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Social Security Organisation of Malaysia

                                       Investing in People

 Return to Work:
 Challenges and Opportunities
  Edmund Cheong, CDMP
  Social Security Organisation
  Malaysia
  COSH 2011 - OSH: Empowerment. Accountable. Responsive.
  Kuala Lumpur Convention Centre
  19 July 2011
Social Security Organisation of Malaysia

                                       Investing in People



                        Health?
Social Security Organisation of Malaysia



 OSH - Definition
   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
      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.
Social Security Organisation of Malaysia



   Disability Management (RTW)
      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.

      Planning and coordination of health care services appropriate to
      achieve the goal of medical rehabilitation. Medical case
                                    rehabilitation
      management may include, but is not limited to, care
      assessment
      assessment, including personal interview with the client, and
      assistance in developing implementing and coordinating a
                    developing,
      medical care plan with healthcare providers as well as the
                                          providers,
      clients and his/her family evaluation of treatment results while
      promoting cost-effective care.
                  cost-
                  cost-effective care
Social Security Organisation of Malaysia

                                        Investing in People
 The Relations of OSH & DM


        Occupational        Promotion    Disability
          Safety &             of
                              Health    Management
           Health
Social Security Organisation of Malaysia

                                       Investing in People
 SOCSO’S RTW/DM PROGRAM
   • This program is established with the
     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)
Accident

   Surgery

Acute Inpatient
  Treatment


No Treatment


  Prosthesis?

Physical Rehab
                                                   Pathology of a Claim




No Treatment
                                                                                    Social Security Organisation of Malaysia




  Vocational
                  Prolonged Disability Duration?




    Rehab


No Treatment



  GOAL???
                                                              Investing in People
Accident

   Surgery

Acute Inpatient
  Treatment


No Treatment


  Prosthesis?

Physical Rehab
                  Disability Management




No Treatment
                                                                                         Social Security Organisation of Malaysia




  Vocational
    Rehab


No Treatment



  GOAL???
                                          Role of the RTW Program? Investing in People
Accident

   Surgery

Acute Inpatient
  Treatment


                  No Treatment


  Prosthesis?

Physical Rehab



                  No Treatment
                                 Social Security Organisation of Malaysia




  Vocational
    Rehab


                  No Treatment



  GOAL???
Accident

   Surgery

Acute Inpatient
  Treatment




  Prosthesis?

Physical Rehab
                                        Social Security Organisation of Malaysia




  Vocational
    Rehab




  GOAL???
                  Investing in People
Social Security Organisation of Malaysia

                                                                                    Investing in People


                SOCSO Disability Case Manager

                       DISABILITY MANAGEMENT                                              Improve Disability
                                                                                          Durations
                       Acute Inpatient




                                                      Physical Rehab


                                        Treatment
                                               Workplace Intervention
                                                                       Vocational

                                                                                          Maintain
                         Treatment

                                         Prosthesis




                                                                                                  GOAL???
Accident




                                  Physical Rehabilitation Healthy
             Surgery




                                                   Safe and
                                                                         Rehab


                               Vocational Rehabilitation
                                                      Workplace                           Stakeholder
                               Constant Communication
                            Rehabilitation
                                                                                          Relations
                       & DisabilityConstant Monitoring
                                    Management
                                                                                          Safer recovery
                                                                                          Return to Work or
                                                                                          Retain @ Work
Social Security Organisation of Malaysia

                                       Investing in People



                    Challenges
Social Security Organisation of Malaysia

                                       Investing in People



               The Social Issue
Social Security Organisation of Malaysia


The Social Issue? – The Micro Perspective

         Often spouses
                                   Injury Leads to Disability
            become
        disabled as well



                        Affecting Love
                            Ones
Social Security Organisation of Malaysia


 The Social Issue? – The Micro Perspective

         Often spouses                       Productivity/
Affecting Siblings
            become
                                    Injury Leads to Disability
                                               Employers
        disabled as well
 A MICRO ISSUE Disabled Family
             A BECOMES A MACRO ISSUE

