Determining WHEN to refer to an Accredited Exercise Physiologist (AEP) in a worker’s compensation claim can be confusing, as AEP’s are typically associated with treating “chronic” conditions (i.e. conditions lasting longer than 6 months). In a worker’s compensation claim, this is certainly not the case and a early referral to an AEP can result in a shorter duration claim, a better return to work outcome and self-management in the long term.
The start of the referral pathway begins at week 0 when an injury first occurs in the workplace. During this time, the injured worker (IW) is assessed by their GP and the first certificate of capacity is issued. It is common for a referral to be made to an acute treatment provider, such as a physiotherapist at this stage. By week 2 (following the occurrence of the initial injury) when the first progress certificate is issued by the GP, a referral to an AEP should be made. As acute stage treatment should be coming to an end at around weeks 4-6, this allows the AEP and acute treatment provider to liaise and work together to create a streamlined handover and treatment plan.
By week 6, the IW should have fully transitioned from acute treatment to a pool or gym programme supervised by an AEP. The main treatment objectives at this stage include providing education around the recovery cycle and pain. The other major focus at this stage is the IW’s compliance to their new programme and an early focus on self-management. Open communication from AEP to the treating GP around the AEP’s initial assessment and the latest functional capacity update will allow the GP to increase the IW’s lifting capacity on the second progress certificate, which is issued at this stage.
If the above timelines are met, by week 10 following an injury, discussions around the readiness of the IW to trial their pre-injury job role should be taking place. By this stage, the IW would have completed close to 6 weeks of exercise rehabilitation programme resulting in further improvements of their lifting capacity, reflected on their third progress certificate. Treatment objectives at this stage typically involve correcting the IW’s biomechanics and proprioception. Manual handling education is also pivotal to give the IW confidence to trial their pre-injury role.
After 4 weeks of trialling their role (week 14), ideally, a final certificate of capacity should be issued. The AEP should be looking at submitting a final client update to the GP and final report to all stakeholders. If the IW is not at a capacity to complete pre-injury hours and duties, the stakeholders should be discussing what other treatments would be appropriate to assist the IW gaining full functional capacity.
For more information regarding the referral pathway or anything else workers compensation related, you can pop into our clinic and chat to one of our worker’s compensation specialists or contact Absolute Balance on 9240 5080.
Tayla O’Halloran (Bsc. Exercise Physiology)
Senior Accredited Exercise Physiologist (AEP) (ESSAM)
Cochrane, A., Higgins, N., FitzGerald, O., Gallagher, P., Ashton, J., Corcoran, O., & Desmond, D. (2017). Early interventions to promote work participation in people with regional musculoskeletal pain: a systematic review and meta-analysis. Clinical Rehabilitation, 31(11), 1466-1481. doi: 10.1177/0269215517699976