Return to Work in Small Workplaces: Sociological Perspective on Workplace Experience with Ontario’s “Early and Safe” Strategy
| Principal investigator(s): | Joan M. Eakin (University of Toronto) |
| Co-investigator(s): | Judy Clarke (Institute for Work and Health), Ellen MacEachen (University of Toronto) |
| Sponsoring Institution: | University of Toronto |
The full text of this study can be found at http://www.iwh.on.ca/products/images/ESRTW.pdf
For more information about this study please contact Dr. Joan M. Eakin at e-mail: joan.eakin@utoronto.ca
Results
When delegated to the workplace, the implementation of Early, safe Return to Work (ESRTW) is superimposed on, and becomes part of, the everyday social organization, interactions and customs of the workplace (“how things are done around here”). The requirements of ESRTW are filtered through the logic of the workplace and ‘adapted’ to the needs and standpoints of the parties involved.
For employers, ESRTW is a business problem, with significant administrative and managerial challenges, that can draw them, often involuntarily, into the disciplinary and medical management of RTW. Compliance with ESRTW and compensation regulations can impose an administrative burden, conflict with workplace norms, undermine their managerial authority, and damage relationships with the injured worker and with other employees.
For workers, ESRTW can be a struggle to protect their personal credibility and integrity, and to reconstruct their physical and working lives within the ambiguous and contested terms of ‘co-operation’. Workers suffer under what the study calls the “discourse of abuse” – persistent, pervasive imputations of fraudulence and ‘overuse’ of rights. Surveillance and its effects can extend into the injured workers’ homes and family life.
During the vulnerable and fragile stage of bodily injury and recovery, workers confront a range of social difficulties in determining when they should return to work, in managing issues of loyalty and commitment to the firm and employers, and in engaging in modified work that can be meaningless or socially threatening.
For both employers and injured workers, damaged moral relationships and trust can trigger snowballing of social strains, induce attitudinal “hardening” and resistance, and impede the achievement of mutually acceptable solutions to the problems of injury and return to work.
Conclusions
The study has produced some important concepts and insight into the process of return to work in small workplaces which can be used to reflect on current policy and practice and to inform other research.
Findings bring into question some of the assumptions and principles of ESRTW, suggesting that the strategy might be transferring costs to workers and their families, and to employers, and that the notion of “safe” needs to include social as well as physical security. The study also points to some paradoxical perversities in the strategy of self-reliance in small workplace settings, and cautions against a one-size-fits-all approach to RTW.
Some issues – such as the disturbing implications of the discourse of abuse for the experience and disability of injured workers – transcend the matter of size and deserve consideration with respect to all workplaces and the system as a whole.
Objectives
Return to work (RTW) after work-related injury is known to be particularly challenging in small workplaces. Injured workers in small firms tend to have lower rates of reemployment, longer periods on compensation, and less access to assistance.
Little is known, however, about the actual process of RTW as it occurs in the workplace, or about the experiences of the workplace parties. We do not know how what happens in the workplace is related to the distinct nature of working life in small work settings, or how it is affected by the regulations, policies and practices of RTW. This study examined the strategy of ESRTW currently used in Ontario — an approach that emphasizes workplace “self-reliance” and “early” return to work before full recovery in “modified” jobs — and its effects on both injured workers and employers.
Methods
The research was carried out using qualitative methods.
Documentary materials (regulations, policy statements, guidelines, educational materials, bureaucratic forms, Web sites) were analyzed to reveal the underlying assumptions and expectations of ESRTW. In addition, injured workers and employers were interviewed using special methods for encouraging them to recount their experience and responses in their own terms, without the researchers’ prior framing of the issues.
Interviews did not use structured questionnaires; instead a “guided conversation” format was used to prompt participants to talk about their working lives and their experiences with and perspectives on injury, compensation and return to work. Interviews were taped and transformed into typed texts which were analyzed using special techniques for interpreting and explaining how the participants understood their experiences and acted upon them.
This approach attempts to uncover the meanings and “logic” underlying workers’ and employers’ comprehension of, and responses to, ESRTW. Their perspectives were then linked to the “structural context” in which they were located – the nature of work life in small settings, and the rules and requirements of the ESRTW system.
Participants included 17 employers and 21 injured workers from independent enterprises with fewer than 50 employees in a variety of different industrial/service sectors. Seven employers and workers were “pairs” in the same workplaces.
A sub-set of participants was re-interviewed on one or more occasions up to a year after the initial interview to cast light on the process over time. Several compensation board and rehabilitation professionals were also interviewed regarding their role in the RTW process and to explore ideas that emerged from the worker/employer data.
Participants were recruited from a number of sources, including the WSIB, government health and safety advisory agencies, community health and legal clinics, medical and chiropractic clinics, and cold calls to businesses listed in a business directory. The sample included a socially diverse set of individuals from a range of different types of workplace settings, reflecting to a fair extent the general character of the small workplace sector in the province.
Publications
Eakin, J. MacEachen, E. , and Clarke, J. (2003), "'Playing it smart' with return-to-work: small workplace experience under Ontario's policy of self reliance and early return." Policy and Practice in Health and Safety 1(2):19-41.
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