Support from experts such as occupational therapists and ergonomists would promote workers’ health and sustainable rehabilitation when returning to work after a prolonged period of disability.
This is one of the findings of researchers from the Institut de recherche Robert-Sauvé en santé et en sécurité du travail (IRSST), an occupational health and safety research institute, which has published the report Retour et maintien durable au travail en contexte de petites et moyennes entreprises (Return and Sustainable Retention at Work in the Context of Small and Medium-Sized Enterprises).
Few studies have documented return and sustainable retention at work in small and medium-sized enterprises (SMEs) with 499 employees or fewer. Yet, these businesses represent 99.7 per cent of companies in Canada.
However, the report's authors note that several studies have shown that people working in SMEs suffer more work-related accidents and illnesses, including musculoskeletal disorders (MSDs), than those working in large companies.
For this research, they interviewed employers, rehabilitation professionals, representatives of prevention mutuals (a group of employers and insurers to better understand the needs, constraints and potential levers for a better application of return and sustainable retention at work principles in SMEs.
Participants reported differences in the return and sustainable retention at work process depending on the nature (physical, mental, illness), the origin of the injury (work-related or not) and the entity providing compensation: a public insurer or a private one.
Temporary assignment or gradual return?
Among the factors that could affect a worker's motivation to return to work, managers mentioned the importance of quick access to medical care and efficient handling of the compensation claim.
Some also indicated that when the worker is motivated to return to their tasks and participate in their return and sustainable retention at work process, contact with them is easier and they are more likely to attend medical follow-ups.
Most of the managers interviewed emphasized the contribution of the prevention mutual as a lever for managing disability cases at work.
Two specific measures to facilitate the return-to-work process after a period of disability were reported during discussions:
1) Temporary assignment, which consists of bringing the worker back to a different position with tasks that respect their abilities. This practice is seen as effective from both an economic and therapeutic perspective.
2) Gradual return, where the worker resumes their pre-injury position with certain accommodations, such as a reduced work schedule or adapted tasks. The labour shortage seems to influence the use of gradual returns. Having a worker in their position for a low number of hours is preferable to a complete absence or the loss of an employee.
Involvement of a rehabilitation specialist
Almost none of the managers interviewed mentioned using external specialists for return-to-work cases involving temporary assignments.
However, the authors state, the absence of such specialists could put the worker at risk of worsening their injury if the assigned tasks exceed their capacities. The presence of an occupational therapist ensures that the worker and their immediate supervisor clearly understand the functional limitations indicated by the physician and their consequences for the employee.
Several external stakeholders indicated that, ideally, this professional should be involved throughout the entire process to adapt the tasks assigned to the worker as their capacities evolve. By being involved upstream, they can suggest temporary assignment positions or task modifications to the physician that are more likely to be accepted.
However, the contribution of rehabilitation professionals in SMEs is considered more challenging, especially financially.
"By promoting a more flexible and supported return to work in SMEs," say the authors of the study, "optimized practices could improve the sustainability of the return to work for employees, reducing the precariousness and social costs often associated with prolonged absences."
