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CASE MANAGEMENT UNDER RETURN TO WORK PROGRAM: THE PERSPECTIVES ON HIRING DISABLED WORKERS AMONG STAKEHOLDERS
By:
FATIMAH ZAHRA BINTI ABDUL MALEK
CASE MANAGER
SOCIAL SECURITY ORGANIZATION (SOCSO), MALAYSIA
PERKESO
DISABILITY MANAGEMENT : RTW
Plan
Implement
Monitor
Review
Evaluate
Acute Stage /
Hospitalization
Rehabilitation
Prosthetics &
Orthotics
Workplace
Modification
Job Placement
Vocational Training
Case
Manager
SAME JOB SAME EMPLOYER
SIMILAR JOB SAME EMPLOYER
DIFFERENT JOB SAME EMPLOYER
SAME JOB DIFFERENT EMPLOYER
SIMILAR JOB DIFFERENT EMPLOYER
DIFFERENT JOB DIFFERENT EMPLOYER
SELF EMPLOYED
CASE STUDY 1 (MUSCULAR DYSTROPHY)
29 years old (Age at time of case registration), male, Malay, married with 2 children
Home address: Penang, Malaysia
Case Category: Medical Board (Permanent Disability)
Date of Injury / Invalidity Notice: 09/08/2012
Date of Initial Assessment: 26/02/2013
Location of Initial Assessment: SOCSO Butterworth Branch
Employer’s Name & Address: Aeon Mall Bukit Mertajam, Penang
Industry: Trading
Client's Education Level: Certificate
Diagnosis: Muscular dystrophy
Hierarchy of RTW: Similar Job Same Employer
Pre Injury Work / Job Title: Electrician
Last drawn salary: MYR2100
Health Status: On Rehab
Employment Status: Sustainability Problem
• “Muscular dystrophy is not work related”-Medical Board
• Progressive muscle weakness and wasting since 4 years ago based on SOCSO’s Medical
Report
• Family history: Parents are well, youngest sister has neurological disease
• Clinical examination: Proximal muscle weakness and wasting (hips and shoulders)
• Case referred to Case Manager by the rehab physician
• Therefore, a special meeting which included the rehabilitation specialist, medical doctor,
rehabilitation nurse, physiotherapist, occupational therapists together with the employers
including Mr Farouk’s Human Resources (HR) manager, supervisor, Mr Farouk himself and
Case Manager was held to discuss the possibility of work modification. Arising from this
discussion, his employer decided to retain him by giving a modified task which was more
suited to his physical capacity at that time.
• Pre and post worksite assessments done by Case Manager together with rehab physician,
occupational therapist and employers.
• Scooter four-wheels and lumbar support provided by SOCSO
• Television broadcasting on the channel “Inspirasi Harapan”
The Insured Person
Multidisciplinary Team Meeting
Mr Farouk at the workplace Scooter Four-Wheels
His leisure activities Featured on TV
Part-time job
CASE STUDY 2: LEFT ABOVE KNEE AMPUTATION (AKA) 51 years old (Age at time of case registration), male, Chinese, married with a child
Home address: Penang, Malaysia
Case Category: Medical Board (Invalidity Pension)
Date of Injury / Invalidity Notice: 02/09/2014
Date of Initial Assessment: 11/08/2015
Location of Initial Assessment: SOCSO Butterworth Branch
Employer’s Name & Address: Seong Huat Auto Parts Sdn Bhd, Butterworth
Industry: Trading
Client's Education Level: Malaysian Certificate of Education (SPM)
Diagnosis: Left Above Knee Amputation (AKA)
Hierarchy of RTW: Different Job Same Employer
Pre Injury Work / Job Title: Lorry Driver
Post Injury Work: Packing
Last drawn salary: MYR1600
Health Status: On rehab
Employment Status: Unemployed
Prosthesis & Orthosis His Workplace
• Level of amputation: Left Trans femoral
• Reason for amputation: Diabetic ulcer
• Case Manager had a discussion with the client together with his rehab specialist and rehab team at the Penang
General Hospital
• He was referred to SOCSO’s Rehab Centre for walking gait training. Treatment done included physiotherapy,
occupational therapy, gymnasium, work hardening, and provided with prosthesis and orthosis including 2 units
of elbow crutches
• Mr Tan was referred to OT department at the SOCSO’s Rehab Centre for prosthesis restoration, maintaining
function, walking without assistive device and stump care
• Now, he is able to perform all the task independently by himself without any supervision after got his prosthesis
• Very motivated and cooperated during attending all the sessions with the therapist
• Shown good in his confidence level when participate in group discussion
• Shown good improvement in socialization and communication skills with others
• After discussion with his employer during worksite assessment by Case Manager, the employer willing to
provide a new job that suited the client, which is home-based work (packing the goodies)
The SOCSO’s Rehabilitation Centre in Melaka
CASE STUDY 3: HAEMORRHAGIC STROKE WITH RIGHT HEMIPARESIS 31 years old (Age at time of case registration), male, Chinese, single, stay with his family
Home address: Penang, Malaysia
Case Category: Medical Board (Not Invalid)
Date of Injury / Invalidity Notice: 3/11/15
Date of Initial Assessment: 12/11/2015
Location of Initial Assessment: Rehabilitation Clinic, Penang General Hospital
Employer’s Name & Address: MyWave Sdn Bhd, Bayan Lepas
Industry: Electrical & Electronics
Client's Education Level: Degree in IT
Diagnosis: Hemorrhagic Stroke with Right Hemiparesis
Hierarchy of RTW: Similar Job Same Employer
Pre Injury Work / Job Title: System Support Engineer
Post Injury Work: Server Admin
Last drawn salary: MYR3050
Health Status: On rehab
Employment Status: Prolong illness (Unpaid Leave)
The client during Initial Assessment His Workstation
• 4 months post Haemorrhagic Stroke secondary to Hypertensive emergency
in July 2015
• Mr Neoh claimed that he still unable to use his right hand to hold and
manipulate objects. However, he already able to perform all activities of
daily living independently.
