Newslink November 2011 WorkCoverSA 2011 Recovery & Return to Work Awards and conference – outstanding achievements recognised In this issue: Professor Kim Burton on the connection between work and recovery Dr Richard Pimentel on communication between supervisors and GPs The science of pain – how the brain processes pain Contents General news The connection between work and recovery 4 Building confidence in youth with mental illness 5 Learn to love the challenge... 6 Workplace news More on the new approach to employer payments 7 Meet the coordinator 8 OHSW a key to success for Courts Administration Authority 9 Communication between supervisors and GPs 10 Workplace culture aids recovery 11 2011 Recovery & Return to Work Award winners and finalists 12 Kenlen Seeds, winner Employer excellence award (small to medium employer) 13 Tackling asbestos dangers in the workplace 14 Model WHS laws update 14 OHSW tips – safe events in the silly season 15 Mental health first aid training and support 16 Health providers Is time off work always the best prescription? 17 There's a lot of evidence for evidence-based guidelines 18 Calling all bilingual providers 19 WorkCover sponsors neurodynamics and the neuromatrix conference 19 Perceptions of back pain treatment 20 WorkCover Medical Certificates and how to access them 21 The science of pain – Dr Lorimer Moseley 22 Cover image: Four of the Recovery and Return to Work Awards trophies on stage prior to unveiling 2 November 2011 From the CEO Welcome to the November edition of Newslink for 2011. The year has passed quickly and now we are heading towards Christmas. As we start preparing for our move to 400 King William Street in the new year, the annual report has been published and our annual results have been released (see the WorkCover website for details). At the time of going to press, the proposed employer payments system mentioned in previous editions of Newslink was being introduced into Parliament. The system is expected to be in place for the financial year 2012-13 subject to the passing of legislation. It will see employer payments (or levies) more accurately reflect an employer's past claims history. It provides a financial incentive for employers to improve their claims experience through good health and safety practices and return to work management (see page 9 for an update). Calls for Expressions of Interest (EOI) for both future claims management services and claims legal services have been issued, with current contracts due to expire in December 2012. I will chair the evaluation committee that will oversee the procurement and includes WorkCover's General Manager of Operations and three external non-stakeholder members. Congratulations to the winners in the Recovery and Return to Work Awards which were held in September to celebrate the outstanding achievements of injured workers and those who have helped them remain at or return to work (see page 12-13). Each year we continue to be inspired by their success and commitment. Following on from the Awards the annual conference was a huge hit. Experts from around Australia and beyond joined together to reinforce the message that recovering at work is better. From the science of pain to bullying at work, feedback from attendees was excellent. As we move towards the end of the year, I take the opportunity to wish you a safe and happy festive season. Rob Thomson Chief Executive Officer General News The connection between work and recovery Professor Kim Burton explains the link Professor Kim Burton speaking at WorkCover's 2011 annual conference – Staying connected. Multi-award winning occupational health expert, author and lecturer Professor Kim Burton was in Adelaide recently to present a keynote speech at the sixth annual WorkCover conference, Staying connected. With a career focus on back pain and other common musculoskeletal problems, Professor Burton's special interest is in ergonomics and workplace injuries. He is a strong believer in return to work as a good business strategy. Professor Burton's research shows injured workers recover better at work or, if they can't get back to work immediately, remaining in close contact with their workplace can improve their chances of recovery. This means keeping in touch with managers and colleagues and maintaining social contact during their recovery, in other words: staying connected. He strongly believes early intervention is the key to smarter and more effective rehabilitation of injured workers. Providing the 'right treatment at the right time' is crucial. He suggested healthcare practitioners examine the way they deal with injured workers and implement recovery plans. This extends to the language used when speaking to an injured worker. If practitioners treat their patients from the perspective of what they are able to do, rather than what they can no longer do, patients will focus on recovery rather than a perceived disability. Healthcare providers should also review the ways they recommend alternative or modified duties by being specific in defining what the injured worker is able to do, rather than recommending 'light duties', which is currently a frequent approach. Professor Burton says along with more specific recommendations for duties, workplaces should be comfortable when we are well and accommodating when we are injured.Managers and supervisors should consider the ways in which they can remove obstacles that prevent injured workers from remaining at or returning to work.If employers and supervisors ask the 'right' questions of the injured worker and the healthcare provider, suitable solutions, that take into consideration the injured worker's needs and those of their employer, can be arrived at more easily. Questions such as 'when do you think you'll be back at work?' or 'what can we do to help you get back to work?' are examples of phrases that demonstrate employers value their workers both when they are fully able and when they are recovering from an injury. Professor Kim Burton's research and practice in workplace injury and rehabilitation shows overwhelmingly that work is a vital therapeutic part in the process of remaining at or returning to work for injured workers. People often identify themselves through their work so keeping an injured worker connected with their workplace, either through quick return to work or a graduated program and maintaining social connections dramatically improves the recovery prospects of an injured worker. For more information visit www.kendallburton.com Building confidence in youth with mental illness Work or study can make all the difference Eσin Killackey's Australian research supports that of his peers in universities around the world, where the importance of maintaining the link between young people and suitable employment or education as a means to rehabilitation and return to work is proven time and time again. "Some of the barriers young people experience that prevent them from returning to work after mental illness include believing a stigma is attached to mental illness and that their colleagues are judging them. "Others behaved strangely during their mental illness episodes and felt too embarrassed to return to work for fear of ridicule. And sometimes well-meaning health professionals encouraged young people to stay away from work to avoid