KITIMAT DRAFT Report

DISTRICT OF KITIMAT 

SITUATIONAL ASSESSMENT REPORT

Situational 

Assessment Report 

District of Kitimat 

DRAFT 

June 2016

This program is a non profit initiative of the 

BCFED Health & Safety Centre. 

The Health & Safety Centre is administered by the 

British Columbia Federation of Labour 

and is funded by the 

BC Workers’ Compensation Board. 


The BCFED Health & Safety Centre 2001. No part of this report covered by this copyright 

may be reproduced in any form of by any means (whether electronic, mechanical, or photographic) 

for storage in retrieval systems, tapes, disks, or making multiple copies, without the expressed 

written permission of the BC Federation of Labour.

Background 

The cost of disability including direct costs such as short-term disability, long-term disability, 

total permanent disability and Workers’ Compensation Board (WCB) costs as well as indirect 

costs such as lost productivity, overtime pay, temporary help and unhappy customers, continues 

to climb for BC organizations. Employers have embraced disability management programs (early 

return-to-work programs for example) in response to these rising costs and increased legislative 

requirements. 

But despite supportive cost data and buy-in from employees/unions and a variety of third parties, 

workplace return-to-work programs are experiencing mixed successes. Too often these programs 

are too narrow in focus, time limited, inconsistent with human rights legislation and many barriers 

to return to work are not properly identified or removed. 

Historical Perspective 

Foreword 

There was a time, not that long ago, when workers injured at work were expected to stay at home 

and remain off work until they were completely recovered and able to do the full functions of 

their job. That ideology changed in the early to mid eighties and the new mentality gained more 

momentum as the courts continued to unravel the meaning of the duties under human rights’ 

legislation. 

There were a number of reasons for the change in attitudes. One reason was the amendment 

and enforcement of human rights’ legislation as well as in some jurisdictions, the introduction of 

statutory re-employment obligations. 

The advancement of a body of medical evidence supporting, that for a majority of musculoskeletal 

injuries, the best rehabilitation was aggressive physiotherapy and a reintegration into modified 

or transitional duties or transitional work. Physicians were of a consensus that for these types of 

injuries, excessive bed rest and passive therapy only served to prolong recovery and lead to the 

acceleration of degenerative conditions. 


Perhaps the most significant reason was, although the economy was generally good, employer 

costs regarding insurance and workers’ compensation premiums were spiraling through the roof. 

Situational assessment 

District of Kitimat 1

More and more employers were being taught that the easiest way to control these insurance costs 

was to get workers off benefits as quickly as possible. There were a number of options available 

in this strategy including: 

• intimidate/threaten a worker so they would not put in a claim 

• dispute any entitlement with insurance or workers’ compensation providers 

• delay sending in proper forms for prompt payment of claims 

• create a workplace attitude that penalizes and isolates injured workers 

• pay a worker to simply sit in the lunch room or change-house 

• hire investigators, medical and claim consultants to dispute genuineness of claims 

• use safety award programs to create co-worker animosity 

• offer modified work that is designed to embarrass or ostracize the worker 

• offer modified work for a short period, and then arbitrarily communicate an ultimatum to 

resume their normal job or go off on benefits 

• offer modified work until the worker can resume normal activities 

As can be seen, almost none of the options seem to approach the problem of rehabilitation or the 

removal of barriers that cause disability. Rather than focus on the provision of therapeutic modified 

work that promoted full recovery and sustainability, employers chose to popularize the sudden 

explosion of a new cottage industry of claim management consultants. 

These consultants focused on disputing claim entitlement and obtaining any claims cost relief 

that was available. This new brand of advocacy did little in regards to the advancement of good 

re-employment practices and resulted in bogging down the adjudication and appeal structures and 

allowed employers to be financially rewarded for engaging in dubious practices. 

Quite simply, Return to Work was NOT working; for employers, workers, unions, insurance 

providers and health care providers. 

Research was undertaken in the field of disability management/accommodation practices with the 

intent of developing leading or best practices. 

One area that was identified consistently was the need to realize where a workplace with respect to 

their return-to-work practices, what performance targets they had, where the gaps in their program 

were and how effective was the evaluation of their overall program. 

In other words, the research confirmed that in order to facilitate positive changes that increased 

successful outcomes, the starting point is determining what the current situation is. This is called 

Awareness”.DRAFT 

“Situational 

2 

Situational Assessment 

District of Kitimat

Situational Awareness 

Situational awareness is the perception of environmental elements within a volume of time and space, the 

comprehension of their meaning and the projection of their status in the near future. Situational awareness 


involves being aware of what is happening around you to understand how information, events and your 

own actions will impact your goals and objectives, both now and in the near future. 

Situational awareness means that a human appropriately responds to important informational cues. This 

definition contains four key elements: (1) humans, (2) important informational cues, (3) behavioural cues, 

and (4) appropriateness of the responses. Important informational cues refer to environmental stimuli that 

are mentally processed by the human. The appropriateness of the responses implies the comparison of the 

response with an expected response or a number of possible expected responses. Expected responses form 

the basis for a performance measure of situational awareness. 

While situational awareness can be defined as a state of knowledge, a situational assessment can 

be described as a process used to achieve that state. It refers to the process of achieving, acquiring or 

maintaining situational awareness. 

Therefore, situational awareness is viewed as “a state of knowledge” and a situational assessment as “the 

processes” used to achieve that knowledge. 

The following “Situational Assessment Survey” will be used to evaluate the effectiveness of the workplace’s 

return-to-work practices and recommend effectual actions to improve outcomes. 

There are 12 areas (attributes) that are explored by the “Situational Assessment Survey”. They are: 

1. Commitment Policy/RTW Policy 7. Linking Primary and Secondary Prevention 

2. Injury/Absence Reporting Procedures 8. Utilization of Disability Prevention Principles 

3. Early Contact & Intervention 9. Compliance with Human Rights 

4. Cooperative RTW Responsibilities 10. Mobilization of RTW Leadership 

5. Elimination of Attitudinal Barriers 11. Internal Dispute Resolution Mechanism 

6. Transfer of Medical Information 12. RTW Program Evaluation 

This first phase of review relies on subjective data gathered by survey questions that are intended to reflect 

the perceptions and experiences of the current RTW practices. The attributes, survey questions and data 

analysis are consistent with the most current return-to-work, evidence-based practices and research. 

The last area of review relies on objective data that will assist to determine the workplace’s retrospective 

performance indicators. 



3

Figure 1 

Key Research: 

The Situational Assessment is developed on fundamental principles and leading practices for successful return to 

work that have been identified by research, including a systematic review of the literature completed by the Institute 

for Work & Health. 

Twelve “Principles” for Successful Return to Work 

1. Strong Commitment/RTW Policy - The workplace has a strong commitment to a successful returnto-work 

program and this is evidenced by a return-to-work policy. 

2. Injury Reporting Procedures - The workplace has a formal Injury/Absence reporting procedure which 

encourages the reporting of injuries, hazards and potential hazards or risks. The absence reporting 

system is consistent for all absences and is communicated to the employees. 

3. Early Contact & Intervention - There is an early contact and intervention strategy. The communication 

is sensitive to the employee and conveys the support of the employer to the health and well-being of 

the employee. 

4. Cooperative RTW Responsibility - Return-to-Work responsibilities are shared cooperatively by the 

workplace parties. There is joint administration of the program in unionized workplaces. 

5. Elimination of Attitudinal Barriers - Education is provided to ensure that misconceptions and negative 

attitudes concerning injured workers are eliminated. 

6. Transfer of Medical Information – There is a communication strategy to ensure health care providers 

are aware of the workplace RTW program and commitment to therapeutic RTW principles. 

7. Linking Primary and Secondary Prevention – Successful accommodation strategies are considered 

and used in prevention strategies. 

8. Utilization of Disability Prevention Principles – Barriers to reintegration into the pre-injury job are 

identified and removed using creative solutions. 

9. Compliance with Human Rights – RTW must default to Human Rights legislation as the highest 

legislative obligation. 


10. Mobilization of the RTW Leadership – All workplace parties must be included and trained on active 

participation in the RTW process. 

11. Internal Dispute Resolution Mechanism – Any disagreement that may arise during the RTW process 

should be dealt with internally through discussions with the key/relevant parties. 

12. RTW Program Evaluation – The program must have continuous scrutiny to ensure it continues to 

provide the necessary support and desired outcomes. 

4 


District of Kitimat

District of Kitimat Overall Assessment Results 

District of Kitimat Situational Assessment Findings: 

Chart 1 

Optimal Score: 38,700 

District of Kitimat Score: 8,410 

21.7% of Optimal Score Achieved 




5

Figure 2 

Strong Commitment/RTW Policy 

Attribute #1 - Key Research: 

The organizational culture is reflected in a policy and indicates that safety and health is prioritized 

alongside productivity and quality control. A policy is a statement of the commitment to safety and 

health and prevention (primary and secondary) of injury/illness in the workplace. All members of 

an organization need to be aware and informed of the safety and health program including policies, 

procedures, roles, responsibilities, training and resources. The written policy should be signed by 

the highest level of management and displayed within the organization in an area where it can be 

viewed by the employer, manager/supervisor, worker and the public. (“Towards an Effective and 

Efficient Regional Occupational health Program for the Health Care Sector in Winnipeg”, disability 

Prevention and Management Guidelines for Health Care – 2003) 

From the onset, employer commitment and involvement in disability prevention and management 

are considered central to the success of disability management. (Chan and Leahy, 1999) 

Managerial policies, practices and attitudes are related to, and perhaps have a causal effect on, 

workplace safety. (Geldart et al – 2010) 

Strong organizational disability management policies and practices are particularly salient for work 

accommodation offers, whereas longer job tenure is particularly salient for acceptance of offers. For 

policy-makers, this suggests that early on in the RTW process, more attention needs to be placed 

on job-level factors, workplace-level factors and policy about mandatory work accommodation to 

improve work disability outcomes. (Franche et al – 2009) 


6 


District of Kitimat

Survey Attributes 

1. Commitment Policy 

Research has shown that a successful RTW program must start with a strong commitment 

from the workplace leadership (management and unions). One method of demonstrating 

this commitment is jointly developing a RTW Policy or mission statement (usually 

one page) that defines the commitment of the parties. The questions were designed to 

assist in determining the commitment of everyone in the workplace regarding a fair and 

equitable RTW Process. 


Optimal Score: 2026 

District of Kitimat 706 

35% of Optimal Score Achieved 

Chart 2 




7

Figure 3 

RTW/AccommodATion Policy 

(The Employer), (The Union) and the Joint Health & Safety Committees (JHSC) (the Parties) recognize their 

moral and legal responsibilities towards employees with disabilities. The Parties have, through consultation 

and a cooperative partnership, developed a Return to Work/Accommodation Program consistent with 

Disability Prevention principles and compliant with all applicable legislation including the Ontario Human 

Rights Code, Occupational Health & Safety Act and the Workplace Safety & Insurance Act. 

The goal of the program is to establish a work environment that promotes health & safety and healthy 

lifestyles, decreases the risk of injury or illness, and enhances the quality of life. A Return to Work 

Committee, with representation of all the parties, will assist in the administration of the Return to Work/ 

Accommodation Program. 

The Return to Work/Accommodation Program is committed to providing a safe and timely return to 

productive and sustainable employment for employees disabled through occupational or non-occupational 

injury or illness. The return to work process restores a worker to the workplace as part of his/her recovery 

program. The program shall be applied fairly and consistently and ensure that every attempt is made to 

provide reasonable accommodation that reintegrates an employee back to their pre-disability position. 

The Return to Work /Accommodation Program will assist employees in achieving safe, timely and effective 

rehabilitation and therapeutic return to work, while maintaining their personal dignity and financial 

stability. The Program will promote a strong relationship between Primary (hazard identification & injury 

prevention) and Secondary(safe, rehabilitative RTW) prevention and ensure the JHSC and the employee are 

active partners in the process. The Program will engage internal and external professional resources where 

appropriate. 

The parties are committed to ensuring that participation in the Return to Work/Accommodation Program will 

not negatively impact the health & safety of other employees. 

All efforts will be made to resolve disagreements or disputes regarding the Return to Work/Accommodation 

Program, or its components, through discussions with management and the union(s) and the JHSC where 

required, and in a spirit of cooperation. Participation in the Return to Work/Accommodation Program will 

not prejudice the employee with disability or any other employee from receiving rights negotiated under the 

collective agreement 

Dated:DRAFT 

The Parties recognize that the duty to accommodate is a shared responsibility. This Program forms part of the 

operating procedures of the organization. 

Signed: 

(Vice President Human Resources) 

(Union President) 

8 


District of Kitimat

Observations: 

1) Less than half of the respondents agree that there is a RTW Policy. This demonstrates in part, 

a lack of effective communication mechanism. 

Chart 3 

The organization has a written RTW Policy statement 

39% 

4% 

8% Strongly Agree 

22% 

Somewhat Agree 

27% 

Unknown 

Whole Audience 

Somewhat Disagree 

Strongly Disagree 

2) Over 50 percent of the respondents agree that supervisors and managers are committed to the 

return-to-work (RTW) policy. This result shows that there is a foundation of respect and trust 

within the organization. This will be an asset should decisions be made to make changes to 

the RTW policy and/or program. 

Chart 4 

Supervisors/Managers are committed to the RTW Policy. 

24% 

17% 

5% 

23% 

31% 

Strongly Agree 



Unknown 






9

3) An overwhelming majority of respondents believe that there is a strong link between Health 

& Safety and RTW and is demonstrated by the policy. As less than half of the respondents 

in previous questions agreed that there was a RTW Policy, it can be assumed that the strong 

response in this question would support that respondents believe that ‘IF” a RTW Policy 

exists, it should support a strong link between H&S and RTW. 

Chart 5 

The RTW Policy supports a link between health & safety and RTW 

16% 

4) Less than half of respondents agree that there is a formal RTW Program. 

Chart 6 

40% 

35% 

13% 

9% 1% 

4% 

18% 

39% 

25% 



Unknown 




The organization has a formal RTW Program. 




Unknown 




10 


District of Kitimat

5) Almost all of the management responses confirmed that they agreed that there was a RTW 

Program, but few others had knowledge of a program if it exists. A strong indicator that a 

communication plan regarding the RTW Program is needed. 

