Page 1

2013

KONEKT MARKET REPORT


Welcome Welcome to the inaugural Konekt Market Report which looks at latest trends in the Australian workers compensation market by analysing data across more than 95,000 Konekt cases from the past five years. For some time we have recognised that there is a lack of local Australian data available in the industry to help OH&S professionals, workers compensation specialists, regulators and employers in their decision making. As Australia’s largest provider of workplace health and safety solutions, we felt that an analysis of our case data from the last five years would provide some interesting insight and would be a useful business tool for our customers. This report is the largest of its type and we believe it provides significant insight into the Australian landscape from the unique perspective of a national rehabilitation provider. The data has been analysed by governing scheme, against socioeconomic data, by injury type and service type. Additionally, with a large pool of non-compensable cases being referred for return to work services, we’ve reported on these two data sets against a number of metrics. We believe this is the first time data of this nature has been made available in Australia. Konekt has partnered with Cortex Solutions, one of Australia’s most experienced and respected researchers and personal injury management consultants in the area of workers compensation, to analyse the data and to ensure the integrity of the findings. We hope you find the analysis and informed views in this report valuable. Please feel free to contact me, or your regular Konekt contact, if you would like to know more about how we can help your business improve health and safety performance.

Damian Banks CEO, Konekt Limited


Table of contents

Page

Overview

5

Workplace psychological injury

6

Compensation costs

6

Rehabilitation 6 A profile of rehabilitation referrals

7

The data

7

Trends 8

Population characteristics

9

All referrals

10

Socioeconomic profiles

10

Population differences – Compensable referrals compared with non-compensable referrals

11

Service and referral type

10

Differences between compensable and non-compensable referrals

13

Injury type

15

A closer look at cases referred with a psychological injury

15

The incidence of psychological injuries

17

RTW outcomes

18

Comparing compensable with non-compensable RTW outcomes

19

Impact of duration of disability on RTW outcomes

20

4

Konekt Market Report


Glossary of frequently used terms RTW or Return to Work

Return to full or partial hours.

Compensable Referrals where there is a compensation claim arising. These referrals are typically made by insurers, scheme agents and self-insured employers.

Non-compensable Referrals where there is no compensation claim arising. These referrals are typically made by employers.

Overview The Konekt Market Report is one of the

This second point is important, as research

In this data ‘compensable’ cases refer

most comprehensive reviews of both

overwhelmingly asserts the less time

to those referrals where there is a

compensable and non-compensable

people spend in the compensation system,

compensation claim arising. These referrals

cases in Australia, and allows a genuine

the greater the likelihood of better health

are typically made by insurers, scheme

insight into the impacts on costs,

and return to work outcomes.

agents and self-insured employers.

durations and outcomes.

‘Non-compensable’ cases refer to cases In addition to providing improved return

where there is no compensation claim

Internationally there is strong evidence of

to work outcomes, early referral results

arising and these referrals are typically

the benefits of early referral impacting on

in a lower service cost, with the average

made by employers. Every workers

return to work outcomes. This experience

cost incurred per successful return to work

compensation jurisdiction is represented

is supported by the Konekt data.

being significantly lower. This point is

in the data. The non-compensable

critical for the viability of personal injury

outcomes are more favourable than the

One of the key findings is that early

compensation schemes and employer

compensable outcomes, with the main

referrals result in more successful return

premium stability. However, at this point

contributory factor appearing to be early

to work outcomes, and also result in a

the Australian market is largely immature

referral. Other contributory factors are

decreased period of rehabilitation services.

in its use of genuine early intervention

likely to be the lack of delays caused

strategies and tools.

by being in the workers compensation system and the more holistic preventative approach taken by employers.

November 2013

5


Workplace psychological injury Emerging from the data is a unique look at workplace psychological injury, again with the ability to review both compensable and non-compensable cases from some of Australia’s largest employers. We see a significant difference between the data sets, with almost three times more referrals for psychological injuries in the non-compensable data. Konekt sees this as an important early warning for the likely flow through effects to schemes and insurers. Currently the direct and indirect workers compensation costs associated with psychological injury claims significantly exceeds the costs associated with non-psychological injury claims. Konekt’s view is that current and future actuarial and premium assumptions do not yet adequately anticipate this change in injury profile and cost. Additionally, it is likely that we will see an acute shortage of skilled staff to manage these cases by 2017.

