Vocational Rehabilitation: Who has the best outcomes and why it matters

When an injured worker receives permanent restrictions that prevents them from returning to his/her pre-injury position a few things may happen.  The employer may modify the injured worker's pre-injury job to accommodate the restrictions.  The employer may offer the injured worker a different position within the organization.  Unfortunately, sometimes an employer is either unable or refuses to do so and the injured worker is without a job to return to.  While many of us would say, well I'd just go out and find another job.  As research has shown, if you're a married male, younger than 50 years in age, who has a solid education, not attorney represented for your claim, and who participates in a vocational rehabilitation program -- yes, you most likely will (Blackwell, Leierer, Haupt & Kampitsi, 2003).  That's because individuals who fit this demographic profile have been found to have the best return to work outcomes after a claim.  That is not to say that other injured workers won't benefit from vocational rehabilitation services such as retraining or on-the-job-training.  Generally speaking, the more transferrable skills and individual possesses, the more likely they are to find work in another setting.  A lower education level and being over the age of 50 may limit an individual in their job search.

It also makes sense that the less "employable" an injured worker is, the more it increases the exposure of the claim -- thereby increasing the value of the claim. The goal of any vocational rehabilitation plan is to assess an injured worker's employment history, transferrable skills, education, and provide services (re-training, job search tools) to identify employment opportunities.  The more dismal the re-employment picture is, the greater the challenge it is to return the injured worker to gainful employment.

Employers can take steps to avoid this process by identifying employment opportunities within their company, looking at potential modifications (see our post on AskJAN.org) or any cross-training opportunities within their organization.  When you can control or influence the outcome, your results will usually be better than when you let an injured worker's future be subject to the employment market.

Employers who have injured workers that are given permanent restrictions should think long and hard about providing modified duty, on a permanent basis to their injured workers.  It is not a decision to be taken lightly.  An unrestricted person may have a difficult time finding work, let alone adding in physical restrictions and a period of unemployment due to a work injury. 

References:  Blackwell, T. L., Leierer, S. J., Haupt, S. & Kampitsis, A. (2003).  Predictors of vocational rehabilitation return-to-work outcomes in workers' compensation. Rehabilitation Counseling Bulletin, 46(2), 108.

What does an injured worker have to do with the US economy?

In an article written by the American College of Occupational and Environmental Medicine (ACOEM) entitled "Healthy Workforce/Healthy Economy:  The Role of Health, Productivity, and Disability Management in Addressing the Nation's Health Care Crisis" the authors highlight the importance of a healthy workforce, and more importantly, the role that RTW can have on the economy, federal programs and the United States' workforce.

Between an aging workforce, increased chronic illnesses among all age groups and people relying on federal programs like Social Security and Medicaid at earlier ages, the future of federal entitlement programs are at a severe risk of bankruptcy.  These programs rely heavily upon the workforce that is contributing to the programs and maintaining what the authors refer to as "a critical balance of net contributors versus net dependents." 

What does an injured worker have to do with the US economy?

Well, if we're doing the right things such as getting the injured worker the appropriate medical treatment, assisting them in their recovery through modified duty work, and returning them to a state of wellness, we are moving in the right direction.  As a result of these efforts, we are returning an otherwise disabled person as a productive, wage-earning, tax-paying contributor to the economy.

Integrating preventative wellness programs, providing modified duty to utilize work as therapy, and assisting employees who are precluded from returning to their pre-injury jobs with alternative employment options or vocational counseling serves an incredibly important role in making sure that our economy continues to grow and that otherwise capable individuals are not becoming dependents.

This is a (very) big-picture approach, but it highlights the importance of modified duty in an injured worker's recovery, as well as the impact it has on society and the economy.

What if the one who treats you is the one who is injured? Returning healthcare workers to wellness

Nurses are usually thought of as playing a role in helping injured or ill people get better, however from a workers' compensation standpoint, members of the nursing profession face unique challenges and opportunities when returning to work after a work-related injury.

Challenges

Physical
Often nurses (as well as CNAs, home health aides and other care staff) may be required to lift a great deal of weight, potentially deal with combative patients, and be on their feet for long periods of time.  The shifts they work may be long, and require them to walk great distances. From a WC perspective, the physical requirements of jobs in the healthcare field can present an obstacle for early return to work opportunities.

To push oneself or self-protect oneself, that is the question...

...asked by many older workers.  Many of us have asked ourselves the same question, whether it's a choice between taking the stairs or the elevator, doing that extra set of reps at the gym, or getting out of bed after pulling a back muscle.  It is also likely that the decision you would have made at age 20 is not the same decision that you would make at age 45. 

What factors go into making these decisions?  More importantly, how can employers and insurers use their understanding of this decision making process to improve the outcomes of WC claims for their older employers?