Support for Recovery

Work May Help Recovery

Evidence suggests that, when possible, people should remain at work or return to work as soon as possible because doing so:

• Is therapeutic;
• Helps to promote recovery and rehabilitation;
• Leads to better health outcomes;
• Minimizes the deleterious physical, mental and social effects of long-term sickness absence or unemployment;
• Reduces the chances of chronic disability, long-term incapacity for work and social exclusion; and
• Improves quality of life and well-being.

Based on the work of Gordon Waddell and Kim Burton: Is Work Good for Your Health and Well-being (UK document)

Recognizing Signs

The key components of early intervention are:

• Early detection of medical issues, which may reduce the likelihood that an employee will need to go on leave; and
• Maintaining the employee's connection with the workplace during an absence.

To encourage early detection:

• Communicate commitment to supporting employee health and well-being by encouraging employees to discuss concerns and ask for assistance.
• Be aware of the early warning signs and possible risk factors. Two of the most common causes of disability within the federal public service are musculoskeletal disorders and mental health issues:
  • Early signs and risk factors for musculoskeletal disorders:
    • Unnatural or unhealthy postures while using a computer;
    • Infrequent mobility breaks;
    • Repetitive and forceful movements;
    • Complaints of numbness and burning sensations in the hand, pain in the wrists, elbows, neck, or back, or frequent tension headaches; or
    • Decreased range of motion, fatigue, loss of grip, rubbing or massaging the symptomatic area;
  • Early signs of possible mental health issues:
    • Lateness or frequent absences (increased use of leave, unusual pattern of absences);
    • Sudden changes in behaviour;
    • Changes in performance;
    • Signs of inattention, difficulty concentrating, poor memory;
    • Loss of interest, involvement, or enthusiasm for work;
    • Negative feedback or concerns expressed by co-workers; or
  • Any other unusual situations or behaviour.

• Note
  • Musculoskeletal injuries may be chronic or episodic.
  • Satisfaction with the management of an insurance or workers' compensation claim promotes better return-to-work outcomes and mental health and influences recovery.
  • IAPA Health and Safety Solutions, Accident Prevention E News, June 2008

Respond to indicators and symptoms in a timely manner by talking with the employee to discuss observations. Encourage the employee to seek early treatment, as required, and to try to gather information to determine if there is a need for accommodation (Mental Health: First Aid in the Workplace—Manager's Guide).

• Provide access to information and services to assist the employee in dealing with potential issues (Canadian Centre for Occupational Health and Safety: Ergonomics).

Proactive Early Intervention Strategies

Research shows that an employee becomes far less likely to return to any form of employment following an absence from work due to an injury or illness, the longer the absence:

• Employees who are away from the workplace for long periods risk losing their employee identity and the structure, support, and meaning that work gives them. This can result in social isolation, diminished economic prospects, and a higher risk of mental illness, such as depression.
• An employee's absence can have significant impacts on the workplace as well. The loss of the employee's skills and experience are costly for the employer in terms of productivity and costs related to staffing and retraining. It may also affect the well-being of other employees.

Being proactive includes:

• Working with the insurer or workers' compensation board to provide the highest level of service to the injured worker and employer;
• Working with workers' compensation to assist the injured worker and employer in finding a qualified medical provider; and
• Finding return-to-work opportunities that minimize downtime.

Successful Interventions

Interventions that help reduce the duration of leave of absence as a result of injury, illness, or medical condition include the following:

• A shared understanding of responsibilities by all partners throughout the disability management process. The employee and manager are the primary players in any situation related to an injury, illness, or medical condition;
• Employee awareness and understanding of rights and obligations in the disability management process;
• An involved, integrated team of partners (such as third-party representatives, insurers, workers' compensation and health care providers);
• A collaborative focus by all partners on assisting and supporting the employee;
• Contact with the employee early in the leave of absence. Both the employee and manager are responsible for maintaining ongoing communication throughout the disability management process;
• A remain-at-work or return-to-work plan, agreed upon by the manager and employee, taking into consideration any identified work-related functional limitations or restrictions.
• Confidence in the disability management process among all partners through the use of communication plans, accommodation plans or return-to-work plans;
• Information regularly updated and provided to the manager by the employee, clarifying the status of abilities, functional limitations and restrictions;
• Departmental/agency ergonomic programs established and put in place to assist employees with assessments and adjustments; and
• Simplified procedures and language for disability management processes and requirements. Adequate and consistent information should be provided to employees in a situation related to illness, disability or injury.

For more information refer to section 5.0 – Support for Recovery - Managing for Wellness - Disability Management Handbook for Managers in the Federal Public Service

Promising Practices

Parks Canada has used an internal funding mechanism as an incentive to ensure that managers are proactive in fostering accommodation and return-to-work plans for their employees.

Salaries of employees who are on disability are charged back to the branch, as are any workers' compensation benefits and administrative fees. This motivates managers to ensure that employees are healthy, remain on the job and have excellent return-to-work programs.

Health Canada: First Nations and Inuit Health

Critical Incident Stress Management has developed a program fornurses working in First Nations communities across Canada. As well as extensive counselling and support services that are available to nurses after a critical incident occurs in a community, the program works with employees with a proactive approach that emphasizes adapting a self-help plan, reflective practice and building resilience.

• Prevention
• Accommodation
• Case management
• Remain-at-work plan
• Return-to-work plan