Study Looks at Relationship Between Employers & Doctors in Return-to-Work

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A key element of a successful return to work is a good, communicative relationship among the injured worker, the employer and the worker’s doctors. But a study found the relationship between employers and doctors can be marred by mistrust and lack of communication.

The study by Institute for Work & Health (IWH) Scientist Dr. Agnieszka Kosny was conducted in the Australian state of Victoria and published online in Policy and Practice in Health and Safety. The study was part of a larger project led by Dr. Danielle Mazza of Australia’s Monash University, which examined workers’ comp and return-to-work (RTW) from the perspectives of several stakeholders: injured workers, employers, healthcare providers and case managers.

The researchers interviewed the people responsible for RTW in 25 organizations with a workforce of 50 or more that recently had a workers’ comp claim. The participants mostly worked in management, HR and health and safety. The study found that:

  • Employers recognize the critical role of doctors in the workers’ comp system and in getting injured workers back to work. But they sometimes view doctors as unsupportive of the RTW process.
  • Participants felt doctors sometimes find it easier to simply order two weeks’ off for an injured worker rather than to engage in the RTW process. They also said some doctors are disdainful of anything related to workers’ comp.
  • Employers have difficulties communicating with doctors. Some spoke about phone calls not being answered. Although many understood that doctors are busy and not paid for engaging with employers, they were still left with a negative impression due to this lack of communication.
  • Employers find doctors lack a realistic understanding of the needs of the workplace, which many felt sometimes resulted in recommendations with which employers couldn’t comply.

Many of these issues came up with respect to injuries that aren’t straightforward, such as gradual onset musculoskeletal disorders, chronic pain or mental health conditions, says Kosny.

In these types of cases, many employers felt like they were excluded or left in the dark, and were unable to get important information about workers’ abilities or limitations. This sense of exclusion fuelled the suspicion among some employers that some workers “cheat the system” by using their doctors to delay return to work, she says.

The researchers did hear about strategies used by employers to exert greater control over the RTW process, such as:

  • Offering to accompany injured workers to their medical appointments or to pay doctors to take part in joint case conferences
  • Laying out RTW plans, task analyses or work modification options that injured workers can then take to their doctors
  • Establishing a relationship with medical clinics that have an understanding of workers’ comp claims and asking injured workers to use those clinics
  • Employing an in-house doctor whose role includes liaising with injured workers’ treating physicians
  • Asking injured workers be assessed in independent medical exams (IMEs), a step that also signals to both the insurer and the treating physician that the employer is unhappy with the way RTW is being managed.

The workers’ comp system in Victoria, Australia, does differ in some respects from the Canadian system. But the many similarities between workers’ comp systems in Victoria and Canada make the study relevant to workplace parties in this country. Both here and in Victoria, having a worker off work is costly to the employer in terms of premiums, says Kosny.

The issues facing healthcare providers are similar, too. Issues such as patient confidentiality, burdensome and time-consuming workers’ comp forms and a lack of understanding of the workplace cut across jurisdictions, Kosny adds.

The OHS Insider has information, resources and tools on return to work, including: