The industrial athlete?

Many similarities can be drawn between the athletic and industrial population. It is time for a shift in the approach toward injured workers utilizing a sports medicine perspective. We must think of workers as industrial athletes and recognize that the sports medicine model can be appropriately adapted to the injured worker. This model includes prevention, early intervention/identification, training and conditioning, and progressive treatment. Sports medicine rehabilitation concepts include treating the entire kinetic chain that is associated with a specific injury and the SAID principle (Specific Adaptations to Imposed Demands).     

Unexpected barriers in return to work: lessons learned from injured worker peer support groups

Some workers who are injured at work have unexpectedly prolonged absences from work. Experiences of workers who constitute a disproportionate cost to the return-to-work system and the systemic and compliance-related barriers they encounter during the process of returning to work are reported. A qualitative interview based study was conducted with 37 members of three injured worker peer support groups in a Canadian province. Four dimensions of peer support were identified: worker experience of being misunderstood by system providers, need for advocates, social support, help with procedural complexities of the workers' compensation, and health care systems. Peer support constitutes a partial return-to-work solution for workers with injuries, but injured workers encounter an uneven playing field. Injured worker peer support group needs and activities show us that sensitivity to structural and social issues may lead to better return-to-work outcomes.     

Left behind in the return-to-work journey: consumer insights for policy change and practice strategies

This study examined system barriers that precluded injured workers from accessing services and supports in the return-to-work (RTW) process. A grounded theory approach was used to investigate injured worker experiences. Methods included in-depth telephone interviews and the constant comparative method to analyze the data. Findings revealed that consumers experienced tensions or a tug-of-war between the RTW system, the health care system, and in accessing and using knowledge. Over time consumers reflected upon these tensions and initiated strategies to enhance return to function and RTW. Insights from consumer-driven strategies that might inform future policy change and promote positive service delivery for injured workers are examined.     

Injured and Silenced: Working with Workers' Compensation Claimants and Their Families

It is not uncommon for rehabilitation and workers' compensation systems to treat the injured worker as either a passive victim or a mischievous malingerer. Much ofthe literatureregardingrehabilitation ofpeople with chronic pain and soft tissue injury speaks of paralysis and powerlessness as if the injured person is a piece offlotsam buffeted about by the socialforces of WorkCare (and other compensation systems), the employer and the medical legal systems. This paper will review the pertinent literature and demonstrate the lack ofobjective supportfor a ‘blame-thevictim’ attitude. The importance of the injured person playing an active role in his/her rehabilitation will be emphasised through a systematic analysis ofthe impact ofthe WorkCare scheme on the injured worker and their treatment. In this light, a systems based approach to therapy with injured workers and their families will be outlined.     

Trauma symptomatology: implications for return to work

Research has suggested that individuals who experience work related injuries may be at an increased risk for developing trauma symptoms or Posttraumatic Stress Disorder (PTSD). The purpose of this article is to provide a brief overview of PTSD from both a categorical and dimensional perspective and discuss implications for rehabilitation planning with workers with industrial injuries. The negative impact of trauma symptoms and PTSD is profiled according the following four areas that are important for effective career and vocational behavior: (a) making occupational adjustments, (b) adjusting performance to meet specific work demands, (c) utilizing appropriate social and interpersonal skills in the work setting, and (d) meeting the production and time requirements associated with the specific job. Recommendations are then offered to increase the effectiveness of rehabilitation professionals working with industrial injured workers who may be experiencing trauma symptoms or PTSD.     

Using the ICF as a conceptual framework to guide ergonomic intervention in occupational rehabilitation

Traditional treatment of work-related musculoskeletal disorders focuses on the body functions and body structures aspects of the injury, with little or no attention paid to ergonomics as a form of treatment. The use of ergonomics in preventing disability in injured workers is a relatively new area of study. There are a number of factors that may contribute to the lack of emphasis on ergonomic interventions in the prevention of disability following musculoskeletal injury. For instance, a review of the knowledge base suggests that there is a lack of a formal conceptualization or standardized approach to ergonomics in the return to work process. In part, this lack of consistency may be due to the varied disciplinary backgrounds of ergonomists, leading individuals to view ergonomics from a specific perspective, rather than utilizing a transdisciplinary approach. The purpose of this paper is to introduce a new practice model of occupational rehabilitation ergonomics. The model draws upon the International Classification of Functioning, Disability, and Health (ICF) and merges this with basic ergonomic and rehabilitation principles.     

A return to work program for injured workers: a reassignment model

The current workers' compensation system does not encourage permanently restricted workers who are disabled due to work related injuries to return to work. Workers are often labeled permanently disabled and are released from their positions with their employers. However, according to the Americans with Disabilities Act of 1990, these individuals may be qualified to return to productive employment. This paper will describe a Reassignment Model for occupational therapy supported by the rehabilitation frame of reference. This Model presents reassignment to a vacant position as a reasonable accommodation to return injured workers to productive employment. A case study will illustrate the successful implementation of the model. The potential benefits of using this Model will be described for clients, society, employers, and the occupational therapy profession.     