Chart 7 

27% 

Opera8ons 

Maintenance 

Union Leadership 

16% 

Management 

0 5 10 15 20 25 

Percent of Total 

6% 

29% 

22% 

Question 11 



Unknown 



6) The responses here support that a communication plan regarding the RTW Program, and its 

identification of roles and responsibilities needs to be developed. 

Chart 8 

The RTW Program has clearly defined roles and 

responsibilities. 




Unknown 






11

Summary: 

In keeping with the leading research, it appears that the vast majority of respondents agree that there 

is a Policy and strong commitment to that policy by the organization. In contrast, some respondents 

do not agree that the primary goal of the Policy is safe, sustainable, timely and therapeutic RTW. 

This may be explained by the response to question 7 which deals with communication of the 

Policy. 

Recommendations: 

1) Educate workplace senior leadership, both management, non-union and union in regards to 

statutory requirements of accommodation practices and benefits of a good RTW program. 

2) Develop a plan to communicate the Policy to the entire workforce of Thames Valley 


12 


District of Kitimat

Summary: 

In keeping with the leading research, it appears that the vast majority of respondents agree 

that there is a Policy and strong commitment to that policy by the organization. In contrast, 

some respondents do not agree that the primary goal of the Policy is safe, sustainable, timely 

and therapeutic RTW. This may be explained by the response to question 7 which deals with 

communication of the Policy. 


1) Educate workplace senior leadership, both management, non-union and union in 

regards to statutory requirements of accommodation practices and benefits of a good 

RTW program. 

2) Develop a plan to communicate the Policy to the entire workforce of Kitimat 




13

Figure 4 

Injury Reporting Procedures 


Successful firms were highly rigorous in their investigation of accidents. Their efforts are characterized 

by immediate response to incidents and timely determination of the root causes of accidents and 

injuries. These firms also employ formal investigation procedures for near misses. The firms not 

only have regular accident investigation procedures that are documented policy with operational 

procedures spelled out, but their management is responsive to the findings of these investigations and 

timely in implementing corrective solutions. (Hunt et al – 1993) 

Verify the element using the 5 Steps. Look for examples: 

Injury/Illness reporting policy/procedure. 

Required forms and time frames for completion detailed. 

Roles and responsibilities included. 

Flow chart of activities provided. 

Keep records of training for both workers and management regarding their responsibilities for 

reporting work-related injuries and illnesses. ( Health and Safety and Return to Work Assessment, 

Disability Prevention Branch, Workplace Safety and Insurance Board – 2009) 

A transparent system will enable each of these stakeholders to understand the benefits which 

‘‘rehabilitation and return to work before compensation’’ would bring to the workers. 

(Tang et al – 2011) 


Moderate evidence indicated that facilitation of navigation through the disability management system 

improved work absence duration outcomes. Cost reductions from these interventions were achieved 

from increased work hours and improved return-to-work rates. (Pomaki et al – 2012) 

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District of Kitimat

2. Injury / Absence Reporting Procedures 

The research establishes a significant relationship between injury reporting and successful returnto-work 

outcomes. A formal and consistent injury reporting mechanism should instill confidence 

in workers that reporting injuries, hazards and potential risks/hazards is encouraged. 



District of Kitimat Score: 814 


Chart 7 




15

Observations: 

1) 96% of respondents agree that they are aware of who to contact immediately after an 

injury or illness. This shows that communication is being sent and understood in the 

areas of injury and illness reporting procedures. 

Chart 8 

2) Over 80% of respondents agree that injury reporting procedures are clearly 

communicated and understood. A concern arises that the majority of the disagreement 

responses, although a small percentage (10% out of the 14%), are found in the RTW 

participant groups. 

Chart 9 


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District of Kitimat

3) It appears that non-occupational reporting is not as clearly understood by the respondents. In 

this question, 21% did not know and 21% disagreed with the statement. 

Chart 10 

4) Almost 60% of the respondents did not know if there are procedures in place to ensure a copy 

of the Form 6 is copied to the employer. This is slightly higher than the 55% that did not know 

if procedures were in place to ensure the Form 7 is copied to the employee. 

Chart 11 

Chart 11 




17

Summary: 

The responses indicate that the majority of staff are aware of reporting requirements and 

also know who to turn to for help. Education on the procedure will assist those who do not 

know. 

The responses indicate a need to review the current RTW process/program in one particular 

area. A program should be jointly developed that satisfies the needs of all stakeholders (i.e. 

injured workers, employer, management, union(s) and employees. Clearly outlining who is 

available to assist workers with their forms (Form 6 and 7 in particular) and ensure they are 

given to the appropriate parties will resolve this issue. A communication plan needs to be 

developed to educate on the fundamental principles and application of the RTW program 

which will also include the detail of reporting and the necessary forms. 


1) Facilitate the joint review of the RTW program that; 

i) identifies clear roles and responsibilities of everyone involved in the RTW process, 

and 

ii) formalizes the RTW process so that it is applied fairly and consistently in each and 

every case 

2) Develop a communication plan to educate the workforce on the RTW program 

especially as it relates to reporting procedures. 


18 


District of Kitimat

Figure 5 

Early Contact and Intervention 


The initial contact with the worker following disability should express that the workplace cares and 

initiate the conversation on return-to-work. (Larsson & Gard, 2003) 

It is essential to instill the return-to-work thought in the employee’s mind. The employee perception 

of whether they will return to work is a very important variable in whether or not the employee will 

return to work. (Hogg-Johnson & Cole – 2003) 

Our data provides some evidence that early intervention could be beneficial for appropriate subsets 

of high-risk patients, probably in the form of workplace coordination and support, physical activation 

or cognitive-behavioural strategies to overcome emotional distress and negative pain beliefs. 

Our primary conclusion is that the use of patient questionnaires of pain-related concerns and 

expectations can be useful to identify patients in greatest need of early intervention to alleviate 

emotional distress, overcome activity limitations, or increase workplace support, respectively. (Reme 

et al – 2012) 

Facilitating navigation through the disability management system, by providing work absent workers 

with information about modified work options, rehabilitation and the disability management process 

appears to be a simple, yet effective, method of improving return-to-work outcomes among workers 

with common mental health conditions, more so than among workers with low back pain or other 

musculoskeletal disorders. It is possible that providing information to this subgroup of workers gives 

them much needed clarity about what lies ahead in the return-to-work process. (Pomaki – 2012) 




19

3. Early Contact / Intervention 

An early intervention strategy is crucial to the success of RTW efforts. Communication through 

early contact must be sensitive to the employee and the message should confirm the workplace’s 

commitment and support to the health and well-being of the employee. It should not be to entice 

them into a premature return to work before they are medically or psychologically ready to return. 


Optimal Score:1432 



Chart 12 


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District of Kitimat

Observations: 

1) 55% of respondents agree that someone from the organization contacts an employee when they 

are injured in a sensitive manner. Chart 14 shows the distribution of answers for this question. 

Chart 13 

2) There are “unknown” responses in every category except leadership and some “disagree” in 

every category except union non-RTW participants. 

Chart 14 




21

3) Over 50% of the respondents did not know whether or not a communication package 

is sent. Although the majority of the respondents who were unaware were in the nonreturn-to-work 

participant groups, almost 20% were from the non-union return-to-work 

participant group. There is also disagreement with this statement across all of the groups. 

