The impact of musculoskeletal disorders on organisation’s and individual’s returning to the workplace.

During 2008-2009, 128 735 serious claims for workers compensation were lodged nationally. Two thirds of all serious claims were the result of injury with sprains & strains of joints and adjacent muscles. The most common disease claims were disorders of muscle, tendons and other soft tissues, accounting for 6% of all serious claims. Muscular stress while lifting and/or handling objects resulted in 33% of all serious workers compensation claims lodged. (SafeWork Australia, 2011

Musculoskeletal disorders (MSDs) include problems such as low back pain, joint injuries and repetitive strain injuries of various sorts (Health and Safety Executive UK). There is a strong relationship between back disorders and manual material handling (National Research Council & Institute of Medicine, 2001, p.9). Within Australia during the 2008-2009 reporting period 22% of all serious claims lodged for compensation involved injury to the claimants back (SafeWork Australia, 2011).

Within the retail trade industry sprains/strains accounted for nearly half of the injuries that required five or more days off work (SafeWork Australia, 2009), however even when injuries involved five or more days off work only one in two workers claimed compensation. There were therefore 10 000 workers who did not claim compensation for their serious work-related injury, this is important to consider when reading on further in this article about the impacts a musculoskeletal disorder can have on a person and the support that WorkCover can provide.

Workplace injuries are disruptive and can have an impact on day-to-day life. Some injuries can have a lifetime impact and require high levels of support and services over a long period of time. In the past many injured workers who suffered a significant injury found that their employer often provided little contact or assistance until they were fully recovered and ready to come back to work. Sometimes the only contact a worker would receive was a notice of termination. Some organisations have been known to show “expressions of accusation and anger toward the injured worker, despite a desire to reinstate the worker at work as soon as possible” (Nuttman-Shwartz & Ginsburg, 2002, p.19). Workers feeling poorly treated or neglected by their employer following a significant injury are more likely to not return to the workplace and potentially sue for damages at common law.

All parties have obligations following any workplace injury.

Employers must provide the injured worker with:

  • First aid and/or transport for medical treatment;
  • Details of the insurer, employer contact, claim form;
  • Suitable duties while helping the worker to recover and return to work quickly.

Workers also have responsibilities including:

  • Workers must report all accidents, injuries, illness, damage and near misses as soon as possible to the employer;
  • All injuries and accidents should be recorded on official report forms and promptly submitted to the appropriate personnel for processing and/or storage;
  • Where necessary, medical records, medical certificates, treatment records and any other associated documentation must be submitted to their manager;
  • Participate in an approved return to work program.

Effects on the person

‘A disability or chronic illness, which has its origin either in birth or in an event occurring during teenage, adult, or later-life years, has a profound impact on one’s life adjustment, opportunities, and quality of life’, (Orto & Power, 2007, p121.)

Musculoskeletal injuries can pose short term and long term implications to an individual. Sprains and strains may appear to be simple injuries at the time, however after time and repeated aggravation they can seriously reduce a person’s capacity for work.

It is important to consider that workers with musculoskeletal disorders are not likely to be able to return to their full range of duties immediately following a workplace accident. Some workers may never return to their full range of duties and be given ‘permanent modifications’ by their treating physician, for example lifting limits of up to 5kg are common for lower back disorders. Persons with musculoskeletal disorders may need to be rotated regularly through tasks and may require frequent rest breaks. Difficulties outside of the workplace must also be considered, such as the worker may have difficulties travelling to and from work. Attention will also need to be paid to ergonomic factors, such as chairs, tables and computers.

Being away from the workplace can be a major barrier in returning. The longer a worker is away from the workplace the more detached they become, they may develop feelings of isolation; they may become depressed, resentful and even suicidal. Being away from the workplace for a long period of time may also allow psychological illnesses to develop.

Workers suffering from a workplace injury may find that the frequency and severity of stressful situations increases. Stressors may include threats to one’s life, wellbeing, body image, autonomy, financial stability. Becoming detached from the workplace can introduce further stressors, workers may develop feelings of abandonment, being socially outcast, not recognised for their contributions, passed up for promotions, etc. All are barriers to a positive return to the workplace.

