If an employee is injured and unable to return to their previous profession, the necessary steps to find new employment should be taken as quickly as possible following the acute treatment phase.
“When the plans for rehabilitation with a view to returning to employment are initiated at a sufficiently early stage, there is high potential for success. The focus of the injured person can be directed towards returning to work, which is beneficial to him or her, the employer and the company alike” summarises Minna Vilkki, Personal Injury Compensation Manager.
Often investigation into rehabilitation with a view to returning to employment is only commenced a long time after hospital treatment has already finished. The employee, at this stage, may have spent a relatively long time away from working life, and this may hinder their return to employment.
Good results and satisfied customers
In the past, everyone in need of rehabilitation was directed to the Insurance Rehabilitation Association (VKK). It functions as the specialist rehabilitation subcontractor for all insurers in Finland.
A little over a year ago, a new operating model was adopted for If’s personal injury compensation in Finland, which has decisively improved the effectiveness of the rehabilitation chain. Under the new operating model, the rehabilitation chain is coordinated by If’s own rehabilitation counsellor.
“Thanks to our own rehabilitation counsellor, we can take on cases where the fast initiation of rehabilitation is of higher than normal importance”, comments Rami Urho, Compensation Manager. The number of cases directed to the Insurance Rehabilitation Association has fallen by around one third over the past year, from 150 to 100.
A decisive role in rehabilitation coordination is played by the rehabilitation counsellor, Sirkku Rissanen, who interviews the rehabilitant, gathers together all their medical information from a variety of sources, investigates various possibilities e.g. regarding the studying opportunities and suitability of the rehabilitant for particular professions, and coordinates and supervises all activities.
Sirkku Rissanen is a rehabilitation professional. She has an MA in Social Sciences, and has wide-ranging experience in the rehabilitation industry. She is very familiar with how, for example, a labourer who has badly injured their knee at a building-site can be guided to find a new profession or to undergo re-training.
The operation is profitable, with satisfied rehabilitants
The new rehabilitation model has now been functioning for just over a year, with good results. The operation has been financially profitable, and the rehabilitants have regarded Sirkku’s contact with them as positive. “A person, whose normal life has come to a halt through injury sustained as a result of a personal accident or traffic accident, feels extremely relieved to be contacted by the insurance company with an offer of help and an opportunity to re-build their future”, Sirkku tells us.
Sirkku’s job is to assist the rehabilitant to pinpoint the best route back into employment. “So that we can achieve the best possible results, discussions as well as numerous and wide-ranging investigations and examinations are often required, because every rehabilitant is an individual. In most cases, face-to-face meetings and a number of online meetings have been held with each of the thirty plus rehabilitants.”
Rehabilitation initiated at a sufficiently early stage offers the best chances for the injured person to return to employment, therefore, reducing the insurance compensation payable. Insurance losses can easily amount to almost one million Euros, if a young professional man or woman is unable to work for the rest of their life.
The results for the first year are quite positive: many rehabilitants have returned to employment, and many are undergoing re-training. During the first year Sirkku has interviewed more than 30 rehabilitants. The savings for a successful rehabilitation process is easily more than 100.000€.
The commencement of vocational rehabilitation is decided in If’s major accident forums, of which there are two: one for statutory accident indemnity and one for traffic accident indemnity. Sirkku participates in both.
The experience from this new model has been so promising, that we are in the process of expanding the rehabilitation work to special rehabilitation team. This team is responsible for coordinating the rehabilitation process in all new cases. This working model is in full use by the end of 2009. This will further improve our customer service to both employers and rehabilitants.
Rehabilitation constitutes cooperation between the rehabilitant, rehabilitation counsellor and various operatives. The result of accomplished and smooth cooperation will be a successful rehabilitation process and return to employment. Successful rehabilitation will improve the rehabilitant’s quality of life. Additionally, its effects can be measured in financial savings to both If and the employer, and in a faster return to employment by the injured person.