• Cognitive, speech, intelligence: Good
• Case Manager had a discussion with the client and his family members,
together with rehab specialist. His sister agreed to accompany him to
SOCSO’s Rehabilitation Centre
• Referred him to SOCSO’s Rehab Centre for physiotherapy, occupational
therapy, gymnasium and work hardening
• Ankle Foot Orthosis (AFO)- casting and fitting at the SOCSO’s Rehab
Centre on 02/03/2016, wheelchair, walking stick, upskilling through
vocational training, and Rehabilitation Allowance provided by SOCSO.
Discharged from SRC after 4 months treatment.
• Showed good improvement in term of functional balance, right UL range of
motion, reduction in spasticity, and gait pattern. He accepted to work:
same employer, different job. His initial target is achieved.
• To perform and continue task-specific exercises as given via home exercise
programme for further hand function’s improvement and maintenance
• During the worksite assessment, the employer agreed to relocate him from
3rd floor to ground floor and installed hand rail in the toilet. He had no
transportation issues as his sister works in the same company
CASE STUDY 4: LUMBAR RADICULOPATHY
55 years old (Age at time of case registration), female, Chinese, single, stay with mother
Home address: Penang, Malaysia
Case Category: Medical Board (Not Invalid)
Date of Injury / Invalidity Notice: 03/03/2015
Date of Initial Assessment: 17/06/2015
Location of Initial Assessment: Penang Water Supply Corporation, Bertam
Employer’s Name & Address: Penang Water Supply Corporation, Bertam
Industry: Public Services
Client's Education Level: Lower Certificate of Education (SRP)
Diagnosis: (1) Right lumbar radiculopathy (2) Left sciatic neuropathy secondary previous operation for abscess
Hierarchy of RTW: Same Job Same Employer
Pre Injury Work / Job Title: Customer Service Officer
Last drawn salary: MYR3914
Health Status: RTW
Employment Status: Sustainability Problem
The Workstation Accessibility issues for wheelchair user(s)
• (1) Right lumbar radiculopathy , (2) Left sciatic neuropathy
secondary previous operation of abscess.
• Left leg nerve injury end up paralysis over knee and ankle.
Wheelchair bound since she was 1 year old
• Manual Light Wheelchair (Model Quickie Xenon) provided
by SOCSO
• Physiotherapy done at the SOCSO’s Physiotherapy Panel in
Penang (Adventist Physiotherapy Centre)
• Repetitive usage of arms example: counter works, driving,
wheelchair transfer causes shoulder pain
• Case Manager done the worksite assessment with Ms Ng
and her supervisor , suggestion made to the employer to do
workplace modification by putting ramp at the stairs.
Negotiation succeed, ramp built by the company
• Reserved special car park for her
STAKEHOLDERS’ PERSPECTIVES ON HIRING DISABLED WORKERS: RESULTS FROM 4 CASE STUDIES
THE HEALTH PRACTITIONERS’ PERSPECTIVES
“Employability is more favorable for all of the Persons With Disabilities if the Insured Persons had successfully undergone comprehensive medical rehabilitation and RTW Programme as well as receiving relevant rehab items (prosthesis, orthosis or walking aids) to assist in ambulation”
“The Insured Persons who have proper transport to work and have supportive employers would remain to be successful in their employment”
“Definitely disabled workers who undergone RTW Programme have a better employability and employment”
EMPLOYERS’ PERSPECTIVES
“Give opportunity and to support disabled people to continue their job career in private sector” “Good for them to show their capability as a good worker and grow with other good worker”
“They are good workers and have potential to grow in future as a leader”
“If possible, supposedly most employer will want to hire back the employee, unless no light duty available. The biggest hindrance is the long prolong medical leave that causes difficulty to company to support it”
CO-WORKER AND SUPERVISORS’ PERSPECTIVES
• Better productivity
• Better employee relations
• The workers will be able to work if the right task and accommodations given to them
• Increase the labor-management relations
THE INSURED PERSON & FAMILY MEMBERS’ PERSPECTIVES
• “ I thank God for it is with His Will that I have been able to continue working and I thank all parties involved in assisting me to continue working”
“ We realized that it is unnecessarily someone who is disabled can not work and only expect on income through SOCSO’s Invalidity Pensions, and staying home and unproductive. By working, one can raise their level of self-confidence, build a social network, and at the same time improve physical, mental and emotional health”
• Better morale
• Skill retention
• Improved quality of life and self esteem, reduce stress and anxiety level
• Financially secured
THANK YOU “Look at the ability and not the disability”
FATIMAH ZAHRA BINTI ABDUL MALEK