Compensation costs In 2008–09, Australian workers compensation schemes spent $6.9 billion, of which 55% was paid direct to the injured employee in compensation for their injury or illness, and 23% was spent on medical and other service costs, including occupational rehabilitation. 1

Rehabilitation The Australian workers compensation scheme data reports that 48% of workers with injuries were identified as having participated in some form of rehabilitation, so understanding the population referred to rehabilitation providers is important. 2 Those referred for rehabilitation usually include people at risk of reduced and/or total work incapacity, It has been suggested that this cohort of injured employee makes a significant contribution to compensation scheme costs through increased healthcare costs and increased claim duration. 3

6

Konekt Market Report


A profile of rehabilitation referrals It is important to note that compensable injuries do not represent all work related injuries. A comparison of compensation claims with the data from the ABS 2005-06 Multipurpose Household Survey indicates that serious workers compensation claims (reported workers compensation claims) represent only one in five work-related injuries.4 In addition, the data from the compensable group presented in this report may not be representative of all workers compensation data – rather it presents a profile of those referred for rehabilitation within compensable schemes.

The data The total population analysed was 95,470 referrals taken from the Konekt case management database KonektivaÂŽ. These referrals were opened in Konektiva between 1 July 2008 and 26 June 2013. Of the 95,470 referrals, 74,395 (78%) were referrals related to cases in the workers compensation system (compensable referrals) and 21,075 (22%) were referrals direct from employers (non-compensable referrals). Of those referred, 77% were for specific services such as functional assessments, activities of daily living assessment, and worksite assessments, and 23% were for return to work (RTW) support and assistance. Closed cases represented 95% of the data analysed, and only these cases were used when analysing outcomes.

November 2013

7


Trends The following trends were observed over the 5 year period analysed:

The number of injured people being referred to Konekt for rehabilitation case management services has remained steady.

The number of referrals for RTW services is decreasing while the number of referrals for specific services is increasing. While the non-compensable referral patterns have remained consistent, the compensable referral patterns are changing, contributing to this trend.

The RTW rates have remained consistent at an average of 88% for compensable referrals and 94% for non-compensable referrals.

The number of referrals following musculoskeletal injuries as a proportion of all referrals is decreasing, as is the average cost and duration of the rehabilitation case management service for these injuries. Specifically looking at the compensable data, the overall number of musculoskeletal injuries have not changed.

The average duration of rehabilitation case management service has decreased by an average of 5 weeks from an average of 12 weeks to 7 weeks.

The average time from accident to referral to Konekt or the duration of disability prior to referral was trending down and reached an average low of 69 weeks. However, the data for the immediate past year analysed shows an increase to an average of 90 weeks delay from injury to referral.

As a proportion of all compensable referrals, the proportion of referrals for mental injuries is 9% which has remained consistent.

As a proportion of all non-compensable referrals, those referred for psychological injuries remained static. However, at 24% the average is significantly more than the compensable referrals.

8

Konekt Market Report


Population characteristics The population being referred for services are on average 41 years old with 51% of all referrals being for people between the ages of 30 – 49 years. Significantly, 27% of all referrals are for those over 50 years, where there is evidence to suggest that recovery may be delayed and RTW more difficult. Overall, 61% of referrals were male. This is marginally above the Australian population data – males account for 56% of work related injuries in Australia. 4 The higher number of work-related injuries among men in the Australian population data is largely due to men making up more than half (54%) of those who were employed at some time during the year. 4

November 2013

Age Bands

Male

Female

16 – 19 years

2%

1%

20 – 29 years

14%

5%

30 – 39 years

17%

7%

40 – 49 years

17%

11%

50 – 59 years

12%

9%

60 – 69 years

3%

2%

> 70 years

0%

0%

Total

65%

35%

9


All referrals

SA

The majority of referrals to Konekt were for musculoskeletal injuries (60%). Overall, 12% were referred for assistance

QLD WA

following a psychological injury. Psychological injury cases incurred the highest average rehabilitation service cost at an average of $1,364 compared to the other injury types.

VIC

Referrals by Jurisdiction

NSW

Every workers compensation jurisdiction is represented in the data with the majority of referrals from New South Wales followed by Victoria. On average, Victoria and South Australia have the longest delay to referral times at 112 weeks, while

Comcare

Queensland has the shortest at 34 weeks.

