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1
Comcare Research Program
The Role of Resilience in
Workers’ Compensation
Dr Peta Odgers
Director Research, Comcare
Australasian Compensation Health Research Forum
Sydney, 10-11 October 2013
2
Background and Context
• Comcare’s Research Team was established in 2010 to provide
better insights into the attitudes, behaviours and experiences of
key stakeholders
• Comcare’s research program with injured workers consists of both
• quantitative and
• qualitative data collection strategies.
• The following information represents:
• over 3,000 responses to four waves of the Injured Worker
Survey, and
• three qualitative pieces of research which examined:
• Long Duration Claims
• Failed RTW, and
• Delays in Claiming.
Over 3,000 injured workers have participated across four waves of the Injured Worker Survey and over 50 injured workers and 6 employers have participated in our qualitative research.
It’s a Fact
The information contained within this presentation was collected through both quantitative and qualitative research.
Don’t Forget
3
Purpose
• To highlight some of the key findings on resilience and the role
it plays within workers’ compensation.
• Specifically, I would like to share with you the relationship
resilience has to:
• claim cost
• return to work, and
• recovery experiences.
• To share just some insights from the qualitative research around
claimant typologies
• Outline some possible actions that have come out of the research
4
Resilience
• Resilience is usually something which refers to someone’s ability:
• to “bounce back” or recover from stress,
• to adapt to stressful circumstances,
• to not become ill despite significant adversity, and
• to function above the norm in spite of stress or hardship.
(Smith et al., 2008)
• The Brief Resilience Scale was used to categorise respondents as
having:
• ‘High’ resilience,
• ‘Medium’ resilience or
• ‘Low’ resilience.
Resilience could play a key role in influencing an individual’s recovery from a workplace injury or illness.
Here’s an Idea
The Injured Worker Survey included the Brief Resilience Scale – a validated measure designed to assess individual resilience.
It’s a Fact
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Resilience
• Some of the factors associated with resilience include:
• Supportive relationships
• Ability to make realistic plans and carry them out
• A positive view of self and confidence in one’s own strengths
and abilities
• Communication and problem solving skills, and
• Ability to manage strong feelings and impulses.
• All of these are important for recovery and RTW
• Importantly, resilience can be influenced both positively and
negatively
How do we build resilience in injured workers with the aim of assisting their recovery and return to work?
Point to Ponder
6
Resilience Breakdown
In the Injured Worker Survey, Resilience is measured at the time of interview – after the injury or illness.
It’s a Fact
• Most injured workers surveyed were classified as having medium
levels of resilience.
• Today’s focus will be on the comparisons between injured
workers with low and high levels of resilience.
Figure 1:- Proportion of respondents in each resilience category.
How can we have a positive impact on an injured worker’s resilience?
Point to Ponder
The four surveys have shown consistent findings for resilience among injured worker’s in the Comcare scheme.
Here’s an Idea
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Average Cost of Claims
What can we do to both promote and protect the resilience of people on workers’ compensation?
Ask Yourself
• Injured workers with low resilience cost around three times as
much compared to injured workers with high resilience
Figure 2:- Resilience by average cost.
$151,155
$50,728
$0
$20,000
$40,000
$60,000
$80,000
$100,000
$120,000
$140,000
$160,000
Low Resilience High Resilience
The average cost of claims for those with low levels of resilience was significantly higher than for those with high levels of resilience
It’s a Fact
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Average Time Off Work
How can we positively influence resilience and help injured and unwell workers return to work more quickly?
Ask Yourself
• Injured workers with low resilience require more than four times
the number of weeks off work compared to injured workers with
high resilience.
Figure 3:- Resilience by average time off work.
150 weeks
36 weeks
0
20
40
60
80
100
120
140
160
Low Resilience High Resilience
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Injury Type
What can we do to promote resilience among people with mental disease claim?
Ask Yourself
• Those with a mental disease claim were:
• more than twice as likely to have a low level of
resilience, and
• half as likely to have a high level of resilience.
Figure 4:- Resilience by injury type.
Do low resilience levels increase an individual’s vulnerability to mental disease?
Point to Ponder
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Medium Incapacity by Injury Type
Figure 5:- Medium incapacity weeks for injury type by resilience.
130 weeks
9 weeks
107 weeks
4 weeks
52 weeks
5 weeks 11 weeks 9 weeks
20
40
60
80
100
120
140
Low Resilience High Resilience
Mental Disease
Musculoskeletal
Other Injury
Other Disease
• The medium incapacity of those with high resilience is quite
similar, regardless of injury type
• The medium incapacity of those with low resilience is very
different depending on injury type
Planning and goal setting can help promote resilience. Making a plan to return to work can have an important role in building resilience in injured workers.
Here’s an Idea
What role does resilience play in an injured worker’s return to work?
Point to Ponder
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Readiness to Return to Work
People do not have to be 100% fit in order to RTW, but they do need to be ready!
Here’s an Idea
• Those with low resilience were less likely to be either physically
or emotionally ready to RTW and more likely to report not being
ready to RTW.
Figure 6:- Resilience by readiness to return to work.
Could returning to work before they feel ready impact an injured worker’s resilience?
