The Intelligent Rebellion, founded by Rhea Mercado is a think tank and community of people who are contributing their vision towards a better future.

Are you are personal injury professional? Get involved at PIPROC

***

“Beyond Traditional Practice: How ESSA and AEPs Can Adapt to the Growing Personal Injury & Workers Compensation Sector”

Written by Rhea Mercado. Healthcare Humanist & CompoNerd

Introduction

 The Exercise & Sports Science Australia (ESSA) membership has experienced remarkable growth over recent years, with members finding employment in a diverse array of industries. These industries include healthcare, education, retail, academia, biotechnology, health technology, engineering, media, and more. This surge in opportunities reflects the growing appreciation of exercise science and exercise physiology expertise across multiple sectors, illustrating the field’s adaptability and importance in different professional settings.

Despite the emergence of new employment pathways, many ESSA members still hold roles in more established clinical and research-oriented areas. They continue to contribute to exercise science research, provide services to amateur and elite sports teams, and support the general population’s health and well-being. One particularly promising area of expansion for ESSA professionals is the compensable injury sector, where they play a key role in recovery, rehabilitation, and return-to-work strategies.

As the profession continues to grow, so does the diversity of ESSA’s membership. Within the organisation, there is a rich variety of cultures, races, gender identities, sexual orientations, abilities, religious beliefs, and neurodiverse perspectives. The ESSA Culture Review highlighted the membership’s desire for a “required culture” that embraces inclusivity and diversity at all levels. These findings underscore the importance of creating an environment where every individual’s background and experiences are valued.

Diversity manifests in multiple ways—whether it is cultural and ethnic diversity, age, race, gender, sexual orientation, differing abilities, religious practices, neurodiversity, or varied skill sets. This breadth of backgrounds enhances collaboration, fosters innovation, and strengthens the overall quality of service delivery. As ESSA moves forward, the continued commitment to inclusivity and respect for difference will remain integral in shaping a dynamic and forward-thinking professional community.

This paper will address the primary topic of personal injury and workers compensation. The goal to shed light on the specific challenges members encounter within these areas, drawing on my own firsthand experiences as well as the observations and viewpoints shared by others. In addition, I aim to propose recommendations to help overcome these challenges, fostering a more supportive and effective environment for everyone involved.

The Roles of an Accredited Exercise Physiologist

An emerging area of professional focus for many ESSA members lies within the realm of personal injury and compensable schemes (the schemes). Having spent most of my career working in this industry, I have observed firsthand the breadth and depth of opportunities available, as well as the complex structures that guide practice in this field. Generally, members who operate in the personal injury and compensation sphere can be grouped into two main categories: 1) Treatment Providers and 2) Consultants.

 Treatment Providers typically work directly with individuals who have sustained injuries, offering clinical services that facilitate recovery and rehabilitation. These professionals may include exercise physiologists, physiotherapists, and other allied health specialists who collaborate closely with clients to develop treatment plans, track progress, and ensure safe, effective return-to-work strategies. Their practice is often guided by standards set forth in compensable schemes, as well as best-practice guidelines within the healthcare industry.[1]

 Consultants, on the other hand, fulfill roles that focus more on guiding, coordinating, and overseeing the broader processes associated with injury management and compensation. This category can be further divided into three principal groups:

 1.       Workplace Rehabilitation Consultants[2]: Their services are largely dictated by the Nationally Consistent Approval Framework for Workplace Rehabilitation Providers. In this capacity, they assess injured employees’ capabilities, work closely with employers to identify suitable duties, and liaise with healthcare practitioners to streamline rehabilitation plans.

2.       Employer-Based Injury Management Advisors: These professionals operate under the policies, procedures, and guidelines specific to their organisation and the relevant Commonwealth or State and Territory schemes. They coordinate directly with employees, monitoring progress and ensuring that injury management plans comply with both internal policies and external regulatory requirements.

3.       Claims Managers and Injury Management Specialists: Employed by regulatory bodies, nominal insurers, self-insurers, specialised claims and injury management service providers (commonly referred to as “insurers”), these professionals work within frameworks established by Commonwealth and/or State and Territory regulations. They handle the administrative and legal aspects of compensable claims, communicate with all stakeholders, and ensure that claims are processed efficiently and in accordance with established guidelines.

 Across these roles, the common thread is a commitment to facilitating effective injury management and fair compensation for those who have experienced work-related incidents or other personal injuries. While the specific duties and regulatory requirements may vary, all professionals in this space share a focus on promoting health, well-being, and a safe, sustainable return to work. As this field continues to evolve, members who choose to specialise in personal injury and compensable schemes can anticipate a challenging yet highly rewarding career path, marked by the opportunity to make a tangible difference in individuals’ lives and in the broader sphere of workplace health and safety.