                         Affecting Love
                             Ones
       Community                            Country?
Social Security Organisation of Malaysia

      Cases According to Injury/Diseases                    “Severe” to “Exteremely Severe” Levels (DASS21)

                  10    5           Head
                  3%   1%
                                    Neck
        7     60                                               41
     3                  56          Trunk/Back
       2%    16%
    1%                 14%          Upper Limbs
     24
     6%                        50   Multiple Locations
                              13%
                                    Lower Limbs
            116          54
                                    General Injuries
            30%         14%
                                    Unspecified Locations

                                    Psychology

    N=385                           Diseases




            31                                                 68
Social Security Organisation of Malaysia

                                       Investing in People



        The Economical Issue
Social Security Organisation of Malaysia

                                       Investing in People



          Social Sustainability
Social Security Organisation of Malaysia




                              =         SOCSO Contributors
                                         (Social Solidarity)

                    No RTW Strategies


                                                                   ???
   Accident




                                                   Outcome?
                No Rehabilitation Strategies
                                                      RTW
              No Monitoring of Insured Person’s
                                                  Possibilities?
                         Progress
Social Security Organisation of Malaysia



                                        Collapse of the
                              =         SOCSO Contributors
                                         (Social Solidarity)
                                         Social System
                    No RTW Strategies


                                                                   ???
   Accident




                                                   Outcome?
                No Rehabilitation Strategies
                                                      RTW
              No Monitoring of Insured Person’s
                                                  Possibilities?
                         Progress




                                                            Injured Workers
Social Security Organisation of Malaysia



                                          Collapse of the
                                =         Maintaining Balance
                                          To the Social System
                                           Social System
   PREVENTION




                  Disability Case Management
                       No RTW Strategies            RETURN
                                                                     ???
     Accident




                                                     Outcome?
                  NoMedical Rehabilitation
                      Rehabilitation Strategies
                No Monitoring of Insured Person’s
                    Vocational Rehabilitation           TO
                                                        RTW
                                                    Possibilities?
                   Systematic RTW Strategies
                             Progress                WORK

Retaining Workers at Work or Return to Work

                                                              Injured Workers
Social Security Organisation of Malaysia


Reported Accidents 2000 - 2010
100,000 95,006

90,000             85,926
                              81,810
80,000    75,386                          73,858
                                                     69,132
70,000               67,163
                                 63,423
                                                                61,182
                                                                           58,321                                           57,656
60,000                                      56,249                                        56,339                 55,186
                                                                                                     54,133
                                                       50,803
50,000
                                                                  43,885
                                                                              40,617
                                                                                            38,657
40,000                                                                                                  35,092                35,616
                                                                                                                   34,376

30,000
                                                                                                                     20,810     22,040
            19,620                18,387                 18,329                                           19,041
20,000                 17,170                 17,609                17,297       17,704       17,682

10,000

     0
           2000       2001       2002        2003        2004      2005         2006         2007       2008        2009       2010
                                 Total Accidents Reported          Industrial Accidents              Commuting Accidents
Social Security Organisation of Malaysia


      Reported Accidents vs Benefit Payments
350,000,000


300,000,000                                                                                              306,382,930
                                                                                                     274,841,608
250,000,000

                                                                                 214,624,319
200,000,000
                                                                       187,892,229
                    166,746,360                   171,535,250 70,168,886
                                                            1
150,000,000                             153,510,745
                              147,189,831

100,000,000                                                                                              109,177,424
                                                                                                     104,007,611
                                                                             85,213,889 94,063,947
                    63,240,962 61,989,990 71,176,577 67,864,706 71,777,133
 50,000,000


         0
                 2002       2003      2004       2005       2006       2007         2008       2009         2010

              Payment for Temporary Disablement Benefits       Payment For Permanent Disablement Cases
Social Security Organisation of Malaysia