the stress of employment," said Associate Professor Killackey. A recent pilot project involved an employment specialist whose specific function was to assist young people with a mental illness to re-engage in employment or education. The results spoke for themselves: young people who were helped and supported back into the workforce or the education system by the employment specialist secured and maintained employment or education at a much higher rate than those without specific support. Having one employment specialist who was the 'go to' person for all things employment or education related, meant the young people built a rapport with this person and felt comfortable seeking them out if they had a problem or issue. The study focused on competitive employment rather than on 'sheltered' jobs, where young people were competing in the open employment market. They were able to secure jobs with real meaning and responsibility rather than those offered in a sheltered setting. This promoted greater confidence and, in most cases, resulted in greater job satisfaction. "Getting people jobs they actually want to do can make a huge difference to the success of their return to work or education. Focusing on getting the person a job within their capabilities in an area that interests them made participants more inclined to continue with the work, to recover and to become more productive members of society in the longer term," said Associate Professor Killackey. Providing participants with employment support for as long as it was needed meant they continued to be involved in the study for as much or as little time as they needed. It also meant they weren't under pressure to stay in a role as the employment specialist was still available to help them transition into another role. Associate Professor Killackey believes one of the most powerful messages that a young person receives when they re-engage in the workforce is that they have skills someone is willing to pay them for. This increases their confidence, and their perception of their value in society, enhancing their self-esteem and self worth, and ultimately leads to greater self motivation. For more information visit www.unimelb.edu.au Learn to love the challenge... Janine Shepherd on turning adversity into triumph Elite athlete Janine Shepherd saw cross- country skiing as her vocation, her career and her life. but after a horrific motor accident she had to completely rethink her sporting career and personal goals. It was on a training bike ride in the Blue Mountains near her home that her Olympic dreams were shattered when she was run over by a truck. In an instant her life changed. Her parents were told she was unlikely to survive, much less walk again. So while her parents were preparing for the worst, Janine was preparing for the fight of her life. She hadn't always wanted to be an aerobatic instructor or a commercial pilot, but circumstances beyond her control took her from being an aspiring Winter Olympics cross-country skier, to fighting for her life and for the ability to walk again – learning to fly along the way. Her message is simple: learn to love the challenge. When told she would never walk again, Janine set about looking elsewhere for meaning in her life. She made the decision: if she couldn't walk, she'd fly. Within a year of her accident she achieved both a commercial pilot's licence and an aerobatics instructor qualification. Slowly, she also learned to walk again despite being without feeling in her legs and feet. Janine's life, which reads like a Hollywood film, was made into a television feature film in the 1998 starring Australia's own Claudia Karvan, alongside Michael Caton. Janine refused to accept that she might never walk again, and took painstaking measures to make sure the doctors who predicted this were proven wrong. Today Janine is in demand as one of Australia's most sought after motivational speakers. She received numerous awards, including the Outstanding Young Persons of the World award for 1998 from Junior Chamber International. Janine has also recently served on the board of the Civil Aviation Safety Authority (CASA). She believes making personal dreams reality serves well to influence our work, our relationships and the way we manage and conquer obstacles. Janine sees the humour and beauty of every situation, even the hardest, most painful, and most difficult. Her advice to people enduring tough times is simple: "Learn to love the challenge. Embrace adversity, because everything is here to teach you something." For more information visit www.janineshepherd.com Workplace news More on the new approach to employer payments In our last edition of Newslink, we reported that WorkCover had started identifying changes to our computer system, operational processes and legislation that would be needed to introduce the new approach to employer payments. By now you would be aware that the South Australian Government is proposing a new approach to the payments employers make to WorkCover. This approach aims to provide medium and large South Australian employers with a payment allocation model that fairly and appropriately reflects their own claims experience, size and the level of risk in their industry. Amendments to the South Australian Workers Rehabilitation and Compensation Scheme are now before Parliament to enable implementation of an Experience Rating System and Retro-Paid Loss arrangements. If this legislation is passed before the end of the year, it is anticipated the new approach will commence for the 2012-13 financial year. The inclusion of claims experience in the premium calculation should encourage medium and large employers to be actively engaged in their claims. Employers will be able to influence their premium payments by focusing on preventing workplace injuries and assisting their injured workers to recover and remain at work or return to work as soon as it is safely possible. For more information visit www.workcover.com or email employerpayments@workcover.com Meet the coordinator Name: Karen Scott Job: Payroll Officer Company: Clean Seas Tuna Limited (Stehr Group) Region: Port Lincoln Years in role: 2.5 years Karen Scott is a Payroll Officer at Clean Seas Tuna. She is also the company's Rehabilitation and Return to Work Coordinator. What is the biggest challenge in the coordinator's role? My biggest challenge is finding 'suitable duties' for partially injured workers. In our industry (fishing and aquaculture) there aren't a lot of alternate resources to draw from. We want to keep the workers involved in their return to work plan and to provide meaningful tasks. This isn't always easy. What do you enjoy most about the role? I enjoy everything about the role, but I especially enjoy the feeling that I am doing something to help my fellow workers, no matter how small that help is. Do you have a particular success story that resulted in a great return to work outcome? We have had a few success stories, one in particular where a worker almost severed his arm in an accident and was back to work in near to pre-injury duties within six months. His return to work can be credited to his remarkable positive attitude. How do you promote your role in the organisation? Information about the role of rehabilitation and return to work coordinator is included in