The “Toxic Dose” of System Problems: Why Some Injured Workers Don’t Return to Work as Expected.

Introduction Most workers who incur an injury on the job follow a relatively straightforward path through a workers’ compensation claim, recovery and return to work. However, a minority of compensation claims is prolonged and can be disproportionately costly. We conducted this qualitative study in o...

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Publicado en:Journal of Occupational Rehabilitation Vol. 20; no. 3; pp. 349 - 367
Autores principales: MacEachen, Ellen, Kosny, Agnieszka, Ferrier, Sue, Chambers, Lori
Formato: research tables/charts Journal Article
Publicado: Springer Nature Sep2010
Acceso en línea:Ver este registro en EBSCOhost
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          MacEachen, Ellen
          Kosny, Agnieszka
          Ferrier, Sue
          Chambers, Lori
        affil: Institute for Work & Health, 481 University Avenue, Suite 800, Toronto, ON M5G 2E9, Canada
      sug:
        subj:
          Job Re-Entry
          Occupational-Related Injuries
          Worker's Compensation
          Organizational Policies
          Disability Management
          Job Accommodation
          Time Factors
          Human
          Qualitative Studies
          Interviews
          Grounded Theory
          Ontario
          Female
          Male
          Adult
          Middle Age
          Audiorecording
          Data Analysis Software
          Occupational-Related Injuries Economics
          Communication
          Funding Source
          Rehabilitation, Vocational
          Employer-Employee Relations
          Physician's Role
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Female
          Male
      ab: Introduction Most workers who incur an injury on the job follow a relatively straightforward path through a workers’ compensation claim, recovery and return to work. However, a minority of compensation claims is prolonged and can be disproportionately costly. We conducted this qualitative study in order to gain an understanding of systemic, process-related problems affecting injured workers who had failed to return to work as expected. Method A total of 69 in-depth interviews were conducted with injured workers with complex and extended workers’ compensation claims and with return-to-work (RTW) providers such as health care providers, insurers, legal advisors, and workplaces. The study was based in Ontario, Canada. A modified grounded theory analysis led to the identification of common mechanisms in RTW problems. Results We identify problems with return to work and extended workers’ compensation claims in dysfunctions in organizational dynamics across RTW systems including the workplace, healthcare, vocational rehabilitation and workers’ compensation. These system problems are difficult to identify because they appear as relatively mundane and bureaucratic. These appeared to have damaging effects on workers in the form of a ‘toxic dose’ affecting the worker beyond the initial injury. Conclusions Worker’s problems with extended claims were linked to RTW policies that did not easily accommodate conflict or power imbalances among RTW parties and by social relations and processes that impeded communication about RTW situations and problems. Avenues for intervention are located in a shift to a critical lens to RTW process that addresses differences of knowledge, resources, and interests among different parties.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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