Mr Edmund Cheong - Socso Malaysia

Social Security Organisation of Malaysia

Return to Work:

Challenges and Opportunities

Investing in People

Edmund Cheong, CDMPEdmund Cheong, CDMP

Social Security Organisation

Malaysia

COSH 2011 - OSH: Empowerment. Accountable. Responsive.

Kuala Lumpur Convention Centre

19 July 2011

Health?


Investing in People

Health?

OSH - DefinitionOccupational health should aim at:

• the promotion and maintenance of the highest degree of physical,

mental and social well-being of workers in all occupations;

• the prevention amongst workers of departures from health caused


Occupational health should aim at:

• the promotion and maintenance of the highest degree of physical,

mental and social well-being of workers in all occupations;

• the prevention amongst workers of departures from health caused • the prevention amongst workers of departures from health caused

by their working conditions;

• the protection of workers in their employment from risks resulting

from factors adverse to health;

• the placing and maintenance of the worker in an occupational

environment adapted to his physiological and psychological

capabilities; and, to summarize, the adaptation of work to man and

of each man to his job.





•• the placing and maintenance of the worker in an occupational the placing and maintenance of the worker in an occupational

environment adapted to his physiological and psychological environment adapted to his physiological and psychological

capabilities; and, to summarize, the adaptation of work to man and capabilities; and, to summarize, the adaptation of work to man and

of each man to his job.of each man to his job.


Case Management is a collaborative process that facilitates

recommended efficient treatment plans to assure the

appropriate medical care is provided to disabled, ill or injured

individuals.

Disability Management (RTW)Case Management is a collaborative process that facilitatesfacilitates

recommended efficientefficient treatment plans to assure the

appropriate medical careappropriate medical care is provided to disabled, ill or injured

individuals.

Planning and coordination of health care services appropriate to

achieve the goal of medical rehabilitation. Medical case

management may include, but is not limited to, care

assessment, including personal interview with the client, and

assistance in developing, implementing and coordinating a

medical care plan with healthcare providers, as well as the

clients and his/her family evaluation of treatment results while

promoting cost-effective care.

Planning and coordination of health care services appropriate to

achieve the goal of medical rehabilitationachieve the goal of medical rehabilitation. Medical case

management may include, but is not limited to, care care

assessmentassessment, including personal interview with the client, and

assistance in developingin developing, implementingimplementing and coordinating a coordinating a

medical care planmedical care plan with healthcare providershealthcare providers, as well as the

clientsclients and his/her familyhis/her family evaluation of treatment resultsevaluation of treatment results while

promoting costpromoting cost--effective careeffective care.

The Relations of OSH & DM


Investing in People

Disability

Management

Occupational

Safety &

Health

Promotion

of

Health

SOCSO’S RTW/DM PROGRAM

• This program is established with the

objective of assisting SOCSO’s Insured


Investing in People

objective of assisting SOCSO’s Insured

Persons with employment injury as well as

those claiming for invalidity pension to be

able to return to work. (Disability

Management)


Pathology of a Claim

Prolonged Disability Duration?

Investing in People

Acc

ide

nt

Su

rge

ry

Acu

te I

np

ati

en

t

Tre

atm

en

t

No

Tre

atm

en

t

Ph

ysi

cal R

eh

ab

No

Tre

atm

en

t

Vo

cati

on

al

Re

ha

b

GO

AL?

??

Pro

sth

esi

s?

No

Tre

atm

en

t

Prolonged Disability Duration?

No

Tre

atm

en

t

No

Tre

atm

en

t

No

Tre

atm

en

t

Disability Management


Role of the RTW Program? Investing in People

Acc

ide

nt

Su

rge

ry

Acu

te I

np

ati

en

t

Tre

atm

en

t

No

Tre

atm

en

t

Ph

ysi

cal R

eh

ab

No

Tre

atm

en

t

Vo

cati

on

al

Re

ha

b

GO

AL?

??

Pro

sth

esi

s?

No

Tre

atm

en

t


No

Tre

atm

en

t

No

Tre

atm

en

t

No

Tre

atm

en

t

Acc

ide

nt

Su

rge

ry

Acu

te I

np

ati

en

t

Tre

atm

en

t

Ph

ysi

cal R

eh

ab

Vo

cati

on

al

Re

ha

b

GO

AL?

??