the induction pack given to each new employee. We have regular HR newsletters which usually touch on the 'go to' people in the organisation. We also have WorkCover information brochures and posters in key areas. What do you do when you need help? One of the good things about living in a regional area is that you get to know a lot of people in the community personally. I can draw from quite an extensive group of professionals. When a claim becomes complicated, a referral to our local service providers is often the best solution. Their professional base includes people with nursing backgrounds, occupational therapists, physiotherapists and other healthcare providers. Our HR Manager who is also back-up rehabilitation and return to work coordinator has a wealth of knowledge, and I 'pick his brain' regularly. The WorkCover website can be a valuable resource. I also find the internet a great help, if I can't find it locally, I just 'Google' it. What common mistakes can a coordinator make? I have found that being apathetic or inactive can lead a case to stall or become stagnant. I try to be proactive wherever I can to keep things ticking along. What key tip would you give to someone who was new to the role of coordinator? Take copious notes on everything. It helps to keep track of events and appointments and to follow the course of a claim from inception to close. It also makes things easier for others to pick up where I have left off, if necessary. What attributes do you think a coordinator needs to have in order to succeed in the role? A coordinator needs to be compassionate and a good listener. They also need to be a bit pushy and insistent. The coordinator must try to promote safe work practices if possible and get involved in that side of things. Injury management and OHSW should go hand-in-hand. Our organisation's goal is to attain zero workplace accidents. What drives you crazy? I get frustrated when I find I'm not kept in the loop. I can't do my job to the best of my ability if I don't have all the information I need to do it. But that just means I have to be a bit more proactive. Nothing I have experienced so far has 'driven me crazy'...yet! What advice would you give to other coordinators? Don't be afraid to ask for help. But most of all enjoy the role. It can be very rewarding. OHSW a key to success for Courts Administration Authority The Courts Administration Authority (CAA) is an admirable role model not only within the public sector but also for private self-insured employers with their visible commitment to the safety of their employees and in providing a safe workplace. This effort has been recognised this last year with numerous OHSW awards at both state and national level. Following recommendations from an OHSW evaluation in 2009, CAA has worked tirelessly to change the culture of its workplace to reflect best practice in occupational health, safety and welfare (OHSW). State Courts Administrator Gary Thompson is CAA's SafeWork Ambassador this year. The SafeWork Week activities were well attended with good staff participation. Significant work has been undertaken, particularly with regard to staff training, planning, OHSW system monitoring and review, auditing, management of change and contractors. CAA leadership is actively involved in driving OHSW programs, which is supported by 'CAA Central' an all-inclusive framework used for online induction, incident reporting and hazardous substance registers, as well as in performance management plans, right through to purchasing and contractor management agreements. Having a robust system in place has increased staff buy-in. One of the most notable aspects from their 2011 WorkCover SA self insurance evaluation was the significant cultural shift across the CAA. Employees and managers are provided with clear direction from their OHSW policies and procedures. "The WorkCover Partnership Plan has been integral to our success. The Plan provides a framework for structured activity between CAA and WorkCover where we can work hand in hand to ensure continuous improvement and demonstrated maturity of the safety system," said Mr Thompson. CAA managers and supervisors demonstrate that they are serious about safe work practices and the care and rehabilitation of injured workers. Staff members are encouraged to take an active role in their safety and work practices, and assist others in their return to work, resulting in fewer OHSW incidents and less time off work following injury. This was reflected in employee survey comments which included, "three years ago if I was attending OHSW meetings or conducting inspections some of my colleagues thought I was getting out of other work, now they are encouraging me to attend..." and, "OHSW always used to be thought of, but now it is discussed and obvious everywhere you go...". CAA works to key performance indicators, recognising areas needing improvement and aligning processes and practices to real achievable outcomes. Key OHSW programs are incorporated into the CAA OHSW Business plan 2010-2013, providing a better basis for analysis and review of the programs, and combined with the internal audit program helping to achieve ongoing improvement of the system. Communication between supervisors and GPs Sharing information for better outcomes Following on from his keynote presentation at the 2009 WorkCover conference, Dr Richard Pimentel was recently back in Adelaide 'by popular demand' to talk with rehabilitation and return to work coordinators (RRTWCs) about ways they can get buy-in from general practitioners, employers and colleagues to achieve better return to work results. Designing return to work programs for large organisations like General Motors and the City of Georgia in the US, Dr Pimentel implemented major changes to the way the City of Georgia managed its workers compensation claims. These changes resulted in a reduction in costs in the area of workplace injury management for the city of $30 million in the first year alone. Dr Pimentel says the 30% of workers who are prescribed time off after an injury by a doctor are only doing so because the doctor has no real understanding of the worker's job tasks. When employers create simple and easy to understand job descriptions to which doctors can refer, doctors can get a clear understanding of how a worker's injury might affect their ability to perform their role, enabling them to make insightful recommendations. Putting this in place also reduces the overall number of injured workers who need to have time off work, instead providing them with modified tasks, which can be increased as the worker becomes more able. Dr Pimentel proposed that RRTWCs and healthcare professionals reconsider the way the WorkCover medical certificate is viewed. Instead of focusing on what the injured worker is unable to do, focus on what they are able to do. For example, a healthcare provider saying a person can lift up to 10 kilograms rather than that they cannot lift more than 10 kilograms, shifts the focus so everyone is now thinking of ways to keep the injured worker at work using their abilities. Enabling supervisors to consider the healthcare provider's recommendations and giving them the authority to modify roles to suit worker's capabilities, is another way to improve remain at and return to work outcomes according