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Purpose: Injured workers can experience adverse effects from work injury and claims processes.Workers may be treated unfairly by employers, compensation boards, and return-to-work coordinators; however,how workers respond to these challenges is unknown. This article describes how injured precarious workersresponded behaviourally and emotionally to procedural unfairness in work injury and claims processes, and whatworkers did next., Methods: Interviews were conducted with thirty-six precariously employedinjured workers recruited in Ontario through social media, email, cold calling, word-of-mouth, and the "snowball"method. Thematic code summaries were analyzed to identify how precarious workers responded to procedural unfairness., Results: Workers went through all or most of these five stages (not always linearly)when faced with procedural unfairness: (1) passive, (2) fought back, (3) quit pursuit of claim, (4) quit job, and (5)won or got further in fight. Feeling confused, angry, frustrated, unsupported, disappointed, determined, optimistic,and wary were common emotions., Conclusions: Identifying unfairness and its emotional,behavioral, and material effects on workers is important to understand implications for compensation systems.Understanding and recognizing unfairness can equip employers, legal representatives, compensation boards, andphysicians, to address and prevent it, and provide worker resources. Policy changes can ensure accountability andconsequences to unfairness initiators., (© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Purpose: The objective of this study was to explore how workers' compensation policies related to healthcare provision for workers with musculoskeletal injuries can affect the delivery and trajectories of care for injured workers. The principal research question was: What are the different ways in which workers' compensation (WC) policies inform and transform the practices of healthcare providers (HCPs) caring for injured workers?, Methods: We conducted a cross-jurisdictional policy analysis. We conducted qualitative interviews with 42 key informants from a variety of perspectives in the provinces of Ontario and Quebec in Canada, the state of Victoria in Australia and the state of Washington in the United States. The main methodological approach was Framework Analysis., Results: We identified two main themes: (1) Shaping HCPs' clinical practices and behaviors with injured workers. In this theme, we illustrate how clinical practice guidelines and non-economic and economic incentives were used by WCs to drive HCP's behaviours with workers; (2) Controlling workers' trajectories of care. This theme presents how WC policies achieve control of the workers' trajectory of care via different policy mechanisms, namely the standardization of care pathways and the power and autonomy vested in HCPs., Conclusions: This policy analysis shed light on the different ways in which WC policies shape HCP's day-to-day practices and workers' trajectories. A better understanding and a nuanced portrait of these policies' impacts can help support reflections on future policy changes and inform policy development in other jurisdictions., (© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background: Following a work-related permanent impairment, injured workers commonly face barriers to safe and successful return to work (RTW). Examining workers' experiences with the workers' compensation (WC) system could highlight opportunities to improve RTW outcomes. Objectives included summarizing workers': (1) appraisal of several WC-based RTW programs, and (2) suggestions for vocational rehabilitation and WC system improvements to promote safe and sustained RTW., Methods: In telephone interviews, 582 Washington State workers with work-related permanent impairments were asked whether participation in specified WC-based RTW programs helped them RTW and/or stay at work. Suggestions for program and system improvements were solicited using open-ended questions; qualitative content analysis methods were used to inductively code responses., Results: Most respondents reported positive impacts from RTW program participation; for example, 62.5% of vocational rehabilitation participants reported it helped them RTW, and 51.7% reported it helped them stay at work. Among 582 respondents, 28.0% reported that no change was needed to the WC system, while 57.6% provided suggestions or critiques. Reduce delays/simplify process/improve efficiency was the most frequent WC system theme-mentioned by 34.9%. Among 120 vocational rehabilitation participants, 35.8% reported that no change was needed to vocational rehabilitation, while 46.7% (N = 56) provided suggestions or critiques. More worker choice/input into the vocational retraining plan was the most frequent vocational rehabilitation theme-mentioned by 33.9%., Conclusions: This study's findings suggest that there is substantial room for improvement in workers' experience with the WC system. In addition, injured workers' feedback may reflect opportunities to reduce administrative burden and to improve worker health and RTW outcomes., (© 2021 Wiley Periodicals LLC.)

