Overcoming and understanding employer barriers when returning Claimants to work

Posted 13th March 2010

The majority of Rehabilitation Case Managers are responsible for not only coordinating the treatment and rehabilitation to assist Rehabilitation Clients (employee/claimant) back to work, following accident or ill health, but they also cross the lines into the return to work management and the role of Vocational Rehabilitation Specialists.

The majority of Rehabilitation Case Managers are responsible for not only coordinating the treatment and rehabilitation to assist Rehabilitation Clients (employee/claimant) back to work, following accident or ill health, but they also cross the lines into the return to work management and the role of Vocational Rehabilitation Specialists.


Dealing with the employer and some of the Vocational issues can often be a challenge for Rehabilitation Case Managers, who tend to be predominantly clinically qualified and don’t necessarily always have the training or skills in VR.


According to the Rehabilitation Counselling Association of Australasia a Vocational Rehabilitation Counsellor has the following technical skills:


·         Counselling theory and skills

·         Rehabilitation Theory and practices

·         Medical , Psychological and Social aspects of disability

·         Psychosocial foundations of behaviour

·         Careers Theory

·         Employment trends

·         Vocational Assessment

·         Employment Legislation

·         Case and Caseload Management

·         Job Development skills

To enable them to develop the competencies outlined above, many Vocational Rehabilitation Specialists in the UK can draw upon both training and experience.  They often have training in Human Resources, Careers advice, Disability Management, Vocational Rehabilitation and understand how to practically support return to work issues within an environment of complex relationships.


However, it is not always possible for a Rehabilitation Case Manager to tap into and utilise the skills of a Vocational Rehabilitation Specialist.  For this reason it is important for the Rehabilitation Case Managers to obtain an appreciation of the employer’s role and their issues.  In all cases where a return to pre accident/ill health role is the goal, the pre-injury employer is the gate keeper; therefore it follows that they themselves need as much expertise and careful management as the Rehabilitation Client, when managing the return to work.


Case example:


Mr X suffered a mild brain injury that had left him with some restricted cognitive function, but with support he was able to complete and pass a training course in CAD (Computer Aided Design), which he had started pre accident.  Mr X’s pre injury employer welcomed him back into the workplace, but within weeks the return to work failed, as Mr X was reportedly unable to manage the duties required to fulfil the role.  At this stage the Medical Rehab Case Manager, who was instructed to support Mr X with his rehabilitation and return to work, made recommendations regarding further treatment that would benefit his recovery.  However when asked about his employment status, the Rehab Case Manager reported that due to difficulties and restrictions clearly demonstrated in the failed return to work, a return to the pre injury employer would not be possible. Therefore the goal would be a return to different job with a different employer.


In this case a Vocational Rehabilitation Specialist would have taken the view that by completing the training and making attempts at returning to their pre injury employer, the Rehabilitation Client/Claimant clearly had potential for achieving this goal.  Therefore further exploration could have been undertaken to identify and explore potential solutions to the following:


  • Why did the return to pre injury employer fail?
  • What aspects of the job did the Rehab Client find most difficult?
  • Would it be reasonable for these aspects to be modified or removed?
  • What about available support of his co-workers?
  • Would the implementation of a support worker, via Access to Work funding, help and provide a solution?
  • What technical equipment could be considered to aid his functioning?


Why is early intervention with employers so important?


Case example – keeping the employer on board


Mr Y suffered a hand crushing injury at work and was absent from work for over 12 months.  At the Immediate Needs Assessment (INA) the Rehab Case Manager was focused on the medical recovery of Mr Y and how an investment in treatment could progress his recovery further.  The employment situation of Mr Y was considered by the Rehab Case Manager and commented on in the INA as follows: “Having spoken to the employer they have expressed that they are keen to support Mr Y in any way they can with his return to work”.  At this stage the Medical Case Manager proceeded with managing the case from a medical perspective.  The Medical Case Manager did not keep in contact with the employer, did not visit the workplace or keep the employer updated with the rehabilitation progress. 12 months later, when Mr Y had completed his treatment and was ready to investigate return to work options, the employers were less receptive.  This was possibly because they had been managing without Mr Y in the workplace and were now less committed to him as an employee. Furthermore Mr Y had built up 12 months of resentment toward his employer; due to the lack of contact he had from them.  The lack of communication was interpreted by Mr Y as lack of care.


