Helping you get the measure of
workplace rehabilitation
Self-assessment of workplace rehabilitation
A checklist for employers
About the self-assessment of
workplace rehabilitation >>
The workplace rehabilitation
environment >>
Checklist for individual
workers fi le >>
Get the measure >> References >>
2
The objective of workplace rehabilitation is to manage employees’ recovery from injury in such a way that they can return quickly and safely to their
pre-injury employment wherever possible. The workplace rehabilitation process for injured employees should be managed in a way that is inclusive,
respectful and considerate of individual needs. For many injured workers, workplace rehabilitation will consist of medical and allied health treatment with
a short period of suitable duties as part of a graduated return to work. Serious or complex injuries will require more comprehensive management and
employers should work closely with their workers’ compensation insurer and the treating medical practitioner in these cases.
The use of the self-assessment checklist is voluntary. The self-assessment checklist was developed to provide a framework for those employers
who wish to assess their workplace rehabilitation systems for the purpose of continuous improvement. As workplace rehabilitation has a crucial role
in reducing the cost of workplace injury, it is important for employers to identify where to focus their efforts in improving workplace rehabilitation
processes and procedures to achieve continuous improvements in outcomes.
The self-assessment checklist is intended to assist employers to assess their performance over several key categories related to the provision of
workplace rehabilitation. The categories include legislative obligations as set out in the Workers’ Compensation and Rehabilitation Act 2003 and the
Workers’ Compensation and Rehabilitation Regulation 2003 (Queensland). Best practice indicators developed from various sources in the rehabilitation
literature (see References at the end of this document) are also included.
Who will benefi t from using the self-assessment checklist?
Q-COMP developed the self-assessment checklist to assist employers, rehabilitation and return to work coordinators and injury management
advisors to assess their performance on key categories of workplace rehabilitation. It includes legislative and regulatory requirements and commonly
accepted principles of good practice.
The self-assessment checklist should not be considered exhaustive and employers should consider adding additional indicators to customise the
self-assessment checklist for their particular circumstances.
Use of the self-assessment checklist in developing a continuous improvement program for workplace rehabilitation is voluntary.
About the self-assessment of workplace rehabilitation
General information
3
How to use the self-assessment checklist
By using the self-assessment checklist, employers should be able to assess
their workplace rehabilitation systems on a range of categories and elements
separated into workplace rehabilitation system specifi c issues and issues
relating to the management of rehabilitation at the individual worker level.
Administration of the self-assessment checklist should preferably be carried
out by an individual with an understanding of the principles of workplace
rehabilitation and some practical experience in the fi eld.
The self-assessment checklist should be used by the employer as an internal
review tool and should be retained by the employer. It is not required that the
completed self-assessment checklist be returned to Q-COMP.
The self-assessment checklist is designed to provide employers with a
knowledge of basic principles of good practice and to assist them to gain a
snapshot of how their system and processes are working in practice.
It is intended that the self-assessment checklist will highlight areas of
performance/compliance and non-performance/non-compliance.
The self-assessment checklist is divided into two sections:
Section One The workplace rehabilitation environment; and »
Section Two Checklist for individual worker’s fi le. »
Section One is designed to assess the environment for workplace rehabilitation
while Section Two is designed to be used in assessing individual workers’
rehabilitation fi les.
The assessor should fi rst work through all the workplace rehabilitation
categories in Section One, progressively examining each element and
indicating evidence
of compliance by ticking the box or non-compliance by leaving the box blank.
An assessment of provided may be indicated if one or more items of evidence
are present.
Following completion of Section One, the assessor should select a random
sample of workplace rehabilitation fi les to assess the management of each
individual workers’ rehabilitation using the self-assessment checklist in Section
Two.
Smaller employers with a limited claims history may choose to assess all
rehabilitation fi les.
Larger employers should ensure that the population from which the sample
is to be randomly selected represents a relevant population that will provide
a meaningful sample to test for compliance with the categories and elements
set out in the self-assessment checklist.
Assessors will be able to see at glance which elements show evidence of
compliance or non-compliance. Partial compliance or other comments can also
be indicated in the Comments/action required column.