Education is required on what is sent to workers who are absent from work. 

Chart 15 

4) Similar results to the previous question. Over 60 percent are unaware if a package is sent 

to the health care provider and this is across all categories. Disagreement, although small, 

is also across all categories. 

Chart 16 


22 


District of Kitimat

Summary: 

Although an overwhelming majority (94%) of participants agreed that early contact was made, 

and more (96%) were aware of who to contact, fewer were aware of the type of contact and 

information supplied when an employee is off work due to injury or illness. Generally, the majority 

of respondents are unaware of the process regarding communication and planning of return to 

work when a worker is absent from work. 


1) Facilitate a joint review of the early contact and interventions including: 

a) Training for supervisors on the workplace’s commitment to support the worker’s 

health and well-being. 

b) Communications to the workers regarding expectations and procedures when 

absent from work for injury or illness. 




23

Figure 6 

Cooperative RTW Responsibility 


The empowerment of important stakeholders in the workers’ insurance and compensation system and their inclusion 

in the planning of service delivery are crucial for developing a sustainable and effective system. (Tang et al- 2011) 

Work disability involves multiple factors and there are now a number of well-recognized disability prevention 

strategies offered as part of comprehensive, occupational rehabilitation services that have been successfully piloted 

in different countries. These strategies mainly target specific biopsychosocial and environmental/workplace factors 

in an attempt to facilitate the RTW and SAW (healthy stay at work) processes. However, such models require a 

contextual adaptation in order to be successfully implemented in a given country. They also require joint agreements, 

good cooperation among stakeholders and a common understanding of the consequences of work disability. (Costa- 

Black, Chen, Li & Loisel – 2011) 

Most studies suggested optimal relationships among stakeholders were important for RTW Intervention. (Kong 

etal – 2012) 

Additionally, worker and management collaboration through JHSCs continue to play an important role in generating 

and maintaining safe and healthy workplaces. 

Internal responsibility for occupational health and safety comes not only from management but also from the 

interaction between management and labour, from mandated safety committees and from empowered workers. As 

expected, greater agency of the JHSC was related to lower injury rates. While nearly all JHSCs were responsible for 

conducting inspections and investigating serious accidents, JHSCs at firms with lower injury rates were more likely 

to have executive functions and to be responsible for the training of workers. They were also more likely to work in 

collaboration with management. (Geldart et al – 2010) 

Workers’ problems with extended claims were linked to RTW policies that did not easily accommodate conflict or 

power imbalances among RTW parties and by social relations and processes that impeded communication about 

RTW situations and problems. Avenues for intervention are located in a shift to a critical lens to RTW process that 

addresses differences of knowledge, resources and interests among different parties. (MacEachen et al – 2010) 

We recommend employing strategies to encourage a “shared understanding” of RTW – for example, processes that 

bring together workers, unions, employers, insurers and healthcare providers. (Workplace-based Return-to-Work 

Interventions: A Systematic Review of the Quantitative and Qualitative Literature – Institute for Work and Health 

- 2004) 


A person’s chance of returning to the labour market is not solely determined by improvement in health but is 

also affected by individual factors (i.e. sociodemographic and psychological characteristics) and factors from the 

workplace, health and social insurance domains. 

Furthermore, the transition from long-term sickness absence from work is often a complex process involving various 

stakeholders (ie, the affected workers, employers, healthcare providers, and insurers), who may have different 

perspectives on how to achieve a successful RTW. (Helverskov et al – 2012) 

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District of Kitimat

4. Cooperative RTW Responsibility 

A successful RTW program starts with the participation of both management and labour in the 

development and operation of the program. When the union is an equal partner in the development 

and management of the process they, by default, take responsibility to find equitable solutions. 

A cooperative approach fosters problem-solving practices and reduces adversarial tactics and 

negative attitudes. 





Chart 17 




25

1) Almost 50% of the respondents are unaware of whether or not there is a return-to-work 

committee. Chart 19 below shows the distribution of responses across the categories. 

Chart 18 

2) The only group which did not have an “unknown” response was the union RTW participant 

group and they were evenly split with agreeing and disagreeing as to whether or not there is a 

formal RTW committee. 

Chart 19 


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District of Kitimat

3) The responses in Chart 20 might be interpreted as an indication of the split between union 

and non-union workers however, when the distribution by category (Chart 21) is analyzed both 

responses are found across all categories. 

Chart 20 

4) Each category has both “unknown” responses and agreement with the statement that grievances are 

filed with respect to RTW or the duty to accommodate. 

Chart 21 




27

Summary: 

In this attribute, the unknown responses are high in the majority of the questions. Nine out 

of 12 questions have an unknown response near or over 50%. It would be expected that 

for some union-related questions, that the non-union groups may have unknown responses 

however, this response is across the union and non-union categories for the majority of 

questions in this section. In most cases the Leadership group either do not have “unknown” 

responses or a low percentage. 


1. Review the structure of the RTW committee and formalize it within the RTW Program. 

2. Facilitate a joint review of the RTW responsibilities including: 

a) A communication strategy for workers that outlines the roles and responsibilities of 

each workplace party 

b) Education for the workforce in roles and responsibilities of each workplace party 


28 


District of Kitimat

Figure 7 

Elimination of Attitudinal Barriers 


Research evidence has shown that it is behaviours in the workplace that are associated with good 

return-to-work outcomes. (Intracorp – 2002) 

Most thought that the greatest barriers to return to work were workers` fears about injuries and 

unsupportive supervisors or co-workers. (Guzman, Yassi, Cooper, Khohar – 2002) 

If others are disadvantaged by the RTW plan, this can lead to resentment towards the returning 

worker rather than cooperation with the RTW process. The injured worker may have to deal with 

co-workers who resent having to take over some of his or her work and therefore feel that the worker 

has managed to get an ``easier`` job (Workplace-based Return-to-Work Interventions: A Systematic 

Review of the Quantitative and Qualitative Literature – Institute for Work and Health - 2004) 

An extensive review of literatures on employment for persons with disabilities identified the following 

key barriers to employers recruiting and retaining persons with disabilities: Negative attitudes, false 

assumptions and myths and perceptions about persons with disabilities held by employers, managers 

and supervisors and other employees. (Recruitment and Retention of Persons with Disabilities ain 

British Columbia – 2004) 

Future research should include disability outcomes other than return to work and address attitudinal 

and environmental factors at home as well as factors at work. (Guzman et al – 2007) 

Workers’ problems with extended claims were linked to RTW policies that did not easily accommodate 

conflict or power imbalances among RTW parties and by social relations and processes that impeded 

communication about RTW situations and problems. Avenues for intervention are located in a shift 

to a critical lens to RTW process that addresses differences of knowledge, resources and interests 

among different parties. (MacEachen, Kosny, Ferrier & Chambers – 2010) 


In conclusion, managerial and worker participation in OHS initiatives characterizes safer workplaces. 

Also, general concern of management towards OHS—illustrated by both attitudes and concrete 

actions—is also associated with lower injury rates. (Geldart et al – 2010) 



29

5. Attitudinal Barriers 

The negative attitudes of co-workers and supervisors and even injured workers 

themselves have been identified as a significant barrier to successful RTW. The questions 

help identify attitudes in the workplace respecting RTW and how the process impacts 

on others. 