Clinical Accredited Exercise Physiologists

Accredited Exercise Physiologists (AEPs) who provide treatment within personal injury and compensable schemes often face two significant challenges: 1) determining appropriate fees for their services and; 2) addressing the need for an independent exercise physiology consultant. These issues have implications not only for the professional practice of AEPs but also for the quality of care received by patients navigating the complexities of compensation.

1. Fees

Uniqueness of AEP Services
Many AEPs argue that their service provision differs substantially from that of other allied health professionals. Their scope of practice extends beyond exercise prescription to encompass psychosocial factors that commonly arise in compensable schemes. By leveraging their expertise in both physical activity and behavioural change, AEPs assert that they can help patients achieve both better functional outcomes and return to work outcomes. However, treating AEPs believe that they require:

• Longer session durations to adequately address patients’ clinical and psychosocial needs.

• Equity in treatment provision compared to other allied health providers.

• Fee parity to ensure financial viability and reflect the level of skill and time required.

 Session Duration and Financial Constraints
A recurring frustration among AEPs is the difficulty of delivering evidence-based services within a 30-minute session. They report that by the time warm-ups and initial assessments are completed, little time remains for thorough exercise interventions or patient education. In attempting to deliver high-quality care, many AEPs feel they are financially penalised by current fee structures, which often do not accommodate extended appointment durations.

 Recommendations

1. Enhanced Training: AEPs benefit from further development in treatment planning, time management, and communication skills.

2. Targeted Communication: Instead of overwhelming patients with information - what some term “premature articulation”- AEPs should focus on listening to patient concerns and disseminating knowledge at the most relevant moments.

3. Clinical Precision: A thorough understanding of exercise prescription principles enables AEPs to determine the optimal frequency, intensity, and duration of interventions for the individual.

2. Equity in Treatment Provision Compared to Other Allied Health Professionals

Another challenge arises when AEPs receive referrals late in the recovery process. By the time a patient is referred for exercise physiology interventions - often after lengthy physiotherapy or other allied health treatments - insurers may be reluctant to approve multiple AEP sessions. Many AEPs express frustration that “the physiotherapist got 50 sessions, why do I only get 8?” especially when the patient remains unprepared or unwilling to engage in a rigorous strength and conditioning program after predominantly passive therapy.

Traditional compensable scheme guidelines often emphasise a transition toward self-management, implying that if a patient has already completed a substantial number of sessions with another provider, fewer sessions with an AEP should suffice. However, in practice, patients may still require a comprehensive reintroduction to active therapies after lengthy periods of inactivity.

Recommendations

1. Advocacy: ESSA should advocate to regulatory bodies, calling for fairer guidelines that recognise the unique skill set of AEPs and the distinct role they play in a patient’s recovery.

2. Fee Parity Discussion: While achieving fee parity is desirable, AEPs must also consider the implications of simultaneously seeking longer session durations.

3. Strategic Practice Models: Many AEPs rely on mobile services, yet this may undermine the compensable scheme’s objective of reintegrating patients into work and community settings. Investments in more robust clinical infrastructures - and ensuring that home visits are employed only when clinically justified - could support better patient outcomes.

4. Interdisciplinary Collaboration: AEPs and other treatment providers should collaborate to develop multidisciplinary teams. This would encourage coordinated treatment planning and facilitate patient-centered and holistic recovery journey for patients.

3. Independent Exercise Physiology Consultation

A recurring concern for AEPs is the absence of an independent exercise physiologist consultant within many personal injury and compensable schemes. At present, physiotherapists, chiropractors, or osteopaths[3] often serve as peer reviewers for exercise physiology treatments, leading some AEPs to question the fairness of this system. Common complaints include “They don’t even know what we do” and “How can a physiotherapist assess an exercise physiologist’s treatments?” Despite advocacy for the inclusion of independent AEP consultants - especially within New South Wales - there appears to be a medico-legal barrier preventing AEPs from meeting the criteria to become independent consultants.

Recommendations

1. Clear Communication from ESSA: Members should receive transparent information about the medico-legal requirements for becoming independent consultants.

2. Defined Pathways: If it is indeed possible, ESSA needs to outline a clear path for AEPs who aspire to become independent consultants. Otherwise, a definitive statement could put this issue to bed, clarifying the reasons behind the current policy.

 Conclusion

The experiences and frustrations voiced by many AEPs working in personal injury and compensable schemes reveal systemic challenges - from fee structures and session durations to referral timing and the absence of independent exercise physiology consultants - that affect both financial viability and patient care. Addressing these issues requires collaboration between ESSA, regulatory bodies, and other allied health professionals to ensure AEPs can fully leverage their expertise. By advocating for equitable fees, improving infrastructure, and clarifying consultant pathways, the profession can foster more effective, patient-centered rehabilitation and recovery outcomes.

