Reference no: EM133334883

Case Study: ACanadian sample was collected as an aspect of a large international project, with representation from Australia, Canada, China, and Switzerland. In each country, interview and survey data were collected using team-created research tools. Canadian survey data on disability management (DM) perceptions were collected from 218 employees in both public and private organisations. Our Canadian employee sample reported perceived influence of disability prevention on job satisfaction, physical health, mental health, and morale for both themselves and their coworkers. Return to work programs were seen as valuable for job satisfaction of both the employee and coworkers, as well as the physical health of coworkers. Similarly, stay at work programs were seen as valuable for mental health and morale of coworkers. There was no relationship between perceived influence of DM interventions and reduction of sickness absence. The influence of DM was perceived as more positive for private and/or nonunionised workplaces. No gender differences were evident. Keywords: disability management, Canada, job satisfaction, health, morale, absenteeism Disability management (DM) has increasingly been recognised on an international scale as a valuable intervention for the reduction of occupational disability (Buys, 2010). Importantly, DM has value for the spectra of workplace stakeholders via its contribution to reduced human and financial costs related to workplace illness and injury. Current estimates suggest that illness and disability in Canada total approximately 2.4% of gross payroll (Stuart, 2013) that, in 2012 alone, totalled 16.6 billion dollars. In Canada, the development of DM has been driven by perceived stakeholder value as well as a changing legislative environment more onerous for employers. Exponentially increasing costs and recent changes in policy and legislation have significantly expanded responsibility for employers in terms of addressing illness and disability in the workplace (e.g., government, WorkSafeBC).

Canadian Context Given its modest universal transfer and social insurance systems, Canada is often considered a liberal welfare state (Esping-Andersen, 1990). Social disability systems are provided by federal and provincial authorities through employer or public taxation. Federal systems are primarily provided through federal employment insurance sickness benefits or the Canadian Pension Plan in the form of disability insurance or disability savings plans. At the provincial level, disability benefits are typically provided through workers compensation or disability. pension (Service Canada, 2013). From the perspective of the authors, Canada continues to face significant challenges to effective DM including differences in legislation by provincial or territorial government, lack of consistency in interpretation and implementation of DM, lack of stakeholder communication, and lack of strong Canadian research evaluating DM value and best practice. Review of Canadian Literature Along with Australia and Germany (and others), Canada has been considered an integral player in international DM, providing several of the primary texts in the field (Dyck, 2013; Geisen & Harder, 2011; Harder & Scott, 2005; Harder, Wagner, & Rash, 2014). In addition, Canadian researchers have contributed to the DM literature in terms of literature/systematic review, qualitative and quantitative work. Effectiveness of disability management. In an effort to evaluate the DM's potential contributions, Franche et al. (2005) completed a systematic review specifically intended to evaluate the effectiveness of workplace-based return to work programs. By searching the English- and French-language literature of seven databases from 1990 through 2003, they identified 4142 peer-reviewed papers looking at return to work intervention and pain related or musculoskeletal condition. From the initial search, 10 studies were considered sufficient quality to be included. From these articles, there was strong evidence for reduced disability duration under circumstances of work accommodation offer and contact between healthcare provider and workplace. There was moderate evidence for reduced disability duration in circumstances of early contact with worker by workplace, ergonomic worksite visits, or presence of a return to work coordinator. Although evidence of sustainability for these effects was limited, all five factors also had moderate evidence for reduced costs. In contrast to Franche et al.'s (2005) positive findings, Mustard, Kalcevich, Steenstra, Smith, and Amick (2010) completed a secondary analysis with existing data from Canadian long-term care facilities. Using a representative sample of compensation records from provincial workers (2005-2006), these authors found no reduction for disability burden under the conditions of modified duty. It was highlighted however, that provincial compensation records are limited and often inaccurate, perhaps accounting for the lack of findings. Factors affecting disability management. Lemieux, Durand, and Hong (2011) completed an exploratory qualitative study investigating supervisor perceptions regarding return to work of employees with common mental health disorders. Semistructured interviews were completed with 11 supervisors from medium and large sized companies who had been responsible for at least a single employee off work due to mental illness. From these interviews, 24 hindering or facilitating factors for return to work with common mental disorders were identified and classified into three primary categories, including factors related to the worker, workplace context, and return to work process. Similarly, Westmorland, Williams, Amick, Shannon, and Rasheed (2005) completed a qualitative study (with a survey component) during which 58 Canadian employees were interviewed and identified job accommodation, meaningful communication, and job retraining as important aspects of the DM process. Ergonomic modifications, DM policy and procedure, and health and safety education were also considered integral aspects of a workplace DM program. Taken together these studies suggest the importance of multi-level considerations when proposing DM interventions. Stakeholder perspectives on disability management. In addition to their contributions regarding DM factors, Lemieux et al. (2011) contributed knowledge regarding stakeholder perspectives. Specifically, these authors noted that although supervisors were open to facilitating return to work for workers with common mental health disorders, supervisors also wanted their own perspectives and constraints recognised in the process. Supporting the perspectives identified by Lemieux et al. (2011), Franche et al. (2005) provide a literature review that contrasts the challenges of diverse stakeholder paradigms in studying and implementing disability interventions. Although these authors recognise that stakeholder friction is inevitable, they propose that dissonance can be reduced such that common goals can be achieved through collaborative problem solving. The writers also propose that calibration of stakeholder involvement, supervisor and insurance case manager roles, and return to work intervention procedures can be important in reducing resulting friction. Also linked to supervisor involvement, Busse et al. (2011) surveyed 88 employees and 75 supervisors from a Canadian insurance company. The employees and supervisors were surveyed about attitudes and experiences regarding the DM process with the majority of respondents endorsing positive views towards the DM experience. However, areas of potential improvement were identified, and included case manager-employee interaction, support during the return to work process, and improvements in modification to work situations. Other research groups have considered stakeholder perspectives beyond the immediate worksite environment. For example, Harder et al. (2006) were interested in predicting return to work of injured workers from employer DM perceptions and policies; examining factors that influence DM policies, procedures and outcomes; and examining the relationship between work, or demographic factors and return to work outcomes. Their findings highlighted that the existence of DM policies were related to company perceptions of DM