Socioeconomic profiles To understand the socioeconomic profiles of those referred,

and the Index of Education and Occupation (IEO) was used.

a socioeconomic score using data published by the ABS was

Overall, the profile of referrals was largely representative of the

appended to the data. The Socio Economic Index for Areas (SEIFA)

Australian population; however referrals were underrepresented

summarises census variables, at the census district (CD) level.

in the areas with the highest SES profiles on both measures used.

In the analysis the Index of Relative Social Disadvantage (IRSD)

%

of All Referrals

Figure 1 Socioeconomic profile of referral data as measured by the IRSD and EOI 14 12 10 8 6 4 2 0

Australian Population

Socioeconomic Deciles by SEIFA index

IRSD Index

EOI Index

The IRSD measures relative social disadvantage. Social disadvantage is typically associated with low income, high unemployment and low levels of education. Since this index only summarises variables that indicate disadvantage, a low score/decile indicates that an area has many low income families, people with little training and working in unskilled occupations, and may be considered as disadvantaged relative to other CDs. The Index of Education and Occupation (IEO) is designed to reflect the educational and occupational level of communities. The education variables in this index show either the level of qualification achieved or whether further education is being undertaken. The occupation variables classify the workforce into the major groups and skill levels of the Australian and New Zealand Standard Classification of Occupations (ANZSCO) and the unemployed. This index does not include any income variables. A low score indicates relatively lower education and occupation status of people in the area in general. 16

10

Konekt Market Report


Population differences – Compensable referrals compared with noncompensable referrals Overall the compensable referrals were on average a year younger at 41 years compared to the non-compensable referrals. There were significantly more males in the compensable group (67%) compared with the non-compensable group (43%). However, this is representative of national workers compensation data where males account for two-thirds of all serious workers compensation claims lodged (claims requiring an absence from work of one working week or more). 5 The compensable referrals had lower socioeconomic profile scores (SES) on both the IRSD and the IEO measures. Within the workers compensation referral data those with lower SES

Our data suggests that

compensable referrals have lower SES profiles and an increased period of disability prior to referral compared to the non-compensable referrals which add significantly to the complex nature of cases, particularly in RTW.

profiles had a significantly longer average delay to referral time (102 weeks) compared to those with the higher SES profiles (84

injury) was significantly longer for the compensable referrals

weeks). Previous research suggests that socioeconomic factors

at an average of 90 weeks compared to 17 weeks for non-

may be useful in predicting RTW outcomes, and a recent study

compensable cases. Delays in reporting any injury or referring

of Australian workers compensation rehabilitation data showed

for intervention reduce the ability to control medical costs and

that higher SES profile scores were associated with positive RTW

duration of recovery. The significant disparity between delay

outcomes. 3, 6 This study also confirmed that a longer duration

to referral for compensable and non-compensable injury may

of disability was associated with negative RTW outcomes. 6

reflect the operation of the compensable system itself and the

Our data suggests that workers compensation referrals have

delays that often occur through its administration.

lower SES profiles and an increased period of disability prior to referral compared to the non-compensable referrals.

A higher proportion of compensable referrals was specifically

This adds significantly to the complexity of cases in RTW.

for RTW services (25%), compared with 12% of the noncompensable referrals.

The duration of the rehabilitation service for the compensable referrals was almost double that of the non–compensable

Referrals for psychological injuries occurred as a significantly

referrals, and the service incurred a significantly higher average

higher proportion in the non-compensable group (24%),

cost. The delay in referral or duration of disability (delay from

compared to just 9% in the compensable group.

November 2013

11


Injury type compensable and non-compensable 63%

100%

46%

9%

9% 18% 3%

9%

3%

24%

17%

100% Non-compensable

Compensable Musculoskeletal Injuries Fractures Psychological Disorders Illness and Disease

Table 1: Population data – Compensable and non-compensable referrals

Other Injuries

Compensable

Non-Compensable

Referrals

Referrals

Variable

Category

[78% of referrals]

[22% of referrals]

Gender

Male

67%

43%

Age

Ave. Age

41 yrs

42 yrs

Service Cost*

Service Cost

Ave. Cost

$1,380

$686

Duration

Service Duration*

Ave. Weeks

11

5

Delay to Referral **

Ave. Weeks

90

17

RTW Service

25%

12%

Specific Services

75%

88%

Fractures

9%

3%

Illness and Disease

3%

9%

Psychological Injuries

9%

24%

Injuries

63%

46%

Other Injuries

17%

18%

Socio-demographic

Referral Type

Injury Type

Musculoskeletal

Closed cases only ** Only referrals with an accident date from 2000 onwards have been included *

12

Konekt Market Report


Service and referral type Overall, 77% of those referred were for specific services such

service costs are higher for RTW services compared to specific

as functional assessments, activities of daily living assessment,

services, and the duration of the rehabilitation service is also

and worksite assessments, and 23% were for RTW support

longer for RTW assistance (23 weeks) compared with

services. As would be expected, the average rehabilitation

specific services (7 weeks).