A space is provided after each category to record more extensive notes
or comments.
Following completion of the self-assessment checklist, a performance
summary report and an improvement action plan should be developed.
The performance summary report and the improvement action plan should
identify opportunities for improvement in performance. The performance
summary report should also identify successful strategies and achievements in
workplace rehabilitation.
The improvement action plan should detail issues for improvement, the
proposed actions to be taken, the timeframes for action and responsibilities
for action. Actions should be implemented within a reasonable time after
completing the self-assessment checklist.
About the self-assessment of workplace rehabilitation
4
Key elements Evidence of verifi cation - one or more
may be used
Tick if
provided
Comments/action required
Workplace rehabilitation policy is dated, current, signed by
CEO or other responsible offi cer and has a review date
CEO or offi cer signature, date and review date
Clearly documented workplace rehabilitation procedures Published and displayed at workplace
Staff responsible for accident reporting also report to the
rehabilitation and return to work coordinator
Case notes
Notifi cation forms
Other evidence
Policy and procedures are part of induction Included in induction material, programs
Awareness of all workers of workplace rehabilitation Policy statement of commitment displayed at the workplace
Policy discussed at work group meetings
Evidence of ongoing education related to workplace
rehabilitation
Minutes of staff meetings
Posters
Newsletters
Memos
Trained rehabilitation and return to work coordinator nominated Name of rehabilitation and return to work coordinator
shown on:
policy
noticeboards
Nominated rehabilitation and return to work coordinator has
suffi cient seniority and relevant skills to successfully undertake
the role
Nominated rehabilitation and return to work coordinator is
allocated suffi cient time for performance of the role
Position description includes duties of the rehabilitation and
return to work coordinator
Key performance indicators for the role include workplace
rehabilitation
Identifi cation of a person or organisation that can provide advice
on workplace rehabilitation
Documents showing:
contact details for persons or organisations
employee assistance program documentation
Commitment of staff at all levels is crucial if workplace rehabilitation is to be effective. The intent of this category is to assess if there is management and
worker commitment for workplace rehabilitation.
Section one The workplace rehabilitation environment
Category one Return to work culture
5
Notes:
Key elements Evidence of verifi cation - one or more
may be used
Tick if
provided
Comments/action required
Business performance in relation to workplace rehabilitation is
measured
Rehabilitation performance reported in management reports
and statistics
Line manager and senior management responsibility for
workplace rehabilitation is refl ected in position description
Position description
Workplace rehabilitation policy and procedures are reviewed at
regular intervals or at intervals required by legislation
Records of reviews
Revised policy or procedure documents refl ect outcomes of the
review
Workers or their representatives involved in development and
review of the workplace rehabilitation system
Consultative arrangements documented in minutes,
correspondence, etc.
Add up the total number of ticks, enter in the box,
then click here to enter your score in category one
under the workplace rehabilitation environment
Section one The workplace rehabilitation environment
Category one Return to work culture
6
Notes:
Section one The workplace rehabilitation environment
Category two Confi dentiality
Trust and cooperation are integral to successful workplace rehabilitation. It is important that information gathered during workplace rehabilitation is used only for
the purpose for which it was intended. Employers and rehabilitation and return to work coordinators would normally only seek information related to capacity for
work or level of function.
The intent of this category is to assess whether information obtained during the workplace rehabilitation process is at all times treated with confi dentiality and
sensitivity by all parties.
Information collected during workplace rehabilitation should not be used to disadvantage the injured worker. For example, medical information collected during
workplace rehabilitation is subject to privacy principles and anti-discrimination legislation and should only be used for the purpose for which it was collected.
The injured workers authority is not required for release of information to the insurer or to Q-COMP. However, an authority must be obtained by the
rehabilitation and return to work coordinator to obtain or release information to any other person related to the worker’s current workplace injury.
