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DPI Treatment and Management (as from 2. Early Intervention)
- Acute injuries are classed as work associated injuries as they do not fit into the class of early intervention. E.g. spraining an ankle when falling over (workplace accident). These acute cases would in most cases fall under work related ACC claims. These cases will still need to be effectively managed however and only differ only in terms of the funding.
- The early intervention process begins with an employee who is reporting worsening discomfort and a referral from the Team Leader to a specialist physiotherapist for assessment and/or treatment of the problem.
- The Physiotherapist will ask for a detailed history of work and non-work practices and will perform a detailed musculoskeletal assessment. The aim of the initial assessment is to determine whether there is an underlying pathology or contributing dysfunction present, or whether the picture is of a strain and soft tissue overload.
In the case of pathology, then the physiotherapist will recommend and undertake treatment, with the individuals consent, and initiate a medical rehabilitation care pathway involving resolving the pathology and reconditioning back to normal duties. This may also include involvement of an individual’s doctor if there is a need for temporary cessation of work. Where no pathology exists and a pure strain overload is present then the physiotherapist will guide the individual on how to manage daily tasks, including work tasks, with the main emphasis being to unload those structures that are involved.
In all cases basic principles of self management and job specific techniques will be reinforced.
- Both Nick and Grant are physiotherapists with specialist experience in occupational health which has enabled them to develop highly effective early intervention care pathways.
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Referral to Willis Street Physiotherapy Case Management
- Rehabilitation and Graduated Return to Work Programme
Cases of DPI which require the individual to be briefly placed on light or alternate duties but who are still expected to work normal hours albeit in a reduced capacity require more in-depth management.
This will involve assessment, treatment and continual reassessment so as to ensure quick resolution of the problem. In some cases it may not be possible for the individual to attend treatment at WSP in which case we would recommend that they see their local provider. We can still help to manage the individual by talking to and reviewing the progress with this local provider.
After this treatment and rehabilitation they may also require a Graduated Return to Work Programme to safely and efficiently integrate back to their normal role. We can help design or manage this also.
The following tables show examples of a graduated return to work programme for a walking postie.
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
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WEEK 1
full run
off
off
full run
off
off
off
|
WEEK 2
full run
off
full run
off
full run
off
off
|
WEEK 3
full run
full run
off
off
full run
full run
off
|
WEEK 4
full run
full run
off
full run
full run
full run
off
|
WEEK 5
Normal
Normal
Normal
Normal
Normal
Normal
Normal
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Back to top Injury or Gradual Process Claim Classification
Once the individual is referred into the Early Intervention program a thorough assessment will be undertaken to elicit information which would suggest whether the DPI may be of a gradual process, insidious onset nature or related to a one off event or injury. If the DPI is related to an acute injury then we will complete the necessary ACC paperwork. If the DPI seems to be of a gradual process nature and fails to settle with 4 - 6 treatments then it is likely that a claim will have to be initiated.
GP, Specialist and Team Leader Liaison
The Early Intervention programme aims to prevent discomfort turning into a Gradual Process claim.
In the situation where a gradual process claim does arise it suggests that the previous steps have not been followed or the problem identified quickly enough. The discomfort has progressed and become more significant resulting in soft tissue injury.
By definition these claims do not fall under the early intervention header as they are more likely to involve increasing discomfort of a long standing duration (>3 months).
Where a gradual process injury is reported by the individual employee it is important to make a referral to a specialist physiotherapist as soon as possible. From this assessment the physiotherapist can make recommendations and suggestions on how best to manage this DPI.
When Workplace pain and injuries are slow in onset and will not be resolved in a few Early Intervention sessions a Gradual Process Claim will need to be lodged.
The role of the Willis Street Physiotherapist is to liaise with the GP completing the forms and provide them with details of the presentation, the person’s capabilities and the alternate duties they are fit for. The Physiotherapist communicates this to the Team Leader also.
In operating this way we avoid the person being signed off work by the GP unnecessarily and improve the return to full duties outcome. Dependent on the injury it may still be possible to make quick progress with treatment, but it may involve more expensive specialist referral or investigation and the recovery timeline will often be significantly longer.Back to top
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