Earlier we touched on the biopsychosocial model. Another term you may hear regularly is 'flag'. The flag concept focuses more on the psychosocial influences of the return to work process and can be used alongside the biopsychosocial model.

Flags help determine why a worker may not be recovering as expected based on diagnosis and prognosis. While clinical factors known as 'red flags' underpin the speed of a return to work progress, it’s important to identify other flags. Failure to detect other 'flags' can draw out the return to work process. Flags can often predict if workers will have issues with the return to work program, or present with pain symptoms inconsistent with injury. On the flip side, identifying 'flags' which help to facilitate return to work can improve return to work outcomes.

So what are the flags?

Red Flags
Medical factors, pathology, diagnosis

Yellow Flags
Behavioural, emotional & coping strategies

Blue Flags
Social and economic influences

Black Flags
Occupational / workplace factors

Yellow and blue flags can be either perceived or actual barriers. For example, a worker may perceive their manager as unsupportive, where as the manager may believe they are protecting the worker from re-injury.

So what's the best course of action to help identify a 'flag' or barrier?

In general, the best approach is to:

  • encourage early and consistent communication between stakeholders about barriers to return to work
  • intervene early when any of the flags become apparent
  • provide injured or ill employees with accurate and balanced information about pain, their health condition and how activity can impact their recovery.

If you believe you have identified a red flag (such as infection or re-injury) this should always been reported back to the treating doctor and treating allied health professional for further investigation as soon as practical.

Mental health and coping strategies play a huge role in the success of a return to work program. Should a worker be struggling with pain levels, or showing signs of poor mental health while injured, adjustment to injury counselling is available (your insurance case manager and preferred doctor will be able to provide you further general information about these services).

Injury Management Flag It Poster V2.0




Kendall, AS & Burton, AK (2009), Tackling Musculoskeletal Problems: A guide for clinic and workplace – identifying obstacles using the psychosocial flags framework, The Stationery Office, United Kingdom

Sarah Millar
Accredited Exercise ScientistHealth and Wellness Support Officer (WA)

Sarah Millar is a Health and Wellness Support Officer for Sonic HealthPlus, delivering onsite and corporate programs for our clients. Sarah has been working with Sonic HealthPlus for over 4 years, initially as a Health and Wellness Consultant, working across Rio Tinto mine sites in the Pilbara, delivering high standard health programs including health screening, fitness facility management and corporate challenges. These years have given Sarah extensive insight into onsite health surveillance.

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