Key elements Evidence of verifi cation - one or more
may be used
Tick if
provided
Comments/action required
There is a clear policy governing privacy in respect to return to
work and rehabilitation
Privacy policy included in workplace rehabilitation policy and
procedures
Appropriate safekeeping implemented for all fi les Rehabilitation fi le kept secure and separate from human
resource fi le
Add up the total number of ticks, enter in the box,
then click here to enter your score in category two
under the workplace rehabilitation environment
7
Notes:
Section one The workplace rehabilitation environment
Category three Evaluation of workplace rehabilitation
The intent of this category is to assess whether workplace rehabilitation is effective. The evaluation assesses the success rate of individual programs, costs and
durations, problems or issues of concern, positive outcomes and injured workers’ satisfaction.
Key elements Evidence of verifi cation - one or more
may be used
Tick if
provided
Comments/action required
Database of all claims is maintained showing costs, duration,
injury type, outcomes
Database of all claims showing costs, duration, injury type,
outcomes
System of workplace rehabilitation is reviewed/audited/self-
assessed regularly and the results documented
Reports noting performance on a range of indicators such as
cost, duration, return to work status, services provided, regular
reports to senior management
Reviewers/assessors are independent of the area being audited/
assessed
Assessment reports demonstrate appropriate selection of
assessors/reviewers
Defi ciencies are highlighted in review/assessment and are
addressed and monitored for improvement
Action/improvement plan on fi le
Plan implemented and monitored as shown in reports to
management
System for processing issues/complaints raised by injured
workers in relation to rehabilitation in place
Issues/complaints system (e.g. Australian Standard 4269)
Add up the total number of ticks, enter in the box,
then click here to enter your score in category three
under the workplace rehabilitation environment
8
Section two Checklist for individual workers fi le
This section can be copied and used as a self-assessment checklist for multiple workers’ fi les
Employer Date of
assessment
Name of assessor Name of
worker
Claim number Date of
injury
Nature of injury
dd/mm/yyyy
dd/mm/yyyy
9
Notes:
Section two Checklist for individual workers fi le
Category one Return to work culture
Commitment of staff at all levels is crucial if workplace rehabilitation is to be effective. The intent of this category is to assess if there is a culture of
commitment for workers undertaking workplace rehabilitation.
Key elements Evidence of verifi cation - one or more
may be used
Tick if
provided
Comments/action required
Rehabilitation does not disadvantage the injured worker Injured worker was not dismissed due to injury
Workers are able to nominate a person to support and assist with
workplace rehabilitation matters
Case notes show worker was made aware of this
In the event of a dispute, the worker is made aware of the
grievance mechanism/process
Documented evidence on rehabilitation fi le that injured worker
was made aware of procedures at time of dispute
Add up the total number of ticks, enter in the box,
then click here to enter your score in category one
under checklist for individual workers fi le
10
Notes:
Section two Checklist for individual workers fi le
Category two Confi dentiality
Trust and cooperation are integral to successful workplace rehabilitation. It is important that information gathered during workplace rehabilitation is only used for
the purpose for which it was intended. Employers and rehabilitation and return to work coordinators would normally only seek information related to capacity for
work or level of function.
The intent of this category is to assess whether information obtained during the workplace rehabilitation process is at all times treated with confi dentiality and
sensitivity by all parties.
Information collected during workplace rehabilitation should not be used to disadvantage the injured worker. For example, medical information collected during
workplace rehabilitation is subject to privacy principles and anti-discrimination legislation and should only be used for the purpose for which it was collected.
The injured workers authority is not required for release of information to the insurer or Q-COMP. However, an authority must be obtained by the rehabilitation
and return to work coordinator to obtain or release information to any other person related to the worker’s current workplace injury.
Key elements Evidence of verifi cation - one or more
may be used
Tick if
provided
Comments/action required
Rehabilitation and return to work coordinator obtained injured
worker authority to liaise with treating doctor
Copy of signed authority on injured worker’s fi le
Authority sent to treating doctor
Rehabilitation and return to work coordinator obtained injured
worker authority to liaise with treating allied health and other
providers
Copy of signed authority on injured worker’s fi le
Authority sent to provider
Add up the total number of ticks, enter in the box,
then click here to enter your score in category two
under checklist for individual workers fi le
11
Notes:
Section two Checklist for individual workers fi le
Category three Planning
This category assesses whether basic planning for workplace rehabilitation and return to work strategies is being provided at the workplace.
