There’s no need to stand around scratching your head over stalled RTW. In fact, acting quickly is vital: the longer someone spends off work, the less likely they are to ever return. The sooner you get things moving again, the better for everyone involved.

If you’re not quite sure where to begin, this checklist will help you identify what’s gone wrong, so you can get all the stakeholders revved up and racin’ to return!

Question 1: Does the time off work match the diagnosis?

Some health conditions and injuries have a substantial recovery time. If you’re confident that the employee and the doctor are focused on RTW and if the doctor is telling you that RTW just isn’t viable yet, then you don’t want to jeopardise the employee’s recovery – or confidence in your concern for them – by unrealistic expectations. If the answer is...

Yes, you need to continue to support the employee to recovery. Stay in touch, ask what you can do to help, and make sure the employee knows that you're keen to have them back in the workplace as soon as it is safe for them to return.

No, then you need to continue with the checklist!

Question 2: Does the employee have gripes you’ve missed?

Frequently, RTW will be delayed for reasons that have nothing to do with the actual illness or injury (which isn’t to say that the illness or injury isn’t real). Ask questions and observe the work environment to see if the following factors are playing a role:

• Conflict between co-workers, or the worker and their supervisor;
• Frustration about being passed over for promotion;
• Dissatisfaction with pay or conditions;
• Workplace bullying; or
• Concerns over safety.

If  yes, you may need to direct the employee to the EAP, initiate conflict resolution processes (including external conciliation where appropriate), and allow the employee to vent their concerns and brainstorm solutions. 

If no, consider double checking, because this is such a common problem! However, if you're certain that you're not missing anything...

Question 3: Does the employee have all the relevant information?

There are several key things that employees need to know about long term work absence:

• There are mental and physical health benefits associated with returning to work asap;
• Most compensation jurisdictions have wage step downs and eventual cessation of payment; and
• Employers with best practice injury management policies and procedures expect safe, early return to work.

If the employee has been off work for a week, it can be a good idea to meet with them and make sure that they're clear on the facts - including the advantages of early return to work and the health and financial costs associated with delayed return to work. If they seem to have a good level of knowledge about these things, consider asking...

Question 4: Are motivational or psychological barriers the problem?

Ask questions and observe to determine whether the employee is:

• Overly concerned about pain;
• Pessimistic about recovery;
• Depressed;
• Anxious; and / or
• Failing to attend medical appointments.

If you think that the employee is unmotivated or that psychological difficulties may be hindering their recovery, interventions such as Cognitive Behavioural Therapy (CBT) may be appropriate. If you have an EAP (Employee Assistance Program) you could direct the worker to that. However, if the employee seems motivated and in good mental health, check...

Question 5: Is the supervisor living up to their RTW responsibilities?

Apart from the ill or injured worker, the supervisor has the greatest impact on return to work outcomes. Things to look out for include:

• Whether the supervisor has maintained contact with the off-work employee;
• Clusters of difficult or drawn out claims around particular supervisors or departments; and
• The supervisor's communication style, especially in terms of empathy and active listening.

If the supervisor is letting the team down, you may need to remind them of their RTW responsibilities and inform them of how they can encourage speedy and safe return to work.

But if the supervisor is pulling their weight, you might need to consider...

Question 6: Is the doctor inadvertently hindering the process?

When delayed return to work is a problem, it is worth asking whether:

• The doctor communicates well;
• The employee has a good understanding of their health problem and treatment options;
• The doctor understands the workplace and the modified duties available;
• The doctor is aware of the rehab value of early return to work;
• The doctor is overtreating the employee; or
• The doctor is undertreating the employee.

Answering these questions will help you decide whether the doctor is hindering rather than enabling return to work.

If yes, you might want to devote some resources to educating the doctor about your workplace and the health benefits associated with return to work. If you have serious concerns about the treatment on offer, you might also wish to suggest that the employee seeks a second opinion, bearing in mind that employees have the right to choose their own medical service providers.

If no, then keep digging!  

Question 7: Is it safe for the worker to return?

Few people would be willing to a situation which they feared would jeopardise their recovery. Ask:

• Are safe, meaningful and modified duties available?
• Have appropriate changes been made to the workplace to ensure that a similar accident / injury / illness is unlikely to occur?

If no, then look into solving these problems asap.

If yes, perhaps the workplace culture is responsible for the delay. Ask...

Question 8: Is the workplace community supportive?

• Is the employee being treated like a number rather than a person?
• Are claims / case managers and supervisors too focused on KPIs, LTI stats and closing the case?
• Has the CEO / MD been in touch to ask after the workers’ wellbeing?
• Have coworkers been in touch with the absent worker to offer their support?

The key to safe and speedy return to work is a focus on the wellbeing of the injured or ill worker. People notice when they are treated as a number or as a liability, and they tend to respond poorly. The best return to work results are achieved when the workplace as a whole is supportive.