Differences between compensable and non-compensable referrals Notably there were significant differences between the

However, the compensable group were also referred significantly

compensable referrals and the non-compensable referrals,

later post injury for RTW services at an average of 62 weeks post

with the average cost of rehabilitation services for both

injury compared to the non-compensable group at 23 weeks.

RTW and specific services being significantly higher for the

For referrals for specific services the compensable group were

compensable group. A number of studies have shown people

referred on average 98 weeks post injury compared to 15 weeks

to have poorer recovery times as part of a compensable system.

post injury for the non-compensable group. Essentially, this means

The relationship between compensation and health outcomes

that the compensable group had a longer duration of disability

is complex and multivariate. The injured person’s motivation,

at referral. Research is very clear in suggesting that the timing

a perceived lack of control over their recovery, the number

of the initial RTW is critical. It has been found that if an individual

of stakeholders involved in a compensable system, and the

is off work for:

processes that stem from legislative or statutory requirements underpinning a compensable system, are all factors that may

20 days, the chance of ever returning to work is 70%;

contribute to the significant disparity in cost and duration

45 days, the chance of ever returning to work is 50%;

for compensable versus non-compensable injury.

70 days, the chance of ever returning to work is 35%. 8

In addition, the duration of the rehabilitation service was significantly longer for both RTW and specific service referrals compared with non-compensable referrals. The difference in service duration is no doubt reflective of the added complexities involved in rehabilitation within a compensation system.

”The evidence is compelling: for most individuals, working improves general health and wellbeing and reduces psychological distress. Even health problems that are frequently attributed to work – for example, musculoskeletal and mental health conditions – have been shown to benefit from activity based rehabilitation and an early return to suitable work.” 9

November 2013

13


70

Total Economic Cost of Work Related Injury 7

economic cost of work related injury to the Australian economy for the 2008-09 financial year is estimated to be $60.6 billion. This represents 4.8% of GDP for the same period.7

0

10

20

30

Economic Cost

40

$ Billion

50

60

According to the most current data available, the total

19921993

2000- 2005- 20082001 2006 2009

Table 2: Referral types – Compensable and non-compensable referrals Referral Type

Compensable Referrals

Non-compensable Referrals

Variance

$1,339

Average Cost by Referral Type RTW Service

$2,824

$1,485

Specific Services

$906

$580

Average [Weeks] Duration of Service RTW Service

23

14

9

Specific Services

7

4

3

Ave. [Weeks] Delay to Referral RTW Service

62

23

39

Specific Services

98

15

83

14

Konekt Market Report


Injury type Consistent with published work injury data, the majority of

Additionally, the proportion of referrals for psychological

referrals were for those with musculoskeletal injuries (60%)

injuries cases in the compensable group was increasing but

while overall 12% of referrals were for psychological injuries.

remained significantly below the proportion of cases in the

These referral trends remained largely consistent throughout

non-compensable group, which averaged 24% over the period

the period analysed, with musculoskeletal injuries as a proportion

analysed. The most recently published workers compensation

of all referrals showing a slight downward trend. The average

data reports that 6% of accepted claims were for psychological

delay to referral time for musculoskeletal injuries increased in

injuries, and the Konekt referral data shows 9% of workers

the last two years to an average of 90 weeks post injury.

compensation referrals were for psychological injuries. 10 Within the workers compensation group, cases referred for psychological injury have the highest average service cost and the highest average duration of service compared with all other injury types.

A closer look at cases referred with a psychological injury A higher proportion of psychological injury cases, as a proportion

The most significant difference was the average delay in referral

of all injury cases, were referred for RTW service compared with

times which was significantly longer in the ‘other injury’ category,

the other injury category.

the majority of which are musculoskeletal injuries.

Table 3 below provides a comparison of cases referred for

Despite no differences in the average duration of rehabilitation

psychological injuries and those referred for all other injuries.

services, the cost of the service was on average higher compared

There were more females in the group with psychological injuries

with that incurred by the ‘other injury’ group.

compared to the group with other injury types. There were no differences in age and the socioeconomic profiles of the two groups.

