Three solutions to Brighter Return-to-Work Programs
No one wants to get hurt. It is much more preferable to go about our days without the pain, frustration, or aggravation of an injury. Therefore, it comes as no surprise that often immediately following a workplace injury, the first question asked is, “When can I go back to work?” Employers share these sentiments. After all, healthy employees are good for business; however, the path from injury to resuming work duties is not always a smooth one. It can be difficult to balance the concerns of the employer and the injured worker alike. Alignment is possible though; managing expectations, comorbid conditions, and outlook can be the key to successful return to work.
Expectations
Consider the following scenario: several weeks after a strain/sprain injury, the physician is recommending the injured worker return to modified duty. The injured worker is looking forward to getting back into their work routine. When presented with the plan, the employer is surprisingly resistant to the idea out of concern for a potential exacerbation of injury, re-injury, or liability. With the plan rejected, the physician is frustrated, the injured worker is defeated, and he or she remains on temporary total disability (TTD) for several more weeks. In this situation, each party to this claim had a different expectation of how the claim should progress.
A very different outcome might have occurred had the process and expectations been managed differently. A total (100%) recovery may not be attainable in all cases; however, this does not necessarily mean the injured worker is unable to work in some capacity. Light or modified duty may be an appropriate, safe, and welcome option for the injured worker. Conversations between the employer and physician can help level-set expectations in this regard and open the door to constructing a return-to-work plan that will make everyone comfortable.
It is also important to keep in mind that physicians are experts in care — not retail operations. By explaining thoroughly a job’s requirements, work environment, and safety policies to the physician, the employer, along with their employee, can better understand the situation, and design a treatment plan that is more appropriate (and more effective) for the injured worker, their position, and their employer. For example, an employer might consider sharing training videos or other visual aids that demonstrate the required job functions with the physician. The knowledge gained not only could influence return-to-work considerations, but also may guide future treatment recommendations to assure optimal recovery. To this point, one such example is as follows: appreciating the safety sensitivity of the position, the physician may opt not to prescribe an opioid analgesic, deferring to a medically-equivalent yet less sedating muscle relaxer or anti-depressant.
Another tactic to help manage and align expectations of the employer and injured worker is to speak of abilities in specific, relatable terms. For example, rather than indicating that the injured worker can lift five pounds, specify that the injured worker can lift a five-pound bag of sugar. Speak about capabilities in definitive terms directly related to their position to align expectations. Doing so eliminates subjectivity and provides a common point of understanding. People may have differing views on what it means to lift five pounds, but generally will have the same view on the level of effort required to lift a five-pound bag of sugar.
It is also imperative that the treatment, and ultimately the return-to-work plan, comprehensively address the injured worker’s physical and psychological impairments. For example, strain, sprain, fracture, or dislocations disrupt coordination. Head injuries affect concentration, memory, and attention span. Amputations can disrupt gait. There can also be post-traumatic stress, depression, fear of re-injury, worry, and other emotions with which to contend. A focus on the injured worker’s progress towards an improvement in function may be a more realistic goal then.
Yet another important consideration when managing expectations associated with return-to-work is the break period. How many consecutive hours may the injured employee safely work before a break is required? When the break occurs, what does it consist of? Is there stretching or exercises to be done? Does it require sitting or resting? In addition, what is the medication therapy regimen? Are there any special needs associated with it to promote compliance? For example, the injured worker might need to take their medicine with food or require a safe place to store their medication(s) while they are working.
Based on their experiences, physicians, employers, claims professionals, and injured workers each carry preconceptions and expectations when it comes to how a (or in the case of the injured worker, their) claim should progress. Managing expectations with open communication surrounding what, when, and how an injured worker may return to work benefits employers and injured workers alike.
Comorbid Conditions
The workplace injury may aggravate or cause health conditions that co-exist with the employees’ work injury or illness. These comorbidities, such as aging, obesity, diabetes, cardiac disease, arthritis, depression, tobacco use, and alcohol use, can hinder and even thwart a full recovery. For example, some medications can cause weight gain. If a person already struggles with their weight, the added pressure of a sprain or strain can make any physical activity needed to improve the condition difficult. Age can intensify medication side effects. Additionally, tobacco or alcohol use might limit physical activity, which is often needed to fully recover from an injury. Meanwhile, pre-existing depression might influence how the injured worker copes with any pain associated with the injury. Therefore, it is necessary to consider not just the workplace injury, but also the comorbid conditions that might also exist for an optimal return-to-work plan.
Outlook
The adage ‘attitude is everything’ is very important to remember when it comes to workplace injuries, and an employer’s disposition can influence outcomes. Injured workers may hold unsubstantiated concerns or fears that because they were injured their job is in jeopardy. Being away from their daily routine can also bring on feelings of unease, loneliness, and feeling left out. The injured worker may be worried about the additional burden their absence is placing on coworkers or feel like they are letting their team down. Some injured workers consider light duty work as a sign of weakness. Overcoming the stigma that can be associated with workplace injuries and return-to-work programs is therefore critical.
It is recommended that employers emphasize ability not disability when discussing an injured worker’s condition and implementing their return-to-work plan. Include return-to-work objectives, along with a timeline, that are specific, reasonable, and attainable to reduce frustration and disappointment that may come with an inability to perform a certain task or lack of progress towards a pre-injury state. Moreover, offering support and encouragement throughout the claim can make all the difference. Let the injured employee know they are missed; periodically check-in on how they are doing; celebrate milestones in their recovery.
Brighter Return-to-Work Programs
A workplace injury can be difficult on both the employer and the employee and the return-to-work process can be just as challenging for all involved. But by clearly communicating expectations, keepi