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How to Use this Workbook
Welcome to this workbook! It is designed to help improve your comfort level and skills in responding to workplace injury and illness.
Learning From Your Experiences
As you read the information and do the activities in this workbook, keep in mind your particular experience at your facility, your organization’s past practices, procedures and resources and future needs. Whether or not you have professional experience with disability and accommodation in the workplace, your experiences and ideas will make a valuable contribution to this training.
Activities
This workbook has various kinds of activities, including short answer, fill-in-the-blank, true-or-false.
Company-specific information
You may come across questions about company policy that you do not know the answer to. It is very important that you follow up with the resources in your company to find out the answers. Make a note in your workbook, or use a sticky note to mark the page. Jot down who you might take the question to. HR? Management? The company nurse?
Contents
The Importance of Your Role ... 2
Business Rationale...7
Supervisor Actions: What You Can Do ... 12
Musculoskeletal Disorders...25
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Your Experience
Your experience makes an important contribution to this learning experience. Take a moment to reflect on your experiences and answer the following questions. This exercise is for you to keep and use. Your answers will not be shared with anyone, so please be honest.
Answer yes (Y) or no (N) based on whether or not the following is true for you.
_____ I have dealt with an employee who came to me with a work-related health issue. _____ I have dealt with an employee who went on disability leave.
_____ I am able to list a few of the kinds of injuries or illness I see at my company. (For example, lower back pain, sprains, trips or falls.)
_____ I have helped an employee come back to work after disability leave. _____ I made decisions about transitional work or modified duty.
Answer the following based on your feelings about being a supervisor with the
responsibility of handling disability issues. Use a scale of 1-10 where 1= not true at all and 10= very true for me.
_____ Confident _____ Frustrated _____ Happy to help _____ Annoyed
_____ Concerned for the employee’s health _____ Suspicious
_____ Supported by your company
_____ Torn between the competing needs of management, the employee and his or her co-workers.
Who is Involved?
1. At your company, when an employee has a work-related injury or illness, who becomes involved in the process? Circle all that apply.
1. Employee 2. Supervisor 3. Company nurse
4. Doctor
5. Claims adjuster 6. Human resources
7. Other _______________________ 8. Other _______________________
2. Who handles the immediate concerns that come up when an injury or illness occurs?
3. Who handles the follow-up during long-term disability leave?
4. Aside from the injured employee himself or herself, who do you think is the most important factor in determining whether the employee files a claim and goes on disability and in determining the length of his or her absence from work?
Supervisor Response is Key
Research shows that your role is the most important factor in preventing disability and in getting the employee back to work quickly. Here is some of the scientific evidence.
Supervisor responsiveness is a major factor in their decision to return to work.
Negative employer response and lack of contact with employee while on disability
leave correlates with prolonged lost time.
Supervisor and co-worker support reduces disability among workers with chronic
pain and mental health disorders.
Low supervisor support is a risk factor for developing low back pain.
What Can Prolong Disability?
The Supervisor
Because you play such an important role, your behavior can prolong disability if you:
Respond negatively
Fail to contact the employee regularly during disability leave
Are not interested in the employee’s return to work
Are inflexible towards accommodation
Adversarial relationships between supervisors and employees tend to interfere with or delay return to work. For example, if communication between supervisors and
employees indicates mistrust or resentment toward an employee who files a workers’ compensation claim, injured workers are less likely to want to return in a timely manner.
Supervisors and managers who communicate with sensitivity – who treat employees fairly and with respect – can greatly reduce the chance of unnecessary lost time.
Non-Disability Sources of Conflict
Poor performance Organizational issuesNegative work relationships
Disciplinary or pay issues Workload concerns Job dissatisfaction
If there are unaddressed performance issues going into an injury, then it is more likely to result in lost time and disability expenses. If someone is unhappy at work, they’re not going to want to come back to work quickly.
Other sources of conflict that could cause the employee to not want to return to work, thus prolonging disability, include performance problems or issues with the
organization.
Other factors such as negative relationships with co-workers, disciplinary or pay issues, workload concerns, or job dissatisfaction can delay or interfere with successful return to work.
If an employee has a problem before an injury, the problem is likely to be greater and more costly to resolve after an injury. Addressing disciplinary issues and other difficult situations can significantly reduce the possibility of extended lost time.
Psychological Barriers to Return-to-Work
Managing employees with work related injuries or illnesses requires an understanding of what motivates an employee to be a productive participant in the workforce – and how different factors can enhance or diminish that motivation.
Personal, psychological factors often present barriers to return to work. These factors can include:
Personal fears and anxieties, including the fear of re-injury
Decline in self-esteem
Depletion of personal financial resources
Family problems
Potential loss of position or status at work
By maintaining open lines of communication with the employee, and by providing appropriate and productive return-to-work opportunities, you can significantly reduce the impact of these factors.
