Injured workers face challenges that extend far beyond their physical injuries. Evidence shows that a biopsychosocial approach to claim profiling—one that considers the interplay of biological, psychological, and social factors—can transform how claims are managed, improving workers’ recovery outcomes and creating more efficient compensation systems.
EML Group (EML), one of the largest specialists in personal injury claims management in Australia, has developed an innovative claim profiling tool to help case managers identify recovery risks across a range of biopsychosocial factors and provide tailored support. The tool, developed by the Federal Self Insurance business unit of EML Group, categorises claims based on a scoring system that evaluates key factors affecting recovery, enabling case managers to prioritise resources and interventions effectively.
To support EML in refining this tool, ISCRR is conducting an evaluation. The first phase of this research used a combination of a literature review and subject matter expert opinions to examine whether the tool’s domains, questions, response options, timing, and scoring align with best practices in biopsychosocial risk screening for case management.
ISCRR’s findings show that the tool’s biopsychosocial domain descriptors are consistent with those in the literature. When compared with other tools, EML’s Federal Self Insurance profiling tool is unique and addresses biological, psychological, and social factors within a compensation setting.
Experts who reviewed the tool praised its concise design, manageable number of questions, and alignment with compensation system requirements. They also identified further refinements and opportunities to enhance, particularly in expanding its screening ability to address psychosocial risks.
These insights will provide EML with the evidence needed to enhance the tool, making it more effective for both injured workers and case managers. For policymakers and researchers, this evaluation highlights the critical importance of tools that bridge rigorous evidence with practical application in injury compensation systems.
By refining this tool, EML and ISCRR are setting a new benchmark for biopsychosocial screening. This approach has the potential to improve recovery outcomes for injured workers, empower case managers with actionable insights, and foster more efficient compensation systems.