Table 3: Profile of cases with mental injuries compared with other injury types Psychological Injuries

Other Injuries

Variable

Category

n=10,203

n=77,117

Gender

Male

50%

63%

Age

Ave. Age

41 yrs

41 yrs

Service Cost

Service Cost

Ave. Cost

$1,364

$1,264

Duration

Service Duration

Ave. Weeks

10

10

Delay to Referral

Ave. Weeks

63

84

RTW Service

29%

23%

Specific Services

71%

77%

Socio-demographic

Referral Type

November 2013

15


Table 4: Psychological injury referrals compensable and non-compensable by year

1 JULY 2008 – 30 JUNE 2009

Financial Year

Compensable Referrals

Non-compensable

n = 74,395

Referrals n = 21,075

% of Referrals

% of Referrals

7%

24%

TOTAL REFERRALS

1 JULY 2012 – 30 JUNE 2013

1 JULY 2011 – 30 JUNE 2012

1 JULY 2010 – 30 JUNE 2011

1 JULY 2009 – 30 JUNE 2010

Comparing work

16

8%

34%

9%

25%

9%

29%

place mental injur y referrals between compensable and non- compensable cases, there is a sig nificant difference betwee n the data sets, wi th almost three times more referrals for menta l injuries in the noncompensable data .

10% 18% 9%

24% Konekt Market Report


The incidence of psychological injuries A recent report into the incidence of accepted workers

(casual) who do not have permanent job security [LaMontagne

compensation claims for mental stress in Australia by Safe

et al. 2010b; and van Wanrooy et al. 2009]. However, the

Work Australia revealed a downward trend in psychological

proportion of workers casually employed in Australia has

injury cases. The report suggests that,

remained relatively constant at about 20% of the workforce since 1999 [ABS 2012, p. 2]”. 10

“It is difficult to know how many employees experience mental stress at any given time because the workers compensation

This leads us to ask what the real incidence of psychological

data is administrative data collected from accepted workers

injuries may be. With significantly higher levels of cases in

compensation claims. It does not include any information

the non-compensable space we can’t necessarily assume that

on unsuccessful claims, any insight into the number of

psychological injuries are on the decline. Employers are obviously

workers who experience mental stress but choose not to

still grappling with this issue and while our data shows that those

claim workers compensation or on workers who are not

with psychological injuries are being referred earlier than those

covered by compensation. This means that the workers’

with physical injuries, the average delays to referral times are

compensation data are skewed towards those workers who

increasing. In the last financial year the average delay to referral

are more likely to claim based on their occupation, age,

was 24 weeks for non-compensable claims and 103 weeks for

industry of employer, and where they have secure employment”. 10

compensable claims.

Additionally, the report states that “There are a number of

Again this highlights the importance of early intervention.

factors that may explain the recent downward trend in successful

Successful RTW outcomes are being achieved across the board.

workers compensation claims for mental disorders caused by

However, those who returned to work on full or partial hours

work-related mental stress. Research has found North American

experienced a significantly shorter average delay to referral

employees deferred claiming compensation because they feared

time in both the compensable and non-compensable groups

job loss [Institute for Work & Health 2009]. This may also apply

of 43 and 17 weeks respectively. This is compared to those

to Australian employees who have experienced job insecurity

with unsuccessful RTW outcomes where the average delay to

because of their precarious work status. Around one-fifth of

referral time was 97 weeks and 32 weeks for the compensable

Australia’s workforce are employees without leave entitlements

and non-compensable groups respectively. See table 5.

Table 5: Psychological injuries by scheme; cost; RTW outcomes Compensable Referrals

Non-compensable Referrals Ave. Delay

Ave. Delay

RTW Outcome

% of Referrals

Ave. Cost

to Referral

% of Referrals

Ave. Cost

to Referral

RTW Achieved

81%

$3,207

43 weeks

91%

$1,703

17 weeks

No RTW

19%

$3,184

97 weeks

9%

$2,468

32 weeks

RTW Achieved No RTW

November 2013

Compensable Referrals

No RTW

RTW Achieved Non-compensable Referrals

17


RTW outcomes Overall the RTW rates achieved for those referred specifically

The RTW rates for those with psychological injuries were

for RTW services remained consistent throughout the period

also consistent, with 86% of those with a psychological

analysed at an average of 88%, with an average of 74%

injury achieving a RTW, while the RTW for those with

returning to full pre-injury hours.

all ‘other’ injuries was marginally higher at 89%.