Chart 22 


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District of Kitimat

Observations: 

1) 67% of respondents disagree with this statement. 

Chart 23 

2) 84% of respondents perceive that injured workers are productive. This is positive in that 

the vast majority of workers believe that injured workers are productive which can assist in 

ensuring there is a continuation of positive attitudes towards injured workers. 

Chart 24 




31

3) 73% of respondents believe that the workplace genuinely cares about injured 

workers. 

Chart 25 

4) Over 50% of respondents agree that RTW in this organization is done within 

healthcare professionals expectations. 

Chart 26 


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District of Kitimat

5) Although responses to other questions in this section show that this organization is a caring 

place when workers can return to productive work, this response seems to indicate that there 

is a perception that accommodating workers causes disruptions in the workplace. Chart 28 

shows that the agreement is across all categories and it also shows that there is disagreement 

to the statement in all categories. 

Chart 27 

Chart 28 




33

Summary: 

It appears that many of the respondents have a perception that the RTW process is fairly 

applied and with the best interest of the injured worker as the focal point. The perceptions 

are contradicted in responses to other related questions in the survey that appear to indicate 

that there may be attitudinal barriers in the workplace when accommodations are needed. 

Those barriers need to be addressed to assure successful RTW outcomes. 


1. Develop a process of identifying attitudinal barriers that may negatively impact RTW 

outcomes. 

2. Provide Training when attitudinal barriers are found. 

The training needs to include legal references to support that injured workers 

do not get to pick their favourite accommodation option, nor does the law 

provide them preferential treatment. What the law and research do support 

is that the accommodation process must maintain the worker as the integral 

part of the accommodation process. This means that each RTW plan should 

be developed with valued and significant input from the worker with the 

disability. 


34 


District of Kitimat

Figure 8 

Transfer of Medical Information 


The systematic review showed that contact between workplaces and health care providers reduced 

work disability duration. Employers who have difficulty contacting physicians or who feel that 

physicians delay RTW may end up second-guessing the worker`s doctor when making judgements 

about the worker`s recovery and ability to RTW. (Workplace-Based Return-to-Work Interventions: A 

Systematic Review of the Quantitative Literature, Franche et al – 2005) 

MCP employers were satisfied particularly with the frequency and quality of communication received 

from the health care provider regarding return to work and work modification issues. Improved 

employer-provider communication may foster early return to work and thereby have a beneficial 

effect on health and employment outcomes for injured workers. While the individual most directly 

affected by the method of treatment and the workers’ compensation system is the worker, employers 

are also affected by the outcome of treatment for work-related injuries/illnesses. Consistent with the 

quality of communication regarding treatment, the intervention-group respondents reported more 

frequent updates on time-loss status than comparison group respondents and were more satisfied 

with the quality of information received from providers regarding time-loss claims. Intervention 

group respondents were also more likely to report that injured workers were placed on modified 

work duty than comparison-group respondents. (Kyes, Wickizer, & Franklin – 2003) 

We found that two relatively straightforward interventions: a primary care delivery model for all 

illnesses and injury regardless of their cause coupled with improved communication between the 

employer and the physician were successful in reducing medical expenditures. ( Keyes et al – 2010) 

Finally, an implicit fourth element of successful interventions emerges from these studies: 

Connecting healthcare and workplace systems to impact the return-to-work process as workers with 

CMHCs (common mental health conditions) can be reluctant to seek treatment, especially those with 

undiagnosed conditions. (Pomaki et al – 2012) 


Clinicians demonstrated a high level of agreement (94%) when making RTW recommendations for 

injuries with clear pathology. However, a lower level of agreement (56%) was observed for back 

pain where the etiology of pain and disability is often more complex. Clinicians, most commonly, 

recommended RTW with restrictions, underlining the importance of work accommodations and 

modified duties in facilitating recovery and resumption of work. (Ikezawa et al – 2010) 



35

O 

1 

2 

C 

6. Transfer of Medical Information 

The transfer of appropriate and timely functional abilities information is crucial to early 

intervention strategies. A communications strategy must be developed that educates treating 

healthcare providers about the workplace RTW program and commitment to therapeutic 

RTW principles. Treating healthcare providers must be confident that they will not be relied 

upon as the “gatekeepers” of the RTW process allowing them to focus on treatment and 

rehabilitation protocols. 





Chart 29 


36 


District of Kitimat

Observations: 

1) The strong (72% ) “disagree” response to this statement is an indication of confidence in the 

organization. 

Chart 30 

2) The response to question 66 shows that the union and management know that the employer 

only contacts the healthcare provider with the express consent of the worker. There is an 

opportunity for improvement in that some union (non-RTW participants) respondents as well 

as non-union respondents are unaware of this good practice. 

Chart 31 




37

Summary: 

There is a good understanding of the confidentiality with respect to medical information and 

the good practices at Thames Valley. It does, however, appear that many of the respondents 

who are not management or union are unaware of the process and responsibilities in the 

RTW process as it relates to interactions with healthcare professionals. 


1) Jointly develop a communication package that outlines the roles and responsibilities 

in the RTW process and include a package for the healthcare professionals outlining the 

commitment of District of Kitimat to therapeutic RTW principles. 


38 


District of Kitimat

Figure 9 

Linking Primary and Secondary Prevention 


Fewer incidents resulting in lost work days and fewer workers’ compensation claims in organizations that 

were more diligent and thorough in their safety efforts, devoted management time and resources to support 

prevention, took a proactive approach to return to work (beginning early and involving all concerned parties in 

the process), and created a work climate that values people. (Habeck, Hunt & VanTol - 1998, Habeck, Scully, 

VanTol & Hunt – 1998) 

In addition, workplaces with lower LTFR (lost time frequency rate) benefitted by having JHSCs with more 

executive functions and greater worker involvement. In conclusion, managerial and worker participation in 

OHS initiatives characterizes safer workplaces. Also, general concern of management towards OHS, illustrated 

by both attitudes and concrete actions, is also associated with lower injury rates. (Geldart et al – 2010) 

Our main findings show strong evidence to support the economic merits of ergonomic and other MSK injury 

prevention interventions in the manufacturing and warehousing sector and strong evidence to support systemlevel 

disability management interventions that cut across multiple sectors. (Tompa et al – 2009) 

Our findings suggest that job-level factors, workplace factors and policy about minimum job tenure for 

mandatory work accommodation are stronger determinants of offer and acceptance of work accommodation 

than individual health factors, 1 month post-injury. (Franche et al – 2009) 

Additionally, worker and management collaboration through JHSCs continues to play an important role in 

generating and maintaining safe and healthy workplaces. Internal responsibility for occupational health and 

safety comes not only from management but also from the interaction between management and labour, 

from mandated safety committees and from empowered workers. As expected, greater agency of the JHSC 

was related to lower injury rates. While nearly all JHSCs were responsible for conducting inspections and 

investigating serious accidents, JHSCs at firms with lower injury rates were more likely to have executive 

functions and to be responsible for the training of workers. They were also more likely to work in collaboration 

with management. (Geldart et al – 2010) 


In conclusion, we have shown in this project that disability can be prevented and successfully managed to 

the benefit of the company and its employees when it is a conscious and coordinated part of the company’s 

overall goals. The twin strategies of trying to prevent injuries in the first place and working to minimize 

their disabling effects through disability management techniques in the second place, are both shown to be 

productive in reducing workplace disability. (Hunt et al – 1993) 



39

7. Linking Primary and Secondary Prevention 

Good accommodation strategies result in good prevention strategies. The Joint Health 

and Safety Committee must be involved in the development of accommodation strategies. 

