Adopting a Societal Approach to Promote Return to Work and Daily Function

Injuries and illnesses that result in lost time from work cost the US economy about $589 billion per year (Integrated Benefits Institute, 2012). Early intervention to promote stay-at-work and return-to-work plays a significant role in a person’s health, recovery from injury or illness, reduction of disability, increased productivity, and financial security. Review of 2011 to 2012 claims by Washington State Department of Labor revealed a 32% probability of return to work after one year of disability.

The International Association of Industrial Accident Boards and Commissions (IAIABC) has published a paper that calls for a more integrated, societal approach to reduce needless workplace disability. It explores common misperceptions and realities that exist among key stakeholders that may influence reintegration of the worker back to the workplace to support a productive, contributing role to society.  This paper includes an Appendix of best practices to promote RTW by states, as well as Guidelines on Return to Work and Reintegration from the International Security Social Security Association (ISSA).

Examples of positive action recommendations referenced in the IAIABC paper include:


  • Support and encourage investments in early return to work through sound public policy, engagement, and stakeholder collaboration.
  • Governments should lead by example to implement effective return to work policies and programs for their own employees.


  • “Employer offer of an accommodation (e.g., light duty, reduced hours) to facilitate return to work has been identified consistently as protective against chronic work disability.” (Turner et al., 2007)
  • Create up-to-date, regular and modified-duty job descriptions to present to a medical provider quickly after an injury. Adjust the modified-duty tasks to align with an injured worker’s limitations.


  • The worker should take an active role in developing the return to work plan with the insurer, employer, and physician.
  • Collective bargaining might also include language encouraging flexibility for temporary duty jobs to keep workers actively engaged.

Health Providers

  • Encourage the patient to remain as active as possible and communicate that remaining at work at full or modified duty is essential to healing and recovery.
  • Use of opioids for pain should be limited and, if necessary, prescribed only during the acute phase of healing.
  • When appropriate, engage patient in active therapy and home exercise.
  • Throughout care, it is important to objectively evaluate functional improvement and discuss what the injured worker is able to do both at home and at work.
  • Physicians may write “Fit-Notes” instead of sick notes to record the functional capacities of their patients that are based on objective measures.
  • Talk to the employer about medical restrictions and return to work options.


  • Attorneys representing insurers and employers should recommend that workers sustaining serious injury and/or significant symptomology be referred for disability management and return-to-work support early in the claim.


  • Insurer representatives throughout the company should be equipped with tools and techniques that demonstrate the value of return to work.
  • In talking with an injured worker, claims personnel must reinforce the message that return to work is important for both physical and psychological healing.
  • If an employer cannot offer modified duty, claims personnel can encourage participation in a “modified” duty program at another facility such as a charity.

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