Those who did not achieve a RTW outcome had a significantly

The delay to referral time is significantly longer for those who

longer average delay in referral time at 115 weeks compared to

did not achieve a RTW outcome. The average service cost

those who did achieve a RTW outcome at an average of 39 weeks.

incurred on those cases where there was no RTW outcome was higher than the cases where a successful RTW was achieved.

Table 6: Comparison of those who achieved a RTW and those who did not RTW Achieved

No RTW

Variable

Category

n=1,1994

n=1,536

Gender

% Male

64%

63%

Age

Ave. Age

40 yrs

42 yrs

Service Cost

Service Cost

Ave. Cost

$2,552

$3,295

Duration

Service Duration

Ave. Weeks

21

26

Delay to Referral

Ave. Weeks

39

110

Psychological Injury (PI)

% of all P I

85%

15%

Other Injury (OI)

% of all OI

89%

11%

Compensable (C)

% of all C

88%

12%

Non-compensable (NC)

% of all NC

94%

6%

Socio-demographic

Injury Type

Referral Type

Referral Type Compensable Referrals

Non-compensable Referrals

88% RTW

94% RTW

12% No

6% No

Achieved RTW

18

Achieved RTW

Konekt Market Report


Comparing compensable and non-compensable RTW outcomes Overall the RTW rates over the period analysed remained

non-compensable group were done in a lower average service

consistent at an average of 88% for compensable referrals and

time of 14 weeks compared with an average of 23 weeks for

94% for non-compensable referrals. The rate of compensable

the compensable group. The RTW for the non-compensable

referrals which did not result in a RTW was 12%, double that

group were achieved at a lower average service cost of $1,430

for non-compensable referrals.

compared with $2,745 for those achieving successful outcomes in the compensable group.

Significantly, the non-compensable referrals were referred earlier for both RTW and specific services. Perhaps because of

Overal the non-compensable cases had a higher RTW rate at 94%,

this early intervention and preventative approach by employers,

at a lower average service cost; however they are referred for the

the RTW rates were better. The RTW rates achieved by the

rehabilitation service much earlier than the compensable referrals.

Table 7: Comparison of compensable and non-compensable RTW outcomes RTW Outcome

Compensable

Non-compensable

n=11,649

n=1,881

Outcome as % of RTW Referrals No RTW

12%

6%

RTW – Full Hours

78%

86%

RTW – Partial Hours

11%

8%

Ave. Service Cost No RTW

$3,389

$2,167

RTW – Full Hours

$2,654

$1,399

RTW – Partial Hours

$3,382

$1,771

Total

$2,823

$1,476

Ave. [Weeks] Duration of Service No RTW

27

18

RTW – Full Hours

22

13

RTW – Partial Hours

26

17

Total

23

14

Ave.[Weeks] Delay to Referral No RTW

115

23

RTW – Full Hours

35

21

RTW – Partial Hours

83

22

Total

50

21

November 2013

19


Impact of duration of disability on RTW outcomes A closer look at the impact the duration of disability has on

These outcomes are achieved at a lower average cost and

successful RTW outcomes clearly demonstrates that the earlier

have a lower average period of rehabilitative assistance

the referral is made post injury, the greater the likelihood of a

across all categories compared to the compensable referrals.

successful RTW. For all RTW referrals, 94% of those referred within the first 6 months post injury achieved a RTW compared

Looking at the compensable data only, 94% of the referrals

to only 76% referred 12 months post injury. Our data again

made within the first 6 months post injury achieved a successful

shows differences between the compensable population and

RTW compared to 86% of those referred between 6 and 12

non-compensable population with 82% of the non-compensable

months post injury. The proportion of referrals that had a

referrals being made within the first 6 months post injury achieving

successful RTW reduced to 68% for those referred more than

a RTW compared to 63% of the workers compensation referrals.

two years post injury. Our data is consistent with previous findings that suggest that a key factor in achieving successful

Across all duration of disability categories the non-compensable

RTW outcomes is the length of time the person had been

referrals have a higher percentage of successful RTW outcomes.

