English version - Fit for Work Europe

MSDs and employers
Given that MSDs are one of the most common work-related health problem, and the importance
of psychosocial factors in determining whether employees remain in employment or return to it
as soon as possible, managers need to have the skills to deal with staff who have MSDs.
The role of line managers in early intervention is crucial, both for work retention and
rehabilitation. Yet many line managers feel ill-equipped to manage long-term absence and
incapacity. They may find aspects of poor mental health or chronic incapacity awkward and
embarrassing to talk about or confront, and are concerned about asking for more information
on sick notes, making home visits or telephoning staff at home. Line managers may fail at these
tasks for the fear of being accused of harassment or falling foul of the law, and thereby landing
themselves and/or their organisation in a tribunal. They are also ignorant of, or uncomfortable
with, the idea of rehabilitation. Most line managers, particularly in small-scale organisations, find
job re-design difficult, irritating and disruptive.
On the face of it, many of the return-to-work challenges faced by employees with MSDs could
be improved if there was an improved level of mutual understanding between employers and
clinicians. As highlighted above, clinical appreciation of most MSDs among the employers can
be cursory. It is often argued that most clinicians, in turn, have little or no appreciation of the
vocational or occupational dimension of many MSDs. Medical students in Japan generally
spend a very small proportion of their course learning about occupational health.
Quite often both employers and occupational physicians will focus on the aspects of the job
which an MSD patient cannot currently perform, rather than on those which they can. Employers
will only very rarely consider the value of an MSD patient’s return to work. Because of the
mutual lack of understanding among employers and clinicians, and the resulting dearth of
dialogue between them the MSD patient is left stranded, with no clear pathway back to work,
and more importantly, no voice in their rehabilitation. An approach to vocational rehabilitation
that is proactive, inclusive, multi-disciplinary, capability-focused,, and one that is informed by the
biopsychosocial model and delivered through case management is widely regarded as the most
effective for dealing with the majority of work-related MSD cases.
Fit For Work? Musculoskeletal Disorders and the Japanese Labour Market 61