Back to work

The challenges of returning to the job after an injury

Suffering a workplace injury can be a devastating, traumatic experience. While overcoming the pain and going through rehabilitation can be difficult, some workers may find the process of returning to their job equally as harrowing. Obstacles to overcome include physical impairment, communication barriers with employers, and even their own pride.

Bringing the employee back to the workforce is vital, and can benefit both workers and employers in the long run. A recent study from the University of Cincinnati cited reports that the 4.2 million recordable work-related injuries during 2005 in the United States had indirect costs estimated at more than $200 billion. A New York State Department of Labor report of the Commissioner on Return to Work, issued in March 2008, said programs that steer employees back to the job can reduce:

• Workers’ compensation costs
• Litigation
• Wage and worker replacement costs
• Productivity losses
• Medical and indemnity costs
• Utilization of short- and long-term disability benefits

However, none of these can be accomplished until the employee walks back through the door.

Back in the saddle

“The most important thing is to get the employee back to some type of meaningful work as soon as possible,” said Kerri Rupe, an occupational nurse and a lecturer at the University of Iowa College of Nursing in Iowa City. Regardless of the type of injury, “the longer they stay out, the harder it becomes to get back into the workplace,” she said.

The reason, Rupe said, is that injured workers become accustomed to not being at work. By settling into a routine at home that includes sleeping later, or generally doing non-work-related activities, it soon feels normal not to be at work, which makes it harder to go back, said Rupe, who also treats occupational injuries in a clinic in Ottumwa, IA.

According to a 1998 study published in the American Journal of Public Health (Vol. 88, No. 11), of 312 workers who suffered injuries to their lower extremities, about 25 percent had not returned to work after one year off. Of those, more than half were not even looking for work but were instead either attending school or keeping house. The rest: 19 percent were looking for work, 29 percent were managing a household and 1 percent had retired.

The type of work employees do when they return to the workplace does not have to be the same type of work done prior to the injury, according to Rupe. Assigning a returning employee to a less strenuous job can ease the transition back into the old job once the worker is fully healed and helps re-establish a daily work routine. “Even if it’s just answering the phone or typing – some role in that workplace,” Rupe said. “If we do that, then the employee stays plugged in.”

The National Safety Council advises safety and health professionals to re-evaluate an employee’s work capacity following an injury. An employer should consider whether or not some work restrictions should be applied; rehabilitation also may be necessary, according to the council.

Avoiding conflict

After a workplace injury occurs, employers will conduct an investigation. Rupe said some employers may become aggressive at this point, and the injured employee may feel an employer is trying to shoulder the blame onto him or her. “Oftentimes, after an injury, it becomes blame-blame,” Rupe said. “It almost feels like [the company] is blaming you because you got injured. That’s not the way it is, but that’s the perception.”

Employers should immediately reach out to the employee to express sympathy, offer assurances that a similar incident will not happen again, and ask what the injured worker needs, Rupe said. These types of nonintimidating exchanges allow the employee to feel that his or her supervisors really do care.

Rupe cautions that an adversarial relationship between employees and supervisors does not bode well for returning an employee to work. “If a supervisor doesn’t like them, or isn’t working with them, they are much less likely to return to work,” Rupe said, adding this can be avoided with open communication between the employee and employer. The New York Commissioner on Return to Work report stressed that a “lack of coordinated supportive processes, procedures and practices often detract from reaching the return to work goal” for the injured employee.

At least one study also has showed huge cost savings among companies that invest in an early-return-to-work program. The University of Cincinnati study, published in the Journal of Occupational and Environmental Hygiene (Vol. 5, No. 9), reviewed the cost savings of the Ohio Bureau of Workers’ Compensation Transitional Work Grant Program. The program was designed to get injured employees involved in work activities as soon as possible – within seven days of their injury and often before they are 100 percent recovered.

Researchers examined 1,992 companies that enrolled in the program in 2002 and 2003. The companies had 4,390 lost-time claims submitted in the year before enrollment. After enrollment, the net reduction among the companies was an 11.5 percent drop in the number of claims, saving an average of $1,524 per company.

“Nationally, this could translate into more than $100 million per year,” the study concluded.

The employee’s role

Part of the effort in returning employees to the job rests in the hands of the injured worker. Robert Aherin is program director for AgrAbility, a program from the University of Illinois Extension Service and Central Illinois Easter Seals that assists farmers with disabilities.

One of the program’s biggest hurdles, Aherin said, is convincing farmers to accept help. “Farmers are very prideful,” he said. As a result, AgrAbility tries to convince farmers the value of experts who offer not a handout but a hand up.

Some farmers who suffered disabilities as a result of their injury may find that such disabilities make performing certain tasks more difficult. For instance, a severe injury could impede a worker from climbing onto heavy equipment or make it more difficult to use familiar hand tools. “They have to come to the realization that they can’t do it the way they did in the past,” Aherin said. “What they can do is to continue being productive.”

When difficulties arise, an injured employee can return to the job using different types of tools or mechanisms. Modifications to machines also can be made. For instance, a farmer who wants to continue growing his corn but can’t climb a ladder into a combine could get a lift attached, Aherin said. Other automatic systems, such as those designed to lift heavy equipment or feed bags, also could be used. Occupational nurse Rupe said some modifications could save thousands of dollars down the line, especially if they are used by other employees to prevent similar injuries.

But when an injury is too severe or modifications to the job are not practical, sometimes an injured worker has to make a career change. Aherin said he has seen some farmers too injured to continue doing the labor side of the job shift to a management capacity or some other type of employment within the farm industry. Rupe stressed that regardless of the job to which an employee returns, the job should not aggravate the injury. However, it should be productive so as not to give the impression to the employee that he or she is being punished. An employee’s skills and muscles need time to return to full capacity, and a company’s occupational safety officer should monitor the employee and decide when to increase his or her workload. This will help avoid another injury.

“If you’re back in the workplace and not 100 percent, and try to achieve those levels before you were injured, that could be really problematic,” Rupe said.