Injured workers who have unusually protracted compensation claims are the subject of curiosity—in part because such claims can entail significant costs to the compensation system which are ultimately passed onto employers. Such inquiries are often couched in terms of “what is wrong with these workers?” The Journal of Occupational Rehabilitation has published an article examining this issue from a different perspective.
“The ‘‘toxic dose’’ of system problems: Why some injured workers don’t return to work as expected” considers the effect of seeming innocuous bureaucratic problems on workers and a potential explanation. The authors posit workers’ experience of these systemic dysfunctions damages them in difficult to see ways which impede recovery and return to work. The study focuses on Ontario but has broad application as most workers’ compensation systems provide employers with incentives to provide modified work to injured workers in order to reduce time away from work.
The study found that return to work (RTW) systems and policies are premised upon inaccurate assumptions about how RTW actually operate. For example, the parties may not be communicating well and there may be conflicting motives among stakeholders for participation in RTW. These issues manifest themselves in seemingly mundane ways: “inappropriate modified work, injuries that are not reported, co-worker hostility, untimely and inappropriate referrals for retraining, physicians who are too busy for paperwork, workers’ compensation decision-makers who communicate inadequately with workers by mail and telephone” (p. 360). The seeming insignificance of these difficulties makes it difficult to “see” them as issues that can compromise the effectiveness of RTW programs.
Yet these systemic defects have important mental and physical consequences for injured workers. For example, “inadequately informed benefit entitlement decisions can result in denial of income and other support benefits to workers, who, can then, suffer financial and mental strain and deteriorating health conditions” (p. 360). This dynamic effectively overwhelms workers who already face injury-related difficulties. Herein lies the “toxic dose” administered by the system to injured workers and perhaps an important piece of explaining why some compensation claims generate seemingly unwarranted costs and delays.