Will Australian workers' compensation insurance management get better soon?

A study of Australian experience in the state of New South Wales (NSW) suggests that private sector underwriting of workers' compensation insurance risk plus insurer competition on premium price may put downward pressure on benefits for injured workers, inhibit rehabilitation, and cause related cost increases for taxpayers and employers. Insurer underwriting also increases workers' compensation administrative costs and means an unnecessary loss of investment income for government and industry. An emerging and better alternative for the Australian community is for government and industry to underwrite a national workers' compensation scheme and to fix premium and benefit requirements which are competitively administered by insurers. In such a regulatory environment insurer inability to compete on premium price should promote competition to provide effective services to help employers prevent injury, assist rehabilitation and contain cost. National standards are necessary to enable widespread dissemination of comparable, reliable information on the outcome of health, rehabilitation, dispute resolution and return to work services. This is required to assess the competitive performance of service providers in order to ensure effective operation of the market to achieve scheme objectives. Holistic, multi-skilled and objective rehabilitation professionals are needed who can clearly demonstrate the effectiveness of their actions in assisting injury prevention, worker rehabilitation, and safe return to work across a range of industry contexts.     

Occupational-psychosocial perceptions influencing return to work and functional performance of injured workers

Much has been done to identify psychosocial factors influencing risk of vocational injury and prolonged disability. The purpose of this paper is to enhance the ability of injured workers to return to their prior worker role through the identification of the influencing psychosocial perceptions. Psychosocial perceptions may assist in the identification of negative or counterproductive factors that hinder the rehabilitative process. Identifying perceptions are individual centered and focused on the views of injured workers as they proceed through the transition in life following injury. Occupational therapists play a key role in the rehabilitative process of injured workers through enhancing the person-job-environment fit [4].     

An exploration of social support as a factor in the return-to-work process

Despite evidence that inter-personal relationships are important in human resource management, little is understood about the nature of workplace social support in a disability context, or what features of support are important to the success of return-to-work programs. The purpose of this qualitative study was to explore workplace disability support from worker and supervisory perspectives and to identify salient features for work re-entry. A total of 8 supervisors and 18 previously injured workers from a range of work units in a Canadian municipality were interviewed, and their views concerning supportive and unsupportive behaviours in work-re-entry situations were recorded and analyzed. A full range of social support dimensions were reported to be relevant, and were seen as arising from a variety of sources (e.g. supervisor, co-workers, disability manager, work unit, and outside of work). Respondents identified trust, communication and knowledge of disability as key precursors to a successful return-to-work process. Future research should explore the specific contributions of support to work rehabilitation outcomes as well as interventions to enhance available supports.     

Perspectives on workplace disability management: a review of the literature

Work-related musculoskeletal injuries represent a major source of work disability. While many employers recognize the importance of workplace disability management approaches and are assuming greater responsibility for preventing and minimizing work-related disability, questions about the effectiveness of these interventions exist. The purposes of this article are to: 1) describe the essential components of workplace disability management programs related to musculoskeletal injuries; 2) review the literature on disability management practices based on research evidence by focussing on workplace-based interventions and the role of the workplace; and 3) provide recommendations for disability management in the prevention and reduction of disability, and the rehabilitation of injured workers with musculoskeletal work injuries. The literature suggests that employer participation, a supportive work climate and cooperation between labour and management are crucial factors in facilitating return to work. Given the complexity of the disability management process and the numbers of individuals involved, it is essential that all workplace parties work together to achieve the goal of safe and early return to work.     

Improving work programs' delivery of information and service to workers' compensation carriers

This paper presents the results of a telephone survey of workers' compensation carriers, addressing how occupational therapy work programs can best meet these carriers' needs. Fifty percent of the market share of workers' compensation carriers in Michigan participated in the survey. Survey results indicated that workers' compensation carriers found Functional Capacity Evaluations, job analyses, and work hardening to be important work rehabilitation services. A significant portion of the respondents (88%) stated that they recognized the need for clinically successful work rehabilitation programs and indicated that if they had return to work rates for different providers, they would utilize providers that had the most successful outcome data in a specific geographical area. Occupational therapists can use these survey results to improve their services and communication with insurance to ensure that injured workers will continue to have access to the efficacious interventions occupational therapists provide in work rehabilitation.     

Proposal for training of workers and researchers as from the participatory return of research results in workers' health

This study streams from a perspective of Workers' Health as a field of intervention where worker's experience on the process of illness is essential to understand and generate changes in the work process, and to contribute to develop knowledge in this area. We intended to collaborate in the training of researchers and nursing workers as a means of contributing to amplify their knowledge related to work and health conditions. As a motto to promote dialogue between researchers and workers, we organized workshops to discuss the results of an epidemiological study on the work-health relationships in nursing. Ten workshops were conducted at two federal public hospitals, in the city of Rio de Janeiro, Brazil. The main aspects discussed during the workshops revealed (i) work nuances for which the questionnaire was not sufficiently sensitive, (ii) some associations between different aspects of the survey, dealt with in the questionnaires, and (iii) recognition that some aspects shown in the epidemiological results were experienced at work. One can appreciate that the proposal presented here contributed to the training of researchers and workers, amplifying their knowledge and contributing to the development of the activity.     

