew nothing

about how the system worked. Twenty-five percent (24.8%) were informed about their rights

and procedures by their employers, 17.2% reported that they gained the necessary

information by their own efforts, 12% received information from their union representative or

workmates, 12.2% from friends or family members, and the remainder cited treating doctors

(8.8%), rehabilitation co-ordinators (5.7%), solicitors (5.7%), rehabilitation providers (2.7%)

and others (including the insurer, the WorkCover Authority of New South Wales,

pamphlets/brochures at work) (10.9%) as their major source of information. These figures

vindicate the perception of rehabilitation providers that dissemination of accurate information

is a problem that requires attention.

Injured workers were also asked about information provision from five key

stakeholders. Table 2 summarises the findings.

_________________________

Insert Table 2 here

_________________________

Rehabilitation providers were significantly more likely (p<.05) than treating doctors and

insurers to provide information on rehabilitation, and significantly less likely than

rehabilitation co-ordinators to provide advice on workers’ compensation procedures. They

were also perceived to have a more open mind on the genuineness of the injury than either

the insurer or the insurance doctor, although one quarter of those workers who saw a

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rehabilitation provider also felt that the rehabilitation provider doubted the genuineness of

their injury. Only half of the workers interviewed thought that the rehabilitation provider had

sufficient understanding of their workplace and injury to advise on suitable duties. Between

25% - 50% of injured workers were dissatisfied with some component of their suitable

duties, including a lack of support from both the worker’s supervisor and co-workers.

To test the view of rehabilitation providers that doctors often sabotaged their attempts

to return injured workers to work, injured workers were asked about the advice given to them

by their treating doctors. Of the workers who continued to work while they were undergoing

occupational rehabilitation (n=70), 61.5% reported that their treating doctor had advised them

to discontinue work until they were completely fit. For the workers who were temporarily

unable to perform their normal work duties (n=235), 56.7% reported that their treating

doctors had advised them not to return to work until they were completely fit. There was a

trend that indicated that workers so advised by their treating doctors were less likely to return

to work than workers who were not given this advice (χ2 = 3.48, df=1, p=.06). These data

support the views of rehabilitation providers, who perceived that doctors often worked

against the principles and goals of occupational rehabilitation.

Injured workers may consult with many stakeholder groups in the post injury period.

Table 3 presents the range of personnel consulted by injured workers together with

satisfaction ratings with the service provided.

_____________________________

Insert Table 3 here

______________________________

The table indicates that 67.4% of injured workers who consulted a rehabilitation provider

were satisfied with their consultation. This compares poorly with satisfaction with the

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treating doctor, with whom 91.5% of injured workers expressed satisfaction. It has been

argued that high satisfaction ratings for treating doctors are related to the collusion of the

treating doctor with the injured worker (Kenny, 1996). The data do not provide insight into

the basis on which satisfaction ratings were made. However, 81.1% injured workers who saw

a rehabilitation provider reported that the provider had consulted them about the development

of a return to work plan and 86% said that the provider followed through on the plan.

Although only 49.5% of workers expressed any confidence that the plan would be successful,

60.4% found that the provider had been helpful in either assisting them to return to work or to

retrain for another job (31% of referrals to rehabilitation providers retrained).

Employers: Newcastle/Hunter Survey (N=93)

Of the 93 employers who responded to the survey questionnaire, 58.6% reported that

rehabilitation providers were effective (48.3%) or very effective (10.3%) in assisting injured

workers return to work. Rehabilitation providers were ranked in a similar way with respect to

effectiveness to rehabilitation co-ordinators (60.7%) and the workplace rehabilitation

program (53.5%) in assisting injured workers return to work.

Employers: State Wide Survey (N=612)

The majority of respondents (71.3%) indicated that their organisations used the

services of an accredited rehabilitation provider. One-tailed tests indicated that there was a

consistent relationship between the size of the employer and the use of an accredited

provider. The proportions of organisations utilising a rehabilitation provider were as follows:

53.6% of organisations with 20 or fewer employees, 69.3% of those with 21-100 employees,

80.8% of those with 101-500 employees, and 95.4% of those with over 500 employees.

Pairwise comparisons of these data were all statistically significantly (Z > 1.65). Respondents

who reported that their organisations referred workers to an accredited rehabilitation provider

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(n = 427) were asked to indicate their reasons for this practice. The most common reasons

were the “length of time off work” (73.1%) and the “severity of the injury” (72.1%). Table 4

presents the percentage frequencies of reasons for referring to an accredited rehabilitation

provider, in total and by the size of the organisation. One-tailed tests indicated that

organisations with more than 500 employees were more likely; (1) than organisations with 20

or fewer (Z > 1.68) or 101-500 (Z = 1.68) employees to report “when a person needs

retraining” as a reason; (2) than organisations with 20 or fewer (Z = 2.04) or 21-100 (Z =

1.79) employees to report “when the employee requests referral” as a reason; and, (3) than

organisations with 20 or fewer employees (Z = 1.68) to report “severity of injury” as a

reason. No other significant differences were identified.