In this case it would be helpful for the Rehab Case Manager to meet with the employer immediately after the INA; identify any concerns and offer them advice on continued, good absence management, for example keeping in regular contact with Mr Y, inviting him to attend meetings or social functions.  Such measures would help to ensure that Mr Y continued to feel and be treated as a valued member of the team. Often employers are fearful of the claim in hand, so suspend all sensible and best practice absence management procedures.  It is therefore important to provide advice and support to prevent this from happening, as it can be a huge barrier to overcome in the return to work process.


How can you support HR and Line Managers?


New regulations to the current sick note system are expected to come into force in April 2010. It is important as Rehab Case Managers to be aware that this has huge implications for employers.  The new “fit note” systems is due to be implemented following the government review “Working for a Healthier Tomorrow” published in 2008.  The “fit note” system will allow GP’s to indicate whether an employee fits one of three categories. These are “fit for work”, “not fit for work” or “may be fit for some work now”.  For the last category GPs will be asked to describe the functional effects of an employee’s medical condition and will have an option to indicate what arrangements will help that employee return to work. This may include provision such as reduced hours or adjusted duties.


The CIPD (Chartered Institude of Personnel and Development) are positive about the new reforms to the current system. For example Mike Emmott, the employee relations advisor for the CIPD states.   "We welcome the announcement from the Department for Work and Pensions that GPs are to be required to provide better advice to employers and patients on return to work options” www.witanjardine.co.uk


However one of the challenges, based on the feedback of GP’s is that they do not have the time, skills, detailed workplace information or resources to enable them to make such decisions.  It is likely that there will be an increased need for Functional Capacity and Vocational Workplace Assessments.  These interventions will equip employers and GP’s with more information and provide recommendations to support the successful implementation of the new system. However, as yet many HR professionals are not aware of the benefits of such assessments. Therefore, further support is required to educate employers and GP’s to improve understanding of the different types of assessment and how they can be utilised to support the return to work process.


The new “fit note” system will also pose a number of legal questions for the employer i.e. can the employer take disciplinary action if the employee refuses to return to modified duties as recommended by the GP? As always, it will be important for employers to obtain legal advice on such issues, but also for Rehabilitation providers to be aware of the implications of legislation such as the DDA and be able to offer solutions for employers, in accordance with the Act.


While the new “fit note” system should have a huge beneficial impact on reducing sickness absence in the UK and bring us more in line with countries such as Australia, Canada and America, stakeholders across a broad range of professions will have a lot to learn and will need our support.


What if the claimant does require a new job/new employer?


Working in the front line supporting people with disabilities with their return to work requires a specific set of skills and competencies, predominantly developed through practical experience, to job search, negotiate with employers, complete competitive CVs/application forms and prepare claimants for interviews.  This job seeking activity also requires the claimant to have access to local vacancies, employer relationships and resources to enable them to be fully supported in their return to work.


Evidence suggests that Insurers do not want to pay for clinically trained staff to carry out the specific roles of job searching and placement activities such as these. Some organisations, such as Shaw Trust, have a unique funding model which means that only return to work outcomes are financially rewarded, therefore staff are motivated and driven by sustainable return to work outcomes, plus they can offer the expertise, resources and local knowledge required, to support the Rehab Case Manager and the Rehab Client to achieving a return to work outcome.


What are the benefits to the case manager outsourcing job searching services?


  • Improved RTW statistics
  • Strong employer links and access to UK wide vacancies
  • Greater employment market intelligence
  • Nationwide coverage and local knowledge of other services
  • More cost effective for your fee paying clients


By working together with Vocational Rehabilitation Specialists and supporting the employer, a better and more cost effective outcome can be achieved for everyone involved in the return to work process.


By Clare Ginders – BA hons, CDMP (Certified Disability Management Professional).  Level A – Psychometric Testing, accredited by and member of the BPS (British Psychological Society), member of CIPD (Chartered Institute of Personnel & Development) and professional member of the VRA (Vocational Rehabilitation Association). clare@gindersvrs.co.uk

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