to Dr Pimentel's research and practice. He says the injured worker's biggest obstacle to returning to work is time: the time it takes to process paperwork and the time it takes to get them back to work. The longer paperwork takes to process and the longer a worker is away from work, the more unlikely the return. Often injured workers who are away from work when they really could be returning are viewed negatively by supervisors and colleagues. If systems enable quick and safe return to work the benefits are felt by everyone. Dr Pimentel says by incorporating the treatment of injured workers into the induction process for all employees, from the CEO to the factory floor, the culture surrounding workplace injuries will change for the better. By training supervisors, who are ultimately the decision makers when it comes to their employees' returning to work, in how to manage return to work, reasonable work-related expectations can be set for their injured workers. If return to work is done 'right', those involved in all stages of the process will take ownership and help achieve the desired goal – return to work. When the injured worker is assigned appropriate but meaningful tasks, they feel more valued and their colleagues will accept their change of duties more readily. In addition, the worker will recognise they are still valuable as an employee and strive harder to get back to full capacity. "Meaningful, beneficial work is the key to positive return to work outcomes ... and everyone benefits because valuable work is being completed, making the supervisor look good, and the worker feel good and work harder. "If the injured worker does need time off work to recover, they should still be included in the social aspect of work, footy tipping for example, so they maintain their connection with their workplace even if their injury has precluded them from attending work. "After all, disability is an attitude for everyone. Injured workers that think they are disabled are disabled. Those who chose not to see their injury as a disability are much more likely to recover and recover well," Dr Pimentel said. For more information visit www.miltwright.com Workplace culture aids recovery The workplace is arguably the most important variable when someone gets hurt at work. Some research even suggests it is more important than the seriousness or type of injury.Research indicates that successful recovery and return to work are very closely linked to early and ongoing involvement of the workplace in a worker's recovery. Social networks we make in the workplace and the support we receive from colleagues have been shown to be particularly important. With this in mind, employers are encouraged to reate a workplace that stays in touch with someone who gets injured at work and recognises that they may recover better ... at work! Workplace culture doesn't have to be something mysterious. Simply put, workplace culture is 'the way we do things around here'. Foster a supportive environment by keeping in touch with injured workers. Ensure team mates understand the return to work process. Misunderstandings can develop if co-workers believe an injured worker is not 'pulling their weight'. This can be avoided by explaining if a graduated return to work is necessary, for example. Co-workers can support each other through this process if they understand the importance of their contribution. For years researchers have known that having a sense of belonging is pivotal to a person's wellbeing. A sense of belonging is when a person feels they are part ofa team or a group. The way someone is treated at work after a workplace injury influences their sense of belonging, and even influences their ability to recover. The research outcomes are clear and consistent – stay connected to anyone who gets hurt at the workplace ... and don't think twice about providing safe work they can do at work while recovering. Following these simple steps will make a big difference in the recovery and return to work process of injured workers everywhere. 2011 Recovery & Return to Work Award winners and finalists These awards recognise the outstanding achievements of injured workers and those who have helped them to remain at or return to work. Return to work achievement award (worker in a large or self-insured company) Joint winners: Officer Tung Tran and Officer Nathan Mulholland, Police Officers, SAPOL Judges' commendation: Rod Filsell, Diesel Fitter, Thiess Finalists: Ruth Pfeiler, Curriculum Consultant, DECS; Andrew Toepfer, Storeman, Bidvest Return to work achievement award (worker in a small to medium company) Winner: Holly Byrne, Facilitator, Globally Make A Difference Judges' commendation: Greg Brook, Truck Driver, Fox Freightlines Finalists: Cindy Millard, Retail Sales, Lenard's; Paul Reeves, Vehicle and Body Builder, Aldom Motor Body Builders Remain at work achievement award (worker and employer collaboration) Winner: Robert Redpath and GM Holden Judges' commendation: James Munt and D&R Electrical Finalist: Andrew Telfer and Fielders Steel Roofing Employer excellence award (large or self insured) Joint winners: Forestry SA and Housing Industry Association Judges' commendation: Eldercare Finalist: Warrina Homes Employer excellence award (small to medium) Winner: Kenlen Seeds Finalists: Kanga Poultry Cleaning; North South Central Freight Lines Health and rehabilitation individual achievement award (individual) Joint winners: Natalie Bottroff, Natalie Bottroff & Associates and Mary Saloniklis, MSVS Consultancy Finalists: Richard Oborn, Gazebo Psychology; Corinne Spadotto, Australian Workplace Injury Consultants; Verity Strauss, Beckman & Associates Case and injury management excellence award Winner: Tracey Flores, Employers Mutual Judges' commendation: Shane Oake, Employers Mutual Finalists: Joanne Rielly, Courts Administration Authority Rehabilitation and return to work coordinator excellence award Winner: Kerry Wiese, JBS Australia Finalists: Eugenie Valero, Western Hospital; Susan Worrall, Maxima Group Kenlen Seeds, winner Employer excellence award (small to medium employer) Small business supports injured worker back to work When a clover harvester ran over a worker at Kenlen Seeds at Naracoorte, owners Tim and Bruce Schultz did everything they could to support their worker, making changes to safety procedures and assisting him back to health and work. His injuries were very serious and included a broken neck, soft tissue injuries and a condition to his heart – the accident came close to being fatal. The worker's medical treatment has been complex, intense and is ongoing. Kenlen Seeds is a small business, employing only four staff members, so when one is injured, the impact on the business is substantial. One of the challenges of a small business is to find suitable duties for an injured worker while they recover sufficiently to return to their pre-injury role. United States-based workplace rehabilitation and return to work expert Dr Richard Pimentel, who was in Adelaide recently, suggested a variety of ways to assist workplaces with this challenge (see page 10). Employers need to focus on what the employee is still able to do when deciding which duties they will perform, rather than looking at the limitations caused by the accident. By focusing on the cans rather than the can'ts, better