A Realistic Look at Lost Time
In some cases, lost time will be necessary.
Disability Can Be Real
Serious injuries do occur from time to time. In a small minority of cases, there is
cumulative trauma or other musculoskeletal injuries that require substantial lost time. In some cases, the employee may never regain full function or total relief from pain. This training will reduce the need for disability leave in your facility, but will not eliminate it altogether.
Serious
Medical
Issues
Also, serious medical issues may come up during recovery or after the employee was perceived to be fully recovered. The employee may need more time off work, or may not be able to come back. The longer the disability leave lasts, the less likely it is that the employee will ever return to any work. In this case, it’s crucial to communicate, to maintain good relationships with the employee and the doctor, and to provide support and encouragement.
What is the company policy on filling in for workers gone on extended disability?
Discipline or Performance Issues
An employee returning to work may show discipline or performance issues. In this case, it is important to be very clear with the employee exactly what the issue is. Communicate regularly that the issue is job performance or attitude and NOT the employee’s physical limitations. When discussing your expectations, make clear that you expect the employee to stay within doctor’s restrictions.
What is the company policy on disciplinary or performance issues?
Supervisor Roles
Turn to your Supervisor Roles handout to accompany the following basic description of your role in handling injury and illness.
Problem-solving allows you to identify problems, assess risk factors and
decision-making. This leads the way to preparing a plan to accommodate recovering employees.
Responding involves both the actions you take and the attitude you respond
with.
Communication involves creating an atmosphere in which safety is important
and being a good listener. It also involves coordinating among the injured employee, the company, and medical providers. Follow-up is a very important part of communication because this is what keeps absent employees in touch with work and what allows you to express how much you want them back at work.
Accommodation involves planning and providing transitional work
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There are very few instances in which a “no work” status is medically indicated – for example, for contagious diseases, or where hospitalization or bed rest is appropriate. In the vast majority of cases, the injuries themselves are not debilitating.
But delayed treatments, delayed recoveries, and miscommunications between the various stakeholders in the process can result in physically, emotionally, and financially distressed workers who fall needlessly out of the workforce and linger on in the workers’ compensation system. Unfortunately, lost time has become routine and expected even for relatively minor injuries.
Unless lost time is medically indicated, it is always better for the employer to make every reasonable effort to keep an injured worker on the job. Your efforts can reduce the frequency and duration of disability leave.
The Prevalence of Injury and Illness
There were a total of 1.2 million injuries and illnesses requiring days away from
work in 2005.
Median days away from work – a key measure of the severity of the injury or
illness – was 7 days for all cases in 2005.
More than 4 out of 10 injuries and illnesses were sprains or strains, most
involving overexertion or falls on the same level.
The Cost of Lost Time
Lost-time injuries are the most expensive type of injury, with costs increasing
every day that an injured worker is not able to work.
In addition to medical costs, it is estimated that lost time due to on-the-job
injuries costs employers between 4% and 6% of total payroll.
Having an established, consistently applied early return-to-work program can
reduce workers’ compensation costs by as much as 30% to 60%.
Study after study has shown that workers who return to work within three or four
days are much less likely to file lost time claims than those whose absences from work extend beyond the third or fourth day post-injury.
Studies show that injured workers who are away from work for six months have
Key Points
Answer true or false.
1. ______ Employees on disability are often away from work unnecessarily. 2. ______ The vast majority of injuries are debilitating.
3. ______ Most injured or ill people are capable of doing some kind of productive work. 4. ______ Lost time can actually hinder the recovery process.
5. ______ Even when lost time is medically indicated, employees should come to work. Fill in the blanks.
1. The most expensive type of injury is _______________________________. 2. An early return-to-work program can help the company reduce payroll costs and
______________ costs.
3. Workers who return to work within _____________ days are less likely to file lost time claims.
4. Workers have a 50-50 chance of ever returning to work when they have been gone from work for ____________________.
Answer Key:
1. T, 2. F, 3. T, 4. T, 5. F Answer Key:
The Downside of Lost Time
Disability leave is a valuable option when used properly. It allows employees to heal in a safe environment while resting assured that their job is awaiting them when they have recovered. But there is a downside to lost time for everyone involved.
Employees may be coping with feelings of restlessness or boredom, since they are
not used to having to stay home from work. They may feel unproductive, and during prolonged disability leave, may come to think of themselves as “disabled.” In addition, they are isolated from co-workers, other working friends, and even their family who leave during the day for work or school. Employees who are discontent with their employer may want to return to work less and less as time goes on.
You may feel pressure to maintain the same productivity with fewer workers. You
may also have to handle co-workers who can express frustration at any additional job duties asked of them.
The company has to pay the benefits costs and profits can be compromised by
lower productivity.
The best approach to lost time – for all stakeholders – is to work to prevent it, and minimize the length of it when it occurs.
