Managing absences and returning to work

Returning to work is a crucial part of an individual’s recovery from any disabling health condition. The transition back to work can be both anxiety-provoking and exciting. Consider what differences occur as a result of the circumstances leading up to the absence, the communication with the employer/co-workers during the absence and the clarity of the return to work plan.

Does your organization have a clear, detailed and well-communicated workplace mental health policy?

• Consider whether your workplace policies and practices include early identification of potential health issues as influences on performance (particularly when a change in performance or behaviour is noticed).
• Consider whether employees are routinely advised of supports that may help to address factors that could impact performance (such as your Employee and Family Assistance Program, occupational health, wellness initiatives, etc.).
• Consider whether employees are offered accommodation if there is a health issue that could be impacting performance.

Sometimes employees will require a disability leave in order to obtain appropriate treatment and adequately recover from an illness or injury.

• If it is the culture of your workplace to send a card or flowers to an ill/injured employee, consider whether this practice is the norm, regardless of the circumstances leading up to the absence.
• Is it policy in the workplace for early contact with ill/ injured employees during an absence? Consider whether the policy is routinely followed. Are there accommodations made to ensure the contact is made by someone with whom the employee feels comfortable?
• Is it procedure to ensure that an offer of accommodation is made to all ill/injured employees?
• Consider whether there is absence/disability management and return to work cooperation between labour and management. Mixed messages may interfere with the disability management process.

Any time an employee leaves the workplace as a result of illness or injury, it is very important that their leader keep the lines of communication open in order to help maintain the employee and employer relationship. These regular conversations will help ensure everyone is aware of the important next steps/milestones in the absence, as well as let the employee know there is a safe and welcoming environment to return to when that becomes appropriate.

Once returning to work becomes a reality, it is important to recognize that how an employee handles the transition back to work will often influence whether or not their return to work will be successful.

You may want to consider the following when developing an organizational approach to safe and effective returns to the workplace.

• Focus on ability - not disability
• Make work meaningful
• Develop a clear plan
  • Document
  • Set goals and timelines
  • Consider a progressive return (maximum of four to eight weeks is suggested)
• Communicate clearly defined accountabilities with all stakeholders
• Proactively manage all relationships involved, and immediately address potential resistance to the success of the plan

According to the Institute for Work and Health, the return to work process has the potential for miscommunication and misunderstanding. This becomes an even bigger challenge if there are functional limitations related to communication, interaction or cognition.

• Does it include close communication between worker, supervisor, management, union, healthcare providers and other disability management stakeholders?
• Is there structured and planned communication throughout the process?
• Does it include check-ins at distinct times to assess progress in the return to work process and the worker’s needs?

• Is there a clear process for ensuring that accommodation is provided in a fair and consistent manner?
• The Canadian Human Rights Commission suggests that an employer should document the accommodation request, describe the actions taken, and the outcome.

1. Pre-disability role

   The first priority should always be to return an employee to their pre-disability occupation.

   A return to the role an employee knows may produce the most successful results. The expectations are familiar, there is little or no training required, and the manager has a good understanding of how the employee performed in the role prior to their disability. The familiar role and expectations make it easier to fine tune the return to work plan and create the most potential for a successful result.

   When developing the return to work plan it may be discovered that the employee requires modifications to the job and/or the hours worked – either temporarily or permanently - depending on the employee’s prognosis for further improvement.

2. Alternate role with current employer

   The second priority is to consider returning an employee to another occupation that matches their ability to function within your organization.

   This change may allow the employee to return to work full time with no restrictions more quickly. Modification of hours and/or duties may be required to help improve the employee’s level of function. Again, the length of the modifications will depend on the prognosis for further improvement.

3. Work trial

   A third priority may be to provide a work trial to gain more information about the employee’s level of function.

   In this scenario, the employer develops a creative combination of duties and responsibilities, each uniquely designed for a particular employee. The type of work done by the employee should still offer real value to the organization. In the absence of value, there is little motivation on the part of the employer to accommodate, the employee may not experience a much needed sense of accomplishment, and they may not feel respected by their colleagues.

   This alternative allows the employee, employer, and even physicians to learn more about realistic, long-term options for return to work.

The return to work process begins at the outset of the absence. The manager does the following:

• Contacts the employee, expresses concern and ensures he is aware of the company’s confidential Employee and Family Assistance Program (EFAP) as well as the procedures for an absence.
• Advises the employee that they offer accommodation to help ill/injured employees return to work in a safe and timely manner. If possible, the manager provides this information in writing, along with any employer-related resources that the employee can access during the work absence.¹
• Advises the employee that someone will be in touch periodically to check in and help plan for his successful return to work when the time is right. (The employer contact is determined by workplace policy, and the specific individual should be identified to the employee whenever possible.)
• Lets the work team know that the employee will be away from work for a period of time and discusses a plan to manage the workload. The team sends a get-well card. Regular check-ins with the employee take place.

When it is determined that the employee is ready to start back to work, specific functional restrictions and limitations are obtained from the employee and his health care team in order to ensure his safety.

• A plan is developed and discussed with the employee so that any concerns or anticipated challenges can be addressed.
• The manager advises the team when the employee will be returning and discusses the expected distribution of work. When he returns to work, he is welcomed back by all team members.

In this case, the restrictions and limitations are identified as:

• Difficulty with consistent energy level and concentration prior to 10 a.m.
• Ability to tolerate occasional exposure to confrontational situations which require action on his part.
• Difficulty tolerating distractions or multi-tasking on more than an occasional basis.

These difficulties are expected to be temporary and improvement is anticipated. It is noted that this employee continues to participate in treatment, which is only available during regular business hours.

This employee’s usual hours are 8:00 a.m. to 4:00 p.m. Job tasks include working on multiple projects and working as part of a team internally and with external customers. The usual work area is in an open-concept centrally located cubicle.

A return to work plan can be developed as follows:

The manager and the employee meet weekly for the first six weeks to check in and discuss any questions or concerns that arise with the plan. During one meeting, the employee appears distressed and overwhelmed and the manager offers him some time in a private space. The manager also reminds the employee that he has access to the company’s confidential EFAP service, provides the number and access to a phone.

When the employee struggles with some work tasks in the first few weeks, strategies for managing these challenges are discussed and he is reminded of the supports in place. He is also reminded that he is not expected to be working beyond the agreed upon return to work plan.

The manager and employee meet every other week for a mutually agreed upon period of time to ensure that the accommodations are working and to determine when the accommodations need to be changed or removed.

¹ Occupational and Environmental Medicine, 63(10): Reducing sick leave by minimal postal intervention: a randomized controlled intervention study: Fleten N., Johnsen R. (2006)