For a decade, from 1999 to 2009, the proportion of disability episodes of long duration compensated by Ontario’s Workplace Safety and Insurance Board (WSIB) steadily went up. This was a serious problem, given that injured or ill workers experience profound emotional, physical and economic losses when their recovery and return to work is delayed. As Judy Geary, the WSIB’s vice-president of program development, puts it:
This led to longer claim durations, higher costs and dissatisfied stakeholders.
To turn this trend around, the WSIB introduced a new case management focus for the delivery of services to injured workers and their employers, with an emphasis on improving RTW outcomes. In doing so, it incorporated procedures based on the best evidence available, and Institute for Work & Health (IWH) research played a pivotal role.
When designing staff protocols and determining what to do when in the life of a claim, we certainly relied on the Institute’s research, Geary says.
Indeed, researchers from the IWH met regularly with WSIB staff during the design and development of the model to offer advice about the appropriate use of research evidence.
IWH research helps inform WSIB thinking
In particular, IWH research on return to work, recovery, claim complexity and interventions was
quite formative in WSIB’s thinking, says Geary. This included the work of IWH scientists such as Drs. Renée-Louise Franche (now an IWH adjunct scientist), Ellen MacEachen, Sheilah Hogg-Johnson, Emile Tompa and Ivan Steenstra.
The WSIB began rolling its new model out across Ontario in the fall of 2008 and into the spring of 2009. The model includes a number of features that Geary traces back to IWH research. For example:
- The model adopts a case management framework, in which a case manager assesses very early in the life of a claim the degree of WSIB involvement needed to ensure an injured worker’s return to work.
IWH research and researchers helped frame the ‘powerful questions’ we ask to determine if an injured worker’s return to work is likely to be straightforward or problematic,says Geary.
- A new role is created, the RTW specialist, for the case manager to call in when an injured worker and workplace are having difficulty developing an RTW plan.
The IWH research leading to the ‘Seven Principles for Successful Return to Work’ showed that RTW co-ordination is key,explains Geary.
The RTW specialist was created directly as a result of that research.
- The new model is designed to ensure that an injured worker quickly learns if his or her claim for workers’ compensation benefits has been accepted. This is based on several IWH studies that showed the time to a first decision is related to recovery and return to work.
Research shows a long delay results in poorer outcomes,says Geary.
So we put a lot of effort into re-engineering the process to enable timely first decisions.
Geary reports that RTW outcomes have improved.
Case duration has declined at the three- and six-month marks for the first time in a decade, she said at the Canadian Association of Researchers into Work and Health conference.
We believe we have a leading practice model.