Return to work resistance often due to workplace problems

Most staff want to return as soon as possible after an injury or illness

With the direct costs of long-term, short-term and workers’ compensation estimated to be between five and six per cent of payroll, it’s understandable employers want to get people back to work quickly.

The good news is that, according to disability management and return-to-work experts, most people want to return as soon as possible after an injury or illness. So long as the proper accommodations are made, getting back to the workplace before being 100 per cent healthy is actually beneficial to the employee.

Being involved in meaningful work provides people with a sense of well-being, says Nancy Gowan, president of Gowan Health Consultants and a faculty member in Mohawk College’s return-to-work co-ordinator program in Hamilton. “All the evidence we have demonstrates that people want to work and they want to keep busy and they want to keep active and involved.”

But from time to time, employers still find people who balk at the idea of coming back to a modified work arrangement.

If a worker resists, the employer should make the decision about the case as objective as possible, says Patricia Boucher, an author and certified occupational health nurse.

Functional abilities evaluations, completed by the doctor, are compared to a physical demands analysis of the job, gaps between the ability and demands are identified and then modified duties are tailored to address those gaps. Some employees may continue to resist but they do so at the risk of losing their benefits, she says.

That said, return-to-work co-ordinators need to look below the surface to find out what other factors, besides the identified illness or injury, may be causing the employee to balk at returning to work, she says.

“There is always an underlying issue,” says Nicola MacNaughton, occupational therapist and owner of Moncton, N.B.-based rehabilitation services firm Occupational Concepts. There may be a fear of re-injury, a concern there won’t be enough support or else a lack of support away from the workplace.

A lot of people worry about returning to work because the company has a bad history, she says. They may have seen other workers return to unsafe situations or to a job where little is done in the way of accommodation. “They may have heard stories about people who have been brought back and re-injured because things haven’t been changed for them.”

Employers are doing a better job of return to work because they understand their legal obligations and the costs associated with poorly structured return-to-work programs, says Gowan.

However, many employers still feel so much pressure to bring people back to work as quickly as possible to avoid workers’ compensation costs that they end up with people returning to work that isn’t valuable. “They get a pool of modified workers doing not meaningful work and the costs begin to rise internally,” she says.

As the workforce gets older, employers will likely face more return-to-work challenges than in the past, says Gowan.

Organizations are already beginning to see the impact of people doing work that was not ergonomically well-designed, she says. One of her clients suddenly saw a large spike in the number of lost-time claims because many of the company’s employees had been doing the same repetitive work for 20 or 25 years.

The increase in lost-time claims will raise interesting cases that will have employers asking how far must they go to meet the duty to accommodate. “How many people do they have to bring back and how many jobs do they have to modify before it becomes undue hardship?” she asks.

At what point will it make sense to hide someone in the business rather than assume the costs of sending someone away on a retraining program. “It is a real dilemma,” she says.

One of the toughest issues for employers, both legally and ethically, is how much information can and should be shared about the employee’s condition, says Patricia Janzen, a lawyer specializing in human rights and the duty to accommodate with the Vancouver office of Fasken Martineau. This is particularly difficult when someone is returning to work after a mental illness problem. It is easier to understand how to accommodate someone who can’t lift the same weight he once could. But it is more difficult to accommodate someone who suffers anxiety attacks and suddenly leaves the office for a couple of hours.

“The more information you share to give people a better understanding of the condition the more likely you are to get buy in. But when you get into mental problems, that becomes very difficult to do,” she says. “Let’s say you have an employee who was returning to work from a major depressive incident but wasn’t 100 per cent…Do you then take the co-workers and give them a lunch time talk? Would that be helpful? You bet it would. However, the theory is you don’t go blabbing about the employee’s private medical affairs to co-workers and yet co-workers have to tolerate behaviour that would be unacceptable for them.”

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