Individualized plans help with return to work

Clear goals, time frames, definitions key to process – and help reduce costs
By Nancy Gowan
|Canadian HR Reporter|Last Updated: 04/23/2013

Being off work can be bad for your health. Worklessness — being off work due to an injury, illness or inability to work — leads to poorer physical and mental health, a loss of self-worth and self-confidence, poorer social integration and more medical care. It has been calculated to have the same negative health impact as smoking 10 cigarettes per day.

“What really matters in work is the social context. We need to change the culture of work, stop focusing on the potential toxic impact of work and understand that long-term worklessness is one of the greatest risks to health,” said United Kingdom researchers Nicholas Kendall and Kim Burton in their 2007 paper Advising Patients About Work: An Evidence-based Approach for General Practitioners and other Healthcare Professionals.

There are both direct and indirect costs to time lost from work due to injuries. Direct costs include medical costs, compensation and insurance, replacement workers and overtime, training, recruitment and administrative charges.

Indirect costs include those related to time spent investigating incidents and injuries, retraining staff, reduced service and care, lost productivity, lost sales, co-worker morale and employee pain and suffering.

The cost of disability per employee per day was $300 in 2008, according to a Conference Board of Canada report. A survey by Gowan Health Consultants that same year found more than 25 days lost per employee per year was still common at 16 per cent of workplaces. Only 15 per cent of employers had fewer than five days lost per employee per year.

Employers should keep in mind the following when communicating with a worker on disability:

• The individual is a worker — focus on return to work early by discussing it at the first opportunity after the injury and illness.

• Focus on what the individual can do at work (use a “can do, can’t do, maybe do” checklist).

• Acknowledge safety concerns and restrictions and ensure modified work adheres to this.

• Focus on the individual as a valued employee doing meaningful, productive work.

Develop individualized return-to-work plans

An individual return-to-work plan lays out the steps that need to be taken to return an employee to her pre-accident job. It is normally developed jointly by a return-to-work program manager (who co-ordinates the process), the worker, the worker’s treating practitioner (through the provision of restrictions), the worker’s supervisor and the union (if applicable).

Supervisors from other areas, the medical department or staff from the insurance board or insurer may also assist in the process.

A return-to-work plan should include:

The goals of the plan: These goals set out milestones for the worker to achieve until he reaches the final goal — a return to pre-accident employment.

Actions required to achieve these goals: This includes the responsibilities of the worker, the supervisor and any co-workers who will be assisting the worker.

Time frames for achieving these goals: These are needed so there is a yardstick to measure the worker’s progress. It is important for the plan to have a beginning and an end, as modified or graduated work is a means to achieve a return to pre-accident work — not an end in itself.

Meaningful and productive work activities: The employee and the department need to find suitable work that meets the abilities of the employee and the needs of the department. It is wise to start with the employee’s own job and make slight changes to that job instead of moving him to a new or modified job. Having meaningful work that is contributing to the department’s bottom line will ensure the program is focused on meeting the needs of both the employee and the department.

A clear definition of what is considered progress: For example, if a worker can work five hours per day by week three or can assume tasks by week five.

Health-care needs: If, for example, a worker is going to attend therapy during working hours, these visits must be co-ordinated with the requirements of the proposed work placement. Staff who will be impacted by these health-care needs will also need to be advised — with the worker’s permission.

Nancy Gowan is president of Gowan Consulting in London, Ont. For more information, visit

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