Contribution vs Payment (Invalidity)
Social Security Organisation of Malaysia


Crisis in the making?                                     Investing in People
                                                                           Number of
                                                                             healthy     Current
          Number of                             Number of                   workers    number of
           Workers                               Workers                   needed to    workers
         Contributing                           needed to                   sustain 1 contributing
         to the Social              Compensatio sustain the    Benefit        (one)    for 1 (one)
  Year      System     Contribution     n         system      Recipients    recipient   recipient
 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 6.88 workers
                     2008 – Surplus of 6.13 workers
                     2009 – Surplus of 4.76 workers
                     2010 – Surplus of 2.41 workers
Social Security Organisation of Malaysia


Crisis?                                                    Investing in People
                                                                   Strategy?
20.00                                                              Increase Malaysian
               18.77
                              17.68         17.31                  Workers population?
15.00                                                      15.75
                                                           13.34
                                                                   Increase contribution?
               11.89                        12.56                  RTW?
                              11.56
10.00
               6.88           6.12
 5.00                                       4.75                   Strategy?
                                                           2.41    Cut down Benefit?
 0.00                                                              Pay for lower quality
                                                                   services/equipment?
           2007          2008           2009          2010         RTW?
  Jumlah Pekerja yang mencarum benefit recipient
   No of workers contributing for one untuk satu penerima faedah

  Jumlah Pekerja yang to pay one benefit recipient
   No of workers needed diperlukan untuk menanggung satu penerima faedah
  Jumlah Lebihan Pekerja
   Surplus Workers
Social Security Organisation of Malaysia

                                       Investing in People



               Opportunities?
Social Security Organisation of Malaysia

                                       Investing in People



                  RTW in OSH?
Social Security Organisation of Malaysia



 OSH - Definition
   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
      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.
Social Security Organisation of Malaysia

                                                       Investing in People
   Practice in OSH?
Worker gets                                                    What happens to
 injured                                                        the worker?
                                Investigate
                           INVESTIGATE
                                                  Report                  Return
    ACCIDENT




                                                               PREVENT
               FIRST AID




                                                     PREVENT
                                         REPORT
                                                                         to Work
                           Disability
                                                                         Retain
                           Management
                            Rehabilitation & Integration
                                                                         @ Work

                                          Prevention stops
                                          the vicious cycle
Social Security Organisation of Malaysia

                                       Investing in People



                    Conclusion
Social Security Organisation of Malaysia


                         Oscar Pistorius
                          the fastest man on no legs
                          In 2007 Pistorius took part in his
                          first international competitions
                          for able-bodied athletes.
                              able-
                          However, his artificial lower
                          legs, while enabling him to
                          compete, generated claims that
                          he has an unfair advantage over
                          able-
                          able-bodied runners.
                                       runners
Social Security Organisation of Malaysia

                                       Investing in People

  “Workplace never discriminates… those
              around do…”
 “Disability is God given, Handicap is man
                   made…”
      “Opportunity and not sympathy…”
Social Security Organisation of Malaysia

                                       Investing in People


  Thank you
   Pertubuhan Keselamatan Sosial
   03-4264 5357
   edmund.cheong@perkeso.gov.my
   BlackBerry PIN:254A5745

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Return To Wok: Challenges & Opportunities by Mr Edmund Cheong