A rehabilitation and return to work plan is required for workers undertaking rehabilitation. Where this occurs, the employer and rehabilitation and return to
work coordinator should liaise with the insurer. The insurers case manager will work with the injured worker, employer and rehabilitation and return to work
coordinator to develop a comprehensive rehabilitation and return to work plan.
Key elements Evidence of verifi cation - one or more
may be used
Tick if
provided
Comments/action required
Evidence of planning for all workers undertaking rehabilitation Suitable duties plan on fi le
Case notes on injured worker’s fi le
Plan has a goal and strategies for achieving the goal Suitable duties plan on fi le
Planning identifi es actions and responsibilities Suitable duties plan shows actions and person responsible
Plan developed in consultation with treating doctor Treating doctor signature on plan (if required)
Consultation documented in case notes
Plan developed in consultation with injured worker Injured worker signature on plan
Consultation documented in case notes
For complex or serious injuries, the insurer case manager is
consulted
Case notes
Copy of suitable duties plan forwarded to insurer case manager
Regular and appropriate contact is maintained with injured
worker
Case notes
Plan is reviewed regularly Case notes
File reviews
Case conference notes
Add up the total number of ticks, enter in the box,
then click here to enter your score in category three
under checklist for individual workers fi le
12
Section two Checklist for individual workers fi le
Category four The return to work process
The National Occupational Health and Safety Commission (NOHSC 1995) describes workplace rehabilitation as a managed process involving early intervention
with appropriate, adequate and timely services based on assessed needs, which is aimed at maintaining injured or ill employees in, or returning them to, suitable
employment. The intent of this category is to ensure that intervention is timely and appropriate and that adequate documentation of the rehabilitation process
is maintained.
4a Early intervention
Early contact and intervention is vital in promoting and maintaining a positive relationship between the injured worker and the workplace. It also assists in
promoting workplace rehabilitation.
Key elements Evidence of verifi cation - one or more
may be used
Tick if
provided
Comments/action required
Early contact with worker following injury to show support and
advise of entitlements and procedures for rehabilitation
Case notes
Other documentation
Assistance to injured worker to complete application for
compensation, if required
Case notes
Early and proactive contact with treating doctor to assess the
potential of the injured worker to return to work
Case notes
Fax
Emails
Correspondence
Report from doctor
Management and staff made aware of their responsibilities and
procedures at time of injury
Case notes
Copies of memos
Emails
Initial assessment by rehabilitation provider considered when:
Estimated loss of function > 4 weeks
Serious injury
Aggravation or injury during suitable duties
Complications with injury
No suitable duties available
No progress towards return to work
Note: may require insurer approval in some circumstances
Case notes
Letter of referral
Reports from provider/s
13
Notes:
Section two Checklist for individual workers fi le
Category four The return to work process
4a Early intervention continued
Key elements Evidence of verifi cation - one or more
may be used
Tick if
provided
Comments/action required
Injured worker aware of the role of the insurer case manager at
time of lodging claim
Induction material
Case notes
Emails
Correspondence
Contact with insurer case manager as appropriate to update case
manager on progress and discuss any diffi culties, concerns or
suggestions
Case notes
Fax
Emails
Reports
Provide insurer with copies of any reports or progress reports
from providers to avoid duplication and keep insurer informed
Case notes
Fax
Emails
Correspondence
Reports
Add up the total number of ticks, enter in the box,
then click here to enter your score in category 4a
under checklist for individual workers fi le
14
Notes:
4b Case notes
Section two Checklist for individual workers fi le
Category four The return to work process
Case notes are a legislative requirement in relation to rehabilitation. Section 107 of the Workers’ Compensation and Rehabilitation Regulation 2003 states
accurate and objective case notes must be kept for each worker undertaking rehabilitation. Case notes must contain details of:
a) all communications between the worker, the rehabilitation and return to work coordinator and other relevant parties and
b) actions and decisions and
c) reasons for actions and decisions.
