Association for Public Policy Analysis & Management

Return-to-work (RTW) following a disabling illness or injury can be a complex process with variable outcomes. Traditionally, research and practice in the field of work disability management has focused on clinical interventions that treat the health impairment and facilitate work reintegration. However, approaches that focus strictly on health care may have limited success in addressing more complicated work disability cases. A growing body of research indicates that the implementation of organizational RTW interventions may complement clinical approaches, and be effective in facilitating early and sustained work reintegration.

Within the framework of a biopsychosocial model of work disability, studies indicate that RTW occurs within a system of diverse factors including health (e.g., injury or illness type, severity of activity limitations), health care (e.g., access to treatment and rehabilitation), psychosocial (e.g., perceived RTW readiness) and work context factors (e.g., social, physical and administrative workplace characteristics). Organizational RTW interventions refer to those that are delivered by an employer and offer adaptions to the work context, and can include modified job duties, graduated RTW plans, and job accommodations (e.g., ergonomic interventions, flexible scheduling). Studies indicate that the implementation of RTW interventions at the organizational-level are associated with a minimization of avoidable disability days. At the same time, the extent to which organizational RTW interventions are administered varies widely across employers, industries, and jurisdictions.

Research conducted by our investigative team in several countries including Australia, Canada and the United States has found that frontline supervisors play a particularly important role in the administration of organizational RTW interventions. Supervisors have direct and daily interaction with frontline workers, and possess knowledge of corporate standards and the authority to adjust working conditions. Not surprisingly, enhancing supportive relationships and strengthening communication channels between a supervisor and an injured worker represents a significantly important organizational approach to work disability management. On the other hand, our research has also found that frontline supervisors lack evidence-based resources to guide their interactions with injured workers, and information on the most suitable accommodations and modifications that foster RTW for injured workers with diverse health impairments.

In this paper, we present qualitative and quantitative data collected within several large employers to underscore the importance of organizational RTW interventions. Specific objectives are to: (1) examine the role of organizations in work disability management; (2) highlight several organizational RTW interventions that have successfully improved work disability management outcomes; and (3) examine the importance of enhancing supportive relationships and optimizing communication between frontline supervisors and injured workers.