____________________________________________________

Insert Table 4

_____________________________________________________

Treating doctors

Treating doctors were generally hostile to rehabilitation providers, claiming that they

were unprofessional, inexpert, and poorly trained. Accordingly, treating doctors perceived

part of their role with injured workers was to advise and guide them through the

compensation system, and to protect them from potentially unhelpful interventions from

rehabilitation providers. Below are some comments from treating doctors reflecting this

perception. “I have to guide workers through the whole confusing system because there are a

plethora of rehabilitation providers out there who are not supplying the goods.....” “There is

an enormous amount of money being wasted on rehabilitation providers. The main problem

is that they do not have a sufficient comprehension of the workplace.” This comment is

particularly intriguing as it is a criticism that most stakeholders have levelled at the treating

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doctor (Kenny, 1996).

Insurers

Insurers identified a number of issues that concerned them about rehabilitation

provider practice. These included “stereotyped case management plans” (about which injured

workers also complained), a lack of mutual respect and co-operation between insurers and

providers, role confusion between rehabilitation co-ordinators and rehabilitation providers

that resulted in lack of ownership and/or responsibility for case management, unnecessary

prolongation of the history of the claim, and over-servicing.

CONCLUSIONS AND RECOMMENDATIONS

The triangulation of data sources in this study offers important insights into the roles

and functions of rehabilitation providers in injury management. The perceptions of the

different stakeholders converged on several issues related to the services of rehabilitation

providers. There was also mutuality in stakeholder accounts with the self-perceptions of

rehabilitation providers. These data provide a basis upon which the role of the rehabilitation

provider can be clarified, and service provision improved.

One of the key barriers identified by rehabilitation providers was the definition of

their core business and identification of their client group. The tension created by the

problem of serving multiple masters (ie insurer, employer, injured worker) simultaneously

was also felt by injured workers, some of whom perceived rehabilitation providers to be ‘yes

men’ to either or both the employer and the insurer. Insurers described role confusion

between providers and rehabilitation co-ordinators which resulted in the abrogation of the

role of case manager by both, leaving the injured worker stranded in the system without a

guide.

The second barrier identified by rehabilitation providers was the problem related to

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transmission of information and misinformation. This barrier was borne out by the finding

that only 13% of injured workers reported that they had sufficient information to deal

effectively with their injury and workers’ compensation claim. Injured workers filled the

information gap by talking to union representatives, work colleagues, family and friends,

doctors and solicitors, among others. These sources are fertile ground for the distribution of

misinformation, particularly about their rights and entitlements, that may perpetuate the

belief in the “pot of gold” notion that mitigates against early return to work.

The third concern of rehabilitation providers, that there was a lack of co-operation and

overt and covert obstruction to the rehabilitation process by different stakeholders was

supported in this study. In the survey of injured workers, it was apparent that doctors were

advising workers to either discontinue working, or to not return to work until they were

“100% fit.” This advice is contrary to the model of active rehabilitation practised by

rehabilitation providers and was not only perceived, but demonstrated, to undermine their

efforts to achieve return to work for some workers.

Loss of respect for the services of rehabilitation providers ensued from the perception

of both injured workers (“one size fits all”) and insurers (“stereotyped case management

plans”) that rehabilitation plans were formulaic and did not address the needs of individual

workers. Doctors also questioned the technical competence of rehabilitation providers. Both

doctors and injured workers complained that rehabilitation providers did not have sufficient

knowledge of the workplace to prescribe appropriate suitable duties. The injured worker

survey confirmed that this was a pervasive concern. Fewer than 40% reported feeling

satisfied with the advice concerning job modification that was offered by rehabilitation

providers.

Rehabilitation providers stressed the importance of developing a trusting relationship

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with the injured worker as a basis for a successful outcome. One third of workers expressed

satisfaction with their contact with their rehabilitation provider, and a quarter stated that the

rehabilitation provider doubted the genuineness of their injury. This is a poor foundation

upon which to build a trusting relationship.

The results of this study indicate that for this sample of injured workers, between a

quarter and a half experienced some difficulty with the process of occupational rehabilitation,

including dissatisfaction with the services provided by rehabilitation providers. However, for

the group who were happy with the service they received from rehabilitation providers, the

role of the provider was often pivotal in their return to work. We can learn from this group

how to improve the practice for all workers. In these cases, the rehabilitation provider

assumed an assertive case management role, negotiated with key stakeholders to achieve

consensus on goals, took a role in information dissemination, devised a plan in consultation

with the injured worker and the treating doctor, and followed through on its implementation.