Effectiveness of problem solving skills in case management on return to work for workers with injuries

The present study aims to explore the case management model by using problem solving skills in assisting workers with injuries in returning to work. A total of five workers with injuries were enrolled and there were four stages during the whole case management process including a medical rehabilitation stage (stage I), a compensation stage (stage II), a return to work stage (stage III) and a follow-up stage (stage IV) respectively. Case managers provided services by using problem solving skills to tackle the problems which workers with injuries may encounter during all four stages. Outcome measurement showed one case return to the same company same job, two returns to different companies and different jobs, the others have self employed work. This study suggested that case management using the problem solving skills of occupational rehabilitation was beneficial to workers with injuries on return to work.     

Use of functional capacity evaluations in workplaces and the compensation system: a report on workers' and report users' perceptions

Until recently, little was documented about how functional capacity evaluations (FCEs) are used by employers and workers' compensation organizations. Such information was one focus of a comprehensive research study on FCEs carried out in southern Ontario, Canada, which involved representatives from the full range of groups involved in FCEs: referral sources, assessors, return-to-work specialists, third party payers and injured workers [1]. This paper shares findings from a cohort of injured workers undergoing FCEs, and explored how their FCE results were perceived and utilized by those receiving the reports. Based on study findings, we provide recommendations as to how FCEs should be requested, undertaken, reported and particularly applied to reduce work disability among injured workers.     

Spinal Cord Injury

ABSTRACT

This article provides an overview of spinal cord injury (SCI) that is useful and informative for social workers and other health care professionals who work with this population. Social workers new to the specialty of spinal cord injury must expand their knowledge base of this chronic injury. Social workers contribute to the rehabilitation process through assessment, education, and discharge planning. This article also may be used to inform persons with spinal cord injury and their families and to encourage them to engage in dialogue about SCI in the earliest stages of treatment and rehabilitation.     

Worker perceptions of procedural justice in workers’ compensation claims: Do unions make a difference?

The differences between union and nonunion workers’ perceptions of the fairness of the workers’ compensation claims process are examined. The hypothesis tested is that union members should perceive this process as more fair due to union “voice.” The data were collected in a survey of injured workers in Michigan who had filed a workers’ compensation claim. The empirical results indicate that unions have little impact on the perceived fairness of the claims process and that the main contribution of unions is the provision of a complaint mechanism. From the Bill of Rights to Chief Justice Earl Warren’s recurring inquiry of counsel, “but is it fair?” fair treatment has been treated as a value enforceable by law, standing at the very core of the constitutional, political, and social rights of the individual. —Westin and Feliu (1988, p. 255)     

Summary report of action research on occupational rehabilitation and community re-integration of migrant workers with work injuries in Mainland China

This article is a summary of an action research exploring the strategies to initiate the occupational rehabilitation and community re-integration of migrant workers with work injuries in Guangdong Province, China. Using two cases of rehabilitation intervention for workers with work injury, a case management model of occupational rehabilitation and community re-integration was illustrated, in the different phases of rehabilitation. Finally, some key elements in supporting occupational rehabilitation and community re-integration for migrant workers with work injury in China were highlighted.     

Liability in child welfare

Child welfare workers and agencies are vulnerable to lawsuits. Recent court rulings have more clearly defined the liability of workers. The distinguishing variable is custody. Children injured while in the custody of the state are entitled to sue for damages. Children injured by their parent, even if under the supervision of a child welfare agency, are not entitled to claim a violation of their 14th Amendment rights. These cases are reviewed and strategies designed to minimize vulnerability are offered.     

Work injury rehabilitation in Guangzhou: 380 case cohort study

Work injury rehabilitation is a new concept in Mainland China. In 2001, the first work injury rehabilitation centre was established in Guangzhou under the management of the Guanghzhou Bureau of Labour and Security. This paper reviews the profile of a cohort of workers with injuries who received rehabilitation services at this centre. The changes in the physical capacity, daily function, and quality of life of the workers with injuries before and after the treatment services were also reviewed. A total of 380 were extracted from the database which occupied 79% of the total patient population admitted to the centre between 2003 to 2004. The assessment results suggested that workers with injuries showed increases in physical capacity in terms of the range of motion, muscle strength and walking tolerance. The daily functioning by using Barthel Index was also improved. Quality of life assessed with the WHOQOL also demonstrated an increase in the physical and psychological domains. Work injury rehabilitation in Guangzhou is at its infancy stage. The cooperation between the rehabilitation centre, employers and workers is of the utmost importance for a successful return to work outcome. The workers' compensation and rehabilitation policy also dictates the future of success of the rehabilitation services.