results can be achieved in the approach to recovery and return to work. At Kenlen Seeds, throughout the ehabilitation process, the worker maintained a positive outlook which was supported by the measures taken by Kenlen and the rehabilitation team to accommodate his restrictions and modify his tasks as he became more able and returned to work.Kenlen found one of the advantages to being a small team was the feeling of family and loyalty it inspired. Tim and Bruce see their workforce as members of their family, so when one of them was injured, they did their utmost to see he and his family were looked after.In larger organisations it is still important that injured workers feel valued despite the larger scale of the operation. Professor Kim Burton who addressed the recent WorkCover conference advocates fostering a sense of belonging and caring in any workplace (see page 3). The feeling of camaraderie was so strong at Kenlen that the worker visited the farm where other workers drove him around to see what was going on, so when he returned he would be up to speed. Tim and Bruce regularly telephoned the worker and his wife to make sure he was progressing well. Maintaining the contact between workplace and worker was very important to this recovery process. Regular on-site meetings were held with the case manager, as were meetings with the worker's GP and other members of his return to work team, through which Tim and Bruce gained a greater understanding of workplace injury and how the Scheme works. Today, the worker is not quite back to full- time, but he is extremely keen to be at work. "We find ourselves having to send him home because he's pushing himself too much!" say Tim and Bruce. Model WHS laws update Following extensive consultation earlier this year, the proposed introduction of new legislation governing occupational health, safety and welfare (OHSW) in South Australia is proceeding towards implementation in 2012. If enacted by the current sitting of the South Australian Parliament, the new Model Act, regulations and Priority Codes of Practice will take effect from 1 January 2012. On this date OHSW will become known as Work Health and Safety (WHS). One set of consistent laws across Australia regulating WHS is predicted to reduce compliance costs for business and protect the safety of every person in the workplace, no matter where their work occurs. For guidance and information on how to prepare your business for the changes, visit www.safework.sa.gov.au/whs where you can also sign up to receive regular updates on the WHS legislation. Tackling asbestos dangers in the workplace Asbestos, the name given to a group of fibrous minerals that occur naturally in the environment, was a common component in the manufacture of more than 3,000 industrial, manufacturing, building and construction products in Australia from the 1940s to the late 1980s. It was used because of its durability, fire resistance and insulating properties. Asbestos containing construction materials have been banned from use in Australia for many years. Despite this they can still be found in and around workplaces and homes built before 1990, and are most likely to be encountered during renovation, maintenance or demolition of buildings. Examples of asbestos containing materials typically encountered in buildings are asbestos cement products, acoustic or thermal insulation, vinyl- backed or composite floor coverings, and panels in electrical switch-boxes. Asbestos containing components can also be found in industrial plant and equipment, and on ships. Managing health risks Section 19 of the Occupational Health, Safety and Welfare Act 1986 requires employers to provide a safe work environment, safe systems of work, plant in a safe condition and information, instruction, training and supervision to their employees. Regulation 208 of the Occupational Health Safety and Welfare Regulations 2010 further details the responsibilities of building owners, and others in possession of asbestos, who must identify asbestos containing products installed in the workplace (in the building or any plant). Any asbestos containing materials in an unstable condition must be removed as soon as reasonably practicable. In occupational settings, a licensed asbestos removalist must be used to remove asbestos containing material. Approval from SafeWork SA must be obtained before removal work of more than 10m2 of non-friable asbestos, or any amount of friable asbestos. Inhalation of airborne asbestos fibres is recognised as posing a significant potential risk to health. Workplace policies and procedures to control the risks of exposure to airborne asbestos fibres, and to regularly inspect and maintain any asbestos containing materials, must be established. Owners of buildings, plant or equipment containing asbestos must create and maintain an asbestos register that details the type, condition and location of any asbestos. This register must be available to employees, subcontractors, tenants or any relevant asbestos safety personnel. Appropriate warning labels and signs must be clearly visible to those in the vicinity of any 'in situ' asbestos containing materials. Displayed signs should conform to Australian Standard AS 1319 Safety Signs in the Occupational Environment.Further information and advice Call the SafeWork SA Help Centre on 1300 365 255, visit www.safework.sa.gov.au (look under 'OHS/Asbestos') or contact the SafeWork SA Bookshop at 100 Waymouth Street, Adelaide Ph (08) 8204 8881. OHSW tips – safe events in the silly season All too soon the 'silly season' will be upon us, with many workplaces organising parties and festive celebrations for workers, their families and customers. The safety of workers and visitors is of utmost importance on any given working day. When the focus is not on work, but rather on fun, irrespective of whether the event is conducted on-site or at another venue, the same safety consideration should be made. Here are a few occupational health, safety and welfare (OHSW) tips to help ensure your events are safe: • access and egress – entry and exit areas should be clear and easily accessible for staff and anticipated crowd numbers • weather conditions – partitions, displays and signage must be well secured for windy conditions; non-slip mats provided for wet conditions; and shade, sunscreen and water provided for hot conditions • inflatable structures – inflatable structures and accessories must be checked thoroughly prior to use (ensure all anchor points, ropes and stakes or ballast are undamaged and fit for continual use) • fireworks – fireworks can only be provided and used by pyrotechnicians licensed by SafeWork SA • manual handling – all staff and volunteers must be trained to assess each task and use safe techniques when lifting or carrying • electrical – make sure the public is adequately protected from risk of electric shock and ensure trip hazards from cords are minimised • first aid – make sure first aid facilities are adequate for the event being held and expected number of visitors • hazardous substances – make sure there is clear signage for hazardous areas or substances. To assist people planning, organising and implementing small to medium-sized community events, SafeWork SA has produced a series of four 'Event Safety Management' fact sheets