Back problems are a source of injury for many staff. In particular those who do a great deal of manual work or manual handling can be at greater risk of injury (such staff include Janitors, Groundspersons, special school staff). Other staff may sustain a back injury in their private lives, such as through a sporting injury. In both cases, the injury may impact on the employees work and needs to be managed.
As many back injuries also impact on the nervous system, employees with these injuries may also feel pain and discomfort in various parts of their body. Back pain can be due to various factors including disc problems, pinched nerves or degenerative conditions. Pain can range from occasional to continuous.
Here are a number of ideas that can help a Rehabilitation and Return to Work Coordinator who is case managing such a case.
Peter is a groundsperson who injured his back while moving some large drums of fertiliser. He has previously suffered from back problems but felt that it was under control. His doctor had advised Peter to limit any lifting to 20 kg but he had not passed this information onto the school.
The injury was serious enough to place Peter in hospital. The Principal and the Rehabilitation and Return to Work Coordinator both visited Peter in hospital and also assisted with the WorkCover claim paperwork. In layman's terms, Peter was diagnosed with a torn disk. Peter admitted the drums were heavy, but wanted to have the job done.
The initial medical certificate gave Peter one month off work. In the meantime the Rehabilitation and Return to Work Coordinator, with Peter's permission, spoke to his doctors and liaised with WorkCover. A full-time replacement was found to replace Peter in the interim.
Peter's WorkCover claim was accepted. WorkCover then arranged for a specialist report from his treating orthopaedic surgeon. This report was sent on to his treating doctor.
After one month of treatment, Peter's doctor reviewed his condition and assessed the latest specialist report. The doctor indicated that Peter could do a return to work program with specific limitations for the next few weeks. These limitations were:
WorkCover arranged for an OT to do an onsite assessment and to actually set up the return to work program. The OT met with the Principal, Rehabilitation Coordinator and Peter to finalise the program and respond to any questions from both the school and Peter's viewpoints.
As it was clear that Peter's work would be very limited, it was agreed to keep his replacement on full time for the initial part of the program (a rehabilitation additional allocation). This also helped to ensure Peter felt no pressure to do tasks he should not do and also to allow the school to have someone able to do the jobs Peter would normally do. The Rehabilitation Coordinator handled all the paperwork and liaised with regional office in relation to pay and staffing issues. The program was signed off by Peter, his doctor and Principal.
The program was then reviewed a month later and supported by medical advice, the jobs Peter could do were increased and the hours Peter's replacement attended the school decreased. Three months later he was given a full medical clearance by his doctor, but with a permanent limitation not to pick up more than 20 kg.
The school also arranged for Peter to attend a manual handling course, and the WH&S Officer reviewed Peter's work practices to ensure that any re-injury was minimised. Peter was given clear instructions not to pick up any loads above 20 Kg and to use a trolley where needed, or to break a large load down to smaller lots for moving.
Peter's case was reviewed again after three and six months to ensure that a sustainable and safe return to work had been achieved.
If the case was not a WorkCover matter the same process should still be followed, although the Rehabilitation and Return to Work Coordinator would need to liaise with regional office to arrange for funding for OT assistance and a specialist report. In the case of a back injury, using an OT to advise on the program is recommended as it is an area that requires specialist direction. At all times ensure that the doctor signs off the return to work plan.
If the injury did prevent Peter doing some of his duties long term, then reasonable adjustment or other options would need to be explored. You Regional Rehabilitation Consultant can assist in this matter.
In an extreme case where a return to normal duties is ruled out by the doctors, then other options need to be explored. These could be, vocational assessment, medical deployment, ill health retirement etc.
Author: Kendal Franks (18/07/2002)