Pro

sth

esi

s?


Investing in People

Acc

ide

nt

Su

rge

ry

Acu

te I

np

ati

en

t

Tre

atm

en

t

Vo

cati

on

al

Re

ha

b

GO

AL?

??

Ph

ysi

cal R

eh

ab

Pro

sth

esi

s?


Improve Disability DISABILITY MANAGEMENT

Investing in People

SOCSO Disability Case Manager

Acc

ide

nt

Su

rge

ry

Acu

te I

np

ati

en

t

Tre

atm

en

t

Vo

cati

on

al

Re

ha

b

GO

AL?

??

Ph

ysi

cal R

eh

ab

Pro

sth

esi

s Treatment

Physical Rehabilitation

Vocational Rehabilitation

Constant Communication

Constant Monitoring

Improve Disability

Durations

Maintain

Stakeholder

Relations

Safer recovery

Return to Work or

Retain @ Work

DISABILITY MANAGEMENT

Rehabilitation

& Disability Management

Workplace InterventionWorkplace Intervention

Safe and Healthy Safe and Healthy

WorkplaceWorkplace

Challenges


Investing in People

Challenges

The Social Issue


Investing in People

The Social Issue


The Social Issue? – The Micro Perspective

Injury Leads to DisabilityOften spouses

become

disabled as welldisabled as well

Affecting Love

Ones


The Social Issue? – The Micro Perspective

Injury Leads to DisabilityOften spouses

become

disabled as wellA Disabled Family

Affecting SiblingsProductivity/

Employers

A MICRO ISSUE BECOMES A MACRO ISSUEdisabled as well

Affecting Love

Ones

A Disabled Family

Community Country?

A MICRO ISSUE BECOMES A MACRO ISSUE

10

3%5

1%

56

14%

50

13%

54

14%116

30%

24

6%

3

1%

7

2%60

16%

Cases According to Injury/Diseases

Head

Neck

Trunk/Back

Upper Limbs

Multiple Locations

Lower Limbs

General Injuries

Unspecified Locations

41

“Severe” to “Exteremely Severe” Levels (DASS21)


Unspecified Locations

Psychology

DiseasesN=385

31 68

The Economical Issue


Investing in People

The Economical Issue

Social Sustainability


Investing in People

Social Sustainability


??????

= SOCSO Contributors

(Social Solidarity)

Acc

ide

nt No RTW Strategies

No Rehabilitation Strategies

No Monitoring of Insured Person’s

Progress

Outcome?

RTW

Possibilities? ??????


??????

= SOCSO Contributors

(Social Solidarity)

Collapse of the

Social System

Acc

ide




Progress

Outcome?

RTW


Injured Workers


??????

= Maintaining Balance

To the Social System

PR

EV

EN

TIO

N RETURN

Collapse of the

Social System

Acc

ide




Progress

Outcome?

RTW


PR

EV

EN

TIO

N

Disability Case Management

Medical Rehabilitation

Vocational Rehabilitation

Systematic RTW Strategies

RETURN

TO

WORK

Retaining Workers at Work or Return to Work

Injured Workers


Reported Accidents 2000 - 201095,006

85,92681,810

73,858

69,132

61,18258,321

56,33954,133 55,186

57,656

75,386

67,16363,423

56,249

50,803

60,000

70,000

80,000

90,000

100,000

50,803

43,88540,617

38,65735,092 34,376 35,616

19,62017,170 18,387 17,609 18,329 17,297 17,704 17,682 19,041

20,810 22,040

0

10,000

20,000

30,000

40,000

50,000

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010

Total Accidents Reported Industrial Accidents Commuting Accidents


Reported Accidents vs Benefit Payments

166,746,360153,510,745

171,535,250170,168,886187,892,229

214,624,319

274,841,608

306,382,930

200,000,000

250,000,000

300,000,000

350,000,000

63,240,96261,989,99071,176,57767,864,70671,777,133

85,213,88994,063,947

104,007,611109,177,424

166,746,360147,189,831153,510,745

171,535,250170,168,886

0

50,000,000

100,000,000

150,000,000

2002 2003 2004 2005 2006 2007 2008 2009 2010

Payment for Temporary Disablement Benefits Payment For Permanent Disablement Cases

Contribution vs Payment (Invalidity)