Goals of this Workbook
Below are the goals of this workbook. You may feel confident in your ability to handle some of these areas, while others you may wish to improve. Read the goals carefully and circle the one or two that you would most like to work on.
Reduce injury and illness through
• Early detection
• Problem solving
• Encouraging employee reporting of concerns
Reduce or prevent lost time through effective communication
Improve long-term outcomes through accommodation efforts
At the end of this training, you will be able to
Prevent problems and create solutions through problem-solving before and after
an injury or illness occurs.
Promote a supportive and flexible response to workers with work-related
discomfort.
Facilitate two-way communication among everyone involved at every phase, from
discussing policies before problems arise, to encouraging early reporting of injury or health concerns among workers, to monitoring the progress of an injured employee who returns to work.
What Makes Training Effective?
You may be wondering why you are participating in this training session. Studies have shown repeatedly that training supervisors to respond effectively to injury and illness reduces the frequency and duration of lost time.
What causes might make such training effective? Here are some contributing factors.
Early reporting and timely medical care prevents “escalation” of the injury to lost
time.
Validated employees feel less need to seek validation through medical treatment.
Supervisors learn how to be flexible and create accommodations.
Reductions in risk factors reduce injuries.
Increased awareness of health and safety improves health and safety.
Some factors take effect before (B) an injury or illness occurs by preventing injury and illness and creating a positive and safe environment. Some take effect after (A) an injury or illness has already occurred by responding effectively to the situation and making it possible for employees to return to work quickly. Write A or B next to each factor, based on whether the training will help you reduce the frequency and duration of lost time before (through prevention) or after (through your response) injury or illness occurs. 1. ____Early reporting and timely medical care prevents escalation to lost time. 2. ____Validated employees feel less need to seek validation through medical
treatment.
3. ____Supervisors learn how to be flexible and create accommodations. 4. ____Reduction in risk factors reduces injuries.
5. ____Increased awareness of health and safety improves health and safety.
Answer Key:
Benefits to All Stakeholders
Here are the positive outcomes when you are properly trained to respond to workplace injury and illness. Add in benefits you can expect that are not listed here.
Employees
They are happier because they stay productive, useful, and connected to their
community.
Medical evidence shows that they will have better health outcomes, returning to
full health sooner by staying on the job.
Supervisor
You gain the trust of all employees and boost worker morale when they respond
appropriately to injury or illness.
You increase your value to the company by keeping productivity high and
returning valuable employees to work as soon as they are able.
The Company
Fewer injury claims
Reduced medical costs and disability costs due to lost time
Higher productivity
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Before injury or illness
When an illness or injury occurs
After injury or illness
• Before employee returns to work
• After employee returns to work
Suggestion on visuals: make into timeline or depict graphically somehow
Before Injury or Illness
The best time to prevent lost time is before an injury or illness occurs.
Create safe workplace to reduce employee injuries.
Create a respectful and communicative work environment.
Communicate company policies on safety, disability leave, and accommodation.
Develop job descriptions for doctors.
Use problem-solving skills to be prepared for high-risk jobs and likely sources of
injuries.
Plan for accommodation with job modifications or alternative tasks.
Communication Skills
Your employees’ feelings about you as supervisor can affect how quickly they report injury or illness, how long they stay away from work, and whether they file a disability claim. By creating a positive work environment that fosters honesty, good
communication and respect, you allow employees to come to you promptly with health concerns and to want to return to work as soon as possible.
Respectful communication can encourage
• Early reporting of injuries • Shorter time away from work
• Fewer disability claims
Communication skills include:
• Two-way communication • Active listening
Two-Way Communication
Communication involves telling your employees about company policies on safety, disability, and accommodation so that they know how they will be taken care of in the event of an injury or illness.
But communication is a two-way street. That means that more than simply telling employees about company policy, you need to be available for them to come to you with health concerns.
You can create this environment by asking for their input, asking about their well-being, and being approachable. Make sure that employees understand the importance of early reporting, so that they do not worry about repercussions of expressing their health concerns.
Short Answer
List three things that make your employees feel you are available to talk to about health concerns.
Active Listening
Keep it confidential. When an employee asks to talk to you, always meet
privately. This will show the employee respect and will encourage honesty.
Make eye contact and nod. When you listen, make eye contact and nod
regularly to show that you understand.
Reflective listening. Reflect back what the employee said and the feelings the
employee conveys. For example, if the employee said “my back has been hurting at this job,” you could say, “It sounds like you are frustrated by this back pain. Is that right?” or “I’m sorry your back has been bothering you.” Sometimes as listeners, we don’t realize that we haven’t understood the whole story. Repeating back to the speaker allows you to find out if you’ve fully understood.
Suspend thoughts and judgments. Keep your mind clear to listen closely
and put aside your instinct to judge, to plan your response, or to respond to distractions like the ringing phone or a knock at the door.
Pay attention! It may seem like obvious advice, but the most important
ingredient to active listening is to pay close attention.
