PERKESO - KIMBERLY CLARKE PRESENTATION

RETURN TO WORK
SOCIAL SECURITY ORGANIZATION MALAYSIA
GAYATHRI VADIVEL
CASE MANAGER
RETURN TO WORK DEPARTMENT
1
Overview
Introduction to SOCSO & SOCSO Benefits
Section 57 of the Social Security Act 1969
The Return to Work Program
Success Stories
Conclusion
2
The Social Security Organisation
Also known as Pertubuhan Keselamatan Sosial
(PERKESO/ SOCSO)
Established in 1971 to administrate the Social
Security Act 1969.
SOCSO covers about 5.3 million workers which
is 43.6% of the Malaysian Workforce.
3
1
PERKESO’
PERKESO’S Social Insurance Scheme
All Industries employing one or more employees (since
1/7/1992)
Employees employed under a contract of service
Wage ceiling for under a contract of service
Wage ceiling for coverage: RM3,000/month (since
1/5/2005)
Principle of once coverage always covered applies when
employee’
employee’s monthly wage exceed RM3,000/month
Voluntary coverage for those never covered and earning
wages exceeding ceiling with consent of employer and
employee
Not Covered: Govt. sector workers, selfself-employed,
informal sector, domestic servants, foreign workers (since
1992)
4
WHAT IS SOCIAL SECURITY ?
An assurance given to the Insured Persons when
they are no longer able to generate income due
to unforeseen circumstances
To provide financial benefits, rehabilitation &
vocational training for Insured Persons with
difficulty of coping in life due to industrial
accidents, invalidity or death through the
benefits that are provided by SOCSO
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SOCIAL SECURITY
SOCIAL SECURITY
ORGANIZATION
PREVENTION
=
WORK INJURY INSURANCE
REHABILITATION
COMPENSATION
6
2
Social Security Schemes
The two main schemes provided by SOCSO:
MAIN SCHEMES
INDUSTRIAL
ACCIDENTS
INVALIDITY
7
INDUSTRIAL ACCIDENT
Medical Benefits
Temporary Disability Benefits (MC’
(MC’s)
Permanent Disability Benefits ( % of impairment)
Dependants Benefit
Funeral Benefits (RM 1500)
Rehabilitation Benefits
Education Benefits ( children of SOCSO recipients of
the Permanent Disability Payment of more than 20%)
Attendance Allowance
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INVALIDITY
Invalidity Benefits
Invalidity Aid Benefits (Bantuan
(Bantuan Ilat)
Ilat)
Attendance Allowance
Dependants Benefit
Funeral Benefits
Rehabilitation Benefits
Education Benefits (Children of the Invalidity
Recipients)
9
3
THE ACTUAL SCENARIO
SOCIAL SECURITY
PREVENTION
REHABILITATION
COMPENSATION
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Contribution & Benefit Payment
1,600,000,000
1,380,972,917
1,400,000,000
1,213,709,000
1,200,000,000
1,143,628,000
1,095,136,000
1,047,728,000
1,000,000,000
879,435,000
898,726,000
629,640,000
672,988,000
573,670,000
383,906,000
366,951,000
237,629,000
316,184,310
290,287,000
120,177,425
211,905,426
Contribution
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1992
1991
1990
288,981,198
214,975,390
139,379,955
100,216,000
1993
200,000,000
754,000,000
722,400,000
638,384,660
585,788,000
506,477,000
499,086,000
400,000,000
0
830,176,000
757,512,000
600,000,000
890,210,000
990,051,000
878,532,000
800,000,000
Benefit Payment
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Statistic Payment Of Temporary
Disablement Benefit - SOCSO
71,176,576.71
71,177,000
72,000,000
70,000,000
68,600,000
68,000,000
66,200,000
66,000,000
63,200,000
RM 64,000,000
61,990,000
Payment
62,000,000
60,000,000
58,000,000
56,000,000
2000
2001
2002
2003
2004
2005
YEAR
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4
Statistic Payment of Permanent
Disablement Benefit - SOCSO
171,535,279.46
178,090,000
166,700,000
180,000,000
153,500,000
160,000,000
140,000,000
167,500,000
120,000,000
147,190,000
100,000,000
RM
80,000,000
Payment
60,000,000
40,000,000
20,000,000
0
2000
2001
2002
2003
2004
2005
YEAR
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Statistic Payment of
Invalidity Pension
188,716,507.03
173,100,000
200,000,000
180,000,000
158,370,000
160,000,000
147,000,000
140,000,000
120,000,000
118,200,000
103,300,000
100,000,000
Payment
80,000,000
60,000,000
40,000,000
20,000,000
0
2000
2001
2002
2003
2004
2005
YEAR
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Statistic Total No. of
Certified Invalid
7,961
7,640
8,000
7,000
7,497
7,687
6,624
6,343
6,000
5,000
4,000
3,363
3,580
3,220
3,000
2,854
2,770
2,276
2,000
1,000
0
2000
2001
2002
2003
Application Invalidity Pension
2004
2005
Certified Invalid
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5
Certified invalid < 40 years old
About 4079 insured persons have been certified
invalid since 1996.
