The Role of the Rehabilitation Provider in Occupational Rehabilitation: Providing for Whom? Part 1: Self-perceptions

Rehabilitation providers were the product of the 1987 Workers' Compensation Act in NSW, Australia. They operate in a complex environment and serve many masters. This paper assesses how rehabilitation providers are faring in the management of workplace injury. Using in depth semi-structured interviews, the self-perceptions of rehabilitation providers are presented. Results indicate that the current practice of rehabilitation providers labours under a heavy load of competing responsibilities, difficult clientele, adversarial stakeholders, economic restraints, and an unwieldy and clumsy workers' compensation system. Specific problems highlighted by rehabilitation providers included the identification of their core business and client group; misconceptions, lack of information and failure of communication among stakeholders; and lack of co-operation and overt and covert obstruction to the rehabilitation process. Rehabilitation providers perceived that they could function most effectively if they developed a genuine, trusting relationship with the injured worker, and educated and supported the treating doctor and employer in the rehabilitation and return to work process. Rehabilitation providers linked employer support of the injured worker to their willingness to provide suitable duties. Early referral was also considered an essential element in successful return to work. It was argued that rehabilitation providers should conceptualise themselves as advocates for the rehabilitation process rather than for any stakeholder group. This conceptualisation allows the provider to move comfortably between groups of stakeholders, addressing their diverse needs while maintaining their focus on their core business.