Practicing Reflective Listening
Now you will have a chance to practice reflecting back both feelings and words. What is the speaker’s main concern? Is the person upset, nervous, worried? Write down a response the shows that you are reflecting back what you hear.
1. “My wrist has been hurting me when I type. Sometimes my whole hand goes numb. It makes me not want to work on the computer anymore, but of course I want to keep my job.”
2. “I just fell down after tripping over some electric cords. I’m sure I’m fine, but I just think those cords should be taken care of before that happens to someone else.”
3. “I heard the last two people who had my job both quit with problems with their back and shoulders. I just can’t stop wondering what happened to them. I don’t want that to happen to me.”
When Injury or Illness Occurs
1. Decide what to do. This is the first step when an employee tells you about an
injury, illness, or health concern.
2. Resources. Make all medical and company resources available to the employee.
3. Communicate. You will also have to communicate what is going on with
management and with the employee.
1. Make Immediate Decisions
Your employee may look to you for guidance about what kind of medical attention he or she needs. How will you decide? Sometimes it is obvious. If there is a broken bone or a lot of bleeding, the employee should go straight to the hospital. If it is an emergency, you may want to call an ambulance.
It may not be obvious what kind of care the employee needs. Did he hit his head but insists he’s fine and wants to get back to work immediately? Did she trip and is now favoring one leg when she walks, but says it doesn’t hurt? There are two rules of thumb to follow.
1. Always err on the side of caution. Having the employee checked out and filing a report, even for seemingly trivial events, is usually the best way to go.
2. Always follow company policy.
Do you know your company’s policy? If so, write it down here.
If not, flag this page and find out the policy. You may wish to talk to Risk Management, the on-site nurse, or another appropriate person who can tell you how to determine how to react. Then come back and write in your answer.
2. Facilitate Access to Company and Medical
Resources
After you make immediate decisions about the needs of the employee, help him or her get access to it.
You can help the employee further by making phone calls to management, the
on-site nurse, doctors, or anyone else who may need to know what happened.
Whether the employee goes to a nurse or directly to the hospital, you should
accompany the employee if at all possible. If an ambulance is not called for, and you cannot leave site, have someone you trust walk or drive the employee to the health care provider.
You should make sure the doctor receives the employee’s job description and
make sure the employee has ID, an insurance card, and any other forms that may be required.
Make sure the employee understands corporate policies so that the employee
understands they will be taken care of and given time to recover safely.
3. Communicate
Communicate with Management
Promptly report all employee work-related illness and injuries, no matter how
slight, to the designated contacts.
Complete the first report of injury form and send promptly to the designated
person(s).
Report all “near misses” (with regard to possible work-related illnesses/injuries)
Do you know how to follow company paperwork and procedures? If so, write it down here.
If not, flag this page and find out the policy. You may wish to talk to management, HR, or another appropriate person who is familiar with these policies. Then come back and write in your answer.
Communicate with Employees
Ensure employees immediately report injuries.
Interpret corporate policies.
Monitor the employee’s health and function – an ongoing job.
Use your communication skills
• Keep it confidential. • Actively listen.
• Show concern and support.
Communication Skills Continued
Respond appropriately. Responding to injury and illness requires an attitude
showing concern, support, understanding, and willingness to help.
Validation means that you do not act skeptical of the employee’s
claims. Rather, you confirm what they are saying and show you understand their
feelings. Validating a claim that you are skeptical of may be difficult for you, but it is crucial to be supportive when an injury or illness occurs. At this point you want to do everything you can to create a work environment the employee wants to return to.
Take action. Taking action often involves filing paperwork and sending the
employee to a health care professional. But sometimes the employee will come to you with a concern that does not require a medical response. For example, he or she may say, “I am worried about the risks of using this machine,” or “I have noticed that others on this same job are frequently injured.” In this case, you may take their concerns to management, Risk Management, or make a note of it for your own efforts to prevent problems in the workplace. Perhaps you are able to do something to assuage the employee’s concerns or to reduce the risk. If an employee asks a question you don’t know the answer to, you can say “Let me find
out the answer and get back to you” or you can refer the employee to the proper person – HR, the company nurse, or the legal department, for example.
Follow up. Regardless of what action you take, always follow up with the
employee. Let him or her know you have taken action. “Check in” about their concerns as time goes on.
Practice Responding Appropriately
Write down 4 sentences that you could use as appropriate responses. Remember to use validation, as well as to reflect concern, understanding, caring, support, and willingness to help.
Examples:
I hear you saying that your back has been hurting. I’m glad you came to me with
this concern.
I want to make sure you see a doctor as soon as possible, but let’s start with a visit
to the on-site nurse. Let me walk you down there.
You can make up scenarios to respond to, or use real-life experiences to write your responses. Need some ideas to get you started? You may choose to use these:
Write a sentence that expresses your desire to see the employee back at work.