  • 1. Social Security Organisation of Malaysia Investing in People Return to Work: Challenges and Opportunities Edmund Cheong, CDMP Social Security Organisation Malaysia COSH 2011 - OSH: Empowerment. Accountable. Responsive. Kuala Lumpur Convention Centre 19 July 2011
  • 2. Social Security Organisation of Malaysia Investing in People Health?
  • 3. Social Security Organisation of Malaysia OSH - Definition 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 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.
  • 4. Social Security Organisation of Malaysia Disability Management (RTW) 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. Planning and coordination of health care services appropriate to achieve the goal of medical rehabilitation. Medical case rehabilitation management may include, but is not limited to, care assessment assessment, including personal interview with the client, and assistance in developing implementing and coordinating a developing, medical care plan with healthcare providers as well as the providers, clients and his/her family evaluation of treatment results while promoting cost-effective care. cost- cost-effective care
  • 5. Social Security Organisation of Malaysia Investing in People The Relations of OSH & DM Occupational Promotion Disability Safety & of Health Management Health
  • 6. Social Security Organisation of Malaysia Investing in People SOCSO’S RTW/DM PROGRAM • This program is established with the 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)
  • 7. Accident Surgery Acute Inpatient Treatment No Treatment Prosthesis? Physical Rehab Pathology of a Claim No Treatment Social Security Organisation of Malaysia Vocational Prolonged Disability Duration? Rehab No Treatment GOAL??? Investing in People
  • 8. Accident Surgery Acute Inpatient Treatment No Treatment Prosthesis? Physical Rehab Disability Management No Treatment Social Security Organisation of Malaysia Vocational Rehab No Treatment GOAL??? Role of the RTW Program? Investing in People
  • 9. Accident Surgery Acute Inpatient Treatment No Treatment Prosthesis? Physical Rehab No Treatment Social Security Organisation of Malaysia Vocational Rehab No Treatment GOAL???
  • 10. Accident Surgery Acute Inpatient Treatment Prosthesis? Physical Rehab Social Security Organisation of Malaysia Vocational Rehab GOAL??? Investing in People
  • 11. Social Security Organisation of Malaysia Investing in People SOCSO Disability Case Manager DISABILITY MANAGEMENT Improve Disability Durations Acute Inpatient Physical Rehab Treatment Workplace Intervention Vocational Maintain Treatment Prosthesis GOAL??? Accident Physical Rehabilitation Healthy Surgery Safe and Rehab Vocational Rehabilitation Workplace Stakeholder Constant Communication Rehabilitation Relations & DisabilityConstant Monitoring Management Safer recovery Return to Work or Retain @ Work
  • 12. Social Security Organisation of Malaysia Investing in People Challenges
  • 13. Social Security Organisation of Malaysia Investing in People The Social Issue
  • 14. Social Security Organisation of Malaysia The Social Issue? – The Micro Perspective Often spouses Injury Leads to Disability become disabled as well Affecting Love Ones
  • 15. Social Security Organisation of Malaysia The Social Issue? – The Micro Perspective Often spouses Productivity/ Affecting Siblings become Injury Leads to Disability Employers disabled as well A MICRO ISSUE Disabled Family A BECOMES A MACRO ISSUE Affecting Love Ones Community Country?
  • 16. Social Security Organisation of Malaysia Cases According to Injury/Diseases “Severe” to “Exteremely Severe” Levels (DASS21) 10 5 Head 3% 1% Neck 7 60 41 3 56 Trunk/Back 2% 16% 1% 14% Upper Limbs 24 6% 50 Multiple Locations 13% Lower Limbs 116 54 General Injuries 30% 14% Unspecified Locations Psychology N=385 Diseases 31 68
  • 17. Social Security Organisation of Malaysia Investing in People The Economical Issue
  • 18. Social Security Organisation of Malaysia Investing in People Social Sustainability
  • 19. Social Security Organisation of Malaysia = SOCSO Contributors (Social Solidarity) No RTW Strategies ??? Accident Outcome? No Rehabilitation Strategies RTW No Monitoring of Insured Person’s Possibilities? Progress