dealing with: • Event Safety Management • Event Safety Administration • Event Safety Risk Assessment • Event Safety Checklist. To help make end-of-year celebrations safe, not silly, pick up an Event Safety Management fact sheet set from the SafeWork SA Bookshop at: 100 Waymouth Street, Adelaide, Ph (08) 8204 8881 or download from www.safework.sa.gov.au (look under 'OHS/Event Safety'). Mental health first aid training and support Providing support early makes the difference In the workplace, physical health is recognised and valued as vital in managing and contributing to employee wellbeing and productivity. Mental health is equally important but often not recognised or managed effectively. The workplace is affected by the mental health of its workforce, regardless of where the mental health issues originate. As part of WorkCover's commitment to the health and wellbeing of all workers in South Australia, Mental Health First Aid (MHFA) training courses have been running in both metropolitan and regional areas of South Australia since September 2010. MHFA is the initial help given to a person with a mental health problem or crisis before medical treatment can be obtained. Workplaces gain many benefits from effective mental health awareness and training. These include the ability to manage risk factors by raising awareness, providing supportive strategies early on, enabling access to appropriate services and promoting effective rehabilitation and return to work. The course is available to workplace rehabilitation providers, rehabilitation and return to work coordinators and case managers. Participants receive a course manual and a certificate on completion of the course. Rehabilitation and return to work coordinator Colin Lampard from Whitehead Timber Sales at Mt Gambier, successfully completed the training earlier this year. Here's an excerpt from a poem he was inspired to write during the training course. The mental health first aid action plan Give support and information, Emotional support too, Be empathetic, With all that you do. Hope of recovery, Or help for an overwhelming task, For if they're suffering, For help they'll not ask... Respect their privacy, And their dignity too, For they bared their soul, When they spoke with you. by Colin Lampard For further information on MHFA courses please contact Doula Theodosi at WorkCover on 13 18 55 or email dtheodosi@workcover.com Further details about MHFA are available at www.mhfa.com.au Health providers Is time off work always the best prescription? Prescribing time off work may initially appear to be the most practical solution for an injured worker, but studies suggest that often the best way for them to recover is to remain at work, where possible. A person's health is influenced by a number of factors, including their level of education, living standards, and social connectedness. Recent studies have also shown that a person's ability to participate in work has a significant impact upon their health –so much so that the Australasian Faculty of Occupational and Environmental Medicine (AFOEM) has released a policy and consensus statement identifying the health benefits of work. International research shows the longer people are away from work the less likely they are to return. If a person has been off work for 20 days, the likelihood they will return is 70%. If they have been off for 45 days, it is 50%, and for those who have been away for 70 days, only 35%*. Occupational physicians report that the reasons many people don't return to work include psychological beliefs, loss of self esteem, social factors, benefit dependency and pressures from the workplace, family and community. Often psychosocial issues prevent people from returning to work even when the original medical condition or injury which required them to have time off work has resolved. Given the health and lifestyle benefits to be gained from working, many health professionals are rethinking their approach to certifying time off work. Dr Kevin Morris, Director of Clinical Services for New Zealand's Accident Compensation Commission, encourages GPs to think of certifying time off work as 'prescribing' time off work. In much the same way as a GP would prescribe medication, prescribing time off work requires the GP to assess the risks and benefits, and ask the question: 'What 'medical' reason prevents this person from being at work today?'. Dr Robin Chase, president of the AFOEM, recommends GPs talk to their patients about the risks and benefits associated with having time off work, and that this occurs in the first consultation. "Enabling people to have a safe return to work as soon as they are capable to do so, is one of the most important ways of making sure their workplace injury doesn't make them disabled for life," he said. Consider making return to work part of your treatment, however small the hours. Research from across the world has shown that this one factor can be the key to recovery for many workers. * Realising the Health Benefits of Work, Australasian Faculity of Occupational & Environmental Medicine (AFOEM) position statement, March 2011 There's a lot of evidence for evidence-based guidelines Improving quality and consistency of care has a big impact on return to work WorkCover recently collaborated with the Personal Injury Education Foundation (PIEF) to present a breakfast seminar for GPs and health providers. Our international guest speaker was Dr Kathryn Mueller, Medical Director for the Colorado Division of Workers' Compensation. Opening the session Dr Mueller asked the audience, "what happens when there is diversity in medical care?" She then answered her own question in a single word: 'disaster'. She went on to explain her reasoning, and how disaster is easily averted. Dr Mueller is a strong advocate of evidence-based medical practice, and using US studies, she demonstrated the dangers of not having such guidelines in place. Take the example of five medical practitioners who were given a 'theoretical patient' and asked to create a diagnosis and treatment plan for the patient. The five practitioners each returned with a similar diagnosis but a different treatment plan for the patient. For the more straightforward workplace injuries, the argument for evidence-based guidelines is even more compelling: the potential of turning a simple short- term injury into a lifetime of disability is reduced when evidence-based guidelines are in place. Dr Mueller says that in Colorado, with the establishment of such guidelines, which are enforcable, 90% of the money spent on managing workplace injuries now goes to the 5% of patients, those who actually need it. Adopting the principle that return to work is therapeutic, and altering the mindsets of those who resist this notion, is one of the keys to having a health system in which workers are encouraged and willing to return to work sooner. Effective patient recovery relies heavily on clearly defined diagnoses and clear guidelines as to what the worker is still able to achieve in the workplace. One of the most common complaints from injured workers is that they are unsure of what they are able to do. The majority of workers with workplace injuries should be able to return to some type of work, whether it be modified duties, restricted hours or another variation in the