Return-to-work effort sufficiency (RTW-ES) is a measure used in the Netherlands. Individuals who have applied for disability benefits go through a review process as part of their application.

Effort sufficiency is an assessment of the endeavours undertaken by both the employee and the employer. For example, has the employer provided appropriate modified duties? Has the employee accepted what is deemed to be a medically suitable job? Has rehabilitation occurred?

The claims assessor reviews whether there has been sufficient effort put into return-to-work by the employee and the employer.

The researchers in this study sought to study what influences return-to-work and return-to-work effort sufficiency. They requested that people applying for disability benefits after two years of sickness absence complete a questionnaire.

The case manager was also asked to complete a questionnaire regarding all cases over a specified period. Questionnaires concerning 415 cases were available. The case manager answered the questionnaire based on the information available within their file, including input from the employer.

The questionnaire included personal factors regarding the employee, such as their age, level of education and years of employment. There were also questions about periods of work resumption, as well as questions about whether the sickness absence was work-related, whether there was conflict between the employee and employer during the return-to-work process, and a series of questions about various return-to-work efforts by the employee and employer.

The researchers then analysed the information using complex statistics.

The researchers noted that the only factor found to be related to return-to-work effort sufficiency was a good employee-employer relationship.

In terms of factors that were associated with higher rates of return to work, they found the education level of the employee, past history of disability, and the relationship between the employee and the employer were influencing factors.

Of these three factors the most substantial factor was the employee-employer relationship.

The authors of this study go on to point out that the relationship between higher levels of education and higher rates of return-to-work is consistent with previous research studies. Low education prolongs the time to return to work.

The only factor that was found to influence return-to-work effort sufficiency and return-to-work outcome was the relationship between the employee and the employer.

The researchers go on to suggest shifting from a straightforward evaluation of capacity and duties to more personal factors such as the relationship between the employee and the employer. This is probably sensible to improve both effort in return to work and return-to-work outcomes.
 

Authors

Muijzer A, Groothoff JW, Geertzen JH, Brouwer S.

Institution

Department of Health Sciences, Community and Occupational Medicine, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, Groningen, The Netherlands.

Title

Influence of efforts of employer and employee on return-to-work process and outcomes.

Source

J Occup Rehabil. 2011 Dec;21(4):513-9. doi: 10.1007/s10926-011-9293-5.

Abstract

BACKGROUND:
Research on disability and RTW outcome has led to significant advances in understanding these outcomes, however, limited studies focus on measuring the RTW process. After a prolonged period of sickness absence, the assessment of the RTW process by investigating RTW Effort Sufficiency (RTW-ES) is essential. However, little is known about factors influencing RTW-ES. Also, the correspondence in factors determining RTW-ES and RTW is unknown. The purpose of this study was to investigate 1) the strength and relevance of factors related to RTW-ES and RTW (no/partial RTW), and 2) the comparability of factors associated with RTW-ES and with RTW.

METHODS:
During 4 months, all assessments of RTW-ES and RTW (no/partial RTW) among employees applying for disability benefits after 2 years of sickness absence, performed by labor experts at 3 Dutch Social Insurance Institute locations, were investigated by means of a questionnaire.

RESULTS:
Questionnaires concerning 415 cases were available. Using multiple logistic regression analysis, the only factor related to RTW-ES is a good employer-employee relationship. Factors related to RTW (no/partial RTW) were found to be high education, no previous periods of complete disability and a good employer-employee relationship.

CONCLUSIONS:
Different factors are relevant to RTW-ES and RTW, but the employer-employee relationship is relevant for both. Considering the importance of the assessment of RTW-ES after a prolonged period of sickness absence among employees who are not fully disabled, this knowledge is essential for the assessment of RTW-ES and the RTW process itself.

PubMed Link: http://www.ncbi.nlm.nih.gov/pubmed/21328060