Return to work programs

Return to work programs are meant to facilitate an injured or ill worker’s return to their pre-leave employment, with an appropriate transition period, when the worker is ready to return to work.

The goal of a return to work process should be to ensure that tasks and duties assigned to the worker are meaningful and productive and have value for the worker and employer. The return to work should have a rehabilitative focus.

If pre-leave employment is not an option, then a hierarchy of return to work options should be respected: (1) same job; (2) modified job; (3) different job-same workplace; (4) similar job-different workplace; (5) different job-different workplace.

The objective is to minimize hardship (financial and emotional), as well as respecting the dignity of the person (performing meaningful work).

Return to work programs should be seen as transitional and for a fixed duration. Permanent measures to support a worker who has a permanent disability are best framed as accommodation measures, as opposed to return to work measures.

Most organizations that have benefit plans also have some form of disability insurance with a focus on rehabilitation.

Why do these programs exist?

Many workers’ compensation laws include return to work obligations for injured workers and the requirement for the employer to protect the worker’s job for a specific time period. Disability insurance plans may also have return to work programs as part of those policies. In the federal public service, specific departmental responsibilities on return to work exist under the Occupational Health Evaluation Standard.

Who is covered?

The return to work program should include employees with permanent disabilities as well as temporary disabilities. The program should apply to all workers with disabilities, regardless of whether the illness or injury is work-related.

Disability insurance applies to workers who have completed six months of employment. Qualifying conditions exist for workers’ compensation cases.

When does a return to work situation arise?

Typically, return to work situation arise from:

  • the return of a worker who has been receiving workers’ compensation;
  • the return of a worker who has been on disability insurance;
  • the return of someone who has been injured or who has developed a disability, but who has not qualified for income replacement programs (worker’s compensation or disability insurance); or
  • other long term leave situations.

How does it work?

Return to work programs should lay out the steps that need to be taken to support the returning worker.

Return to work discussions should identify and eliminate any root causes of the absence from the workplace, where applicable. Return to work programs should not create a revolving door response to unsafe working conditions.

Individual assessments are key to return to work programs. These programs should not be seen as one-size-fits-all measures but should respond to the needs of the individual’s situation.

In addition, work-related and non-work-related disabilities should be treated in a similar manner.

Job task analysis ensures that the job duties and tasks are assessed (using job-related criteria) and compared with the functional limitations of the returning worker. Typically, job task analysis will assess physical requirements of job duties (such as tools used, postures required, endurance) and will involve observing workers performing job duties. In cases of mental health disabilities, factors such as communication, exposure to conflict, and the nature of their contacts with others would also need to be assessed. The returning worker should be an active participant in the job analysis and evaluation, along with a local health and safety representative.

Timeframes spelled out in the return to work plan should not be arbitrary but should respect the needs of the returning worker. Having timeframes associated to key activities ensures accountability for their implementation.

Medical assessments should be completed by the medical practitioner who is best placed to understand the medical condition of the returning worker - their treating physician. Physicians may be able to provide a diagnosis and treatment, but not be able to provide a functional analysis. Additional expertise, such as an occupational therapist, may be required.

There is an increased focus on medical assessments in cases of return to work of workers with disabilities and it is important to understand the difference between a medical prognosis and a functional limitation.

Return to work programs must not lead to a watering down of collective agreement rights.

The program should be consistent with the collective agreement. For example:

  • layoff and recall provisions for the injured worker should be the same as if they were not injured;
  • wages of the injured employee should be the same as if they had not been injured.

Confidentiality rights of returning workers should be protected. Information sought should directly relate to the return to work program and only be used for this purpose. Workers’ compensation or other income replacement programs may require signing a release of information form. The returning worker is not required to disclose a medical diagnosis (unless they choose to do so). However, information about functional limitations needs to be clear.

Return to Work Programs are likely to touch on issues that the union is trying to pursue elsewhere. Union representatives should be drawing a link with work or discussions at other important tables such as joint health and safety committees, employment equity committees, or duty to accommodate committees.

Early assistance can make a difference in the successful re-integration of a returning worker. As an example, studies show there is only a 50% chance that a worker will return after a six-month absence. At the same time, returning too early may jeopardize the rehabilitation of the returning worker or worsen the medical condition.

Recourse rights in return to work situations can be exercised via:

  • Disability insurance appeals
  • Workers compensation appeals tribunals
  • Grievances (depending on the language in your collective agreement)
  • Human rights complaints

The support of co-workers is critical to a successful return to work situation, particularly when the situation involves job tasks modifications or job re-bundling.

November 13, 2019