Who’s Really In Charge of Return to Work?


In workers’ compensation, there’s some confusion around who’s really in charge of return to work. The answer becomes clearer when you consider who ultimately must make the decision to return to work. An employer has to offer return to work, and the medical provider needs to assess if the return-to-work offering is safe, but the worker ultimately needs to make this important personal decision. The American College of Occupational and Environmental Medicine is aligned with this perspective. 

How well do you accept decisions that were made for you by other people? How well do you react to being pushed toward something you haven’t considered or bought into?  It all starts with the worker – doing so is the easiest, fastest, least expensive, and most effective way for a person to return to work or stay at work. While the claims advocacy approach can be a foundational starting point, it is insufficient to solve the more complex work disability issues that are ruining lives and plaguing the industry.

This is precisely why a worker-centric approach is a necessary cornerstone for any work disability prevention and mitigation program. Back in October 2021, Vickie Kennedy wrote an Expert’s View article entitled “Introduction to a Worker Centric Model”. In her editorial, she talked about how this approach uses evidence-based strategies to shift human behavior – specifically, the worker’s behavior toward choosing to return to work. This doesn’t mean the employer and medical provider don’t play important roles in return to work - they do.

Causing a worker to be sidelined, confused, unsure of their role or the role of others, having no voice, not being included, having things happen to them, and feeling like they are just a number, is a recipe for disaster. Let’s talk about the ingredients of that recipe for a moment:

  • A splash of perceived injustice;
  • A dollop of catastrophic thinking;
  • A dash of fear/avoidance;
  • A heaping spoonful of uncertainty make it easy for a worker to choose not to return to work.

Put yourself in their shoes. Do you like feeling this way? Are you able to use good judgment when you are in a crisis, in pain, and uncertain of the future? When you feel this way, are you naturally pulled toward being compliant? Probably not.

Using a worker-centric approach doesn’t mean giving the worker everything they want or ask for. That would be negligent. It means taking the time to discover the worker’s expectations, fears, concerns, goals, and next steps. Then, it's important to collaborate on a plan with the worker and coaching them to achieve their goals - within the boundaries of the jurisdictions and policies. The worker-centric approach requires serious engagement and activation to combat system-driven inertia.

There is a lot of evidence suggesting the industry would benefit from breathing life into the concepts found in the literature to better serve workers and employers – the people who are the basis for the existence of the workers’ compensation industry. In practice, synthesizing these concepts requires courage, a cultural shift, leadership, investment, and tenacity in order to see how it can be done.

Have questions? Linea can help.

Linea Solutions has been helping our clients with improving their processes since our inception over 20 years ago. If your organization is considering a BPI initiative, contact us to see how we can help. Linea not only identifies the issues in your organization but will follow through to implement these solutions in a way that enables maximum leverage of the proposed solutions.

Have questions? We can help.

Linea Solutions has been providing strategic guidance that has improved our clients for almost 25 years. We would be happy to meet with you virtually to discuss what type of assessment would be ideal for your organization. If you have questions about the best way to improve your organizational efficiency, contact us to see how we can help.

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