Some workers may be concerned that their income is reduced whilst they are off work and awaiting approval on their claim. This can potentially leave an incapacitated (weekly paid) worker without wages until their claim is accepted by the insurer. Medical and pharmaceutical costs (out of pocket expenses) can also become a burden to the injured worker – expenses are reimbursed once a claim has been accepted, however this can take some time and leave workers short of money.

The best thing for all concerned is to return injured workers to the workplace as soon as it is safe for them to do so. ‘Research shows that staying home until completely recovered is often not the best thing for your injured worker to do – returning to work with the doctor’s consent, event to restricted duties, is an important part of recovery for many people’, (WorkCover SA, 2008)

Where workers are unable to return to the workplace immediately, communication is extremely important to show workers they are still a valued member of the team, their position is waiting from them and the workplace wants to see them back.

A worker who receives the appropriate support while returning to work in the workplace often shows the business firm desire to increase in capacity and return to full duties, an appreciation of all the business has done to assist them with their recovery and often have a greater sense of loyalty to the company.

Effects on the family

An injury to a family member may have consequences to the whole family unit. The injured person may be the primary income source to the family; they may be a parent, a son or daughter. No matter the position within the family an injury will impact the whole group.

Injury to an income bringer within a family can introduce a range of additional stressors to the injured person and their family members. An injury resulting in complete incapacitation for a period may reduce the potential income that family member can bring home (even whilst receiving workers compensation).

The potential for the injured family member to not be able to drive, or perform their usual home tasks is very high following a musculoskeletal injury, in these cases most families ‘cope’ with the short term inconvenience. In the case of a musculoskeletal disorder, where a person may be prone to re-aggravating a past injury or may have reached a point where they are unable to completely recover extra stress would be brought onto the family to cope with those restrictions.

It can also be difficult for parents to support their children when injured, this could bring a financial burden on the parents, whilst lending money to the person until their compensation payments begin, driving the person to and from appointments (which can include multiple visits per week, e.g. physio, doctor, counsellor, etc).

In some cases WorkCover helps to support families by making modifications to persons homes/cars where required – e.g. installing handrails into bathrooms to assist a person moving around their home, installing ramps to replace steps, etc. The costs of making these structural changes can be very high and the Workers Compensation scheme is designed to help reduce the financial burden of these changes as a result of a workplace injury.

Effects on the organisation

Injuries within the workplace can effect an organisation in many ways, the most visible effect on an organisation is through the direct costs of the incident, expenses such as providing medical attention, rehabilitation services, legal counsel, medical examinations, investigations and weekly compensation payments.

A commonly used phrase to describe the costs of injury is the ‘tip of the ice berg’, direct costs to the business are only the ‘tip’ the true financial extent rests ‘below the water’ in the indirect costs.

Indirect costs to an organisation include the time lost by workers and supervisors when completing reports, cost of investigation, man hours spent cleaning up accident areas, loss of skill and experience in the workforce, lowered production of worker replacement, time lost by workers providing first aid, idle time of workers whose work is interrupted, damage to the organisations image, lowered worker morale, possible property loss, replacement worker costs and increased labour conflict and industrial relations problems.

Workplace injuries also pose intangible costs. An injury can interfere with the balance of the relations between employer and worker, workplace injuries cause feelings of anxiety and insecurity regarding safety and management authority in the workplace (Nuttman-Shwartz & Ginsburg, 2002). The cost of pain, suffering and depression of the injured person, their family, friends and the community can not be measured – nor can the feelings of guilt, helplessness and the impact a workplace injury can have on workplace culture.

There are additional organisational costs which must also be considered, such as when industrial action or litigation results from a workplace injury or disease, or where disputes and complaints over work practice arise.  Managers and workers may be required to attend interviews, make statements, prepare reports, leave the workplace to attend court, etc. Conciliation and resolution procedures can be extremely costly, and to add to all of these costs further legal, administrative, and punitive charges may apply.