Point to Ponder
What can we do to better prepare an injured worker to return to work?
Ask Yourself
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Qualitative Findings
• The survey research program has provided us with some
excellent population level information
• The qualitative research program has provided us with insight
into the actual experiences of injured workers
• Three projects have been conducted:
• Long Duration Claims
• Failed RTW, and
• Delays in Claiming
How does being on workers’ compensation impact people?
Point to Ponder
What can we do to better support injured workers?
Ask Yourself There is a strong stigma associated with workers’ compensation , with people being perceived as a “bludger” or a “whinger”.
It’s a Fact
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Claimant Typologies
High Resilience
Low Resilience
Low
Tru
st
in E
mplo
yer
Hig
h T
rust
in E
mplo
yer
Defensive & Entitled
Strivers
Victims Temporarily
Floored
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Strivers
“Go with the flow”… get on with their job and not complain.
Resilient… and able to adapt well to change
Cope… when challenged with illness or injury through work
Flexible… do what they can to adapt and manage the
situation to the best of their ability.
General Description
Empowered… maintain control over recovery journey
Trust… the organisation will play a role in recovery
Pragmatic… in their approach
Communicate constructively… with all key parties
Experienced… tend to be in more senior roles
Achievers/“Over-achievers”… sense of pride, very driven
Supported… strong support networks
Key Characteristics
Ideal group… for successful RTW
Still vulnerable… can transition towards other less constructive
groups depending on the process experience
E.g. if handled poorly by the organisation, potential to fracture
the level of trust sending them towards ‘Defensive and Entitled’
typology.
Potential Transitions
“The system is there to get you going while you’re healing – its
not meant to be a crutch”
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Temporarily Floored
Everyday resilience… cope well with everyday situations,
Anchored… strong relationship with organisation & colleagues
Easily destabilised… coping skills are lower than Strivers –
especially with unexpected situations
Holistic… focus on recovery and RTW in combination – need to
make sure they “stop and take a breath” before RTW
Worriers… concerned that issues will be ongoing
General Description
Less empowered … than ‘Strivers’
Seek support… trust the organisation, looking for guidance
Responsible… accept all requirements of them
Self-protecting… want to RTW, but worry about the conditions
Middle management… or admin roles, mid-career or close to
retirement
Key Characteristics
Potential… positive organisational management at all stages
can empower and shift them to ‘Striver’ territory.
Concern… poor management can lead to break down in trust -
danger of a shift into ‘Victim’ typology.
Potential Transitions
“You feel helpless, frustrated, and lonely - sometimes you just have
to rely on everyone”
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Defensive and Entitled
Strong minded… stick up for themselves
Protective… work within boundaries, look after themselves &
recovery first
Assertive… quick to learn about entitlements
Cautious… won’t RTW until they feel completely ready
Resilient… in their approach towards return to health over return
to work
General Description
Personally empowered… to look after themselves – appear in
control
Cynical… low level of trust in the organisation
Self-determined… recover is on their terms – well versed in
rights and responsibilities
Reactive… may put up barriers easily – appear less cooperative
Key Characteristics
Potential clash… with organisation can detract from sense of
empowerment – shifting to “Victim” typology
Potential to shift… to “Striver” if organisation works alongside
them, but harder to move them
Potential Transitions
“I said point blank that it would be a graduated return”
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Victims
Dependent… generally more reliance on support
Disempowered… if anything goes wrong – it is everyone else's
fault and out of their control, they have lower resilience levels
Incapacitated… when things go wrong
Validation seeking… become reliant on the advice of those who
sympathise with their problems
Defeated… don’t believe they will RTW or that they will recover
General Description
More often associated with mental illness
Mistrust… noticeable lack of trust in the organisation
Dethatched… don’t appear to want to be involved in recovery
Institutionalised… even agoraphobic
Lower skilled… lower ranked position, less responsibility
Poor support… weaker social networks
Key Characteristics
Challenging… to shift into more positive typologies
Organisation can transition them to “Temporarily Floored” with
significant understanding, sympathy, flexibility
Potential Transitions
“I don’t believe I will ever work again”
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Keys to Success
Understanding Corporate Culture
Transparency Foster Value
19
Research into Action
The research program associated with Injured Workers has explored a large range of
issues of which only a few have been presented today. The key actions currently being
explored by Comcare to better support the successful recovery and return to work of
injured workers included:
Developing a conversation tool for our first contact team to better
understand the circumstances of injured workers, implement early
interventions where necessary, set expectations and clarify roles and
responsibilities at the beginning of a claim.
Integrate the concepts of resilience, trust, and the four typologies into
the motivational interactions training being run with Comcare’s
Claims Service Officers to improve claims management standards,
practices and processes.
Explore strategies for actively building resilience in injured workers and
preventing their involvement in workers’ compensation negatively
impacting individual resilience.
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Such as RTE
It is important for us to remember that it is
easy to become focused on a single point …
... and this can
be hard!
…such as
RTW
21
So, we need to keep the whole picture,
including the person, in mind…
… and
we need to
do this
together!
For more information please contact:
Dr Peta Odgers The Comcare Research Team
[email protected] [email protected]
Thank you!
