Rehabilitation

1. Rehabilitation • What is it? • Does it work? • Is it cost effective?

2. At work in the UK... • 200mdays lost through certified absences from work* • 33m days per year due to occupational accidents or work-related ill health • 27,000people leave employment every year due to ill- health at work – many will never work again • 30m days lost through work related stress • 6000incidents of violence at work reported to the HSE *The Work Foundation: Absence rates increasing: • 2001: 2.9% • 2002: 4.12%

3. The cost of sickness absence • Costs to employers of £400 - £500 per employee head • Average of 9 days absence per employee head • Best performing companies 3.5 days per annum • Worst performing companies 14 days per annum • Uninsured hidden and direct costs 8:1 - 36:1 in lost production, cover & inefficiency equating to £11billion per annum (CBI)

4. Rehabilitation - the concept... • Early intervention • Co-ordination of treatment and reintegration • Individually tailored & non-adversarial • An advocate for the individual • Managing the best & most cost effective means to reintegration back to health and employment • Early & safe return to graduated or full-time employment

5. The Medical Case Manager • Medically qualified with experience of working in a primary or acute healthcare setting • Has the ability to interpret medical information and implement appropriate treatment plans • Is able to liaise effectively with health professionals, injured clients and their employer or future employer, as well as their representatives • Acts as the point of contact for employers & employees

6. Medical Case Management • To assess a client’s medical status through liaison with their treating practitioners • To arrange private treatment on a cost effective basis, as appropriate • To work with all key parties involved in the case management process, to ensure a timely and safe return to work • To identify cases suitable for vocational intervention

7. Vocational Consultancy • To provide an opportunity for clients to return to work without exacerbating their condition • Aims to understand the needs of both injured party and employer • Carries out Vocational Assessments, Job Analysis and organises Graduated Employment Programmes • Monitors the client as they return to work • Investigates re-training and redeployment options

8. The Vocational Consultant • Has experience of working with people with disabilities in employment settings • Aware of issues concerning physical disabilities, learning difficulties, mental health issues and sensory disabilities • Aware of available private services and public funded opportunities • Find employment solutions through creative thinking • Is able to effectively liaise with solicitors, employers and clients in a variety of work settings

9. Rehabilitation Process Early notification of incident / illness from employer/handler Promptly obtain consent & medical evidence Co-ordinate medical & vocational intervention Organise return to work /employment programme Rehabilitation - the process

10. Case Study - How it has worked • A warehouse operative: • Age 28, salary £15,000 per annum • Sustained a hernia while lifting an object at work and immediately went off sick • The employee had been advised that surgery on the NHS would take six months • The employee would be unable to work during this time. • A Case Manager gained appropriate consent from employee and organised funding for surgery to be organised privately • Surgery was organised five weeks later • Medical recommendations, which helped the employee to return to suitable duties and did not pursue his claim • Potential future loss of earnings £350k • Costs for management and treatment £3,022

11. Case Study - How it has worked • An office administrator: • Age 28, salary £14,000 per annum • Complained of work related stress • Had been taking several periods of absence • A Case Manager secured the appropriate funding and organised private counselling, based on medical recommendations • Liaised with the employer to collate a graduated return to work programme • The employee returned to work without pursuing a claim • Monitoring continued until full hours had been achieved • Potential future loss of earnings £392,000 • Costs for case management & treatment amounted to £3,927

12. Case Study - How it has worked • A human resources manager: • Age 33, salary £30,000 per annum • Had a significant period of sickness, reported as work-related stress. • A Case Manager ascertained that the employee was already receiving adequate medication and counselling under care of their GP, on NHS • A Vocational Consultants provided the employer with advice regarding mental health issues • A graduated return to work plan was formulated to welcome the employee back to work • No claim was submitted by the employee • Costs of management and treatment £3,522 • No claim was submitted against the company

13. Case Study - How it has worked • A chef: • Age 21, salary £23,000 + overtime per annum • Suffered a considerable back and shoulder injury after an unstable load fell on her • A Case Manager arranged private medical treatment • Employee suffered a permanent disability as a result of the accident and could not return to her original role • A Vocational Consultant attempted to adjust the original role although not practical • Assistance provided to employer to identify alternative role • Our Case Manager sought medical validation that the individual was fit to do an alternative job • Individual returned to work as a supervisor in a different kitchen of the employer • Potential future loss of earnings £750k - £1m • Claim paid at £33,000 • Costs for management and treatment £15,800

14. Rehabilitation - the debate….. • More than saving insurers money • More than support to the litigation process • More than support to EL & motor • Wider concept of support to PL, PHI and occupational health services • Benefits to individuals, their families & society as a whole • Alleviates the benefits & NHS system & thus our tax burden • Better for employers as well as their employees

15. The Financial Benefits • Early & effective medical intervention impacts on average claim costs by over 25%: • Client comparison: • rehabilitation v non-rehabilitation client • Claim costs: £2631 v £5067 • Claim file comparison of 25,500 PI claims: • rehabilitation v non-rehabilitation settled claims • £5406 v £8139