Joint Worker-Management Support and Empowerment
The foundation of workplace disability management is joint worker-management support and empowerment. Worker and management representatives are key contributors in the disability management process when they participate cooperatively as decision-makers, planners and coordinators of interventions and services.
Responsibility, Accountability and Authority
The strength and effectiveness of a workplace disability management program often depends upon the extent to which responsibility, authority and accountability are vested in the disability management practitioner or designated workplace representative and others who are involved in return to work activities.
Workplace Culture and Policy Development
Effective workplace disability management programs require consistency between the intentions of employers and the expectations of workers. Successful disability management programs require effective cohesion between the defined roles, responsibilities and expected outcomes for all parties in the disability management process.
Information and Communication Management
Workplace disability management programs require consistent and accurate internal communications among workers, managers/supervisors and worker representatives. External communications enhance the relationship between the workplace and treating physicians, claims managers, rehabilitation service providers and workers compensation administrators.
Benefit Design and Influences
Benefit design often has a significant influence over the involvement, participation and commitment of both employers and workers, particularly, the allocation of benefit costs. The structure of the benefit program can, in some instances, influence the effectiveness of the disability management program.
Knowledge and Skills of Disability Management Practitioner(s)
Workplace-based disability management practitioners are responsible for implementing disability management and return to work processes for injured and disabled workers. Individuals at workplaces who assume this role facilitate the reintegration of workers who have become injured or ill, on or off the job. A critical component of the function is promoting the values of return to work / disability management and human rights within the organization. They must balance their responsibilities toward both the worker and the workplace. They may act as an advocate challenging barriers to return to work, act to protect the employability of the worker, maintain the cost effectiveness of the program, help ensure that there is no discrimination in the workplace, all while maintaining a cooperative working relationship with workers and management. These multiple roles and functions require knowledge and skills in important areas such as early intervention, case management, return to work planning, workplace accommodations, and other disability management functions.
Accident Prevention and Safety Programs
Critical to the success of a workplace disability management program are the structure, design and effectiveness of its accident prevention and safety programs. Safety policy and procedures must be top priority for both workers and management. In progressive organizations, there is a close relationship between all parties in the execution and administration of safety initiatives. Formal safety departments and/or joint committees on safety are responsible for administering the safety program and investigation of accidents and injuries. There is also close monitoring of all potential risk hazards in the workplace.
Occupational Ergonomics
The overall objective of occupational ergonomics is to fit the task and equipment to the physical and mental capabilities of individuals in order to enhance their effectiveness in the workplace. Ensuring maximum long-term health and safety of workers by preventing and/or controlling occupational injuries and illnesses is an important and prominent goal of ergonomics. It also plays a key role in returning to work the injured or ill worker who has limitations.
Health Promotion and Wellness
Research evidence suggests that those workplaces demonstrating a caring attitude for the health and wellness of their workers are likely to have greater success in positively impacting the socio-economic cost of disability. Workplaces with optimal health promotion and wellness programs are ones that have actively determined the needs and interests of workers and have involved them in the development of these programs. Effective programs are characterized as having leadership, commitment and results-oriented strategies for motivating all parties to participate. These workplaces also equip their workers with ongoing support to maintain healthy lifestyles.
Injury, Disability, and Lost-time Patterns
Most workplaces maintain statistical information on the incidence and magnitude of lost time and medical only injuries and illnesses. Quality data is needed to design a customized disability management system that is responsive to types of injuries and illnesses among workers within various age groups and employed within different work categories. Many workplaces, by the nature of their business, tend to have high risk jobs and, subsequently, experience greater numbers of accidents and injuries (e.g. construction, manufacturing, mining, etc.). However, the extent to which they can control such patterns is based initially, on their ability to quickly access relevant data and make accurate interpretations that lead to appropriate solutions.
Disability Cost Benefit Data
The total cost of injury and illness to a workplace can be elusive as it has been shown that the hidden costs of disability such as recruitment, orientation, lost productivity, administrative costs, etc., add significantly to the direct disability related costs such as medical and wage replacement costs. Effective collection and analysis of disability cost data is pivotal to not only maximizing the effectiveness of disability management programs, but in the evaluation and continuous improvement of disability management programs. It is also essential to gather disability management cost data to ensure that benefit programs are optimized to achieve both the social and economic objectives of the program.
Early Intervention and Worker Communication Protocol
Return to work success for injured or disabled workers is based, to a significant extent, on early intervention. An immediate response to the rehabilitation needs prevents the person from feeling powerless and reinforces their responsibility for recovery. Worker participation is critical to the return to work process and begins with the initial injury that is expected to result in work restrictions or lost time. Worker participation should be with a focus on the physical, psychosocial, economic, occupational and family needs of the worker with a disability. Worker participation should be supportive, ensuring access to information related to medical treatment, accommodations and resources to facilitate the return to work process. Effective early intervention and supportive worker participation requires the workplace representative to maintain direct, continuous contact with the injured/disabled worker, monitoring medical treatments, outcomes and all objectives of the return to work plan. Effective worker mentoring, when done in a caring fashion, gives assurance that both workers and management value the injured/disabled worker as a contributing member of the work group.
Case Management Procedures
Case management services are necessary to facilitate the development and implementation of disability management strategies and return to work plans for workers with disabilities. The case manager serves as a central disability management team member by functioning as a liaison between employers, worker representatives, workers with disabilities, community healthcare providers and others. Some workplaces have a disability management practitioner who assumes case management responsibilities. A contractual case manager can be an effective alternative support system for maximizing the effectiveness of the return to work process.
Return to Work Coordination
Effective return to work programs require a high level of internal coordination and communication, as well as the coordination of activities among external medical services, rehabilitation providers and others. Return to work coordination requires an understanding of both the worker with a disability and the work environment. Among optimal disability management programs, the steps from an impairment occurring to return to work are clearly delineated and understood by workers and employers. Supervisors/managers of workers with disabilities should play an active role in the return to work coordination process.
Transitional Work Options
The success of the transitional work program is only limited by the flexibility and creativity of those involved in developing transitional work options for the worker with a disability. Transitional work is viewed as any combination of meaningful and productive tasks, functions or jobs that a worker who has functional restrictions can perform safely, for pay, and without the risk of injury to self or other workers. Transitional work options include designated jobs or job tasks that are modified, over time, to accommodate the worker during the recovery process. This process begins with objective worker evaluations (physical and mental capacities or abilities) and an analysis of job tasks (demands of work). The transitional work plan delineates periodic modifications in the worker's job task assignments, as the worker's capacity to work is increased. Through transitional work, the worker is accommodated and provided an opportunity to gradually "transition" back to work. The worker continues to earn a pay cheque; lost time is reduced or eliminated.
Workplace Accommodations
Workplace accommodations include modifications or adjustments to the job, jobsite, or the way that a job is performed to allow a worker with an injury or disability to perform work tasks safely and with increased independence. Managers, worker representatives and workers have been implementing job modifications and accommodations informally for many years. Increasingly, workplace accommodations are being recognized as an effective tool in the overall disability management planning. Optimal workplaces use a structured approach to anticipate, identify, implement and evaluate job accommodations in the workplace. By accommodating a worker's injury or disability, unnecessary lost time is often reduced or eliminated. The outcome of the workplace accommodation process is the identification of realistic, attainable options for resolving questionable or unknown disability and work performance problems. Such options may include jobsite redesign, reasonable accommodations, rehabilitation engineering, ergonomic job restructuring, or a temporary assignment to a modified job.