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Study focuses on importance of ensuring successful return-to-work solutions

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Managing return-to-work

Managing return to work of injured workers can be a complicated and stressful process, both for employers and workers alike. The Institute for Work and Health has released a report highlighting some of these challenges in an effort to help facilitate safe and successful returns for injured workers.

The Institute for Work and Health (IWH) has released a report aimed at helping employers go through and resolve common challenges with establishing return-to-work (RTW) processes, ultimately benefitting both workers and employers.

The report, titled, Red Flags, Green Lights: A Guide to Identifying and Solving Return-to-Work Problems, utilizes the metaphor of red flags and green lights to identify potential hazards and warning signs that can complicate RTW arrangements and offer guidance to help managers establish effective RTW strategies.

The report is broken down into four major sections, with each dealing with a different aspect of RTW planning— work performance, vocational rehabilitation, worker health and compensation claims. One thing that remains constant throughout the report, though, is the importance of careful planning, potential hazard analysis and open communication in ensuring a successful and timely return to work.

The work performance section, for instance, points to a number of important questions that conscientious employers need to consider when constructing a RTW approach. One example is the issue of transportation— while an injured or rehabilitating worker may be fit to perform a job function, are they fit to transport themselves to and from work? It's a question that often goes unasked, but it can be important in establishing the reasonability of a return-to-work timeline, especially when coupled with other potential issues and question marks.

The report uses a worker with a broken ankle as a case-in-point. If the injury is severe and the commute complex enough— particularly if they're commuting from a distance— the worker may not be able to drive and not have the benefit of affordable public transportation to get to the job site. This may not be a significant issue in and of itself, and could perhaps be moderated by the employer making alternate arrangements— whether with a co-worker or shuttle service— but it becomes an even greater issue if the employer does not recognize it as an obstacle, especially if other unforeseen obstacles become a matter of contention.

If, for example, the injured worker struggles with the employer to find a mutually-agreeable method of transportation, and— upon finding a viable means of getting to and from work— arrives only to find that the modified job function they will be performing will not allow them to keep their ankle elevated as their doctor has required, the worker may come away feeling that the employer is not doing enough to accommodate their injury, or else is unwisely rushing them back to work. The employer, meanwhile, might feel that the worker is being non-compliant, or that they are trying to avoid returning to work.

These kinds of oversights or miscommunications have the potential to leave both parties frustrated with the process and the prospect of the worker's return to work. That's why communication is important in working to establish an effective way of mediating these situations, the IWH study said.

In each of the remaining three sections the report is divided into, communicating well and looking at potential issues from every angle is a common theme. Where vocational rehabilitation is concerned, for instance, the report warns against retraining workers under the wrong circumstances, or for the wrong position. While it is important to set the returning worker up in a work arrangement that makes them feel like they are an important part of the process— nobody wins when a returning worker is relegated to a position specifically created to keep them occupied with menial tasks— it's also important to bear in mind the worker's key competencies and potentially compromised state they may return in, the study said.

Using an injured delivery truck driver as an example, the report points out that the worker in question will likely not be satisfied to return to a position where they are folding items in the warehouse. At the same time, given their expertise, that worker may not be fit to be trained in a role where they will be working with a computer. Even training them on some jobs they might have been previously capable of doing— such as a role in shipping and receiving— can be complicated if they're on pain medications or require appointments for treatments. These are again issues that can strain employer-employee relations and make return-to-work scenarios unnecessarily difficult, or untenable, so it is important to communicate with employees and plan diligently to prevent these situations from transpiring.

Personal health is another area where keeping the lines of communication open and considering all the potential obstacles can make a big difference in the success of a worker's return to work. According to the study, in some cases the progress of an injured worker returning may be complicated by other non-workplace-related injuries or afflictions they may be going through.

The most troublesome of these from an employer's perspective can be "invisible injuries," or depression and mental health problems, as they can have a dramatic effect on a worker's recovery and can often be difficult to spot. According to the report, depression and mental health problems can be created or exacerbated by the financial strain and feelings of helplessness and frustration that sometimes come along with extended disability leave. These feelings can also lead to more serious problems, like abuse of medication. For these reasons, it is critical that employers discuss these issues with injured workers if they see any potential warning signs, and ensure the mental well-being of the individual in question when proceeding with the RTW process.

Claims are another aspect of the RTW process where communication and thoughtful planning are key. Claims and compensation processing are typically the most contentious part of return-to-work scenarios, and if not handled carefully, they have the potential to become a source of employer-employee frustration and animosity, the report said. IWH suggests face-to-face contact, conflict resolution and timely follow-up over and against indirect contact and unilateral decision-making when it comes to dealing with claims issues.

Compensation is a complex issue, and one that tends to be affected by a lot of variables, so it's important to keep all relevant parties informed and communicating during the process, the report said. This applies just as equally to employees and medical professionals as it does to employers and compensation boards, but with a concerted effort by all parties, claims resolution doesn't have to be the struggle it is sometimes associated with.

Aside from the need for open communication and strategic planning, the one thing the report highlights is the fact that structuring RTW scenarios is much more multifaceted and complex than merely making sure you're not rushing an employee back too soon or leaving them away from work too long. There are many considerations that need to go into RTW planning if it is to be effective, and the report goes a long way towards helping employers and managers understand those considerations.

For more information, or to view the report, visit http://www.iwh.on.ca/rtw-problems-guide.

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