This scoping review identified what kinds of work disability policy issues are critiqued in articles published in countries with cause-based versus comprehensive welfare systems. Drawing on a review of work disability policy research, we identified 74 English-language, peer-reviewed articles that focused on program adequacy and design. Articles on cause-based systems dwelled on system fairness and policies of proof of entitlement, while those on comprehensive systems focused more on system design complexities relating to worker inclusion and scope of medical certificates. Overall, we observed a clear difference in the nature of problems examined in the different systems. Gaps in work disability policy literature are identified, and challenges for comparative policy research are discussed.

Today's labor market has changed over time, shifting from mostly full-time, secure, and standard employment relationships to mostly entrepreneurial and precarious working arrangements. In this context, self-employment (SE), a prominent type of precarious work, has been growing rapidly due to globalization, automation, technological advances, and the rise of the 'gig' economy, among other factors. Employment precarity profoundly impacts workers' health and well-being by undermining the comprehensiveness of social security systems, including occupational health and safety systems. This study examined how self-employed (SE'd) workers sought out support from informal support systems following illness, injury, and income reduction or loss. Based on in-depth interviews with 24 solo SE'd people in Ontario, Canada, narrative analysis was conducted of participants' experiences with available informal supports following illness or injury. We identified three main ways that SE'd workers managed to sustain their businesses during periods of need: (i) by relying on savings; (ii) accessing loans and financial support through social networks, and (iii) receiving emotional and practical support. We conclude that SE'd workers managed to survive despite social security system coverage gaps by drawing on informal support systems. [ABSTRACT FROM AUTHOR]

Background: Roughly 10% of occupational injuries result in permanent impairment. After initial return to work (RTW), many workers with permanent impairments face RTW interruption due to reinjury, unstable health, disability, and layoff. This study used open‐ended survey data to: (1) explore workplace factors identified by workers as important levers for change, some of which may previously have been unrecognized; and (2) summarize workers' suggestions for workplace improvements to promote sustained RTW and prevent reinjury. Methods: This study included data from workers' compensation claims and telephone surveys of 582 Washington State workers who had RTW after a work‐related injury involving permanent impairment. The survey was conducted in 2019, about a year after claim closure. We used qualitative content analysis methods to inductively code open‐ended survey responses. Results: The most frequent themes were: safety precautions/safer workplace (18.1%), adequate staffing/appropriate task distribution (16.2%), and safety climate (14.1%). Other frequent themes included ergonomics, rest breaks, job strain, predictability and flexibility in work scheduling practices, employer response to injury, social support, communication, and respect. Many workers reported that they were not listened to, or that their input was not sought or valued. Workers often linked communication deficiencies to preventable deficiencies in safety practices, safety climate, and RTW practices, and also to lack of respect or distrust. In counterpoint, nearly one‐third of respondents reported that no change was needed to their workplace. Conclusions: Policies and interventions targeting worker‐suggested workplace improvements may promote safe and sustained RTW, which is essential for worker health and economic stability. [ABSTRACT FROM AUTHOR]

Sickness insurance and workers' compensation systems decide on peoples' eligibility for benefits, and are commonly based on medical certificates and assessments of work ability. Systems differ in the extent to which they preserve clients' dignity and right to fair assessments. In this article, we define a new concept for studying interactions between individuals and systems: social insurance literacy, which concerns how well people understand the different procedures and regulations in social insurance systems, and how well systems communicate with clients in order to help them understand the system. The concept was defined through a scoping literature review of related concepts, a conceptual re-analysis in relation to the social insurance field, and a following workshop. Five related concepts were reviewed for definitions and operationalizations: health literacy, financial/economic literacy, legal capability/ability, social security literacy, and insurance literacy. Social insurance literacy is defined as the extent to which individuals can obtain, understand and act on information in a social insurance system, related to the comprehensibility of the information provided by the system. This definition is rooted in theories from sociology, social medicine and public health. In the next step, a measure for the concept will be developed based on this review. Social insurance literacy is a new concept that is based on theories in sociology, social medicine and public health. It provides conceptual orientation for analyzing factors that may influence different outcomes of peoples' contacts with social insurance systems. The concept is of relevance for rehabilitation professionals since it focuses on how interactions between individuals and systems can influence the rehabilitation process. The study will in the next step develop a measure of social insurance literacy which will have practical applications for rehabilitation professionals. [ABSTRACT FROM AUTHOR]

