When an employee is injured at work, they require support, treatment, and financial assistance as they recover. Most provinces have their own Worker’s Compensation / Safety Insurance Board who partner with employers and employees to guide them through the reporting process, and support and compensate injured employees so they can safely heal and return to work. Typically, this involves providing medical information such as restrictions and limitations to facilitate a return to suitable modified duties, or conditioning programs to improve an employee’s function if they are unable to do so.
There are cases, however, where employees receive appropriate treatment and recovery time, but are still unable to return to the full demands of their pre-injury job. This may be due to the severity of the injury itself, a pre-existing condition, conditions that the injury aggravated, or a combination of the two. At this stage, the Workers Compensation Board will determine if the employee has medically stabilized” (formerly known as plateaued – meaning they do not anticipate any improvement within the next 6 months to a year or more). They will then outline any permanent limitations or, restrictions that are identified as a result.
Each province has their own terminology and process for this stage of the claim, but the goal remains the same; returning employees to work in an available, suitable role – one where any permanent limitations, restrictions, or pre-injury earnings are accommodated or restored. Ideally, all parties strive to return the employee to their pre-injury employer to mitigate any disruption to their career and family. However, if this is not feasible, the objective is to accommodate them at the earliest phase that is appropriate and suitable. Stabilized individuals are assigned a Vocational Rehabilitation Consultant or Return-to-Work Specialist who will assist them through this process, in a phased approach.
Phase 1
Returning an employee to work at the same pre-injury job with the same employer– Employers may need to adjust to accommodate a returning individual, to the point of undue hardship, assuming their permanent limitations are minor or do not greatly affect them resuming work at their pre-injury job position. If the employer can provide evidence that this isn’t possible, the claim will move to the next phase.
Phase 2
Exploring the availability of other positions with the same employer – These positions should satisfy accommodations for any permanent limitations or restrictions and pre-injury earnings. If the employer can provide evidence that there are no other suitable roles within the organization, they move to the next phase.
Phase 3
Identifying other opportunities for the employee in a similar or related industry, to utilize an employee’s transferrable skills – If the employee finds it difficult to obtain employment within the same industry that fits within their accepted limitations and/or restrictions, they may explore the next phase.
Phase 4
Working with the employee to move them into a different industry – one where they can use their skills, work experience, aptitudes, or interests. This must be reasonable, it must build upon their existing experience, and it should not cause significant financial hardship for the employer.
Phase 5
Where required, developing and training an employee to gain any additional or necessary skills for them to return to suitable work, as outlined in Phase 4.
While the five phases above are simplified, there is guiding policy and procedures in place that require cooperation from multiple parties to safely rehabilitate an employee to a suitable workplace. Fortunately, relatively few claims make it to the last phase, as many individuals are accommodated by their employers.
Rehabilitation & Return to Work Support
Knowing how to navigate the rehabilitation process is vital to reducing the duration of complex files. Engaging with stakeholders, including health care providers, to identify cost effective solutions focused on regaining recovery and Return-to-Work (RTW) are an integral part of the process. At DMI we focus on early intervention and stay-at-work opportunities, embracing returning to work as part of the recovery journey. It is well-established in literature that graduated RTW efforts build self-efficacy, a capability which correlates strongly with sustainable RTW. We advocate wherever possible for early re-entry efforts but understanding how to effectively manage claims that go longer term is critical to retaining valued employees and improving upon your experience rating.
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DMI is committed to providing timely support and information to our clients. We have been working with employees and employers nationwide to provide comprehensive end-to-end solutions for their absence and disability management needs.
Interested in learning more about our services and how disability management services can help control disability claim costs? Request a free review of your claims experience from a DMI expert to determine if you will benefit from DMI’s claims management services.