Successful prevention strategies (secondary prevention) should be utilized by the JHSC in 

primary prevention strategies. 





Chart 32 


40 


District of Kitimat

Observations: 

1) This question has the strongest agreement in this attribute yet only 66% agree that there is a 

relationship in the workplace between RTW and prevention. 

Chart 33 

2) There is agreement across the groups on this question yet respondents still have a relatively 

large unknown component in all but union RTW participant and management groups. 

Chart 34 




41

3) 75% of respondents do not know whether or not the JHSC uses successful accommodation 

strategies to prevent injuries in the workplace. 

Chart 35 

Summary: 

It appears that many of the respondents who are not management or the union are unaware 

of the process and responsibilities the JHSC plays in the RTW process. 


1) Jointly develop a communication package that outlines the roles and responsibilities in 

the RTW process and include information on the roles of the JHSC in the RTW process. 


42 


District of Kitimat

Figure 10 

Utilization of Disability Prevention Principles 


A permanent modification of the pre-injury job is the most advantageous form of modified work. 

Yet in the Institute for Work & Health study of 1500 BC workers mentioned above, only 3.5 

percent reported they were offered layout or equipment changes to their work station. Temporary 

modifications such as reduced hours, a flexible schedule and lighter jobs were repeatedly offered to 

15 percent, 13 percent and 28 percent of workers respectively. Neglecting to alter the pre-injury job 

leaves open the possibility for recurrent episodes of back pain in the future. (NIOSH Musculoskeletal 

disorders and workplace factors: US Department of Health and Human Services – 1997) 

Work disability involves multiple factors and there are now a number of well-recognized disability 

prevention strategies offered as part of comprehensive, occupational rehabilitation services 

that have been successfully piloted in different countries. These strategies mainly target specific 

biopsychosocial and environmental/workplace factors in an attempt to facilitate the RTW and SAW 

(healthy stay at work) processes. However, such models require a contextual adaptation in order to be 

successfully implemented in a given country. They also require joint agreements, good cooperation 

among stakeholders and a common understanding of the consequences of work disability. (Costa- 

Black, Chen, Li & Loisel – 2011) 

Return-to-work interventions that include a workplace component result in improved vocational 

outcomes for workers disabled due to a health problem. This effect has been demonstrated 

internationally, across a range of conditions and workplaces and the impact of workplace interventions 

is greater than medically-focused interventions that lack a workplace component. 

Focus group discussions revealed that nurses are more frequently involved with both coordinating 

RTW and managing medical care. Thus, they may need specific medical evaluation skills, knowledge 

about treatment efficacy and best practices. This knowledge may be useful for other RTW coordinators 

without this role but was not found to be essential. 


Conversely, those with vocational counselling backgrounds were more likely to be directly 

involved with not only coordinating the RTW process but evaluating and designing specific job 

accommodations. These activities require skills in work capability evaluation, job task analysis, and 

a high degree of integration into the worksite, more so than other RTW coordinators without these 

responsibilities. (Pransky et al – 2010) 



43

8. Utilization of Disability Prevention Principles 

Every effort must be made to reintegrate a worker back to their pre-injury job by identifying 

barriers to performing tasks and generating creative solutions using work reorganization 

strategies, assistive devices and other internal resources to overcome those barriers. 

Transitional or accommodated work must have a therapeutic value and promote full 

recovery. There should be a holistic approach in RTW planning that takes into account 

social, economic and psychological factors. The worker needs to be the focal point of any 

discussion on RTW planning. 





Chart 36 


44 


District of Kitimat

1) 73% of the respondents agree that the pre-injury job is the goal in return to work. This is an 

underlying principle of disability prevention. 

Chart 37 

2) The answers for this question are almost evenly split but the lowest score is in the “agree” 

category. This indicates that communication and education is needed. Also, a communication 

package needs to be developed to clearly communicate the RTW procedures. 

Chart 38 




45

3) This may be a perception that carries through from the positive results in the commitment 

section. Disability Prevention Principles clearly make the pre-injury job the first and 

best choice. Suitable alternative work may be perceived as doing what is best for the 

injured worker. 

Chart 39 

4) Social considerations are important when determining individual return-to-work plans. 

Removing the worker from the social network of co-workers may have a negative effect 

on return-to-work outcomes. 

Chart 40 


46 


District of Kitimat

5) This relates back to the commitment of the employer and indicates good practices. 

Chart 41 

6) With input from the health care provider as to functional abilities, the workplace parties 

developing the RTW plan are following disability prevention principles. 

Chart 42 




47

7) Although 67% (chart 42) agreed that employees are consulted with respect to the RTW plan, 

only 46% feel that the input is meaningful. 

Chart 43 

8) Only 42% of respondents disagree with this statement and there is agreement with it in all 

categories. 

Chart 44 


48 


District of Kitimat

Summary: 

There are some good disability prevention practices but they need to be communicated to the workers. 

Education is essential in understanding the principles of disability prevention. Having a RTW policy and 

procedures that follow these best practices of disability prevention does not facilitate worker acceptance 

unless they are trained both in the principles and the process used at Thames Valley. 

Recommendation: 

1. Joint worker training in disability prevention principles. 

2. Joint development of a communication package outlining the roles, responsibilities and goals of the 

RTW practices at Thames Valley. 




49

Figure 11 

Compliance with Human Rights 


Human Rights legislation is quasi-constitutional. All other legislation other than the Charter of 

Rights and Freedoms has less authority than human rights. Since protection from discrimination 

for disability is protected under human rights legislation, all accommodations and return-towork 

practices must comply with applicable human rights legislation. 

BC Human Rights Tribunal: Snow v. of Canada Manufacturing Honda (2007) confirms that 

determinations of cooperation under the Workplace Safety and Insurance Act have no direct 

bearing on whether or not the employer has satisfied their obligations under human rights. 

Many Human Rights Tribunal decisions have confirmed the high standard required in the Duty 

to Accommodate and the dual process required in order to meet that standard. The duty has a 

procedural duty and a substantive duty. The procedural process requires a thorough evaluation 

of the barriers and possible accommodations that prevent the worker from fully participating in 

the workforce. Then, the substantive duty is invoked which requires the employer to make the 

modifications or provide the accommodation necessary to allow the employee to fully participate 

in the workforce unless doing so would cause undue hardship (Lane v. ADGA Group consultants 

Inc. – 2007), (Baber v. York Region district School Board – 2011), (Gourley v. Hamilton Health 

Sciences – 2010) 

The essence of accommodating people with disabilities is individualization. As a result of the 

three-step test proposed by the Supreme Court of Canada and re-affirmed by the BC Court of 

Appeal in Entrop, each person with a disability must be considered, assessed and accommodated 

individually. (Policy and guidelines on disability and the duty to accommodate BC Human 

Rights Commission -2009) 


The duty to accommodate on return to work is dynamic and the dual process outlined in previous 

research must be repeated as the workers disability changes and as the ability of the workplace 

to accommodate changes. These changes can be a deterioration or improvement of the condition 

and a change for the better or worse in the ability to accommodate. Changes in the ability may 

include new assistive devices or technology that now allow for an accommodation to occur 

(Cassidy v. Emergency Health and Services commission – BCHRT 2009) 

50 


District of Kitimat

9. Compliance with Human Rights 

The return-to-work program must be designed to default to the highest legislative obligation 

which is Human Rights. A thorough joint investigation of any and all reasonable accommodations 

up to the point of undue hardship ensures the program will meet human rights obligations of the 

workplace parties. The program must also guarantee a process that is timely and treats the worker 

seeking accommodation with respect throughout the process. 