624 cases reported in 2006.
WHATS HAPPENING TO THE 4079 CASES
RECEIVING PENSION ?
16
Statistic: receiving MC > 100 days
About 5000 cases reported annually of insured
person having MC of more than 100 days
51107 reported cases since 1996.
17
Statistic: Permanent Disablement
Benefit > 40%
2709 cases reported since 1996.
235 Cases reported in 2006
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6
Implications
Malaysia is loosing its productivity edge. (About 5000
cases reported annually of insured person having MC >
100 days)
Young /skilled workers who are prime movers of the
economy are out of work due to injury/disease
Companies are spending more to rere-train and replace
the injured workers.
The Malaysian Workforce will be too dependent on
foreign workers?
High insurance
insurance costs
80% of contribution money have been paid out
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SOCSO’
SOCSO’s Initiatives
SOCSO took the initiative to address these
problems at grassgrass-root level by enhancing the
benefits with the implementation of the ReturnReturnToTo-Work Programme,
Programme, incorporating Section 57
of the Employees Social Security Act for the
Insured Persons.
20
Section 57(1)
“An Insured Person suffering from or
claiming to suffer from invalidity or
permanent disablement may be provided
by the Organization, free of charge
facilities for physical or vocational
rehabilitation.”
rehabilitation.”
(Employees Social Security Act 1969)
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7
Return to Work
This programme was established with the
objective of assisting SOCSO’
SOCSO’s Insured Persons
with employment injury as well as those claiming
for invalidity pension to be able to return to
work through a biopsychosocial and
multidisciplinary approach.
22
Pilot Project
SOCSO has started this programme (February
2005 – February 2006) in KL & Ipoh as a pilot
project which focused only on musculoskeletal
disorders (back and neck).
However, there was inadequate multidisciplinary
intervention, thus limiting the full potential
outcome of this rehabilitation programme.
programme.
23
Out come of the Pilot Project
Number of Insured Person enrolled in the
programme
127
Number of those improved physically
70 (55%)
Number of those who Return To Work
49 (70%)
(out of those who completed)
Number of those who did not Return To Work
21 (30%)
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Limitations of the Pilot Project
Less Effective Case Management
Limited to only back & neck injuries.
Inadequate Psychosocial intervention.
Lack of understanding and support from Insured
Persons.
Delayed intervention period for rehabilitation.
(Patients have been unemployed for 1.58 years)
Insufficient awareness amongst all related parties.
25
How can we improve this?
More effective case management (personalized)
Integrating a programme to look into the macro
point of view
By appointing appropriate service providers for
effective rehabilitation.
Awareness campaigns & educational
programmes
26
Case Management
The main component of the RTW.
Monitor
Referral
Initial Needs
Assessments
Rehabilitation
Planning &
Coordination
Completion
&
Evaluation
Review
27
9
Integrated return to work model
Workers
compensation
and income
support
Employment
providers
Hospital
Medical /
Psychological
Rehab
Return to Work
Vocational
Rehabilitation
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Return to Work Hierarchy
Same job same employer
Similar job same employer
Different job same employer
Same job different employer
Similar job same employer
Different job same employer
Self Employed
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Target Groups
Injured workers on Temporary Disablement Benefit
(MCs). – early intervention
Recommendation by the Medical Boards for workers
applying for Permanent Disablement Benefit.
Recommendation by the Medical Boards for workers
below 50 years of age applying for Invalidity Pension .
Workers who have been certified invalid but will be
able to benefit from certain job modifications.
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10
Why Early Intervention?