Returning a worker to the workplace sooner, results in lower claim costs, less time loss, greater involvement in the return to work process, a better understanding of the worker’s condition, and faster recovery.

Potential barriers in returning a worker effectively to the workplace

  • An organisation without a job dictionary or clearly defined position descriptions may have difficulties mapping the prescribed duties of an injured worker against the physical demands of the workplace duties. Implementing a detailed job dictionary can significantly increase the effectiveness of the return to work strategy (OHS Alert, 2010)
  • Organisations who do not provide effective training and support to return to work personnel can potentially be in breach of OHS Legislation. In Victoria (as an example) 2009 amendments to the State Accident Compensation Act 1985 require returntowork managers to be senior staff members with the authority to make decisions and influence operations that get people back on the job,
  • Effective injury management and return to work processes should be established within the organisation, this not only benefits the worker but also helps the organisation to fulfil its legal obligations. In 2010 retailer Aldi was ordered by the Victorian Magistrates Court to donate $12,000 to charity for its ‘sloppy return to work and injury management processes’  (OHS Alert, 2010)

 Bibliography

Health and Safety Executive UK. (n.d.). Musculoskeletal Disorders. Retrieved March 14, 2011, from HSE: http://www.hse.gov.uk/msd/hsemsd.htm

National Research Council & Institute of Medicine. (2001). Musculoskeletal Disorders and the Workplace: Low Back and Upper Extremities. Washington, D.C.: National Academy Press.

Nuttman-Shwartz, O., & Ginsburg, R. (2002). Early Rehabilitation Program after Workplace Injuries. Employee Assistance Quarterly, 19.

OHS Alert. (2010, September 15). Labour-hire company’s “job dictionary” assists speedy return to work. Retrieved March 14, 2011, from OHS Alert: http://www.ohsalert.com.au/nl06_news_selected.php?act=2&stream=2&selkey=43672&hlc=2&hlw=return+to+work&s_keyword=return+to+work&s_searchfrom_date=631112400&s_searchto_date=1300090551&s_pagesize=10&s_word_match=2&s_articles=2&stream=2

OHS Alert. (2010, September 1). Neglect return-to-work practitioners at your peril. Retrieved March 14, 2011, from OHS Alert: http://www.ohsalert.com.au/nl06_news_selected.php?act=2&stream=2&selkey=43548&hlc=2&hlw=return+to+work&s_keyword=return+to+work&s_searchfrom_date=631112400&s_searchto_date=1300090551&s_pagesize=10&s_word_match=2&s_articles=2&stream=2

OHS Alert. (2010, September 3). Sloppy workers’ comp process costs Aldi $12K. Retrieved March 14, 2011, from OHS Alert: http://www.ohsalert.com.au/nl06_news_selected.php?act=2&stream=2&selkey=43575&hlc=2&hlw=return+to+work&s_keyword=return+to+work&s_searchfrom_date=631112400&s_searchto_date=1300090551&s_pagesize=10&s_word_match=2&s_articles=2&stream=2

Orto, A. E., & Power, P. W. (2007). The Psychological and Social Impact of Illness and Disability. New York: Springer Publishing.

SafeWork Australia. (2009). Work-related injuries 2005-2006: Retail Trade Industry. Retrieved March 12, 2011, from SafeWork Australia: http://www.safeworkaustralia.gov.au/IndustryInformation/retailtrade/Pages/Retailtrade.aspx

SafeWork Australia. (2011, February 28). Compendium of Workers Compensation Statistics Australia 2008-09. Retrieved March 14, 2011, from SafeWorkAustralia: http://www.safeworkaustralia.gov.au/News/Pages/TN010311Compendium.aspx

WorkCover SA. (2008, December). All you need to know about Rehabilitation and Return to Work Coordinators. Retrieved March 14, 2011, from WorkCover South Australia: http://www.workcover.sa.gov.au/public/download.aspx?id=1715