Supervisors: A Key Factor in Employer Success at Return to Work
When a company experiences a workplace injury or has a worker who develops a chronic disease, sometimes the outcome is expected to be a prompt return to work, as the injury or illness does not threaten long-term employment. However, many times the injury or illness does pose a potential risk to return to work and for long-term unemployment.
WHEN THAT HAPPENS, WHAT ARE THE MOST IMPORTANT FACTORS THAT DETERMINE THE WORK OUTCOME FOR THE EMPLOYEE AND THE EMPLOYER?
The experience of one doctor treating a specific injury, or of one employer in returning employees to work, is interesting but may not be reflective of injury outcomes, or employment outcomes across all doctors, or all employers. For this reason, doctors and evidence-based medicine have realized the best data on causation for outcomes comes from systematic reviews of longitudinal studies.
Systematic reviews are publications in which the authors searched for ALL published studies on a topic in several major databases listing scientific publications. Just as one individual may flip a coin 50 times and get 40+ heads, when all coin flippers are considered, 25 heads is the answer. Considering all the evidence prevents conclusions based on small studies that don’t generalize.
“Longitudinal studies” mean the authors measured baseline demographic and injury/disease conditions, and then followed the group over time to determine what influenced outcomes. If an employer studies their current employees with cancer, they may not realize that over the past 20 years they have had “X” number of employees develop cancer and leave employment or pass away. So the number of current employees with cancer is interesting, but does not tell the entire story of the company’s experience with cancer.
WHAT FACTORS DETERMINE WORK OUTCOMES FOR EMPLOYEES WITH CHRONIC ILLNESSES?
The Organization for Economic Cooperation and Development is composed of 38 member countries, not employers or industries. In 2021, they published their systematic review of published epidemiological studies on which factors determine return to work and continued employment versus long-term disability in workers with chronic illnesses. They searched four large scientific study databases, retrieved citations for 4,456 published studies, and then limited the search to articles describing longitudinal studies of employees developing chronic illnesses and work outcomes. Fifty published studies met their inclusion criteria.
The strongest evidence of benefit for faster return to work and for long term employment was with supervisor willingness to make accommodations or work modifications and to provide social support for the worker with chronic illness(es). This had much better evidence of effectiveness compared to the company having a corporate culture that states it supports employing those with disabilities, or that the company is willing to make work accommodations. Five of the published studies were exclusive to musculoskeletal illnesses, and eight to mental illnesses. Most of the other studies considered a wide range of chronic illnesses.
SO WHAT IMPLICATION CAN WE DRAW FROM THIS STUDY FOR TENNESSEE EMPLOYERS?
When employers have a workplace injury or a worker with a new onset chronic illness, and the injury/illness potentially threatens the employee’s continued employment, the return-to-work coordinator should meet with the employee’s supervisor to educate the supervisor on the value of return to work, and to the extent legally permissible involve the supervisor in discussions on return to work or stay at work accommodations that could facilitate the employee’s return to work/employment.
One size doesn’t fit all. But the empirical data certainly supports the above conclusion.
Communicative and caring supervisors can be an employer’s best resource when seeking to return employees to work as soon as possible.
Having a return-to-work policy and culture is important. But the individuals who effectuate the policy and culture are the critical link to achieving the goal.
ABOUT DR. TALMAGE
Dr. Talmage is a graduate of the Ohio State University for both undergraduate school (1968) and medical school (1972). His orthopedic surgery training was in the United States Army. He has been Board Certified in Orthopaedic Surgery since 1979 and was Board Certified in Emergency Medicine from 1987–2017. Since 2005, he been an Adjunct Associate Professor in the Division of Occupational Medicine, Department of Family and Community Medicine at Meharry Medical College in Nashville. In 2013, he was Acting Medical Director for the State of Tennessee Division of Worker’s Compensation. In 2014, he became Assistant Medical Director for the renamed Bureau of WC. He has been an author and co-editor of the AMA published books on Work Ability Assessment, and the second edition of the Causation book. He was a contributor to the AMA Impairment Guides, 6th Edition, and he has served as co-editor of the AMA Guides Newsletter since 1996.
R.E.W.A.R.D. PROGRAM: RETURN EMPLOYEES TO WORK AND REDUCE DISABILITIES
Supervisors who do not support the return-to-work program can undermine it. These supervisors may discourage employees from returning unless they are "100 percent". They may be unwilling to look for possible accommodations that would allow injured employees to return to work sooner and make it difficult or unpleasant for employees who have job restrictions and need accommodations. To read more about the need for supervisors to support the program and to access additional return-to-work tools and tips, download the REWARD Program Toolkit.pdf.
MEET WITH LIKE-MINDED EMPLOYERS 📅
Attend the next REWARD Employer Support Network Virtual Meeting on Tuesday, February 13, 2024, at 1:00 PM Central. Dr. Robert B. Snyder, Dr. James Talmage, and Jay Blaisdell, MPA, will lead the discussion on the Certified Physician Program (CPP) and how it benefits employers and employees. Don’t miss this informative session. Register Today
Disclaimer: Views expressed in the REWARD Report are solely those of the authors and may not reflect the official policy or position of the Tennessee Bureau of Workers’ Compensation, the Tennessee Court of Workers’ Compensation Claims, the Tennessee Workers’ Compensation Appeals Board, or any other public, private, or nonprofit organization. Information contained in the REWARD Report is for educational purposes only.