workplace, within the first couple of weeks. Dr Mueller says workers with delayed return to work outcomes not based on physical limitations can benefit from psychological evaluations, so they can start to receive psychological support if required, or return to work if that is the best therapy. The goal of evidence-based guidelines is to improve quality, provide consistent care and to achieve better return to work rates. By calling on the expert healthcare providers in return to work to influence others and to teach what they are already practising, return to work rates will rapidly improve. Sharing knowledge and practical experience is also important in developing appropriate guidelines. Practitioners who are better equipped to understand workplace injuries and recovery can consistently diagnose and treat common workplace injuries in a way that helps people get back to work safely and quickly, thereby limiting the numbers of injured workers with minor injuries who remain disengaged. About Dr. Kathryn Mueller Dr Kathryn Mueller is Medical Director for the Colorado Division of Workers' Compensation and Professor in the Department of Surgery and the School of Public Health at the University of Colorado. Dr Mueller works extensively with the American College of Occupational and Environmental Medicine, has been instrumental in the development of the original American College of Occupational and Environmental Medicine course on impairment, and continues to study and work in the field. She has completed extensive studies into the need for evidence-based guidelines for the treatment of workplace injuries. She was one of the six section editors for the American Medical Association's Guidelines for the Evaluation of Permanent Impairment 6th edition and has numerous publications relating to interstate variation of practice in workers compensation, use of practice guidelines, and impairment rating. Calling all bilingual providers Bilingual health and rehabilitation providers provide an important service to injured workers from non-English speaking backgrounds through communicating in their preferred language and because they have an understanding of cultural issues. If you are a bilingual provider, you are encouraged to let WorkCover know that you speak a language other than English, so details can be included on our claims management system. You don't need to be an interpreter or translator as these professionals will still be called upon to attend meetings and to translate as required. If you'd like to participate or need more information call WorkCover's Equity Services Manager on 13 18 55 or email equityservices@workcover.com WorkCover sponsors neurodynamics and the neuromatrix conference Following the success of the Neuro Orthopaedic Institute's (NOI) first international neurodynamics and the neuromatrix conference in Nottingham, UK in 2010, a second conference is to be held at the Adelaide Convention Centre from Thursday 26 April to Saturday 28 April 2012. Conference themes include neuroscience-backed biopsychosocial approaches, health literacy, modern coping and cognitive behavioural therapies, brain-based neurosciences, immunology and stress sciences. These are seen as critical to novel and evidence-based productivity strategies in recovery from injury. Examples of these strategies, which will be presented in workshop form, include therapeutic neuroscience education, graded imagery programs, conceptual change workshops, enhanced pacing programs, therapeutic dance and early and novel assessment of at risk patient programs. The conference is aimed at all professionals involved in rehabilitation and will be delivered with the same blend of humour, education and entertainment as in 2010. For more information about the conference visit www.noi2012.com Perceptions of back pain treatment Differing views from patients and GPs A recent study into back pain perception and management investigated whether patients and general practitioners (GPs) have different perceptions about the management of simple mechanical back pain*. In the study 533 patients and 81 general practitioners responded to eight simple statements about the usefulness of certain procedures or activities in the management of back pain. Their answers were measured on a scale ranging from 'essential' through to 'potentially harmful'. When the healthcare provider takes the time to explain their intended treatment or management plan, then patients better understand the reasons for them and this will often result in better outcomes. Patients and GPs were asked about eight treatments/diagnostic tools taking a history performing a physical examination performing lumbar spine x-rays prescribing or advising medication referring for physiotherapy/osteopathy advising back exercise referring to a specialist allowing nature to 'take its course' Both groups agreed on the usefulness of two points: history taking and back exercise. For all other areas there were significant perception differences. The main areas of difference were: Getting an x-ray: only 3% of GPs responded that this was appropriate and 60% of patients thought it was appropriate. Allowing nature to take its course: whilst 83% of GPs responded that this was an appropriate course of action only 43% of patients considered it so. Examining the patient: just 70% of GPs' responses were that this was necessary, yet 90% of patients said it was necessary. With such breadth of views across patients and doctors on the best management options, it's no wonder confusion arises. All healthcare providers, as the authorities in managing back pain, should ensure patients understand the reasons that specific actions or activities are taken and equally why certain actions are not taken. When the healthcare provider takes the time to explain their intended treatment or management plan, then patients better understand the reasons for them and this will often result in better outcomes. * Do patients and general practitioners have different perceptions about the management of simple mechanical back pain? Amonkar SJ, Dundar AM; International Musculoskeletal Medicine, 2011:33 (1); 3-7 WorkCover Medical Certificates and how to access them When a medical practitioner first sees a patient after a workplace injury, a WorkCover Medical Certificate (WMC) is completed so the worker can make a claim for compensation. The WMC assists WorkCover's claims agent Employers Mutual, or a self-injured employer, to determine an injured worker's claim for compensation. It identifies capacity and this information can be used to plan the injured worker's recovery and identify suitable duties or modifications to the workplace so they are able to continue participating in the workplace. At the recent WorkCover conference keynote speaker Professor Kim Burton discussed the crucial role medical certification plays in recovery (see article page 3). He demonstrated that practitioners can make a difference by noting what patients can do, rather than using generic phrases such as 'light duties'. In emphasising the positive, these phrases help employers to consider suitable duties that a worker can complete in their safe return to work. How to submit WMCs There are three ways to submit WMCs to WorkCover: 1. hard copy 2. electronically, via patient management software 3. electronically, via