Non-Clinical Accredited Exercise Physiologists

Within personal injury and compensable schemes, “consultants” serve in a broad range of roles -from workplace rehabilitation consultants and employer-based injury management advisors to insurer-based claims and case managers, and technical specialists. Increasingly, Accredited Exercise Physiologists (AEPs) are embracing these positions, moving away from traditional clinical or treatment-focused jobs. Although such transitions can offer career advancement, higher salaries, and more flexible working conditions, AEPs who become consultants often encounter two major obstacles: 1) a perceived lack of acknowledgment by their professional body and; 2) insufficient professional development opportunities.

1. Acknowledgment by ESSA of Members who are Consultants

A longstanding concern among consultants in these roles is that Exercise & Sports Science Australia (ESSA) devotes significant resources and advocacy to members working in clinical or treatment settings, while overlooking those in non-clinical positions. Many AEPs who have shifted to consulting report feeling like “second-class members.” They describe the focus of ESSA’s efforts - resources, seminars, networking events - as predominantly geared toward treatment providers, leaving little space for those whose responsibilities revolve around claims management, employer-based injury management, or workplace rehabilitation consulting.

This perceived lack of support and recognition contributes to a growing trend: some AEPs find that, once they transition into consultant roles, they no longer require formal accreditation to fulfill their job duties. Consequently, they may choose not to renew their ESSA membership as they see little added value in remaining accredited if it is not mandated by their employer or if ESSA does not provide resources relevant to their day-to-day functions. For ESSA, the challenge lies in retaining these members and demonstrating that it values their contributions as integral to the profession’s broader ecosystem and evolution. Indeed, AEP consultants often become powerful allies for treating AEPs by helping to facilitate decisions around patient care and advocating for the profession within larger regulatory and corporate structures.

Recommendations

1. Active Acknowledgment of Non-Clinical AEPs: ESSA should explicitly recognise and validate the roles of consultants within personal injury and compensable schemes.

2. Enhanced Membership Value: By tailoring services, networking events, and professional resources to consultants, ESSA can create a compelling reason for these professionals to maintain their accreditation.

2. Lack of Professional Development Opportunities

Another critical issue for AEP consultants is the scarcity of professional development resources specific to their work. While most continuing professional development (CPD) offerings cater to clinical or treatment-focused practitioners - addressing topics like exercise prescription for specific pathologies and populations. AEP consultants often need entirely different skill sets. They may require training in claims adjudication, communication with multiple stakeholders, workplace policy, and legal frameworks, all of which are essential to effectively manage and advise on complex cases within compensable schemes.

Due to this gap, some AEP consultants seek education outside of ESSA-sponsored events or rely on in-house training. Alternatively, they turn to other professional associations or private education providers who offer specialised programs focused on the aspects of injury management. While these options may fulfill certain educational needs, they can also create a disconnect between consultants and their professional organisation, perpetuating the idea that ESSA’s offerings are not relevant to their career path.

Recommendations

1. University Curricula: Institutions offering exercise physiology programs should provide a more comprehensive overview of consultancy work, including modules on workplace rehabilitation, injury management, and the various career paths available beyond clinical practice.

2. ESSA Accreditation Criteria: By continuing to emphasise personal injury, workplace rehabilitation, and injury management in accreditation requirements, ESSA can reinforce the importance of these areas for aspiring AEPs.

3. Expanded CPD Opportunities: ESSA should partner with other professional organisations including the Australian Rehabilitation Providers Association (ARPA) and Australian Society of Rehabilitation Counsellors (ASORC), members, and employers to develop specialised workshops, webinars, and courses that address the distinct needs of non-clinical AEPs.

4. Equal Recognition of CPD: ESSA might also consider granting equivalent CPD points for relevant external conferences and training programs, encouraging consultants to pursue professional development tailored to their roles.

Conclusion

As more AEPs venture into the personal injury and compensable schemes as consultants, the profession must adapt to recognise and support this evolving landscape. Consultants fulfill crucial roles - from liaising with employers and insurers to orchestrating comprehensive injury management plans - thereby wielding significant influence over patient outcomes. By acknowledging these professionals and offering them meaningful professional development opportunities, ESSA can ensure that the expertise of AEPs remains integral to the industry and that accreditation retains its value, regardless of the specific career pathways chosen. Through intentional advocacy, focused education, and a commitment to inclusivity, ESSA can strengthen its standing as the professional home for both clinical practitioners and the growing contingent of non-clinical AEP consultants.

Cheers for now, -Rhea ✌🏽

My opinions are strong and lightly held. Let’s have a discussion.

31 January 2025

Footnotes:

 [1] https://www.comcare.gov.au/about/forms-pubs/docs/pubs/claims/clinical-framework-for-the-delivery-of-health-services.pdf

[2] https://www.dva.gov.au/sites/default/files/2023-07/HWCA-Principles-of-Practice-for-Workplace-Rehabilitation-Providers-2019.pdf

[3] https://www.sira.nsw.gov.au/for-service-providers/A-Z-of-service-providers/independent-consultants