  • 20. Social Security Organisation of Malaysia Collapse of the = SOCSO Contributors (Social Solidarity) Social System No RTW Strategies ??? Accident Outcome? No Rehabilitation Strategies RTW No Monitoring of Insured Person’s Possibilities? Progress Injured Workers
  • 21. Social Security Organisation of Malaysia Collapse of the = Maintaining Balance To the Social System Social System PREVENTION Disability Case Management No RTW Strategies RETURN ??? Accident Outcome? NoMedical Rehabilitation Rehabilitation Strategies No Monitoring of Insured Person’s Vocational Rehabilitation TO RTW Possibilities? Systematic RTW Strategies Progress WORK Retaining Workers at Work or Return to Work Injured Workers
  • 22. Social Security Organisation of Malaysia Reported Accidents 2000 - 2010 100,000 95,006 90,000 85,926 81,810 80,000 75,386 73,858 69,132 70,000 67,163 63,423 61,182 58,321 57,656 60,000 56,249 56,339 55,186 54,133 50,803 50,000 43,885 40,617 38,657 40,000 35,092 35,616 34,376 30,000 20,810 22,040 19,620 18,387 18,329 19,041 20,000 17,170 17,609 17,297 17,704 17,682 10,000 0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 Total Accidents Reported Industrial Accidents Commuting Accidents
  • 23. Social Security Organisation of Malaysia Reported Accidents vs Benefit Payments 350,000,000 300,000,000 306,382,930 274,841,608 250,000,000 214,624,319 200,000,000 187,892,229 166,746,360 171,535,250 70,168,886 1 150,000,000 153,510,745 147,189,831 100,000,000 109,177,424 104,007,611 85,213,889 94,063,947 63,240,962 61,989,990 71,176,577 67,864,706 71,777,133 50,000,000 0 2002 2003 2004 2005 2006 2007 2008 2009 2010 Payment for Temporary Disablement Benefits Payment For Permanent Disablement Cases
  • 24. Social Security Organisation of Malaysia Contribution vs Payment (Invalidity)
  • 25. Social Security Organisation of Malaysia Crisis in the making? Investing in People Number of healthy Current Number of Number of workers number of Workers Workers needed to workers Contributing needed to sustain 1 contributing to the Social Compensatio sustain the Benefit (one) for 1 (one) Year System Contribution n system Recipients recipient recipient 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 6.88 workers 2008 – Surplus of 6.13 workers 2009 – Surplus of 4.76 workers 2010 – Surplus of 2.41 workers
  • 26. Social Security Organisation of Malaysia Crisis? Investing in People Strategy? 20.00 Increase Malaysian 18.77 17.68 17.31 Workers population? 15.00 15.75 13.34 Increase contribution? 11.89 12.56 RTW? 11.56 10.00 6.88 6.12 5.00 4.75 Strategy? 2.41 Cut down Benefit? 0.00 Pay for lower quality services/equipment? 2007 2008 2009 2010 RTW? Jumlah Pekerja yang mencarum benefit recipient No of workers contributing for one untuk satu penerima faedah Jumlah Pekerja yang to pay one benefit recipient No of workers needed diperlukan untuk menanggung satu penerima faedah Jumlah Lebihan Pekerja Surplus Workers
  • 27. Social Security Organisation of Malaysia Investing in People Opportunities?
  • 28. Social Security Organisation of Malaysia Investing in People RTW in OSH?
  • 29. Social Security Organisation of Malaysia OSH - Definition 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 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.
  • 30. Social Security Organisation of Malaysia Investing in People Practice in OSH? Worker gets What happens to injured the worker? Investigate INVESTIGATE Report Return ACCIDENT PREVENT FIRST AID PREVENT REPORT to Work Disability Retain Management Rehabilitation & Integration @ Work Prevention stops the vicious cycle
  • 31. Social Security Organisation of Malaysia Investing in People Conclusion
  • 32. Social Security Organisation of Malaysia Oscar Pistorius the fastest man on no legs In 2007 Pistorius took part in his first international competitions for able-bodied athletes. able- However, his artificial lower legs, while enabling him to compete, generated claims that he has an unfair advantage over able- able-bodied runners. runners
  • 33. Social Security Organisation of Malaysia Investing in People “Workplace never discriminates… those around do…” “Disability is God given, Handicap is man made…” “Opportunity and not sympathy…”
  • 34. Social Security Organisation of Malaysia Investing in People Thank you Pertubuhan Keselamatan Sosial 03-4264 5357 edmund.cheong@perkeso.gov.my BlackBerry PIN:254A5745