•
Probability of returning to work
%
6 months absent: 50% will RTW
12 months absent: 20% will RTW
24 months absent: 10% will RTW
(Source: National worker Comp Symposium,
June 2000 – Australia)
Time
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SOCIO – ECONOMIC
ASPECTS
Injured Workers
Downtime/Loss of manpower
Social & Economic Stress
Loss of focus at work
Negative
Socio-economic
Cycle
Workers on Prolong
Medical Leave
Production Cost Increase
Overtime/New employee
Economic impact on society,
Higher Cost of Living
32
What improvements HAVE been done?
SOCSO has appointed Case Managers from a
multidisciplinary background
Program started of with 5 case managers in 2007
Due to the success of the program and high demand,
currently there are 35 case managers
(From January 2010, each state will have an appointed
case manager to handle SOCSO cases)
Appointed more service providers to broaden the range
of treatment
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TYPE OF REHABILITATION
Stroke / Neurological Rehab
Musculoskeletal (Back )
Optometry
Hand & Microsurgery
Pain Management
34
CHALLENGES
A large group of companies are yet to employ
persons with disabilities in their workplace.
Workplaces with inadequate disabled friendly
facilities.
Lack of awareness (Benefits of employing
PWDs)
PWDs)
No regulation for employment of OKU’
OKU’s /
PWDs
35
The next steps forward
To expand the RTW Programme nationwide.
Employ more Case Managers.
Aggressive awareness campaigns.
More participation of employers, employees, the
dependents, related parties/agencies, insurance
companies to be more involved in this
programme.
programme.
Award Scheme to motivate more employers
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12
The next steps forward
A holistic approach of case management
(referrals, planning, monitoring, followfollow-through)
Change of mindset: “Employment is the best
form of social security”
security”.
The government to take the leading role in
coordinating and promoting RTW? (SOCSO
only covers 40% of the Malaysian workforce)
37
SOCSO RTW Statistics
Insured Persons Reactions to the Programme
(Accumulated 2007-2008)
N=703
38%
Motivated
Not Motivated
62%
38
SOCSO RTW Statistics
Accumulated Status of the RTW (2007-2008)
8%
N: 439
4%
11%
Return to Work
Under Rehabilitation
Acute Stage
Job Seeking
77%
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SOCSO RTW Statistics
Cases Based on the RTW Hierarchy (Accumulated 2007-2008)
24%
Same Job Same Employer
Similar Job Same Employer
47%
3%
Different Job Same Employer
Same Job Diff erent Employer
2%
Similar Job Dif ferent Employer
Different Job Dif ferent Employer
16%
8%
40
CASES ACCORDING TO INJURY
OR DISEASES
No. of Cases According to Injury/Diseases
3%
0%
8%
8%
1%
Head
Neck
19%
Trunk/Back
Upper Limb
Multiple Locations
30%
Lower Limb
General Injuries
Unspecified Location Injury
Psikologi
3%
28%
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SUCCESSFUL CASES
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SUCCESSFUL CASES
43
SUCCESSFUL CASES
SELF EMPLOYED
44
Some of the Successful Cases
AMBUCHELVAM AL
SINGARAN, 35 YEARS OLD.
DIAGNOSIS: STROKE WITH
DIABETIS AND
HYPERTENSION
STATUS: CLAIMING
INVALIDITY BUT REJECTED
RETURN TO WORK WITH THE
SAME EMPLOYER DOING HIS
PRE-INJURY DUTIES
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Some of the Successful Cases
INSURED PERSON: SELVAM
AL APPANAN
DIAGNOSIS: RIGHT ANKLE
FRACTURE
STATUS: TEMPORARY
DISABILITY
RETURN TO HIS PRE-INJURY
DUTIES WITH THE SAME
EMPLOYER AT PALM OLEO
SDN BHD.
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Conclusion
“Disability is God given but
handicap is manman-made”
made”
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Conclusion
This ReturnReturn-ToTo-Work Programme with the collaboration of
all the parties, will ensure that the Insured Persons in particular
particular
and the Malaysian Workforce in general will achieve the
following:
Competitive and healthy workforce.
Maximization of Malaysia’
Malaysia’s human resource potential.
Increase productivity at work place.
Improves Malaysia’
Malaysia’s economy by reducing the downtime.
By 2020, Malaysia will be a developed nation with great human capital
capital
value.
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Gayathri Vadivel
03 - 4264 5504
[email protected]
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