RTW Knowledge Base
RTW Knowledge Base
Home Employee Employer Medico Insurer View All Types About Champions Contact
Approaches and Interventions
Halve the length of sickness absence and double the rate of return to work

At a glance:
People have a better chance of getting back to work after illness or injury if their job can be modified to make it more manageable. On average, modified work programs halve participants' sickness absence and double their chance of getting back to work.
Perspectives:
Employee
People return to work sooner when they are offered modified duties.

Getting back to work quickly can be important. When you've been off work for a couple of weeks, it might not feel like it matters whether it takes a few more weeks to return. The research shows that it does matter: those who get back to work early have a better chance of staying in the workforce over the long term. Remaining off work in the long term increases the risk of physical and mental health
mental health
Emotional wellbeing. Ability to cope with difficulty and enjoy life. THe absence of a mental health problem.
 problems.

Do what you can to get back to work early. Think about what you can do at work, and talk to your doctor and employer. You are likely to get the best results if you can return to your normal job, with modifications if necessary. Do your best to make this happen. It helps if your employer provides modified duties and you can often help by identifying what is suitable. Modified duties work best when they are productive and meaningful and fit within the natural work flow.
Employer
Providing modified duties for injured employees helps them to return to work. This reduction in sickness absence and long-term disability
disability
A condition or function that leaves a person unable to do tasks that most other people can do.
 means reduced costs and improved productivity.

For the employee, remaining off work is associated with poorer health, isolation, and depression.
depression
A symptom of mood disorder characterized by intense feelings of loss, sadness, hopelessness, failure, and rejection. Major depression is likely to interfere significantly with everyday activity, with symptoms including insomnia, irritability, weight loss, and a lack of interest in outside events. The disorder may last several months or longer and may recur, but it is generally reversible in the short run.
 Programs which help people get back to work can improve their situation in very important ways.

Finding modified duties can be difficult and time consuming, especially in smaller workplaces. Remember that being flexible early on helps people make the transition back to work. In the long run, this is in everyone's best interests.

Return to work programs are more successful when they have clear goals and return people gradually to their normal job. Working in partnership with the employee, supervisors and line managers is the best way to manage a successful program.
Treater
Providing modified duties is now a common return to work strategy in Australia. As this review shows, it's a strategy that produces good results.

Information provided on a medical certificate should reflect the person's capacity for work, even if they don't believe that modified duties are available. Patients are not always aware of the accommodations that might be available.

Return to work restrictions should be as non-restrictive as possible, since this gives the employer the best chance of finding suitable modified duties. A medical reception area would be difficult to run if two out of the four receptionists were not able to deal with patients. Similarly, employers find it difficult to remain productive if a significant proportion of the team is unable to manage the basic requirements of the job. Medically necessary restrictions must be applied, but keeping work restrictions realistic and not unnecessarily limiting function can help employers to find modified duties.
Insurer
Claims managers can support return to work by advising employers on the advantages of modified duties. People with work injuries are more than twice as likely to return to work when they are offered programs of modified duties. Sickness absence is also significantly reduced. This, in turn, reduces the chance of the person staying off work in the long term.
Original Article, Authors & Publication Details:
N. Krause1, L. K. Dasinger2 and F. Neuhauser3 (1998).

Modified work and return to work: A review of the literature. Journal of Occupational Rehabilitation; 8(2):113.

1School of Public Health, University of California, Berkeley, California.
2Public Health Institute, Berkeley, California.
3UC Data, University of California, Berkeley, California.
Background, Study Objectives, How It Was Done:
This study reviews research on modified work programs, to see how effective they are in getting people back to work after an injury. The review found 29 studies on the topic dating between 1975 and 1998, 13 of which were of high enough quality to be included. Programs were considered “effective” if they helped people return to work.
Study Findings:
Types of modified work:

Five main types of modified work were described in the study:

Light duty:

The person's activity in their job was reduced. This could be achieved by adapting the person's existing job, or providing a new one.

Graded activity:

The person's hours, duties or performance expectations are gradually increased until they return to their normal duties.

Work trial:

Unpaid or paid work that may be stopped by the worker or employer.

Supported employment:

Paid employment with ongoing work site support from a specialist, usually at a worksite designed for the disabled. Programs of this sort are suitable for workers who have a severe disability.

Sheltered employment:

Paid work, usually at a lower wage, in a position provided as a social service for disabled people.

Two thirds of the modified work programs reviewed were light duty programs, about a third of which involved the worker returning to a new position. Most of the treatment programs reviewed also included other elements like instruction in pain management.

Effectiveness of modified return to work programs:

Nearly all of the studies reviewed found that a program of modified duties helped people return to work. When compared with people who were not offered modified duties, those who were returned to work twice as often and they spent half as many days on sick leave.

Efficiency of cost for modified return to work programs:

Modified work programs reduce the cost of disability. Studies reviewed found a direct cost reduction of between 8% and 90%. None of the studies took indirect benefits (reduced time on administration, prevention of future injuries, etc.) into account, meaning that the savings were underestimated.
Conclusions:
Modified work programs help temporarily and permanently disabled workers get back to work. On average, these programs halve the length of participants' sickness absence and double their chance of getting back to work.

Some programs also seem to reduce disability and workers' compensation costs. This requires mores study before definite conclusions can be reached.

It's not really known how many employers provide modified work duty programs. More education for employers, employees and doctors might help to make such programs more widely available.
References:
No PubMed Abstract Available
Total Votes for this Article: 21 Average Rating: 1.3
Poor                               Excellent