Write a sentence that shows you want to be helpful in dealing with HR and
benefits.
Write a sentence that shows sympathy and concern.
Write a sentence showing your willingness to work with the doctor’s restrictions
After Injury or Illness: Before Returning To Work
1. Interacting with doctors2. After the doctor visit
3. Making decisions about returning to work status 4. Keeping in touch
1. Interacting with Doctors
You should open two-way communication with the employee’s doctor as soon as
possible, to let the doctor know that you are concerned about the employee’s well-being and you will take action to accommodate him or her at work.
What doctors need to know from you:
Employee’s job description and requirements, including tasks performed and
work conditions
Possible transitional work assignments
Your willingness to comply with doctor’s restrictions and to support employee
during recovery
Your contact information
If the doctor does not understand the employee’s job or understand the kinds of transitional work available, the doctor may recommend the employee stay home from work until fully recovered.
If you have made this information available to the doctor, and the doctor perceives your company as willing to work with the patient’s new needs, he is more likely to be
comfortable with the patient returning to work.
You need to find out from the doctor as much as you can about the employee’s
restrictions, how to help the employee come back to work as soon as possible, and how to allow him or her to recover on the job.
You will not want to breach the patient’s rights to a confidential relationship with the doctor. For this reason, you should protect yourself legally by avoiding questions about the specific diagnosis and treatment. For example, you do not need to know that the employee has carpal tunnel syndrome, but you do need to know that the employee needs an ergonomically designed desk and keyboard.
Legal Questions
Can the employee return to work?
When can the employee return to work?
What restrictions will the employee have?
Potentially Illegal Questions
What is the diagnosis?
What treatment will he or she receive?
Your company may also choose to request that the employee have a waiver that he or she can take to the doctor, allowing you and your company access to the relevant information about how best to help and accommodate the employee.
Review
1. What are 3 important components of effective communication?
1. ____________________________________________________ 2. ____________________________________________________ 3. ____________________________________________________ 2. What does it mean to validate an employee’s claim or concern?
3. List 4 or 5 things you need to tell the employee’s doctor.
1. ____________________________________________________ 2. ____________________________________________________ 3. ____________________________________________________ 4. ____________________________________________________ 5. ____________________________________________________ 4. What are two questions that may be illegal to ask the employee’s doctor?
1. ____________________________________________________ 2. ____________________________________________________
Answer Key:
1. Two-way communication, active listening, and responding appropriately. Correct answers also include any component of those three items, such as being approachable, keeping it confidential, reflective listening, and acting concerned and willing to help.
2. Validation is to confirm what the speaker is saying and show you understand the person’s feelings.
3. Job description, transitional work assignments, your willingness to make accommodations, and your contact information.
2. After the Doctor Visit
After the employee has seen the doctor, you should discuss these topics with the employee:
The doctor’s instructions
The employee’s return-to-work options
The next steps
• Date of next medical visit
• Permitted employee activities during recovery • Contact person for employee’s medical questions
• Supervisor-employee communication plan
3. Return-to-Work Status
The employee’s return-to-work status will be based on the doctor’s restrictions. After these have been discussed, you and the employee can come up with a plan.
1. The employee is able to come back to work with few or no restrictions. An example of few restrictions might be: take more breaks, do not work overtime, or do not lift anything over 40 pounds. If the employee has few restrictions, he or she can return to the job without any creative accommodations being made.
2. The employee needs to recover at home for a while. This will usually be a week or so, but will depend on the injury or illness. Later in the recovery stage, you can discuss return-to-work options.
3. A transitional work assignment means that the employee cannot perform the essential functions of his or her job. But as we discussed, almost everyone is capable of useful work. A transitional work assignment allows the employee to remain productive while recovering.
4. The employee is unable to ever return to work and will become permanently disabled or retired. If this is what the doctor concludes is necessary, you as supervisor have done all you can to bring the employee back to work. This is a rare conclusion and the vast majority of injuries or illnesses will lead to some sort of return to work.
4. Keeping in Touch
One of the most important actions you can take while the employee is away from work is to keep in touch. Regular calls show the employee that you are concerned about him or her and you want to see the employee back at work as soon as possible. You should work together to make a plan for how you will keep in touch. You can also encourage the employee’s co-workers to keep in touch, as this will help the absent employee to feel connected to the workplace and his or her colleagues. Keeping in touch should allow you to stay informed about recovery progress.
Communication Plan
You should agree on a plan with the employee about how you will contact him or her and how often. Calls are the most common method. Visits are more personal and emails are more impersonal. When forming the plan together, take into account company policy, your relationship with the employee, and both of your preferences.
How often will you call? Weekly? Every 10 days? One approach is to call the
employee after each medical provider visit. In the case of a longer recovery, calls may be frequent at first as you and the employee learn how the recovery will progress, but may taper off and become more infrequent over time. If you know the employee will be gone for more than a month, you may call every two weeks. It is important to keep in touch and follow the plan you established with the employee, continuing to remind the employee that you want him or her back at work.
