In Canada and other countries, sickness-based absences among workers is an economic and sociological problem. Return-to-work (RTW) policy developed by both employer and worker’ representatives (that is, bipartite policy) is preferred to tackle this problem.
OBJECTIVE:
The intent was to examine how this bipartite agreed-upon RTW policy works from the perspective of occupational health professionals (those who deliver RTW services to workers with temporary or permanent disabilities) in a public healthcare organization in Canada.
METHODS:
In-depth interviews were held with 9 occupational health professionals and transcribed verbatim. A qualitative, social constructivist, analysis was completed.
RESULTS:
The occupational health professionals experienced four main problems: 1) timing and content of physicians’ medical advice cannot be trusted as a basis for RTW plans; 2) legal status of the plans and thus needing workers’ consent and managers’ approval can create tension, conflict and delays; 3) limited input and thus little fruitful inference in transdisciplinary meetings at the workplace; and yet 4) the professionals can be called to account for plans.
CONCLUSIONS:
Bipartite representation in developing RTW policy does not entirely delete bottlenecks in executing the policy. Occupational health professionals should be offered more influence and their professionalism needs to be enhanced.
KalischDW, AmanT, BucheleLA. Social and health policies in OECD countries: A survey of current programmes and recent developments. Organization for economic Co-operation and development (OECD). Labour market and social policy occasional papers, No. 33, OECD Publishing. http://dx.org/10.1787/720018345154; 2003.
3.
OECD. Transforming disability into ability. Policies to promote work and income security for the disabled. Paris: OECD. 2003
4.
WHO (World Health Organization). The World Health Report 2006 - working together for health. WHO, 2006.
5.
ILO (International Labour Organization). Code of practice on managing disability in the workforce. Tripartite meeting of experts on the management of disability at theworkplace. ILO, 2001.
6.
MacEachenE, FerrierS, KosnyA, ChambersL. A deliberation on “hurt versus harm” logic in early return to work policy. Policy and Practice in Health and Safety2007;5(2):41–62.
7.
MacEachenE, KosnyA, FerrierS. Unexpected barriers in return to work: Lessons learned from Ontario injured worker peer support grouWORK2007;29(2):155–164.
8.
MacEachenE, KosnyA, FerrierS, ChambersL. The ‘toxic dose’ of system problems: Why some injured workers don’t return to work as expected. J Occup Rehabil2010;20(2):349–366.
9.
MaiwaldK, de RijkA, GuzmanJ, SchonsteinE, YassiA. Evaluation of a workplace disability prevention intervention in Canada: Examining differing perceptions of stakeholders. J Occup Rehabil2011;21(2):179–189.
10.
TjulinA, MacEachenE, EkbergK. Exploring the meaning of early contact in return-to-work from workplace actors’ perspective. Disabil and Rehabil2011;33(2):237–245.
YerkesM, van der VeenR. Crisis and welfare state change in the netherlands. Social Policy & Administration2011;45(4):430–444.
14.
EtheringtonD, IngoldJ. Welfare to work and the inclusive labour market: A comparative study of activation policies for disability and long-term sickness benefit claimants in the UK and Denmark. J European Social Policy2012;22(1):30–44.
15.
AnemaJR, SteenstraIA, UrlingsIJM, BongersPM, de VroomeEMM, van MechelenW. Participatory ergonomics as a return-to-work intervention: A future challenge?. Am J Indus Med2003;44:273–281.
16.
FrancheRL, BarilR, ShawWS, NicholasM, LoiselP. Workplace-based return-to-work Interventions: Optimizing the role of stakeholders in implementing and research. J Occup Rehabil2005;15(4):525–542.
17.
GuzmanJ, YassiA, BarilR, LoiselP. Decreasing occupational injury and disability: The convergence of systems theory, knowledge transfer and action research. WORK2008;30:229–239.
18.
van OostromS, AnemaJR, TerluinB, VenemaA, De VetHC, Van MechelenW. Development of a workplace intervention for sick-listed employees with stress-related mental disorders: Intervention Mapping as a useful tool. BMC Health Services Research2007;7(127).
19.
WestmorlandMG, BuysN. A comparison of disability management practices in Australian and Canadian workplaces. WORK2004;23:31–41.
20.
WilliamsRM, WestmorlandM. Perspectives on workplace disability management: A review of the literature. WORK2002;19:87–93.
21.
MaiwaldK, MeershoekA, de RijkAE, NijhuisFJN. How policy on employee-involvement in work reintegration can yield its opposite: Employee experiences in a Canadian setting. Disabil Rehabil2013;35(7):527–537.
22.
Maiwald K, Meershoek A, De Rijk AE, Nijhuis FJN. How policy on manager involvement in work re-integration might instead put them out of action: Managers’ experiences in a Canadian setting, WORK (Epub: July 2013, ahead of print).
23.
KosnyA, MacEachenE, FerrierS, ChambersL. The role of health care supporters in long term and complicated workers’ compensation claims. J Occup Rehabil2011;21(4):582–590.
24.
GardnerBT, PranskyG, ShawWS, HongQN, LoiselP. Researcher perspectives on competencies of return-to-work coordinators. Disabil Rehabil2010;32(1):72–78.
