Potential Causes of Post Traumatic Stress Disorder (PTSD)

  • Injured workers have been exposed to trauma that has either threatened their life or the life of another

  • Injured workers may have witnessed the death of another person

  • Not all workers exposed to trauma will go on to suffer post-traumatic stress

  • Fundamentally, PTSD is a disorder of fear and memory after trauma

  • People with post-traumatic stress typically suffer a lack of function in their sense of self, relationships,
    occupation, education, etc.

  • Post-traumatic stress can be caused by a single event or multiple events over time

  • Post-traumatic stress can be delayed in onset

Common symptoms of PTSD include:

  • Flashbacks – repeated and unwanted memories of trauma

  • Memory disturbance – impairment of memory formation, poor recall

  • Sleep disturbance – delayed sleep onset, early waking, reduced sleep quality

  • Depression – low mood, motivation, impaired cognition, impaired memory formation, decreased libido, poor sleep, decreased energy levels

  • Substance misuse – misuse of illicit and prescribed drugs to cope with symptoms and emotions

  • Avoidance behaviours

  • Aggression

  • Guilt

  • Shame – usually connected with the guilt of surviving a traumatic event

  • Social detachment – isolating or obscuring symptoms from loved ones and/or avoiding social settings

  • Irritability

  • Suicidality – this ranges from passive thoughts of suicide without planning to actual planning

  • Hypervigilance – a heightened fear response in unfamiliar situations and/or locations where trauma was experienced

  • Heightened fear response – a severe anxiety response where there is no apparent trigger

  • Deliberate self-harm – sometimes through cutting but can also take the form of substance misuse
    (alcohol, illicit drug use).

  • Physical complaints – usually this is coupled with an increased focus on somatic symptoms that although minor produce a heightened anxious response.

Where can I seek help?

I am an Employee. What should I do next if I think I have
post-traumatic stress from my occupation?

If you have a general practitioner, treating doctor or psychologist, we recommend making an appointment to discuss your symptoms and situation. If possible, be prepared to work with your employer to find ways to recover at work.  If you are not satisfied with their ability to understand and manage your concerns please contact Heartwood Recovery to discuss your situation via our enquiry page.

I am an Employer/RTW Coordinator and finding it difficult to manage the relationship with my employees Treating Doctor (NTD):

There are many steps and skills required to support an injured worker to successfully recover at work and regain their
pre-injury enjoyment of life. A key stakeholder in the process is the workers Treating Doctor (NTD). Research indicates the challenges experienced by Return to Work Coordinators and employers when dealing with an NTD include:

Reasons why an injured worker may struggle to return to work include:


Heartwood Recovery is committed to doing this differently. We aim to effectively manage these challenges with a balanced approach to improve outcomes for the injured worker and the workplace.

Tips for the Employer/ Return to Work Coordinator:

  • Recognise the impact of both psychological and physical injuries for the injured worker. Take the time to discuss:

       –  Time and transport to attend specialist appointments

       –  Concerns regarding WorkCover payments to meet financial commitments

       –  Flexible work arrangements you can offer recognising the risk in their current workplace/ work duties.

  • Discuss your process to maintain your workers privacy regarding their health information

  • Educate the Treating Doctor by providing photos or a short video on workplace

  • Support the Treating Doctor by providing a Job Description and suggested suitable duties for the injured worker to recover at work

  • Discuss with the injured worker if they are satisfied with their NTD’s approach and potential ideas for improving their graded return to work plan

  • Suggest a Case Conference to facilitate quality communication between stakeholders

  • Communicate with the injured worker the benefits of recovering at work

  • Create a Return to Work Plan that is realistic given your workers injury

  • If practical, offer support to their partners and family

  • Most importantly, create and review workplace systems to prevent the cause of psychological
    and physical injury for workers.


Injury Management Plan

NSW Workcover Insurance Provider Injury Management Program

Recover at Work Planning Tool

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