From The Ergoweb® Learning Center

Disability Management From the Front Lines

Mark is a 45 year old man who works as a mechanic.  He came to our facility with a diagnosis of a soft tissue injury resulting from lifting a 200 pound automotive part from the floor to the workbench, with the assistance of a co-worker.  He was off work for six months and had been referred for assistance in a gradual return-to-work program.

An ergonomic assessment of Mark’s workplace revealed that it was not uncommon for workers to assist each other in lifting tools and parts that weighed in excess of 50 pounds, work benches did not accommodate the varying statures of the workers and there was no evidence that would suggest that workers were aware of safe manual material handling techniques.

Prior to commencing the gradual return to work program, recommendations were forwarded to the employer to explore the possibility of modifying the workbenches, providing a mechanical hoist lift and offering manual material education sessions to the employees.

In comparing the cost of the medical interventions that had taken place during Mark’s six month absence — medical, benefits, lost production, and damage to the part that was dropped at the time of the initial injury — with the cost of purchasing a mechanical hoist, adjusting the individual work benches to the appropriate height and implementing a safe manual material handling protocol, the employer and employee would have saved significantly both in human and financial cost.

Disability Management is managing resources to enable a safe and timely return to work.  The injured or ill worker is the center of this process.

In my day to day practice as an Occupational Therapist, we utilize the Occupational Performance Process Model (OPPM) as a foundation for effective Disability Management Programming.  The process involves a seven step approach to enabling maximum occupation.  Step one is naming, validating and prioritizing of the worker’s occupational performance issues.  Step two selects a theoretical approach for intervention. Step three identifies occupational performance components and environmental conditions. Step four identifies strengths and resources that will facilitate the return to work.  In step five, the team negotiates targeted outcomes and develops action plans.  The action plan is implemented in step six and the outcomes are evaluated in step seven.

Throughout the process of returning an injured worker to work, ergonomic intervention is key to the success of identifying occupational performance components and environmental conditions. Without ergonomic assessment and intervention the return to work coordinator may find be presented with barriers, for example when the worker  fears re-injury.

The psychosocial stress that workers experience as a result of an injury or illness is tremendous.  They become accountable to the benefit provider to attend scheduled appointments, submit information, participate in the rehabilitation plan and deal with the financial stress of a reduced income.  The expectation that a worker will resume a pre-injury/illness position without apprehension when an investigation of the worksite has not been conducted may be perceived by the worker as evidence that the employer is not concerned for their well being.  Job dissatisfaction lends itself to decreased motivation and productivity.  The end result is that everyone loses.

Incorporating an ergonomic assessment as a component of the rehabilitation plan goes hand in hand with safe return to work programming.  In keeping with a client-centered approach it is important that the worker is an active participant in the process. Who better to know the dynamics of the work environment than the worker who was injured at the worksite? But all too often ergonomic assessments are conducted without the injured worker present and as a result worker input is lacking.

A key element to any successful Disability Management Program is the inclusion of prevention strategies, and as a result ergonomic assessment is an integral component in the exposure of workplace risks and the identification of controls. As the baby boomers get set to retire, recruitment of skilled workers is going to become more and more difficult. Companies can’t expect to remain competitive if workplace injuries and illnesses resulting in lost time claims, machine shut downs and equipment damage are seen simply as ” a cost of doing business.”

An ergonomic assessment plays an important role in offering a tool that analyzes worker technique, the workstation and the work organization.  It is with this comprehensive approach that we can successfully return injured workers to work and contribute to the support of safe workplaces. 

In Mark’s case, the recommendations to the employer were implemented. Mark proceeded with a safe gradual return-to-work program and has successfully resumed his pre-accident duties.  The message to the employer, and every employer, is that while ergonomics helped return Mark to work, this injury could have also been prevented through ergonomics.

Nicola MacNaughton BSc(OT), MSc, OT(C), CDMP, CDMA is a certified Occupational Therapist and owner of Occupational Concepts, a private rehabilitation company specializing in workplace wellness, injury prevention, and occupational evaluation. She has been involved in Disability Management for thirteen years.

This article originally appeared in The Ergonomics Report™ on 2004-04-01.