Case notes facilitate the rehabilitation of injured workers by maintaining a record of communications, actions and decisions. Case notes can also be useful if an
injured worker decides to pursue common law action at a later date. Case notes can be an excellent source of information regarding how the employer (through
the actions of the rehabilitation and return to work coordinator) and the injured worker met their obligations regarding rehabilitation.
The intent of this category is to assess whether case notes for workplace rehabilitation are kept to a standard as outlined in the Workers’ Compensation and
Rehabilitation Regulation 2003.
Key elements Evidence of verifi cation - one or more
may be used
Tick if
provided
Comments/action required
Case notes are kept Case notes on rehabilitation fi le
Are signed and dated All entries signed; if electronic to be printed out, all entries
initialled and each completed page signed
Contain actions and decisions Clearly stated in case notes
Contain reasons for actions and decisions Clearly stated in case notes
Are objective and provide a chronological, accurate account of all
communications with relevant parties
Contain observed facts and relevant information
Add up the total number of ticks, enter in the box,
then click here to enter your score in category 4b
under checklist for individual workers fi le
15
4c Suitable duties
The intent of this category is to assess whether suitable duties are provided in consultation with all parties and provide a medically approved, safe and graduated
return to work.
Key elements Evidence of verifi cation - one or more
may be used
Tick if
provided
Comments/action required
Where practicable, suitable duties are offered to all injured
workers with medical certifi cation for partial incapacity
Suitable duties plan
Case notes
Correspondence
Suitable duties take into account workers medical condition and
nature of their incapacity
As shown on suitable duties plan
Case notes or other documentation
Suitable duties plans developed in consultation with treating
medical practitioner
Signature on suitable duties plan if required
Record of case conference
Case notes
Suitable duties plans developed in consultation with injured
worker
Signature on suitable duties plan
Record of case conference
Case notes
Where suitable duties are unfamiliar to injured worker,
appropriate training and induction in the role and relevant safety
procedures and supervision are provided
Case notes
Injured worker signs acknowledgement of receiving relevant
training and induction
Suitable duties are goal focused with tasks and restrictions
considered in development
Suitable duties plan shows goal, tasks, and restrictions
Suitable duties are time limited and have a review date Suitable duties plan has a review date
Add up the total number of ticks, enter in the box,
then click here to enter your score in category 4c
under checklist for individual workers fi le
Notes:
Section two Checklist for individual workers fi le
Category four The return to work process
16
The intent of this category is to assess whether employers are ensuring rehabilitation service providers are able to meet some basic standards of service
provision. By developing a service agreement that sets out the terms and expectations under which those services are to be provided, employers will be able to
assess whether these terms and expectations have been met.
Key elements Evidence of verifi cation - one or more
may be used
Tick if
provided
Comments/action required
The role of rehabilitation providers is clear to all parties Request for services or referral clearly sets out what services
are required, expected costs and the timeframes for delivery
Rehabilitation service providers are evaluated against the
request/referral
Costs compared to estimates
Progress reports/communication from providers are:
timely
easily understood
Treatment providers contacted (with injured worker permission)
to obtain updates on worker’s treatment and condition
Case notes
Fax
Emails
Add up the total number of ticks, enter in the box,
then click here to enter your score in category 4d
under checklist for individual workers fi le
Notes:
Section two Checklist for individual workers fi le
Category four The return to work process
4d Engaging rehabilitation service providers
17
Notes:
Section two Checklist for individual workers fi le
Category fi ve Rehabilitation strategies for long term or seriously injured workers
Key elements Evidence of verifi cation - one or more
may be used
Tick if
provided
Comments/action required
Redeployment considered when appropriate Offer of redeployment on injured worker fi le
Referral to rehabilitation providers for vocational assessment,
and job seeking skills training when appropriate (requires insurer
approval for payment of costs)
Referral on fi le
Case notes
Relevant documentation
Retraining including host employer work trial and brief
vocationally oriented training courses offered with realistic job
prospects (requires insurer approval for payment of costs)
Offer on fi le
Add up the total number of ticks, enter in the box,
then click here to enter your score in category fi ve
under checklist for individual workers fi le
This category assesses whether appropriate assistance has been provided to seriously injured workers who are unable to return to work with their original employer.
