Steep learning curve on return to work

School board staff learn you don’t have to be 100 per cent healthy

There are two main reasons why people may be reluctant to return to work after a disability leave.

They either don’t understand what is expected of them or there are underlying workplace problems that go beyond the injury or illness, says Maria de Eyre, manager of health promotion and wellness for the Dufferin-Peel Catholic District School Board, just west of Toronto.

There will always be those who cause problems and don’t want to co-operate, and they are typically very vocal when they complain. But most people are happy to hear they can get help to return to work as quickly as possible, she says.

When someone resists going back to work after an illness or injury, it is usually because there are other problems at the workplace that need to be addressed, says de Eyre. She recalls a study several years ago that examined the indicators of a successful return to work. It found that the two questions that reveal the most about a person’s potential to return to work were: “Do you like your job?” and, “Do you like your boss?” If the person answers “yes” to these questions, a return-to-work plan will likely succeed.

When she joined the school board seven years ago, most people there hadn’t even heard of disability management and had little or no experience with return-to-work programs.

There was also a lot of labour unrest at the time, so any new initiative from the administration was eyed with suspicion.

“It was a change (for employees) to have someone call them at home and say, ‘Can I help you.’ And it wasn’t a change they welcomed, so it was difficult,” says de Eyre.

The climate was all new to de Eyre, who had left the private sector to take the job with the school board. “(In the private sector) we could ask for certain information from the physician, and if it wasn’t provided the employee didn’t get access to sick days.”

At the school board, the administration would receive a note from the doctor saying the employee couldn’t work for however long, and it was simply accepted without any effort to get more information to at least explore the possibility of accommodation.

“That concept was foreign to the employees in the school board… so we had to ease it in a little bit,” she says. But over time employees got a better understanding of what de Eyre and her team were trying to do. They have become much more accepting, she says.

“Sometimes people just don’t understand the concept of disability management or return to work. They feel they have to be 100 per cent better before they come back to work,” she says.

“They tend to want to stay off work until they are able to do the job the way it was before they left.” But people should not be expected to be completely healthy before going back to work. Employees, and often physicians, don’t understand this.

Some doctors are very good about return to work but there are some who have no interest in helping the employer, she says. There is nothing particularly ill-intentioned about these, she says. “Physicians are advocates for their patients and they should be,” she says. They only know what the patient is telling them. “If the custodian tells them, ‘I have to lift 100 pounds’ — and there is always a little bit of truth to that — then the doctor tells them, ‘You can’t do that,’ but doesn’t have any idea we can accommodate. It isn’t anyone’s fault,” she says.

Though there are some physical injuries arising from accidents, many of the lost-time claims at the Dufferin-Peel Catholic District School Board involve some stress. Therefore, functional capability assessments have to take into account psychological capabilities like ability to endure stress or to interact with others.

The school board doesn’t have an official stress leave policy, but teachers can use two sick days a month, which they can bank, to take time off to recover from excessive stress. de Eyre and her two occupational nurse case workers try to accommodate workers who are suffering from stress-related problems.

A guiding principle in those efforts — and an underlying tenet of most early and safe return-to-work initiatives — is that the sooner the employee returns to a normal working routine, the speedier the healing process.

If, for example, a teacher has been off work after suffering a miscarriage, it may be difficult for her to be around kids. But if she is given work away from the classroom, her life begins to return to normal sooner. “She is getting up in the morning and getting dressed, interacting with peers and having lunch in the staff room.”

If someone is having a problem with the administration or staff at one school, he could be placed in another school for a while.

“We would expect that they were getting some help to learn some strategies to deal with that stress,” she adds. “The stress is not going to go away. It is the reaction to it that needs to change.”

And while de Eyre’s group has enjoyed some success, there are still improvements to be made, she says. “We’d like to be a little more proactive.”

Right now they only deal with employees who have been away for five days or more in a row. Someone who, month in, month out, is sick two or three days is never contacted. Ideally those employees should be called and asked if anything can be done to assist them.

“We’re not approaching them like a truant officer,” she says. “We aren’t calling them to say, ‘Why aren’t you at work?’ We are calling them to say ‘We understand you’ve been off work, do you need some help?’”

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