Year

Number of

Workers

Contributing

to the Social

System Contribution

Compensatio

n

Number of

Workers

needed to

sustain the

system

Benefit

Recipients

Number of

healthy

workers

needed to

sustain 1

(one)

recipient

Current

number of

workers

contributing

for 1 (one)

recipient

2007 5.45mil $1.7bil $1.1bil 3.5mil 290,463 11.89 18.77


Crisis in the making? Investing in People

2007 5.45mil $1.7bil $1.1bil 3.5mil 290,463 11.89 18.77

2008 5.67mil $1.8bil $1.2bil 3.7mil 320,615 11.56 17.68

2009 5.62mil $1.9bil $1.4bil 4.1mil 324,798 12.56 17.31

2010 5.47mil $2.0bil $1.7bil 4.6mil 347,125 13.34 15.75

2007 – Surplus of 6.886.88 workers



2010 – Surplus of 2.41 2.41 workers


Crisis?

18.7717.68 17.31

15.75

11.89 11.5612.56 13.34

6.88

10.00

15.00

20.00Strategy?Strategy?

Increase Malaysian

Workers population?

Increase contribution?

RTW?

Investing in People

6.88 6.124.75

2.41

0.00

5.00

2007 2008 2009 2010

Jumlah Pekerja yang mencarum untuk satu penerima faedah

Jumlah Pekerja yang diperlukan untuk menanggung satu penerima faedah

Jumlah Lebihan Pekerja

No of workers contributing for one benefit recipient

No of workers needed to pay one benefit recipient

Surplus Workers

Strategy?Strategy?

Cut down Benefit?

Pay for lower quality

services/equipment?

RTW?

Opportunities?


Investing in People

Opportunities?

RTW in OSH?


Investing in People

RTW in OSH?

OSH - DefinitionOccupational health should aim at:

• the promotion and maintenance of the highest degree of

physical, mental and social well-being of workers in all occupations;



Occupational health should aim at:

• the promotion and maintenance of the highest degree of

physical, mental and social well-being of workers in all occupations;

• the prevention amongst workers of departures from health caused • the prevention amongst workers of departures from health caused




• the placing and maintenance of the worker in an occupational

environment adapted to his physiological and psychological

capabilities; and, to summarize, the adaptation of work to man and

of each man to his job.





•• the placing and maintenance of the worker in an occupational the placing and maintenance of the worker in an occupational

environment adapted to his physiological and psychological environment adapted to his physiological and psychological

capabilities; and, to summarize, the adaptation of work to man and capabilities; and, to summarize, the adaptation of work to man and

of each man to his job.of each man to his job.

Practice in OSH?


Investing in PeopleA

CC

IDE

NT

AC

CID

EN

T

FIR

ST

AID

FIR

ST

AID

INV

ES

TIG

AT

EIN

VE

ST

IGA

TE

PR

EV

EN

TP

RE

VE

NT

What happens to What happens to

the worker?the worker?

Worker gets Worker gets

injuredinjuredInvestigateInvestigate

ReportReportPREVENTPREVENT

Return Return

AC

CID

EN

TA

CC

IDE

NT

FIR

ST

AID

FIR

ST

AID

INV

ES

TIG

AT

EIN

VE

ST

IGA

TE

RE

PO

RT

RE

PO

RT

PR

EV

EN

TP

RE

VE

NT

Prevention stops Prevention stops

the vicious cyclethe vicious cycle

ReportReportPREVENTPREVENT

Disability

Management

Rehabilitation & Integration

Return Return

to Workto Work

Retain Retain

@ Work@ Work

Conclusion


Investing in People

Conclusion


In 2007 Pistorius took part in his

first international competitions

for ableable--bodiedbodied athletes.

Oscar Pistoriusthe fastest man on no legs

for ableable--bodiedbodied athletes.

However, his artificial lower

legs, while enablingenabling him to

compete, generated claims that

he has an unfairunfair advantage over

ableable--bodied runnersbodied runners.

“Workplace never discriminates… those

around do…”

“Disability is God given, Handicap is man


Investing in People

“Disability is God given, Handicap is man

made…”

“Opportunity and not sympathy…”

Thank youPertubuhan Keselamatan Sosial


Investing in People

Pertubuhan Keselamatan Sosial

03-4264 [email protected]

BlackBerry PIN:254A5745

Mr Edmund Cheong - Socso Malaysia

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