Chart 45 




51

1) Almost three quarters of the respondents agree that the RTW program is compliant with 

human rights. 

Chart 46 

2) Over 50% of respondents do not know how the RTW program is applied to different groups. 

Chart 47 


52 


District of Kitimat

Summary 

The workplace parties believe that the RTW Program is compliant with Human Rights legislation 

although they are not aware of specific aspects of the program such as its application with respect 

to all employees. 


1. Educate the workforce on specific human rights responsibilities for the different groups. 

2. Jointly review RTW program to ensure all aspects meet human rights legislative requirements. 




53

Figure 12 

Mobilization of RTW Leadership 


Supervisors can play an important role in the RTW process. They were identified as important to the 

success of RTW due to their proximity to the worker, their ability to manage the immediate RTW 

work environment and their organizational position which provides a link between the worker and 

senior workplace decision-makers. These findings are reinforced by moderate evidence from the 

quantitative literature that educating supervisors and managers leads to reductions in work disability 

duration. (Workplace-based Return-to-Work Interventions: A Systematic Review of the Quantitative 

and Qualitative Literature – Institute for Work and Health - 2004) 

Most of the supervisors interviewed were very open to finding ways to facilitate the return to work of 

these workers but felt that the interventions used should take both their perspective and the constraints 

they face in the workplace into account. (Lemieux, Durand & Hong – 2011) 

Efforts need to be placed on building the competence of professionals in the system who provide 

services for injured workers. The empowerment of important stakeholders in the workers’ insurance 

and compensation system and their inclusion in the planning of service delivery are crucial for 

developing a sustainable and effective system for China. (Tang et al – 2011) 

We propose that a ‘consensus’ paradigm informs RTW policy and procedures and involves assumptions 

about benign, harmonious social relations and communication processes among RTW parties. This 

approach cannot easily accommodate problems related to power inequalities and social conflict that 

we found in situations of workers with problematic and longterm claims. In identifying the potentially 

damaging role of system processes in RTW problems, we draw attention to issues of procedural 

fairness and competing stakeholder goals. We propose that new solutions to RTW problems might 

emerge from a critical lens on social relations that recognizes and plans for differences in resources 

and interests among RTW systems and players. (MacEachen et al – 2010) 


54 


District of Kitimat

10. Mobilization of the RTW Leadership 

RTW leadership must include front-line supervisors, health and safety representatives and other 

workplace parties. Adequate training must be provided that encourages active participation in the 

development and monitoring of RTW plans. 



District of Kitimat Score: -82 

-12% of Optimal Score Achieved 

Chart 48 




55

1) It would be expected that the employees would not know whether or not the Leadership 

group had received adequate training, however only 29% of the respondents think that 

training has been adequate. There was disagreement with this statement within the 

Leadership group. 

Chart 49 

2) 78% of respondents indicated that not all employees get training on RTW. This 

disagreement with the statement was seen in all categories and can be seen in Chart 51. 

Chart 50 


56 


District of Kitimat

3) 78% of the respondents feel that employees do not get training in the RTW Program. This 

disagreement with the statement was across the board in all categories. 

Chart 51 

Summary 

There is opportunity for improvement in this category. It appears that leadership, as well as most of 

the other categories, feel that more training is required in evidence-based leading RTW practices. 


1. Provide joint training for all workplace parties on evidence-based leading RTW practices. 


2. Ensure all parties are aware of the practices used at District of Kitimat with respect to RTW. 



57

Figure 13 

Internal Dispute Resolution Mechanism 


A workplace may appear to have comprehensive return-to-work procedures in place but if the 

program operates in an adversarial context, these efforts are unlikely to fulfill their main aim of 

getting injured workers back on the job in a safe and timely way. Adversarial circumstances may 

include situations in which injured workers are treated with suspicion as to the legitimacy of their 

claims or when workers believe that the priority of management is only to maximize profits with 

little regard for worker well-being. Studies by the Institute and others examining such issues as the 

perceived legitimacy of injuries and workers income security, have found that these factors can lead 

to damaged relations in the workplace and/or emotional stress and often have a negative impact on 

the workers early return-to-work. (Smith et. al Institute for Work& Health Working Paper #67 – 

1998) 

Research and best practice suggests that mediation, conducted by an independent third party, may help 

resolve claims caused by a breakdown in workplace relationships and assist claimants in returning to 

work. (Bingham, 2004; Bingham & Novac, 2001; Brett, Barsness, & Goldberg, 1996) 

Due to the subjective and emotional aspects of workplace interpersonal conflict, this review considers, 

in a return-to-work context, the relational rather than settlement-based features of mediation models. 

(The Impact of Mediation on Workplace Relationship Conflict and Return to Work Outcomes: A 

Snapshot Review Institute for Safety, Compensation & Recovery Research – 2012) 

Evidence from the research suggests that mediation is potentially a significant new tool for managing 

conflict in the workplace. Findings indicate, certainly for disputes centred on relationship issues, that 

mediation offers an alternative route to traditional and, arguably, more adversarial options such as 

grievance and discipline. Furthermore, there is evidence that, given the right support, mediation can 

offer more control of the process and its outcomes to disputants, again in comparison to alternative 

routes. (Bennett – 2012) 


Furthermore, professional education and training on improving workplace-based intervention 

structures and procedures differs among the deliverers. These issues complicate agreement on 

appropriate strategies to address work disability at this health organization, including implementation. 

Calls for employer and union representatives to co-operate in an approach to work disability and 

interventions at the workplace have an undeniable logic. (Maiwald et al – 2011) 

58 


District of Kitimat

11. Internal Dispute Resolution Mechanism 

Every endeavour should be made to resolve any disagreement about the RTW Program internally 

through discussion amongst the key parties. These parties may be the RTW co-ordinator, the injured 

worker, the supervisor/manager/lead hands, the union, co-workers and the healthcare provider. 

The discussion may require informal consultation, involvement of the JHSC, an agreement to 

obtain independent medical information, seek out more expert advice on accommodation options 

or it may require the creation of a mediation process. 





Summary: 

Chart 52 

65 percent of respondents do not know about any dispute resolution process with respect to RTW. 

It is encouraging that only 13 percent feel the process is adversarial however, this is higher than 

those who feel it is not cooperative. 