‘disabled’ due to their injury prior to being referred.11,12

Table 8: Impact of duration of disability on compensable and non-compensable RTW outcomes Compensable RTW Referrals n = 11,649 Ave. Duration

% of Referrals

Ave. Duration

% of Referrals

Duration of

Ave. Service

of Service

achieved

Ave. Service

of Service

achieved

Disability

Cost

[Weeks]

RTW outcome

Cost

[Weeks]

RTW outcome

0-6 months

$2,739

22

94%

$1,554

14

95%

6-12 months

$2,880

24

86%

$1,468

14

92%

12-24 months

$2,980

25

82%

$2,057

18

93%

> 24 months

$3,015

26

68%

$1,996

15

91%

Compensable RTW Referrals 94%

0-6 months

86%

6-12 months

82%

12-24 months

68%

>24 months

20

Non-compensable RTW Referrals n = 1,884

Non-compensable RTW Referrals 95%

0-6 months

92%

6-12 months

93%

12-24 months

91%

>24 months

Konekt Market Report


In summary Early intervention is the key to improved cost effective outcomes There are significant differences in the population referred and outcomes achieved for compensable and non-compensable referrals There is a need to better understand the incidence of workplace psychological injury. Internationally the evidence of the benefits of early referral impacting on return to work outcomes is strong. This experience is supported by the Konekt data where 94% of those referred within the first 6 months post injury achieve a RTW compared to 76% referred 12 months post injury. However, our data also

As well as providing improved return to work outcomes, early referral results in a lower average rehabilitation service cost, with the average cost incurred per successful RTW being significantly lower. This point is critical for the viability of personal injury compensation schemes and employer premium stability; however the Australian market is largely immature in its use of genuine early intervention strategies and tools.

suggests that the ability of the rehabilitation provider to provide early intervention may be compromised due to the length of

The compensable and non-compensable groups referred have

time between the injury and when the referrals are made –

different profiles, with the compensable cases more likely to be

at an average 62 weeks and 23 weeks post injury for compensable and non-compensable cases respectively

male, have a lower socioeconomic profile, and have a longer

It is not suggested that those with prolonged durations of

compared to 17 weeks for the non-compensable group.

disability do not benefit from rehabilitation, as they do achieve

The non-compensable outcomes are more favourable, with

successful RTW outcomes. Our data shows that of those

the main contributory factor appearing to be early referral.

referred greater than 12 months post injury, 76% achieved a

Other contributory factors are likely to be the lack of delays

successful RTW outcome. Overall, however, the data supports

caused by being in the workers compensation system and

early referral for improved RTW rates.

the more holistic preventative approach taken by employers.

period of disability prior to referral at an average of 90 weeks

13

It is also possible that the non-compensable referrals are for As well as providing improved return to work outcomes, early

injuries of a lesser severity. The compensable group incurred

referral results in a lower average rehabilitation service cost,

a higher average cost of rehabilitation services for both RTW

with the average cost incurred per successful RTW being

and specific services and a significantly longer period of

significantly lower. This point is critical for the viability of

rehabilitation service.

personal injury compensation schemes and employer premium stability; however the Australian market is largely immature

With a substantial body of evidence supporting the benefits

in its use of genuine early intervention strategies and tools.

of work on health, rehabilitation efforts need to be directed towards staying in the workplace, and if away from the

Early referrals also result in a decreased period of rehabilitation

workplace towards RTW. This is effectively done by ensuring

services. For compensable referrals this is particularly important,

injured people have the necessary supports in place as soon

as research suggests that exposure to the compensation system,

as possible following their injury – early intervention.

and specifically duration of exposure to the compensation system, has a negative impact, so the less time people spend in the system,

Finally, our data suggests a closer look at the incidence of

the greater the likelihood of better health and RTW outcomes.

psychological injury cases in Australian workplaces may be

14,15

warranted. Our data shows there are a significantly higher proportion of referrals for mental injuries in the non-compensable group (24%) compared to just 9% in the compensable group over the period analysed.