How will you act? You should be friendly, supportive, and sensitive to their
whole family’s needs.
What will you talk about? Your company policy should be your first guide.
Some companies place guidelines for what each role says. For example, HR handles the benefits and the nurse discusses health concerns. Aside from following company policy, you will want to take these suggestions into account:
• You should say that you want them back at work and ask about their recovery process.
• You should not ask about specific medical diagnosis or treatment. As we discussed earlier, this may lead to illegal questions that breach doctor-patient confidentiality.
Who else?
• A co-worker may call the employee, especially if you do not have a good
relationship with this employee.
• You should keep in touch with all parties involved and keep everyone on the same page. This could include the doctor, your on-site nurse, HR, insurance, and management.
After Injury or Illness: After Returning To Work
Transitioning employee back to work
• Preparing for the employee’s return
• First day back and the return-to-work meeting
• On-going
Accommodations
• How to plan accommodations
• transitional work assignment
Transitioning Employees Back to Work
Update your team. Before the employee returns to work, you will need to
update your team. Tell them when the employee will return to work, and let them know about any changes that may affect each worker’s job. While communication with co-workers is essential, they do not need to know medical or disability details, and the employee, when he or she returns to work, should not feel obligated to discuss these details with co-workers.
Prepare for the employee’s return to work. If the transitional work
assignment requires training or orientation, prepare for this in advance. You may also need to provide or set up a new work space, equipment, or access to
technology.
Greet the employee on the first day back. Make sure you see and speak
with the employee this first day to welcome him or her personally. You should also convey how glad you are to see the employee back at work.
Hold a return-to-work meeting. (See below for details.)
On-going. As the employee continues to heal, you should check in with him or
her regularly. Make sure the employee is comfortable with the job tasks and that the accommodations are acceptable. As the employee recovers, work
modifications should reflect the employee’s growing abilities. Do not exceed doctor’s limitations, but on the other hand, do not hold the employee back from the full range of ability allowed by the doctor.
Return-to-Work Meeting
The employee’s first day back at work is an important time to put into action all the reassuring things you told the doctor and the employee. You can now provide the accommodations you ensured them would be arranged.
Who attends? A return-to-work meeting includes, at minimum, you and the
employee. If you have held a return-to-work meeting or are aware of company policy, who attends the meeting? Anyone besides you and the employee? HR? On-site nurse?
Doctor recommendations. You and employee should come to a common
understanding of what the doctor recommends and what restrictions the doctor has placed on the employee’s work. It is very important that you encourage the employee to stay within the doctor’s restrictions and to respect his or her body’s limitations. The employee should not do anything that he or she should not or cannot do.
Accommodations and new job description. You will also need to discuss
the employee’s duties. If there have been any changes at work, such as personnel changes or changes to company policy, communicate these to the employee.
Employee concerns. Make time to discuss any concerns the employee has and
what the plan will be going forward in terms of communicating about the doctor’s gradual easing of restrictions, about employee concerns, and about changes in the work to be performed.
Paperwork. Does the company provide any paperwork regarding the
employee’s transitional work or return to work?
Accommodations
Accommodations may be formal or informal. Formal accommodations are based on the doctor’s requirements. Informal accommodations are ones that you decide along with the employee as he or she recovers.
Will this employee be on the same job with some restrictions, or will the employee need a new set of duties during recovery?
There are many types of accommodations you can make for a recovering employee. Base the decision on doctor’s recommendations, the employee’s needs, and the types of alternative work you have available.
Here are some possibilities:
Light duty Part-time
Avoid use of a body part
Modification of job duties
Totally new job duties
As supervisors, you have an overview of several different job functions within one facility. You are in a good position to determine how to best use this employee’s skills and abilities. Potential solutions could include working with supervisors in other areas of the facility, part time work, lifting lighter items or exerting less force, helping you with paperwork and phones in your office, etc. You may need to think creatively and come up with realistic and useful alternatives.
Transitional Work Assignments
Transitional work provides a normal routine and a productive meaningful activity for an employee during the healing process. You and the company gain the benefit of the employee’s contribution during healing process. Transitional work allows the employee to return gradually to wellness and normal work, rather than go abruptly from complete unemployment to full employment.
Benefits of transitional work assignments:
To the employee: faster recuperation
To co-workers : demonstrates company policy and build trust
To the company: reduces costs and increases productivity
Gaining Support
In order to gain the support of all your employees for the accommodations or new work assignments, you will need to address their feelings and concerns and communicate with regular updates. If any employees have changes to their job duties, you should explain them and get them any necessary training.
One of the most important things you can do to gain support and to create a supportive environment is communication. Talk to them, listen to their concerns, and take
everyone’s concerns into account.