Recommendation: 


1. Jointly develop an internal dispute resolution mechanism 

2. Provide training to the workforce on the internal dispute resolution process. 



59

Figure 14 

RTW Evaluation 


Companies need to track, gather and analyze data, especially as it relates to the direct and indirect 

costs associated with employee absences. Without creating this primary foundation for the company’s 

disability management infrastructure, it is impossible to create the necessary benchmarks to measure 

outcomes. (Calkins et al – 2000) 

Like most programs, disability management initiatives require ongoing evaluation to ensure that the 

program operates effectively and weaknesses in its design or operation are identified and corrected. 

It is important, however, that the outcomes of the program are not measured too narrowly. Returning 

workers to modified work (or even to their regular job) is only one outcome. Workers may have 

recurrent episodes of pain and/or time off work and this is particularly true for those with back injuries 

who are more likely to have recurrences than those with other types of injuries. Thus, the injured 

worker’s improvement on measures such as pain severity should also be assessed as a component of 

the evaluation. (Butler, Johnson & Baldwin – 1995) 

The development of mechanisms that monitor the operation and effectiveness of established IN and 

RTW policies and procedures with the intention of identifying and addressing any weaknesses that 

arise. By implementing the policies and procedures outlined above, James, Cunningham & Dribben 

(2006) assert that the needs of injured workers are able to be identified in a timely and collaborative 

fashion so that they can be addressed in a co-ordinated and positive way by the employer. (Best 

Practice in injury management and return to work – literature review – 2007) 

The process evaluation utilizes questionnaires, interviews and municipal data. The effect evaluation 

tests whether participants in the intervention have a (i) shorter duration of full-time sickness absence, 

(ii) longer time until recurrent long-term sickness absence, (iii) faster full RTW, (iv) more positive 

development in health, workability, pain and sleep; it also tests whether the program is (v) costeffective. 

The process evaluation investigates: (i) whether the expected target population is reached; 

(ii) if the program is implemented as intended; (iii) how the beneficiaries, the RTW teams and the 

external stakeholders experience the program; and (iv) whether contextual factors influenced the 

implementation. The Danish RTW program is, to date, the largest RTW intervention ever conducted. 

The program combines a multidisciplinary, coordinated and tailored approach delivered by specially 

trained RTW coordinators and multidisciplinary RTW teams within the municipal sickness benefit 

offices. The evaluation of the program is extensive and includes effect, process and economic 

evaluations. . (Helverskov et al – 2012) 


60 


District of Kitimat

12. RTW Program Evaluation 

The program must undergo continuous evaluation to ensure that it is administered effectively and 

to implement any necessary corrective measures in the design or administration of the program. 

The program is not meant to be administered simply as a cost savings measure. The evaluation 

must include worker based outcomes. 





Chart 53 




61

1) The majority of respondents did not know about program evaluation which would 

be reasonable if this process has not been developed. Over half of the respondents 

indicated that training is not offered frequently to upgrade skills 

Chart 54 

2) There is disagreement across the board indicating that training to upgrade skills may be 

warranted. 

Chart 55 


62 


District of Kitimat

Summary 

With the exception of training being offered to upgrade skills, the most common response and 

highest percentage (over 50%) for this set of questions is unknown. Education of the workforce 

once the process of evaluating the RTW program is established will lead to valuable feedback 

from the workforce when the program is being updated. 


1. Jointly develop a program evaluation tool which includes data on worker-based outcomes as 

well as cost savings related details such as length of absences and secondary prevention solutions 

that have been implemented for primary prevention. 




63

OVERALL SUMMARY 

The situational assessment of the District of Kitimat has shown areas with 

opportunities for improvement; however, it also shows good practices that can form 

the basis for a strong return-to-work program. 

The results indicate that the strongest attribute is first; commitment. Eighty percent 

of the respondents indicate that the intent of the return-to-work program is to return 

workers to safe, timely, sustainable and therapeutic work. This basis forms a very 

good baseline for any changes made to improve the RTW process. 

Along with Attribute 1, Attribute 2 scored well. Having a process for injury reporting 

that is known and understood by employees will assist the organization in preparing 

for RTW. A formal and consistent injury reporting mechanism instills confidence in 

workers that reporting injuries, hazards and potential risks/hazards is encouraged. 

Again, this forms a good baseline for any changes made to improve the RTW process. 

Attribute 10 - Mobilization of RTW Leadership had the highest opportunity for 

improvement. The main cause for the low score on this attribute was a perception of 

lack of education of the workforce. By addressing this concern, RTW leadership will 

be able to continue their work which, for the most part, follows the best practices. 

Changes that are made to RTW practices must be communicated to the workforce as 

well as the leadership so that everyone has an understanding of the leading practices 

used at District of Kitimatfor RTW. 

Attribute 12 - Program Evaluation, and Attribute 4 - co-operative RTW responsibility 

should improve with education of the workforce on the leading practices of RTW. 

With respect to Program Evaluation, all parties, once they are aware of the need 

to evaluate and have training will provide valuable input into the Program. For 

Attribute 4, the results are low due to larger numbers of “unknown” responses rather 

than disagreement with the statements. Education should improve this attribute as 

well. 


To build on the good practices already in place and take advantage of the opportunities 

for improvement, the following overall recommendations should not only enable 

District of Kitimat to provide RTW for workers with disabilities that is safe, timely, 

sustainable and therapeutic but also see improvements in objective indicators such 

as reduced insurance (compensable and non-compensable) costs. 

64 


District of Kitimat

VALIDATION OF GOOD PRACTICES 

1. The organization has a RTW policy. 

2. The organization has a formal RTW Program (specific comments follow). 

3. Occupational and non-occupational disability/accommodation treated the same. 

4. Full-time, part-time or casual workers are all treated the same in the RTW process. 

5. The RTW program promotes access to health care. 

6. The organization assumes the responsibility of costs associated with getting 

necessary information to facilitate RTW. 

7. New hires receive appropriate information regarding the RTW process through 

new employee orientation. 

8. The organization utilizes the services of external experts where required. 

9. The organization performs an annual review of the RTW program. 




65

OVERALL RECOMMENDATIONS 

1. Educate workplace senior leadership, both management, non-union and union in regards to 

statutory requirements of accommodation practices and benefits of a good RTW program. 

2. District of Kitimat review and edit RTW Policy and Program, as necessary to ensure leading 

practices and disability prevention principles are followed. Within this Program should 

be a provision for communications packages for workers with disabilities and healthcare 

providers outlining the procedures to follow and the guiding principles of the RTW Program. 

An internal dispute resolution mechanism and a program evaluation should also be built 

into the program. 

3. District of Kitimat should educate the workforce on Human Rights and the revised RTW 

Policy and Program with additional education for Leadership, union representatives and 

Joint Health and Safety committee members on their obligations and responsibilities. This 

would include employee responsibilities under the law regarding non occupational disability. 

The training would explain the inappropriate use of sick time and the consequences. 

Resources: 

Examples of RTW Policies that reflect disability prevention practices are available for reference, 

however, the content of each Policy needs to be cooperatively determined by the workplace 

parties so that it best reflects their workplace. 

Examples of RTW Programs that reflect disability prevention practices are available for 

reference, however, the content of each Policy needs to be cooperatively determined by the 

workplace parties so that it best reflects their workplace. 

Many training programs are available on disability prevention, Accommodation Law, 

Elimination of Attitudinal Barriers and Return to Work. 


66 


District of Kitimat




67

KITIMAT DRAFT Report

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