Welcome to the Winter, 2007 issue of HealthBeat. HealthBeat is a semiannual occupational health and wellness e-newsletter put together by experts from the University of Michigan Health System’s MWorks Occupational Health and MFit Health Promotion Divisions. To sign up to receive the electronic version of HealthBeat, or to give us feedback on what you read, visit https://www.med.umich.edu/secure/mworks/feedback

Workplace Health

Successful Strategies for Return to Work
Sue Bade, M.P.H., O.T.R., Senior Occupational Therapist/ Ergonomic Consultant,
University of Michigan Health System, MWorks Occupational Health

How can an employer determine whether an employee has the ability and motivation to return to work after an injury? What if the employee is physically healed but is so afraid of re-injury that attempts to return to work have failed? What can an employer or an insurance program do to facilitate a successful return to work?

Employing the services of a skilled occupational therapist who can conduct a holistic evaluation of the worker, including physical, cognitive and mental health capacities, is a good place to start. The occupational therapist will also analyze job tasks, taking the employer’s perspective into consideration. A skilled occupational therapist strives to develop a win-win outcome by identifying and facilitating a match between the employer’s needs and the worker’s capacities.

The best occupational therapists have the ability to negotiate with all parties in the return to work process to develop and implement a plan to achieve the common goal of a safe and successful return to work. The plan may involve development of accommodations, strategies and compensatory techniques that the employee can utilize to overcome limitations in physical, cognitive or mental health capacities.

Below are examples of three cases where an MWorks occupational therapist was instrumental in achieving a successful return to work that was a win-win for both employer and employee. (The names have been changed to protect the identity of the employee.)

Case #1
Maria was a valued 20-year manager diagnosed with depression, anxiety and diabetes. Both Maria and her employer hoped that she could return to work from her mental health medical leave, however, all were concerned that the difficulties she experienced in meeting performance requirements prior to her leave would return. That risk, and a decline in work relationships related to the mental health issues, was very scary for both Maria and her employer. An MWorks occupational therapist met with the department manager and Maria. The occupational therapist acknowledged Maria’s most recent performance limitations, reviewed Maria’s current status as well as the department’s needs, and developed a plan to support her return to work. For two months, the occupational therapist met weekly with Maria and her supervisor to review her week’s performance and to plan for the next week’s production. With structured meeting agendas, the group progressively advanced Maria’s schedule and responsibilities and implemented accommodations (such as developing computer-based accommodations to help organize her workload). Maria returned to full duty and both she and her supervisor were grateful and perceived that the occupational therapist facilitated a win-win return for Maria and the department.

Case #2
Jerome was a valued and popular material handler/machine operator released by his doctor to return to work following a catastrophic automobile accident. His new limits in memory and material handling precluded the possibility of returning to his prior job which required working as part of a machine-paced assembly team and lifting 50 pounds. Jerome’s company felt with Jerome’s knowledge of the business he could still be a valuable employee. They called in an MWorks occupational therapist who reviewed the company’s work tasks and met with Jerome and his employer. Together, the team identified jobs that could be accommodated to meet Jerome’s return to work restrictions. Those jobs applied Jerome’s prior knowledge of the workplace, using repetitive tasks and self paced timing to meet the production goals.

Case #3
Michael had amputated a couple of fingers while working on his machine operation job. Now, surgically healed, but fearing re-injury, he returned to work where he continued to have problems with hyper-sensitivity and limited range of motion in his dominant hand. An MWorks occupational therapist provided a functional capacity evaluation. The occupational therapist encouraged Michael to be active at home within his newly appreciated safe limits learned in testing, and she helped with adapting a protective glove for Michael to wear while working. The occupational therapist, Michael and the employer met to review the job demands and perform an on-site evaluation of Michael’s ability to work safely and meet production demands. Through a gradual return to work process and weekly reviews with the employer and occupational therapist, Michael and his employer developed confidence in Michael’s abilities and safety. The occupational therapist facilitated group development of accommodations for hand tools and modified work strategies within the employer’s guidelines. Michael returned to full duty and is thrilled to be re-engaged with his co-workers.

MWorks has occupational therapists who are skilled at assisting with all types of return-to-work scenarios. For more information call 734-975-3045.

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