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Rehabilitation: Performance-Based Programs Vs. Prescriptive Standards

Rehabilitation: Performance-Based Programs Vs. Prescriptive Standards

Workplace rehabilitation focuses on safely returning injured workers to work in a timely manner. WorkCover Queensland states: being off work for long periods of time can significantly reduce the likelihood of a worker ever returning to work and can have a negative effect on the worker and their family”1; simply put, the sooner the worker returns the better. But given a choice, which do you think is the best way to get your staff back to work in a safe and timely manner – following a prescriptive step-by-step regime, or embracing performance-based programs. Me? I’m for performance-based methods.

Performance-based return to work programs have no set direction or approach and I believe that this flexibility and freedom:

i) Creates a more meaningful and relevant program;

ii) Improves acceptance of the program by the worker; and

iii) Promotes a more positive attitude and commitment from the employer.

I’ve seen the more formal and prescriptive program and its communication system labelled as “unnecessarily complex and incomprehensible to the great majority of claimants”2, and I believe that less strict and rigid programs promote greater adaptation to the Australian working landscape and the countless technologies and processes, company organisational structures and diverse employment relationships that exist in modern day business.

To assist with the measurement of progress, performance-based return to work systems have the potential to move towards incorporating functional capacity evaluations (FCEs) on the injured worker. FCEs are broad and thorough “batteries of performance-based tests”3 used to “inform return-to-work decisions for injured workers”3 in Northern America. As an evaluation of operation, these tests are currently being reviewed as being “more objective [and] less dependent on patient self-ratings”3.

In the interests of a balanced argument, I do acknowledge that there is some comfort to be found in certainty and uniformity, and it is arguably easier to investigate and / or evaluate whether parties are indeed meeting their obligations when they are more standardised in nature. As a result, I can understand any uncertainty and resistance to the concept of performance-based compliance for return to work programs.

The 2011 Australasian Faculty of Occupational and Environmental Medicine (AFOEM) and the Royal Australasian College of Physicians’ position statement, ‘Realising the Health Benefits of Work‘ tells us that “long-term work absence, work disability and unemployment are harmful to physical and mental health and wellbeing”, so if you had the choice, how would you get your crew back on deck?


Direct References

1. WorkCover Queensland, Realising the Health Benefits of Work

2. Shop, Distributive and Allied Employee’s Association (2008). Submission to Accident Compensation Act Review. Retrieved from

3. Gross, D., (2006). Are Functional Capacity Evaluations Affected by Patient’s Pain?. Current Pain and Headache Reports 10, 107-113

4. Australasian Faculty of Occupational and Environmental Medicine (AFOEM) and the Royal Australasian College of Physicians’ position statement,Realising the Health Benefits of Work. July 2011


Influential Prose

Bluff, E., Gunningham, N., Johnstone, R. (2004). OHS Regulation for a Changing World of Work. The Federation Press, Sydney.

Country Fire Authority (2008). Submission to Accident Compensation Act Review. Retrieved from

Hanks, P. Q.C. (2008). Accident Compensation Act Review Final Report – August 2008. Retrieved from

Kivisto, P., (1998). Government Role in Advancing Occupational Health and Safety. Safety Science Monitor 2, 1-16.

Queensland Government Department of Employment, Training and Industrial Relations (2000). Health and Safety in the Building and Construction Industry.   Building and Construction Industry (Workplace Health and Safety) Taskforce – Final Report. Report 047. Retrieved from

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