These findings indicate the minimum requirements for effective rehabilitation

provider practice in the complex task of assisting injured workers to return to work in a safe

and timely manner. The current practice arrangements for rehabilitation providers are

problematic and need to be addressed at the pre-practice training, systemic and policy levels.

Clear guidelines for each stakeholder, and clear definition of roles and responsibilities must

also be formulated and/or negotiated on an individual basis to mitigate the competing forces

that appear to be operating within the current system, that serve to undermine the common

goals of occupational rehabilitation.

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Satisfaction with rehabilitation services for 26 injured workers referred to a rehabilitation provider

Rehabilitation services Ratings of satisfaction Very Undecided Satisfied Very Dissatisfied Dissatisfied satisfied

No

%

1

2

3

4

5

Rehabilitation Assessment

14

61

21.5

7

0

57

14.5

Functional Assessment

15

65

13.5

6.5

0

53.5

26.5

Workplace Assessment

15

65

6.5

26.5

0

13.5

53.5

Job Analysis

9

39

22

22

0

33

22.5

Advice Concerning Job Modification

8

35

12.5

50

0

37.5

0

Rehabilitation Counselling

8

35

25

12.5

12.5

25

25

Vocational Assessment

12

52

16.5

16.5

0

50

16.5

Advice or Assistance Concerning Job Seeking

5

22

40

0

20

40

0

Advice/Assistance re Vocational Re-education

11

48

9

9

9

45.5

27.5

Preparation of a Rehabilitation Plan

14

61

14.5

14.5

14.5

43

14.5

Work Conditioning

5

22

0

20

0

60

20

Functional Education

9

39

0

11

11

55.5

22

Monitoring

13

56.5

7.5

15.5

0

61.5

15.5

Aids and Equipment

7

30.5

0

14.5

28.5

14.5

43

Travel

8

35

0

25

25

37.5

37.5

Table 1

22

Table 2

Workers’ Responses to Information Provision by Stakeholders

Yes, the (stakeholder)

RC1

(33.3%)2

TD

(80.1%)

RP

(33.7%)

I

(38.1%)

ID

(44.6%) gave me information/advice on workers' compensation procedures?

50.0

30.5

30.4

29.9

N/A3

gave me information on rehabilitation (and/or rehabilitation procedures)?

68.9

36.1

80.9

14.5

N/A

talked with my treating doctor about suitable duties and/or when I could return to work?

54.5

N/A

52.9

N/A

N/A

talked with my employer or rehabilitation co-ordinator about my injury, suitable duties, and/or when I could return to work?

N/A

30.0

72.1

N/A

N/A

had enough understanding of my workplace/injury to implement the necessary changes to allow me to return to work (eg organising suitable duties)?

55.6

N/A

50.4

N/A

N/A

hae enough time to attend to my needs?

58.2

N/A

63.0

N/A

N/A

showed care, respect and concern for meas an injured worker?

70.4

N/A

77.0

N/A

42.1

had an open mind about the genuineness of my injury?

69.6

N/A

76.3

42.1

36.7

1 RC = Rehabilitation Co-ordinator; TD = Treating Doctor; RP = Rehabilitation Provider; I = Insurer; ID = Insurance Doctor 2 Percentage of the sample (n=407) who had contact with stakeholder 3 Question not asked

23

Table 3 Personnel Consulted by Injured Workers (IWs) and Satisfaction with the Consultation (in percentages) Personnel

Number of Injured Workers

Unhappy

No Opinion

Happy

Treating doctor

326

4.1

4.4

91.5

Nominated medical specialist(s)

198

9.2

7.2

83.6

First aid officer

138

11.6

11.6

76.8

Solicitor

120

10.3

13.8

75.9

Physiotherapist

234

12.1

13

74.9

Occupational health nurse

118

15.4

10.3

74.3

Industry/union representative

86

19

10.7

70.3

Rehabilitation provider

137

21.5

11.1

67.4

Psychologist

47

21.7

17.4

60.9

Rehabilitation co-ordinator

136

29.6

12

58.4

Company doctor

181

30.6

11.7

57.7

Financial or family counsellor

12

30

20

50

Insurance investigator

28

44.4

22.3

33.3

Insurance doctor(s)

182

50.3

20.3

29.4

24

Table 4

Employer Reasons for Referring Injured Workers to Rehabilitation Providers (N = 427)

Reason

Total(%)

referred

Size of employer

1-20

21-100

101-500

501+

Length of time off work

73.1

72.2

74.2

73.2

72.9 No suitable duties

37.0

42.3

33.3

33.1

42.1

When a person needs retraining

40.0

30.7

36.5

36.0

50.0

When an employee requests referral

35.6

21.2

29.0

33.1

47.9

Severity of injury

72.1

61.5

64.5

74.6

78.6

Other

26.9

19.2

28.0

28.2

27.9