The National Occupational Health and Safety Commission (NOHSC 1995) states that when it is apparent that placement with the pre-injury employer is not possible,
an alternative employer should be sought. The workers’ compensation insurer will be able to assist the employer in this situation. It should be recognised that
placement or relocation away from colleagues and familiar work practices may add to the diffi culties associated with returning to work. Referral to an appropriately
qualifi ed rehabilitation provider to provide placement assistance including vocational assessment, counselling and development of job seeking skills will assist with
placement of these workers.
18
Key elements Evidence of verifi cation - one or more
may be used
Tick if
provided
Comments/action required
Injured worker feedback in relation to workplace rehabilitation is
sought during rehabilitation and following case closure
Case notes/correspondence indicating evaluation sought from
injured worker (may be telephone survey or other form of
survey)
Evaluation by injured worker on fi le
Evaluations are collated and summarised
Return to work status noted on individual worker fi le Case notes or fi le summary
Rehabilitation of individual workers evaluated to highlight
positive outcomes and any concerns
Case notes, fi le reviews
File summary
Report
Results collated and summarised to inform systems
management
Add up the total number of ticks, enter in the box
then click here to enter your score in category six
under checklist for individual workers fi le
Notes:
The intent of this category is to assess whether workplace rehabilitation programs continue to remain effective. The evaluation assesses the success rate of
individual programs, costs and durations, problems or issues of concern, positive outcomes, and injured worker’s satisfaction.
Section two Checklist for individual workers fi le
Category six Evaluation of workplace rehabilitation
Checklist for
individual
workers fi le
The workplace
rehabilitation
environment
Category one
Category two
Category three
Category one
Category
two
Category three
Category four
Category fi ve
Category six
ADCB
Total Score
The self-assessment checklist was developed to provide a framework for employers wishing to assess their
workplace rehabilitation systems. It is recommended that you use the overall score from the self-assessment
checklist as a benchmark against which to compare future self-assessments. The higher the score, the better.
But remember – be as objective as you can with your scoring to get the most out of the self-assessment
process. The self-assessment checklist will help you to identify strengths and weaknesses in your workplace
rehabilitation processes. It is an opportunity to identify areas where improvement can be made.
The self-assessment checklist should not be considered exhaustive and employers should consider adding
additional indicators to customise the self-assessment checklist for their particular circumstances.
Workplace rehabilitation is a dynamic fi eld and it is important to keep up to date with relevant changes in
legislation that relate to the requirements for employers to provide rehabilitation. You should ensure that
those responsible for coordinating rehabilitation in the workplace maintain regular contact with the workers
compensation insurers case manager.
To fi nd out more about getting assistance to improve workplace rehabilitation processes at your
organisation, visit the employers section on the Q-COMP website (www.qcomp.com.au) or call Q-COMP on
1300 361 235 and ask to speak with a Senior Rehabilitation Advisor regarding any workplace rehabilitation
enquiries you may have.
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Helping you get the measure of
workplace rehabilitation
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References
Accident and Compensation Commission New Zealand 2000, The Self Management Programme for Accredited
Employers, Partnership Programme, New Zealand.
Comcare 1996, Return to Work: A Guide to Workers’ Compensation Case Management, Canberra.
Rieve, Julia A, RN 2001, Best Practice in Case Management, The Case Manager, vol. January/February, pp. 36-37.
National Occupational Health and Safety Commission 1995, Guidance Note for Best Practice Rehabilitation
Management of Occupational Injuries and Disease, Canberra.
Tasmanian Workers’ Compensation Authority 2002, Injury Map. Injury Management Assessment Program, Tasmania.
Workcover New South Wales 2001, Self Insurers Injury Management Self Audit Tool, New South Wales.
Case Management Society of America 2002, Standards of Practice for Case Management, Arkansas.
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