25.
JamesC, SouthgateE, KableA, RivettDA, GuestM, Bohatko-NaismithJ. The return-to-work coordinator role: Qualitative insights for nursing. J Occup Rehabil2011;21(2):220–7.
26.
ShawWS, HongQN, PranskyG, LoiselP. A literature review describing the role of return-to-work coordinators in trial programs and interventions designed to prevent workplace disability. J Occup Rehabil2008;18(2):2–15.
27.
BernhardD, MacEachenE, LippelK. Disability management experts and the impact of jurisdiction on practice. An ontario example. International Journal of Social Security and Workers Compensation2010;2(1):1–16.
28.
PranskyG, ShawWS, LoiselP, HongQN, DésorcyB. Development and validation of competencies for return to work coordinators. J Occup Rehabil2010;20(1):41–48.
29.
StoneDA. Policy paradox: The art of political decision making. Revised ed. New York- London: WW Norton & Company; 2002.
30.
LipskyM. Street-level Bureaucracy: Dilemmas of the Individual in Public Services. New York: Russel Sage Foundation; 1980.
31.
MeershoekA, KrumeichA, VosR. Judging without criteria? Sickness certification in Dutch disability schemes. Sociology of Health & Illness2007;29(4):497–514.
32.
MeershoekA, KrumeichA. Multiculturalism and the construction of ethic identities in labour and health practices: avoiding the culturalistic fallacy in applied research. Health Care Anal2009;17:173–197.
33.
van der VeenRJ. De sociale grenzen van beleid: Een onderzoek naar de uitvoering en effecten van sociaal beleid [The social boundaries of policy: A study into the implementation and effects of social policy]. Leiden: Stenfert Kroese; 1990.
34.
van der VeenRJ. De transformatie van wetgeving [The transformation of regulations]. In: Het bereik van de wet [The reach of the law]. Witteveen, Stout, Trappenburg, editors. Zwolle: Tjeenk-Willink; 1992.
TedlockB. The observation of participation and the emergence of public ethnography. In: DenzinNK, LincolnYS, editors. Handbook of qualitative research. 3rd ed. Thousand Oaks: Sage; 2005. pp. 467–481.
38.
StakeR. Qualitative case studies in handbook of qualitative research. In: DenzinNK, LincolnYS, editors. Handbook of qualitative research. 3rd ed. Thousand Oaks: Sage; 2005. pp. 443–466.
PolitDF, BeckCT. Nursing research: Principles and methods. Philadelphia PA: Lippincott Williams & Wilkins; 2004.
41.
CorbinJ, StraussA. Basics of qualitative research: Techniques and procedures for developing grounded theory. 3rd ed. Thousand Oaks: Sage; 2008.
42.
HigginsA, O’HalloranP, PorterS. Management of Long Term Sickness Absence: A systematic realist review. J Occup Rehabil2012;22:322–332.
43.
StåhlC, MüssenerU, SvenssonT. Implementation of standardized time limits in sickness insurance and return-to-work: Experiences of four actors. Disabil and Rehabil2012;34(16):1404–1411.
44.
HoefsmitN, de RijkA, HoukesI. Work resumption at the price of distrust: A qualitative study on return to work legislation in the Netherlands. BMC Public Health2013;13:153.
45.
AnemaJR, SchellartAJ, CassidyJD, LoiselP, VeermanTJ, van der BeekAJ. Can cross country differences in return-to-work after chronic occupational back pain be explained? An exploratory analysis on disability policies in a six country cohort study. J Occup Rehabil2009;19:419–426.
46.
De RijkAE, Van RaakAJA, van der MadeJ. A new theoretical model for cooperation in public health settings: The RDIC model. Qualitative health Research2007;17(8):1103–1106.
47.
SoklaridisS, CassidyJD, van der VeldeG, TompaE, Hogg-JohnsonS. The economic cost of return to work: An employer’s perspective. WORK2012;43:255–262.
48.
WestmorlandMG, WilliamsR, StrongS, ArnoldE. Perspectives on work (re)entry for persons with disabilities: Implications for clinicians. WORK2002;18:29–40.
49.
HoefsmitN, HoukesI, NijhuisFJN. Intervention characteristics that facilitate return to work after sickness absence: A systematic literature review. J Occup Rehab2012;22(4):462–477.
50.
VosR, HoutepenRH, HorstmanK. Evidence based medicine and power shifts in health care systems. Health Care Analysis2002;10(4):319–328.
51.
HorstmanK, HoutepenR. Vertrouwen, sturen of leren : Een pragmatisch filosofisch perspectief op ‘goed professioneel werk’ [Trust, steering and learning: A pragmatic philosophic perspective on ‘good professional work’]. In: Goed werk:Verkenningen van normatieve professionalisering [Good work: Explorations of normative professional development]. G. Jacobs and R. Meij, editors. Amsterdam: SWP; 2008.
52.
LoiselP, DurandM-J, BarilR,JG, FalardeauM. Interorganizational collaboration in occupational rehabilitation: perceptions of an interdiscipinary rehabilitation team. J Occup Rehabil2005;15(4):581–590.