the WorkCover website * Please note: only WMCs submitted electronically will attract a fee, provided they meet specific conditions. Type of certificate Hard copy About Medical practitioners may use these forms to handwrite certificates. How to access Forms are available in pads and should be requested in writing, advising the name and provider number of the medical practitioner. Post requests to: GPO Box 2668, Adelaide SA 5001, or fax to (08) 8233 2466. Associated fees No fee incurred for paper based or hard copy or faxed WMCs. Type of certificate Electronic –submitted via patient management software (eWMC) About The following software has this facility: Medical Director, Medtech, Zedmed, Genie, Best Practice. How to access Contact your software supplier for installation instructions. Benefits of using the electronic WMC facility include reduced data entry of patient information and automatic invoice generation for the eWMC fee. Associated fees A fee is paid for each eWMC received within 24 hours of a consultation that meets the specific conditions outlined in WorkCover's medical fee schedule. Type of certificate Electronic – submitted via WorkCover website (eWMC) About The WorkCover website can be used to submit eWMCs by practitioners who do not have access to the above patient management software. How to access You will need a username and password to access the secure site. For access please complete a registration form on our website at: www.workcover.com > Health provider > The WorkCover system > WorkCover medical certificates Associated fees A fee is paid for each eWMC received within 24 hours of a consultation that meets the specific conditions outlined in WorkCover's medical fee schedule. The science of pain – Dr Lorimer Moseley Retraining the brain to manage pain According to pain expert Dr Lorimer Moseley, each year pain costs Australian society in excess of $35 billion*, more than cancer, diabetes and cardiovascular disease put together. This cost is primarily in lost productivity, he said speaking at the recent WorkCover conference. Considering the significant fiscal and social costs of pain, research funding into pain management falls well short of that for cancer, diabetes or cardiovascular disease says Dr Moseley. Dr Lorimer Moseley is Senior Research Fellow, Neuroscience Research Australia, and Professor of Clinical Neuroscience at UniSA. His extensive research into pain and the way it is processed in the brain demonstrates that pain is a conscious experience that can hinder a person's recovery, long after the physical injury has been repaired. He says the longer you have pain, the more pain your brain will produce. It is common knowledge that injuries nearly always hurt but why don't the same injuries hurt the same amount? How the body reacts to pain is related to the way various parts of the brain process the information. The brain's reaction is based on past experience, and pain is an exaggerated response to a stressful situation. Pain is based on a set of beliefs relating to past experience and knowledge and it is crucial to recognise factors that interact to make one person's pain debilitating and another's a minor irritation. Pain emerges with the activation of the pain 'neurotag', which is a set of neurons that join together to create a pain experience. They rejoin later to create an anticipated consequence for a similar action. In persistent pain, the neurotag works with other areas of the brain to continue to register pain even when the original injury may well have healed. Within the neurotag reaction two neurological phenomena occur: sensitisation and disinhibition. When sensitisation occurs, the stimulus required to evoke pain reduces. When disinhibition occurs, brain maps become less precise and the stimulus required to evoke pain generalises, creating perceived pain, even where physiologically there should be little or none. A number of studies suggest that in chronic pain, sensory stimuli that would ordinarily imply safety become dominated by sensory stimuli that imply danger. This in turn leads sufferers of chronic pain to continue suffering often long after the actual injury has repaired. Once the science of pain is understood by practitioners who help injured workers manage their pain, strategies can be implemented to retrain the brain so the pain no longer has a major influence over the injured worker and they can return to 'normal life'. Dr Moseley says healthcare professionals should explain how the brain reacts to pain to patients so they can gain an understanding of pain and consciously work towards changing their actions and thoughts about perceived pain. By reprogramming the brain, the body can acknowledge that it has healed and lost productivity, particularly in relation to injured workers, can largely be avoided or reduced. Giving chronic pain sufferers an understanding of how their body is interpreting pain can help them retrain their brains to interpret the pain in a way that helps them recover better. If injured workers understand that their pain is regulated by a complex set of neurotags linking together, and that it is possible to reverse the influence of these neurotags, chronic pain can often be reduced or reversed. About Dr Lominer Moseley Dr Moseley's studies and work have shown the brain determines how, why and when we feel pain, and that pain is not something that simply exists in the muscles or body. He writes a regular blog for mindbody.org where he talks about the latest research into pain and pain management. To view Dr Moseley's presentation, go to www.workcover.com/conference For more on his research visit www.neura.edu.au and search Lorimer Moseley. * Report by Access Economics (2008): The cost of chronic pain, Sydney: Medical Benefits Fund in collaboration with The University of Sydney Diary dates: 26 December Public holiday for Christmas Day (which falls on a Sunday) 27 December Public holiday for Proclamation Day (which falls on the above public holiday) 1 January 2012 Proposed date for introduction of new Work Health and Safety laws 26 – 28 April 2012 Neurodynamics and the neuromatrix international conference 28 – 29 April 2012 Musculoskeletal education intensive – upper limb Free information support services are available for: TTY (deaf or have hearing/speech impairments) call (08) 8233 2574. Languages other than English call the Interpreting and Translating Centre (08) 8226 1990 and ask for an interpreter to call WorkCoverSA on 13 18 55. Braille, audio, or e-text call 13 18 55. The information in this publication is compiled by WorkCover Corporation of South Australia. The data and facts referred to are correct at the time of publishing and provided as general information only. It is not intended that any opinion as to the meaning of legislation referred to is to be relied upon by readers who should seek independent advice as to any specific issues relevant to you, your workplace or organisation. © WorkCover Corporation of South Australia, 2011 2396_CC Published November 2011. ISSN: 1448-4692 Enquiries: 13 18 55 100 Waymouth St, Adelaide SA 5000 Fax 08 8233 2990 info@workcover.com www.workcover.com This email was sent to [email address suppressed]. If you are no longer interested you can unsubscribe instantly: http://workcoversa.createsend1.com/t/r/u/iykttyd/l/i/