How might the returning employee be feeling about accommodations?
How might his or her co-workers be feeling about the accommodations?
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We are going to spend some time focusing on Musculoskeletal Disorders (MSDs) in particular because they can cause such long-term problems, resulting in long recoveries at home or doctor-required work modifications. These are some of the most
misunderstood injuries because they are invisible, and diagnosis is entirely dependent on what the patient tells the doctor.
Although the symptoms are painful, they may not be consistently painful. Recovery is hard to predict.
Learning about MSDs can help you to become more understanding of employees who are diagnosed with an MSD and more helpful to employees who complain about symptoms but have not gone to seek help. As we discussed earlier, when you approach health issues with a positive attitude, the employee is much more likely to have a shorter recovery, return to work sooner, and is less likely to file a disability claim.
Definition of MSDs
Musculoskeletal disorders are defined by the US Department of Labor as an injury or disorder of the muscles, nerves, tendons, joints, cartilage, or spinal discs. MSDs include sprains, strains, tears, back pain, soreness, and carpal tunnel syndrome. It can result from reaction/bending, climbing, crawling, reaching, twisting, overexertion, or repetition.
MSDs do not include disorders caused by slips, trips, falls, car accidents, or similar accidents.
MSDs Are Common
Lower back strains and soft-tissue injuries account for half of all lost-time work injuries. In 2005, MSDs accounted for 30% of the injuries and illnesses with days away from work. MSDs consistently account for about a third of all injuries and illnesses. MSDs result in a median number of 9 days away from work.
MSDs Cause Lost Time
MSDs can result in some of the longest stretches of disability leave, especially if you fail to establish a supportive relationship with the employee.
Repetitive motion is one cause of MSDs, and causes on average more days away from work than injury from fire or explosions! Repetitive motion injuries have a median of 19 days away from work.
Musculoskeletal conditions have a variable course of recovery. Medical professionals lack accurate tools for precise diagnosis. Treatment will not be the same for every case. And employees are likely to feel frustration caused by persistent or recurring pain.
MSDs at Your Facility
What kinds of MSDs do you encounter?
What are some causes of MSDs at your workplace?
What kinds of accommodations have you made for workers with MSDs?
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General Problem Solving
1. Identify the problem. 2. Identify possible solutions. 3. Implement the best solution.
4. Collaborate with employees throughout the process.
Identify the Problem
The first step is identifying the problem. Your company may collect statistics on the number and types of injuries. These statistics are a good place to start. You can also survey or simply talk to employees. Where do they see problems? Especially if you have an employee with an MSD, be sure to ask him or her what the problem is. Remember that collaboration is important.
As a supervisor, you will always want to take note of risk factors at your facility, and common sites and causes of injury. Also, take note of common types of injury.
What are your observations about your facility?
What are common risk factors?
What are common injury sites / locations?
What types of injury are most common?
Find Solutions: Analyze the Workplace
After identifying problems, you will want to analyze your workplace in order to come up with possible solutions to the problem. The problem might be as simple as a lack of training – workers simply do not know how to use a tool right. Or training might have been provided, but management has not created an atmosphere that highly prioritizes safety. Workers may come in with their own attitudes towards the training that makes the safety training less effective.
Worker Behavior & Attitudes
Posture Body movement Duration at workstationFeelings and attitudes
Working Environment
Health and safety environment
Company attitudes and policies Training Enforcement of policies
Read the list above and circle any items that are especially pertinent to your facility. Then below, take a moment to jot down possible solutions to that problem. For example: “At our facility, we have a lot of workers putting in overtime hours. We need to be
especially careful about repetitive stress injuries for these workers. Our policies suggest regular breaks for all workers, but what if we encouraged workers on a second shift to take more frequent breaks?”
Item 1:
Item 2:
Possible Solution:
Item 3:
Possible Solution:
Problem-Solving with Ergonomics
Ergonomics can be considered a science or a design process of fitting the work
environment to the body of the worker. This can include adjusting machines, equipment, processes, body movements, and other aspects of the work or work environment that can affect the worker’s body. Every body is different, so it is important to remember that you can use general ergonomic principles but you have to tailor ergonomic solutions to the individual.
The purpose of ergonomics is to reduce the risk of injury, especially musculoskeletal disorders. Properly applied, ergonomics enhances worker safety, comfort, productivity, and efficiency.
Has your company incorporated ergonomic principles into the workplace? If so, how? For example, if your company has many workers at computer stations, have you
discussed with employees ways to adjust chairs, computer monitors and keyboards to the best height? Or, if your company has job descriptions that include heavy lifting, have you discussed with employees the proper way to lift heavy objects to reduce the risk of
injury?
If so, has this been through formal company-wide training or through supervisors talking one-on-one with employees?
Collaborate and Implement
Communicate the plan to employees. Gaining support will be easy if you have collaborated with them in the decision-making process. Don’t forget to monitor and evaluate the solution as time goes on.
