Research shows that an early return to work (RTW) is crucial to a successful RTW. In 2011, in a seminar presented by the Institute for Safety, Compensation and Recovery Research (ISCRR), Professor Katherine Lippel of Ottawa University explained how an injured worker's ability to make a successful return is influenced by the system regulating that process.

Drawing on her knowledge of different systems operating around the world, Professor Lippel argued that the most effective systems are those with in-built incentives that encourage both employees and employers to pursue an early RTW.

Focusing on how legal rules and policy can help or hinder RTW, Professor Lippel explained how the best systems provide incentives:

1. for employers to get employees back to work as quickly as possible; and,
2. for employees to want to return to and stay at work.

This kind of emphasis was said to represent a win-win scenario for workplaces. Encouraging a speedy and sustainable return to work saves time and money for the employer, and improves the physical and mental wellbeing of the worker.

The importance of systems

Citing a study by Anema et al (2009), Professor Lippel explained how rates of success with RTW outcomes depended upon the nature of the system governing that process.

Incentivising RTW for the employer

Early RTW = Successful RTW

Professor Lippel discussed her study of RTW systems in Ontario and Quebec. Her findings suggested that from the employer's perspective, getting an injured employee back to work as quickly as possible represents the best possible result  (helps productivity, morale).

Making early RTW an economic incentive, not disincentive, for employers

The importance of providing employers with economic incentives to get injured employees back on the job was also discussed. Professor Lippel suggested that in some countries around the world, the benefits of early RTW have been jeopardised by systems that allow RTW cases to be subject to a cost analysis assessment.

Incentivising RTW for the employee

Engaging with the injured worker on a personal level

Professor Lippel stressed that an injured worker’s feeling of alienation from the RTW process is a barrier to successful RTW. This kind of feeling was demonstrated through the words of an injured worker featured in a 2003 Australian study by Roberts-Yates, who said of the process, “I felt like a number with skin on.”

Professor Lippel suggested that effective RTW systems consider the emotional state of the injured worker, and are able to:

• build worker confidence;
• ensure the worker is given appropriate duties;
• accommodate a gradual RTW;
• ensure physical and psychological dignity;
• foster self-confidence; and,
• provide real support.

Minimising anti-therapeutic practices

An enthusiastic and dedicated injured worker will usually experience a return that is quicker and more sustainable. It is therefore important that RTW systems do not discourage this kind of mindset.

According to Professor Lippel, the systems in Ontario and Quebec strongly encourage employees to be given ‘temporary assignments’ while awaiting ‘maximum recovery.' Indeed, Lippel pointed out that employers can be sanctioned if appropriate temporary work is not provided. 

Citing Giroux’s 2004 study, Professor Lippel explained the counter-productive nature of the anti-therapeutic application of temporary duties. In that study, one worker was temporarily assigned to sit in a cafeteria and do nothing. This resulted in adverse psychological consequences for the worker, and impacted negatively on their rehabilitation.

The bottom line

Encouraging a return to meaningful work, at the earliest possible stage, often represents the best result for both employers and employees. According to Professor Lippel, if this kind of result is to be as commonplace as it should, the systems that oversee that process must do a better job of encouraging it.

Katherine Lippel is a member of the Québec bar and professor of the University of Ottawa's Faculty of Law. From March 2006 she has held the Canada Research Chair in Occupational Health and Safety Law.