Returning successfully to work

Responding to a rise in work-related injuries, SOCSO introduced the Return to Work Programme. Making use of individual but systematic case management while promoting early intervention, the programme considerably improved return to work rates. The benefits outweigh by far the costs by a 1.43:1 ratio.

Many countries outside Europe and North America lack return-to-work assistance for employees acquiring a disability. Malaysia is the first Southeast Asian country which has effectively improved rates of return to employment, for which a comprehensive disability management programme is crucial. HISTORY: Tackling the rising trend of workers suffering from disability due to injuries and diseases, the Malaysian Social Security Organisation (SOCSO) introduced the Return to Work Programme in 2007, following an 18-month pilot programme. This pilot programme was implemented based on the results of cost-benefit research conducted by the Australian government in 2003 and a visit of senior officials from SOCSO to Australia in 2006. The Return to Work Programme is carried out in accordance with the Employees’ Social Security Act of 1969 (in particular §§40, 53 and 57) and offers comprehensive physical and vocational rehabilitation to employees suffering from employment injuries and invalidity. From 2009, the programme became operational in every region of Malaysia. Currently, private companies are starting to introduce disability management policies in their human resource management practices. The programme is promoted as an innovative practice both for countries seeking to improve their approach to facilitating the return to work of workers who acquire a disability and for those aiming to introduce such a service, by the World Report on Disability, the International Institute for Social Law and Policy, and the International Social Security Association, which is using it as the basis for its draft guidelines to be discussed at its world congress in 2013. SUMMARY: Many countries outside Europe and North America lack return-to-work assistance for employees acquiring a disability. Malaysia is the first Southeast Asian country which has effectively improved rates of return to employment, for which a comprehensive disability management programme is crucial. Responding to a rise in work-related injuries, the Malaysian Social Security Organisation introduced the Return to Work Programme in 2007. Providing for a comprehensive physical and vocational rehabilitation, the programme uses individual case management to assist employees to recover and return to employment. Case managers effectively coordinate the early bio-psycho-social intervention, recovery assistance and workplace adaptation. The programme is promoted as an innovative practice by the International Social Security Association both for countries seeking to improve their return to work approach, and for those aiming to introduce such a service.

Solution, Innovation and Impact

A legal mandate The Employees’ Social Security Act of 1969 allows the Social Security Organisation to provide facilities for rehabilitation free of charge. Individual case management Making use of individual but systematic case management while promoting early intervention, the programme considerably improved return to work rates. Empowerment Enhancing economic empowerment, the programme provides qualitative benefits to employees such as improvement of physical condition, health, skills, career goals, independence and self-esteem. Sustainable use of financial resources The benefits outweigh by far the costs by a 1.43:1 ratio, with possible average returns reaching RM7,884.06 compared to RM3,239.38 costs per person. KEY FEATURES: The Return to Work Programme is managed by the Social Security Organisation of Malaysia. Offering comprehensive physical and vocational rehabilitation, it may assist, free of charge, workers who suffer from employment injuries and invalidity to be able to return to work. Several factors have contributed to its success: a legal mandate, early intervention, coordination of benefits, standard case management protocols, bio-psycho-social intervention, stakeholder participation, data mining and evidence-based strategies. Most important is the effective coordination of rehabilitation through systematic individual case management, by means of which the programme promotes job retention, re-employment and social reintegration. Each case starts with an initial assessment by the case manager, who identifies the key problems and the rehabilitation needs, and plans the recovery assistance. This can involve physiotherapy, vocational retraining and provision of assistive devices/modifications, but also vocational counselling or workplace intervention. Case managers are involved from the beginning to the end, communicate with the specialists, doctors, employers, family members and rehabilitation professionals, and can be assisted by job placement officers. Since the programme’s inception, 4,842 workers have returned to work. In 2011, the number of successfully rehabilitated employees was 1,812. Of those who returned to work (65% in 2010), 84% continued to work for the same employer; out of these almost 70% continued to do the same job. In 2012, the Ministry of Human Resources had already achieved almost 50% of its target (to return 1,700 workers to work) by June. There has been a 640% increase in the number of cases (2,815 in 2011). Furthermore, the benefits outweigh by far the costs by a 1.43:1 ratio and the therapeutic results are highly positive.

Funding, Outlook and Transferability

SOCSO plans to complete its first Rehabilitation Centre for Return to Work by 2013. It engages to reduce further the average number of days required per case (189 days in 2011; benchmark: 59.4 days). In addition, law reform to increase employer involvement is being prepared.