Injured workers are taking a long time to come back to work. Increasing delays are having a negative impact on the lives of injured workers and are blowing out costs for insurance companies.

By deepening our understanding of what is happening for injured workers - why some take longer to come back to work, and why some never recover - we can tailor solutions that will help speed up recovery and limit the cost.

The single most important factor correlated with injury recovery is self efficacy: the injured employee believes they will recover and return to work [1]. Taking a human-centred approach to solve the problem makes sense because it can help encourage self-efficacy. Inside most organisations today, return to work is structured within a fixed processes. By taking a person centred experience approach, it is possible to create a Recovery eXperience (RX) that prompts improved internal processes, improved Return to Work outcomes for employees, and ultimately lowers the cost of insurance.

The economic impact is increasing

Data from Safe Work Australia [2] shows the cost of Return to Work programs to Australian business included $1.54 billon in lost productivity and $201 million for back filling injured or ill workers’ roles during recovery. The overall cost to Australia as a nation was far greater. The total economic cost of work-related injury to the Australian economy for 2012-13 financial year was $61.8 billion (4.1% of GDP). A subsequent focus on workplace health and safety has reduced the number of claims. However total costs have increased because the average recovery time is worse and the proportion of workers returning to work has not improved.

Return to work programs are becoming less effective

There are important reasons to improve Return to Work outcomes for all stakeholders. Only 5% of total costs are borne by employers. 74% of the cost is borne by workers and 21% by the community. A long absence costs 7x as much as a short absence. Time spent off work for serious workers’ compensation claims increased 32% in the decade to 2017-18 to 5.8 weeks, up from 4.4 weeks. This suggests that Return to Work programs are getting less effective over time.

Taking a human-centred approach can help

The research shows some key design factors for improvement:

• Increasing the worker’s belief that they will recover (self efficacy)

• A written plan increases the odds of return by 1.7x – 3.4x [3]

• Employer support increases the odds of return by 5x [4]

These elements point to the potential for curating better Return to Work experiences for employees to reduce their recovery time. There is a general trend towards more person-centric recovery programs, however there is an opportunity to apply deep motivational insights to investigate the Return to Work problem and capture the benefits.

The Recovery Experience journey

An ideal Recovery Experience journey is shown through five distinct journey stages outlining some of the injured worker’s most important needs. It is not a straight-line process as - like most of life - there are ups and downs. Across this journey, moments occur when what the employee is doing, feeling and thinking strongly impacts their recovery.

Managing these moments is the key to unlocking better Return to Work outcomes as they create and drive self efficacy.  Scientific research links the belief a worker has about their ability to return-to-work following an absence and the success of their rehab program (for example see Black [1]).

CX target state experiences are designed and curated to ensure touchpoints result in customers feeling a certain way and leaving with specific memories. In the same way RX journeys can nudge injured workers to buy in to the possibility they can return to work quickly, fully recovered and ready to resume their careers.

How this journey plays out depends on the players involved.

One size fits few

The most significant gap we have observed with the current Return to Work approach is lack of segmentation. Insurance schemes and employers tend to segment on the length of claim (0-6 months, >6 months), expected time of work, and the severity of the injury.

Injured workers are subject to the same support and administrative process, regardless of their belief about recovery. Individual Return to Work objectives are largely ignored because Return to Work has been built on a processing mindset that is more appropriate to standard insurance claims than health care. This process orientation can have a negative effect of the well-being of workers. The table below outlines the range of different actions injured workers may take based on belief they will recover and their personal objectives overall when making a worker’s compensation claim after injury or illness. This approach creates twenty possible recovery orientations. Managing Return to Work (RTW) well means flexing the Recovery Experience journey to take recovery orientation into account.

The traditional insurance approach of having a single efficient ‘one size fits all’ process does not work due to the limited ability to control claims leakage.  Insurers minimise this leakage by using claimant and other data. This data allows the insurer to prevent fraud, reject claims not covered, enforce claims limits and control repair and recovery costs.

