Injury and Rehabilitation

What you need to know

Worker disability costs Canadian employers between 10 and 20 billion dollars annually, according to The Physician Education Project in Workplace Health (PEPWH). Workplace injury isn’t just costly for employers; it also has a huge impact on the workers’ lives.

The Research Action Alliance on the Consequences of Work Injury (RAACWI) has found that injured workers can experience declines in their physical and mental health after injury. Their research shows that injured workers who can’t return to work can experience decreased sense of self worth, more depression, anger, role disruption and powerlessness, family stress, financial strain and substance abuse. Dr. Emile Tompa, academic lead at RAACWI, found that after controlling for financial aspects of work injuries, there was an increased probability of marital breakup of about 25% compared to the rest of the population. This may be because of the stress and strain of the injury.

Mary Ann Baynton, M.S.W., is a specialist in crafting complex accommodation strategies for return-to-work situations. Baynton says there are a number of factors to consider when an employee has taken an extended leave from work. “If someone is absent from work for 12 weeks or more, the literature says the human brain is likely to forget some details about doing the job, such as tasks or processes. After a 12-week absence, there’s usually some need for reorientation, reintegration, or retraining,” says Baynton. She gives an example of an experienced worker who has been off for a lengthy illness, and is perceived as a very competent, experienced and knowledgeable worker. “But they might need to be re-skilled on things because, if it doesn’t happen, they start to become conscious of the fact that they’re not doing [work] right. And this sets up a dynamic where someone might think they’re not working as hard,” says Baynton.

After a 12-week absence, there’s usually some need for reorientation, reintegration, or retraining,” says Baynton.

Steve Mantis, community lead at RAACWI, has been involved in advocacy since he lost his arm in 1978. He says that it isn’t enough to just get people back to work as fast as possible. “When you go back to work and you don’t have the capacity, someone else has to pick up the slack, so that person can get resentful, and risk his or her own health to pick up your work load. Now relationships are beginning to be ruptured. There is also a very high risk of re-injury: you go back to work and get injured again. The cycle repeats. And if you then leave work without [insurance], then you’re on the path to poverty.”

Creating a successful return-to-work plan

The workplace needs to have a plan in place before the injured employee returns to work. Baynton created a six-step process when she was an employee at The Great-West Life Centre for Mental Health in the Workplace. She says that return to work planning should begin as soon as someone takes leave, because it’s too late to start thinking about it when they are ready to return. The steps she recommends are:

Step 1: Maintain contact
The successful return-to-work plan starts at the beginning of a disability leave. By staying in touch with the employee you maintain your connection and make the return easier. Sometimes we don’t know what to say, so we don’t say anything, but offering support and concern, even in a card or email, can ensure you don’t lose contact and risk disconnection.

Step 2: Recognize and address co-worker reactions
Although you need to respect the confidentiality of medical information, you need to find an appropriate way to address co-worker reactions and concerns about his or her colleague. If employees feel negatively impacted by the situation and you tell them to ignore it and keep working, the return to work will be much more difficult. These issues need to be discussed and resolved, while maintaining reasonable privacy.

Step 3: The role of the supervisor
Regardless of who creates the return-to-work plan, the supervisor will be responsible for the successful implementation. The supervisor needs to reconcile the demands of the organization, co-workers, the returning employee as well as his or her own needs.

Step 4: The job
When considering a return to work, it is important to understand the various tasks and responsibilities of the employee’s job.

Step 5: The employee’s role
The only person who knows what it takes to get the employee back to work, is the employee. He or she knows where the challenges lie and it is much better if he or she has a hand in the plan. If you make a plan and give it to them they are likely to agree, even if there are potential issues.

Step 6: Creating the return-to-work plan
The plan itself has to deal with more than the tasks of the job. It should include perceived challenges or triggers from the employee. It might also include things they’ll do differently for their own well-being.

Breaking down barriers

Mantis believes that injured workers face many unnecessary challenges in addition to their actual physical injury. He thinks that injured workers’ health can be helped by changing our attitudes. “Having a disability myself for the last 30 something years, I’ve seen that people can be productive with a disability if the work structure takes that into account. I got hurt in construction, and my prosthetic arm doesn’t work well above waist height. Now I do waist height work or lower… . How we work is often designed around the machines and technology we use, and not the people who use them. I think it could be greatly improved if we worked around the people instead.”

Another barrier injured workers face is repeatedly having to prove that they’re truly hurt, and require modified duties. Many people have a story of someone who took advantage of the system. And it’s unfortunate. However Mantis comments that the number of people who are dishonest about their injury is quite low. As a member of the board of directors at Ontario’s Workplace Safety and Insurance Board (WSIB), the fraud unit only discovered about 14 cases in 350,000 to be fraudulent

“You might think he or she’s scamming the system, because if he or she’s in the garden he or she could be at work. We need to realize that healing doesn’t happen lying in a bed. You must try to regain function slowly, physically and mentally…

The fear of being labelled a fraud can impede activities that would promote recovery. For example, you might see your injured neighbour tending his or her garden. “You might think he or she’s scamming the system, because if he or she’s in the garden he or she could be at work. We need to realize that healing doesn’t happen lying in a bed. You must try to regain function slowly, physically and mentally. So, we should encourage workers to be active, while reassuring them their income is secure,” says Mantis.

As in most life situations, it is far more productive to focus on solutions instead of looking extensively at a problem. “We often go around in circles focusing on the problems, and the problems get bigger and bigger,” says Baynton. “We need to look beyond the problem to solutions, and the focus should be on how to help employees be successful. By following clear guidelines, we can have greater success, even during complex return-to-work planning. Helping people be successful at work is much more effective than feeling sorry for them, or trying to be a disciplinarian.”

By ensuring that we treat injured workers fairly, with dignity, accommodation and respect, we can increase the chances of a successful return to work. A co-operative effort to ensure prompt diagnosis, appropriate treatment and ongoing support increases the likelihood that workers will have better health outcomes and will continue to lead healthy, fulfilling lives, which benefits both the employer and employee.

Originally published in issue 12-2 of Your Workplace magazine.