Case Finland
Tiina (27 years old) had a serious accident at work in 2007 when her hands were caught in the wood-processing machine. Her both hands were injured - left one very badly. Due to the accident she could not continue in her work in wood handling process, which required the use of her hands. Her accident was first handled in If's large claim forum approximately six months after the accident. Before the large claims forum the claims handler had discussed her situation several times with both Tiina and her employer. In large claim forum it was decided to continue to investigate the possibility for Tiina's return to her old employment. It was further decided that If's own rehabilitation counsellor take part in this process.
After the large claim forum a meeting was set up with the employer and besides Tiina, also If's claims adjuster and rehabilitation counsellor participated. The result of meeting was that Tiina should be re-educated to a profession, where she can manage with her injuries. The employer could not offer a suitable job for Tiina, who was enthusiastic about the new opportunity to re-educate herself.
Tiina and If's rehabilitation counsellor together mapped options for re-education. It was arranged that Tiina would have support from her local rehabilitation service provider. If's rehabilitation counsellor arranged a work trial in order for Tiina to get practical experiences from the new profession. Tiina has now started the new education in university of applied sciences and is generally satisfied with her situation. She is studying to become a social worker. During the re-education Tiina receives compensation for loss of income, which is based on her earlier salary. Also the employer is satisfied, even though there were no possibilities for Tiina to continue at her old workplace. Successful rehabilitation is also in the interest of the employer.
New claims handling concept in Denmark
In Denmark we are using proactive case handling concept in personal claims. That has led to positive consequences for the injured persons, the employer, and the insurance companies that have to pay for the bodily injuries;
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We contact the injured person if there is a risk that they incur injury resulting in a longer period of illness.
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We ensure that the injured person will go through the time of illness on the best terms possible.
- We agree on actual treatments and pay for it.
- We pay indemnification or compensation as fast as possible.
In other words –we now influence the life behind the case, instead of just taking care of the legal issues around the case. So far we have contacted more than 200 persons who have incurred injuries and their employers.
Case Denmark
One Tuesday a man goes to work. He is a mechanic and 37 years old; he has a wife and a 2 ½ years old son. That day at 1.00 pm he is taken to the hospital in Jutland – his arm has been wedged between a truck and the floor – the jack broke. He is being operated 9 times. Inflammation and later on putrefaction are being scraped off 9 times. At last he is taken to a specialist section, but his arm cannot be saved. His wife wants to be with him but living in a hotel for several weeks is expensive, and someone is going to take care of their son. He is alone in the hospital. He knows that he cannot work any longer, he knows they cannot keep their house, he knows that life has changed one of a sudden.
When the claims handler gets the case she thinks it is not that serious in the first place – a man got his arm wedged – but she calls him just to hear if everything is okay. It is not. He is in the hospital, and tomorrow he will know whether he can keep his arm. The claims handler calls him on the next day – he cannot keep his arm, actually he feels that there is not much he can keep. She contacts the hospital; however the hospital cannot offer him psychological aid. She calls the psychiatric hospital that is prepared to help (however first in 6 weeks). Therefore she contacts our own psychologist who takes to the hospital to talk to him and his wife after the amputation of his arm. It is hard to the family that he is in a hospital so far from home for a longer period. Therefore the claims handler and the wife agree that If pays for a room in the patient hospital. It is up to the family to decide whether his wife or another member of the family should stay there – as long as he has somebody with him so he is not alone for so long at a time. When he is discharged from hospital they contact a psychologist in Jutland who can help them through this – we will agree gradually whether their need is 1 hour or 20 hours. It is agreed with the claims handler that they shall meet to agree the further development as soon as he is ready. She discusses the case with our doctor and in the team. When he is ready, two claims handlers from our team meet with him and his wife to determine the further development. We pay DKK 400,000 on account in compensation for permanent injury and agree now to concentrate on his future working opportunities.
We agreed on his rehabilitation as an auto technologist. He will finish in 2 years.
It has taken time to build up the resources we need to have in our department to handle a case like this and the cost is a little beyond the normal level, however in this actual claims case the extra cost is below DKK 15.000 so far.
Had we used the old way of working, we would have registered the case in the claim system, and eventually paid compensation.
Rami Urho
Minna Vilkki
Sirkku Rissanen
Kristine Wagner
Ulla Rokkila-Heinonen