Return to Work is different as costs depend on both the injured worker’s orientation towards recovery and the extent of their injury. The solution is to treat injured workers differently depending on personal objectives and belief levels. This changes the consideration around using digital claims management platforms.

Digital alone is not enough

Digital solutions are normally designed to apply more complex data analysis to reduce claims leakage, compel claimants to self-serve, and automate the back end of claims processing and management to reduce head count. Many digital solutions have been contemplated and trialed over the last 10 years however no cut-through solutions are in use across the sector.

What we know, is that automation works better when digital is combined with humans [5], instead of seeking to replace them. This certainly applies for Return to Work situations.

A better use of a digital investment is to gamify the recovery process.

Simple mobile apps have been shown to increase patient compliance with medical treatment plans. In Return to Work this effect may be re-directed to increase rehabilitation plan compliance.

Mobile apps also build motivation by highlighting real time progress markers. Celebrating progress not only reinforces a positive action orientation, but also leverages cognitive consistency to increase self efficacy. Mobile apps also provide access to hard-to-capture recovery data when appropriate privacy waivers are agreed.

This enables Recovery Experience journeys to improve over time as greater insights about key moments of truth are discovered.  Sharing this data with Return to Work coordinators combines digital and human effectively.

Case workers need an uplift too

Case Managers are often constrained by the administrative burden of ensuring ‘process flow’ and may lack the time and skills to address the specific needs of the injured worker.  In many instances the case allocation is governed by practices or funding arrangements. Further constraints come with decreasing the time available to deal with the needs of injured workers. There may also be a need for skills uplift.

In Return to Work, case workers need ‘para-therapeutic’ skills, similar to the difference between paramedics and doctors. These skills should be focused in applied psychology. Some of the required skills include:

• Assessing veracity accurately in face-to-face interactions

• Applying motivation theory to improve goal achievement

• Utilising the variability inherent in medical assessments

• Holding clients accountable for commitment to their rehab

• Exploring non-traditional options for returning to work

• Reducing future injury by reporting on causal factors

Re-imagining and evolving the Recovery Experience

CapFeather’s research and experience point to four critical elements of focus to re-imagine and evolve the Recovery Experience. Any one of these elements will improve Return to Work rates. Combined, they will help improve the well-being of workers, speed up return to work, or help workers find new career directions. It’s all about an intelligent blend of improving the mechanics of the experience, better empowering clients to be active participants in their recovery, lifting the skill and capability of case managers, and using technology in targeted ways.

Find out more about designing a Recovery Experience and lowering the costs of Return to Work.

Why CapFeather?

We are innovation experts who apply a human lens to organisational and societal challenges. We value people and base our work inside a philosophy of kindness, whilst being driven by commercial success. We help mature firms find new and sustainable opportunities for customer growth by looking beyond the immediate horizon.

Ambidexterity is needed for exponential growth. While your team excels at business right now, we help you design the path for its future success.

Over 20 years of senior advisory, our people have worked on more than 200 projects to deliver bottom line growth and new revenue through product and service innovation - achieved though compelling customer
relationships. CapFeather has presence in Australia, the United Kingdom and North America.

References

[1] Black, O., Keegel, T., Sim, M. R., Collie, A., & Smith, P. (2018). The Effect of Self-Efficacy on Return-to-Work Outcomes for Workers with Psychological or Upper-Body Musculoskeletal Injuries: A Review of the Literature. Journal of occupational rehabilitation, 28(1), 16–27

[2] Safe Work Australia (2017) Australian Workers’ Compensation Statistics: 2015-2016  and Safe Work Australia (2020) National Return to Work Strategy 2020-2030

[3] SWA (2017) National Data Set for Compensation‑based Statistics: 2016-2017

[4] COMPARE Project Team (2018) Employer support for injured Australian workers: Overview and association with return to work, Monash University

[5] Dew, R., Russell, B., Allen, C. & Bej, G. (2021). Lean CX: How to Differentiate at Low Cost and Least Risk. Berlin, Boston: De Gruyter.