Published by Axis Occupational Health and Wellbeing | helloaxis.com.au
When a worker is injured on the job, the goal is straightforward: get them the right care, support their recovery, and help them return to meaningful work. But for a significant and growing number of Australian workers, the compensation process itself is adding a second injury on top of the first — a psychological one.
Safe Work Australia’s 2026 Scorecard Report for the National Return to Work Strategy 2020–2030 brings this issue into sharp focus, and the research behind it is a wake-up call for employers, insurers and healthcare providers alike.
What Is Secondary Psychological Injury?
Secondary psychological injury occurs when a worker develops a mental health condition — anxiety, depression, post-traumatic stress — not from the original workplace incident, but as a result of what happens after it. The claims process, the uncertainty of not knowing what comes next, financial stress, feeling dismissed or unsupported — these experiences compound the original injury and can turn a recoverable physical claim into a complex, long-duration one.
Safe Work Australia commissioned Monash University to investigate this phenomenon, and the findings are clear: the workers’ compensation system, as it currently operates, is generating psychological harm in the very people it is designed to protect.
What the Research Found: Uncertainty Is the Key Driver
The Monash research identified uncertainty as the primary factor undermining a worker’s ability to cope during a workers’ compensation claim. This uncertainty takes three forms:
Uncertainty about the claims process — Workers often don’t understand their rights, what will happen next, how decisions are made, or how long things will take. Every unreturned call, delayed decision or unexplained outcome adds to this anxiety.
Financial uncertainty — The gap between injury and compensation payments, combined with confusion about entitlements, creates real economic stress that compounds the psychological burden of being injured and off work.
Uncertainty about recovery — Workers who lack clarity about their prognosis, their treatment plan, and what a realistic return to work looks like struggle to maintain a sense of agency and progress.
Together, these three forms of uncertainty create the conditions for secondary psychological injury to develop — often quietly, and often before anyone in the system notices.
The Numbers Behind the Problem
The 2026 Scorecard report makes clear that psychological claims remain the most difficult and costly in the system. While improvements have been made to insurer decision times nationally, claims involving mental health conditions still take more than double the time to process compared to physical injury claims — 11.0 weeks on average versus 4.7 weeks for non-mental health claims. That’s 11 weeks in which a worker is sitting in limbo, uncertain about their financial security and their future.
At the same time, worker experiences of the system are deteriorating. The proportion of workers reporting stressful interactions with a healthcare provider rose from 29.8% at the strategy’s baseline to 39.6% in Year 6. Workers’ overall perception of the fairness of the workers’ compensation process dropped sharply from 74.6% to 60.1%. And 42% of workers who hadn’t returned to work agreed that better understanding and communication from their workplace could have helped them get back sooner.
These aren’t just statistics. They describe real people, sitting at home, waiting, worried, and losing faith in the system around them — exactly the conditions in which secondary psychological injury takes hold.
The Cost of Getting This Wrong
Secondary psychological injury dramatically changes the trajectory of a claim. What begins as a manageable physical injury can become a prolonged, high-cost claim once psychological complexity enters the picture. Recovery timelines extend. Treatments multiply. The worker’s relationship with their employer and the compensation system deteriorates. And the window for a successful, durable return to work narrows.
For employers, the financial impact is significant — but the human cost matters just as much. Workers who develop secondary psychological injuries experience worse health outcomes long after their claim has closed. Preventing it is not just good claims management. It is the right thing to do.
The Solution: Early Intervention That Addresses Uncertainty Head-On
The research is consistent on this point: early, coordinated intervention — before uncertainty takes root — is the most effective way to prevent secondary psychological injury. This doesn’t mean waiting until a worker shows signs of distress. It means building support structures that eliminate the conditions in which distress develops.
Here is what that looks like in practice.
Clear, Consistent Communication From Day One
Workers need to understand what is happening, what to expect, and who to contact with questions. Simple, proactive communication in the first days of a claim — from both the employer and healthcare providers — dramatically reduces the anxiety that fuels secondary psychological injury. Don’t leave workers to fill silence with their worst fears.
Fast Access to the Right Clinical Care
Delays in treatment extend uncertainty. When workers are quickly connected to qualified professionals — physiotherapists, psychologists, occupational health specialists — they gain a clear picture of their injury, their prognosis and their recovery pathway. That clarity is protective. It replaces uncertainty with a plan.
Psychological Support Alongside Physical Treatment
Physical injury and psychological wellbeing are not separate issues during a workers’ compensation claim — they are deeply interconnected. Integrating psychological support early, even before a worker shows overt mental health symptoms, is a best-practice approach that the 2026 Scorecard data strongly supports. Workers who feel heard and supported psychologically recover faster and more durably from physical injuries.
A Return to Work Plan That Gives Workers a Roadmap
One of the most effective antidotes to uncertainty is having a plan. Research consistently shows that workers with a collaborative, well-structured return to work plan have better outcomes. The plan doesn’t need to be complex — it needs to be clear, agreed upon, and revisited regularly. Giving a worker a visible path forward is itself a therapeutic intervention.
How Axis Supports Early Intervention for Secondary Psychological Injury
At Axis Occupational Health and Wellbeing, early intervention is at the core of everything we do. We understand that the window between injury and the development of secondary psychological complexity is short — and that what happens in that window determines the outcome of a claim.
Our services are specifically designed to step in early, address uncertainty, and support both the worker and the employer through the process:
Premium Care Triage Service — Our early triage service connects injured workers to the right clinical care fast, reducing the delays and confusion that fuel uncertainty. Workers get answers, a clear treatment pathway, and the reassurance that qualified professionals are in their corner from day one.
Adjustment to Injury Counselling (ATIC) — Axis’s ATIC service provides targeted psychological support specifically for workers navigating the emotional and psychological challenges of a workplace injury. It bridges the gap between physical treatment and mental wellbeing, addressing the uncertainty and distress that drive secondary psychological injury before they escalate.
Onsite Psychology — For organisations with an onsite or embedded health service, our psychology team provides accessible mental health support that destigmatises help-seeking and intervenes early when workers are struggling.
Return to Work Services — Our occupational rehabilitation specialists work with workers, employers and treating practitioners to develop clear, collaborative return to work plans — removing uncertainty about recovery and giving workers a meaningful path forward.
Onsite Physiotherapy — By keeping physiotherapy accessible and embedded in the workplace, we reduce the time between injury and treatment, shorten recovery timelines, and maintain the worker’s connection to their workplace during recovery.
When workers feel informed, supported and heard from the very beginning of their injury journey, the risk of secondary psychological injury drops substantially. That’s the Axis difference — and it’s what the evidence demands.
If you want to know how Axis can help your organisation prevent secondary psychological injury and support better outcomes for your people, we’d love to talk.
Visit us at helloaxis.com.au or call 1300 196 393.
Sources: Safe Work Australia, National Return to Work Strategy 2020–2030 Scorecard Report 2026; Monash University, Research examining pathways to secondary psychological injury during the workers’ compensation process (commissioned by Safe Work Australia).