November 2013

21


References 1 Safe Work Australia. Workplace Relations Ministers’ Council 2010. Comparative Performance Monitoring Report. 12th edition. 2 Heads of Workers’ Compensation Authorities (HWCA) 2010. Australia and New Zealand Return to Work Monitor 2009/2010. 3 Krause N, Frank JW, Dasinger LK. et al. 2001. Determinants of duration of disability and return-to-work after work-related injury and illness: challenges for future research. Am J Ind Med. 2001; 40:464–84. 4 Australian Bureau of Statistics (ABS), 2011. Australian Social Trends, June 2011. Work and Health Cat no. 4102.0. 5 Safe Work Australia, 2013. The Compendium of Workers’ Compensation Statistics 2010-11. 6 Casey PP, Guy L, & Cameron, ID. Determining return to work in a compensation setting: A review of New South Wales workplace rehabilitation service provider referrals over 5 years. Work 03/2013; DOI:10.3233/WOR-131608. 7 Safe Work Australia. 2012. The Cost of Work-Related Injury and Illness for Australian Employers, Workers and the Community: 2008-09. 8 Australasian Faculty of Occupational and Environmental Medicine (AFOEM). 2011. Realising the health benefits of work, The Royal Australasian College of Physicians. 9 Australian Faculty of Occupational Environmental Medicine (AFOEM). 2010. Realising the Health Benefits of Work: A Position Statement. 10 Safe Work Australia, 2013. The Incidence of Accepted Workers’ Compensation Claims for Mental Stress in Australia. 11 Krause N, Ragland D. Occupational disability due to low back pain: A new interdisciplinary classification based on a phase model of disability. Spine 1994; 19: 1011-20. 12 Krause, N, Dasinger, LK, Deegan, LJ, Rudolph L, Brand RJ. 2001. Psychosocial job factors and return-to-work after compensated low back injury: A disability phase-specific analysis. Am J Ind Med 374-392. 13 Jordan, K. D., Mayer, T. G., & Gatchel, R. J. (1998). Should extended disability be an exclusion criterion for tertiary rehabilitation?: Socioeconomic outcomes of early versus late functional restoration in compensation spinal disorders. Spine, 23(19), 2110-2116. 14 Harris I, Mulford J, Solomon M, et al. Association between compensation status and outcome after surgery: a meta-analysis. JAMA 2005;293:1644–52. 15 Casey, P P, Feyer, A M, & Cameron, I D. (2011). Identifying predictors of early non-recovery in a compensation setting: The Whiplash Outcome Study. Injury, 42(1), 25-32. 16 Australian Bureau of Statistics (ABS) 2008. Information Paper: An introduction to Socio-Economic Index for Areas (SEIFA) (2039.0). Canberra: Australian Bureau of Statistics.

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Konekt Market Report


the leader in workplace health solutions Konekt Sydney Level 12, 234 Sussex Street, Sydney NSW 2000 T: (02) 9307 4000 F: (02) 9307 4044 Adelaide Level 7, 41 Currie Street, Adelaide SA 5000 T: (08) 8214 4000 F: (08) 8214 4040 Canberra Fern Hill Technology Park, Ground Floor, Unit 2, 9 Thynne Street, Bruce ACT 2617 T: (02) 6129 5200 F: (02) 6129 5222 Darwin Tenancy 9, Level 1, 396 Stuart Highway, Winnellie NT 0820 T: (08) 8995 8300 F: (08) 8995 8333 Hobart Level 11, 39 Murray Street, Hobart TAS 7000 T: (03) 6225 8000 F: (03) 6225 8050 Brisbane Suite 3.3, Level 3, 67 Astor Terrace, Spring Hill QLD 4001 T: (07) 3230 8333 F: (07) 3230 8399 Melbourne Level 4, 179 Queen Street, Melbourne VIC 3000 T: (03) 9624 5000 F: (03) 9624 5055 Perth Level 3, 8 Outram Street, West Perth WA 6005 T: (08) 9219 7222 F: (08) 9219 7233 Konekt has more than 35 offices nationally, for contact details of all offices go to www.konekt.com.au or call 1300 723 375.

Disclaimer While every reasonable effort has been made to ensure that this document is correct at the time of printing, Konekt Australia Pty Ltd, Cortex Solutions and their employees disclaim any and all liability to any person in respect of anything or the consequences of anything done or omitted to be done in reliance or upon the whole or any part of this document.

Copyright notice We encourage you to use this information and you are welcome to reproduce the material that appears in the Konekt Market Report 2013 for personal, in-house or non-commercial use without formal permission, as long as you attribute the work to Konekt Limited and abide by the other licensing terms. The report should be attributed as “Konekt Market Report, November 2013”. All other rights are reserved. If you wish to reproduce, alter, store or transmit material appearing in the Konekt Market Report for any other purpose, request for formal permission should be directed to marketing@konekt.com.au.

Authors Konekt: Megan Connell, Matt May, Philip Paysden Cortex Solutions: Petrina Casey

M001037 Iss 1 Nov 13 © Konekt Limited 2013 Konektiva is a trademark of Konekt Limited.

Konekt Market Report November 2013

Konket Market Report 2013  

Workplace Health Solutions

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