Background: First‐line health care providers are the primary access point for workers' benefits. However, little is known about their impact on quality of care and return‐to‐work. Our objective was to critically compare literature on the practices of first‐line providers for workers with musculoskeletal injuries in Ontario and Quebec (Canada), Washington State (United States), and Victoria (Australia). Methods: A critical interpretive synthesis of peer‐reviewed scientific literature was conducted. The search across six databases yielded 59 relevant publications that were critically appraised. Results: Three themes emerged: 1) how policies about first‐line health care providers' modulate worker access to care, 2) how these providers' roles, practices, and training shape disability management, and 3) how the quality of care and disability outcomes are evaluated. Conclusions: First‐line health care providers have a critical influence on workers' trajectories of care. A focus on their role while taking the complexity of the context into account will help orient future policy changes. [ABSTRACT FROM AUTHOR]

Purpose:Theoretical and empirical research findings attest to the workplace being a social environment in which co-workers have a critical influence on the employment outcomes and return-to-work (RTW) success of other employees. However, co-workers do not have a formal role in RTW planning. The aim of this study was to explore how managers responsible for developing and implementing RTW procedures view the role of co-workers in this process. Method:An exploratory qualitative pilot study was conducted in Canada. Participants (1 male; 13 females; mean experience in RTW = 11.8 years) were workplace (n=8) or RTW managers (n=6) with direct oversight of RTW plans. The participants were recruited via invitation from a research institute and were drawn from three different provinces. Data were gathered via open-ended questions and were coded and subject to thematic analysis. Findings:Three key themes were identified: (1) Managers view RTW as having little relevance to co-workers but expect them to cooperate with the arrangements; (2) Formal procedures are inadequate when psychosocial barriers to work resumption are present, so managers use informal strategies to engage co-workers’ emotional and social support; and (3) Managers have difficulty integrating RTW procedures with other legal obligations, such as privacy and confidentiality requirements. Conclusion:Existing arrangements for the development and implementation of RTW are sufficient most of the time, but may be inadequate when an injured worker presents with psychosocial barriers to work resumption.Implications for RehabilitationStandard RTW arrangements can be inadequate when a RTW plan requires active co-worker support.Privacy and confidentiality provisions can result in managers using informal procedures for information exchange and to engage co-workers.The use of risk management strategies – assessment, consultation and communication – could be used to include co-workers when workplace issues threaten the success of a RTW plan. [ABSTRACT FROM PUBLISHER]

There is a large body of research examining work disability management and the return to work (RTW) of sick or injured workers. However, although this research makes clear the roles of the returning worker and supervisor, that of the co-workers is less well understood. To increase understanding of this topic, we have identified, reviewed, and discussed three studies that emerged from our connection with a Canadian research-training program. The first study, conducted in Sweden by Tjulin, MacEachen, and Ekberg (2009), showed that co-workers can play a positive role in RTW, but this is often invisible to supervisors. The second study, undertaken by Dunstan and MacEachen (2013) in Canada, found that RTW could both positively and negatively impact co-workers. For instance, co-workers may benefit from learning new skills, but may also be burdened by the need to assume extra work to accommodate a returning worker. The third study, performed in Belgium by Mortelmans and Verjans (2012) and Mortelmans, Verjans, and Mairiaux (2012) reported the need to include the expectations and objections of co-workers in RTW plans and implemented a three-step RTW tool that involves co-workers. Taken together, these studies highlight the social context of work, the positive role played by co-workers in the RTW process, the impacts of workplace social relations on RTW outcomes, and the benefits to all of involving co-workers in RTW plans. [ABSTRACT FROM PUBLISHER]