Citation

Eakin JM, Maceachen E, Clarke J. Pol. Pract. Health Saf. 2003; 1(2): 19-41.

Copyright

(Copyright © 2003, Institution of Occupational Safety and Health (Great Britain))

DOI

unavailable

PMID

unavailable

Abstract

Although there is considerable research on the effectiveness of various approaches to promoting successful return to work after work-related injury or illness, little is known about the process in small workplaces. This paper reports on a study of the effects in small workplaces of a particular set of policies and practices in Ontario, Canada, called 'early and safe return to work', an approach that emphasises workplace self-reliance and return to work before complete recovery via 'modified' work accommodation. On the basis of qualitative analyses of documents and interviews with employers, injured workers and compensation/rehabilitation professionals, the study found that early and safe return to work can disrupt workplace norms and patterns of social interaction, and create hardship, albeit of different sorts, for both employers and workers. Employers experience conflict between their administrative role in the early and safe return-to-work process and the demands of running a small business, while injured workers find their participation governed more by the 'discourse of abuse' and the social dislocations of injury and modified work than by best rehabilitation practice. This situation can lead to an erosion of trust arising from what both employers and workers perceive to be the betrayal of moral understandings in the workplace, to the 'hardening' of co-operative intent, and to an increasing tendency to 'play it smart' with the system of early and safe return to work - responses that can subvert the objectives and intent of the policy, and compromise possibilities for mutually satisfactory solutions. The paper concludes with reflection on the implications of these findings for return-to-work policy and practice, particularly in relation to small workplaces.