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Before you complete your workbook, take a minute to review key topics and to see how much you remember.
Before Injury or Illness
Create a workplace that is:
• Safe
• Respectful
• Communicative
Promote company policies on safety, disability, and accommodation.
Develop job descriptions.
Prepare for high-risk jobs and likely sources of injuries.
Plan for accommodation.
1. What is the purpose of the job descriptions?
2. What are the steps of problem-solving?
When Injury or Illness Occurs
Make immediate decisions about the kinds of attention required
Facilitate access to corporate and medical resources
Communicate with management and employee
• Two-way communication
• Actively listen
3. What is our company’s policy about making immediate healthcare decisions?
4. What can you do to facilitate access to resources?
5. Why is two-way communication important?
6. What are some signs that you are actively listening?
7. What are some characteristics of an appropriate response?
8. Write down what you could say to an injured employee that would be a good response, as you described in your answer to #7.
After Injury or Illness: Before Return to Work
Interacting with doctors
After the doctor visit
Deciding on return-to-work status
Keeping in touch
9. What do doctors need to know from you?
10. What information can you legally ask for from the doctor?
11. After the doctor’s visit, what should you discuss with the employee?
12. When you make your communication plan, what is the longest amount of time you should go between phone calls?
After Injury or Illness: After Return to Work
Preparing for the employee’s return Return-to-work meeting On-going communication Planning accommodations
Transitional work assignment
13. What might you need to do to prepare for the employee’s return?
14. What is one the most important message at the return-to-work meeting?
15. When you make accommodations, what are some changes you can make to an employee’s job?
16. What can you do to gain the support of co-workers?
Answer Key:
1. You can give them to the doctor so the doctor understands what kind of work the employee does. You can also use them to develop alterative work options in anticipation of accommodation needs. 2. Identify the problem by finding risk factors, etc. Find solutions by analyzing the workplace. Implement the solution and collaborate with employees throughout the process.
3. The answer will be whatever your company’s policy is, or if there is no set policy: “Err on the safe side.”
4. Make health care recommendations, get the employee the attention needed (make phone calls, walk employee to on-site nurse, drive employee to hospital), take job description and other forms, and explain corporate policies.
5. It creates an environment in which employees feel comfortable coming to you with problems. It also makes sure you have told employees about company policies.
6. Eye contact, nodding, reflecting back what was said and the feelings conveyed, suspending thoughts and judgments, and keeping free of distractions.
7. Caring, validating, supportive, concerned, understanding, and helpful.
8. Your answer should show that you understand how the employee feels, that you want to help, and that his or her feelings are valid. See the section Practice Responding Appropriately for examples. 9. A job description, possible transitional work assignments, your intent to comply with doctor’s restrictions and to support employee during recovery, and your contact information.
10. When can the employee return to work, what restrictions will the employee have, and how can I accommodate the restrictions?
11. Doctor’s instructions, return to work options, and what happens next. 12. If the employee is not out of work for many months, no longer than 10 days.
13. Update co-workers, install phone or computer, and prepare new worksite or job description. 14. The employee should stay within the doctor’s restrictions. Communication about any concerns or changes.
15. Light duty, part time work, more frequent breaks, avoid use of hurt body part, new job duties, etc. 16. Keep them informed, listen to their concerns and feelings, and anything else you feel is important.
Key Points
You have covered a great deal of information in this workbook. But in this section, Key Points, we will focus on the key points for you to remember. You can use this section along with Supervisor Roles and Take-Away Tips to refresh your memory throughout the year.
Discourage employees from staying home unnecessarily.
Show all employees that they are capable of doing some kind of productive work.
Improve employees’ physical and mental health by shortening and reducing
disability leave.
Create a safe and positive work environment that employees want to return to.
Regularly review your notes from your training and support other supervisors in
training to reduce the frequency and duration of lost time.
The Abilities of a Trained Supervisor
Now that you have completed the workbook, you are able to:
State the importance of supervisor response to reducing the frequency and
duration of lost time.
List causes and symptoms of musculoskeletal disorders and characteristics of
MSDs.
Reduce, prevent, and respond to health issues using ergonomics and
problem-solving skills.
Reduce injury and illness and lost time by creating a safe and communicative
workplace.
Make decisions and facilitate access to resources when an injury or illness occurs.
After an injury or illness occurs:
Shorten length and frequency of lost time by responding in a caring and
supportive manner and by keeping in touch.
Resources
OSHA offers ergonomics information, e-tools, and industry-specific and
task-specific guidelines.
The Bureau of Labor Statistics supplies industry-specific data on common causes
of injury and illness.
WorkCompEdge provides other training materials and tools to learn more.
What company resources are available to you?
Thank You
Thank you for your participation in this workbook on disability management to improve supervisor response to workplace illness and injury. I hope you now feel empowered to make positive changes in your workplace.
