Toronto • May 28-29, 2010 • Student Day and Workshops: May 27
Paper: “That’s not part of the compensable injury”: Subcontractor relations and the under-recognition of health problems among injured workers in Ontario’s Labour-Market Re-Entry program
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Session : 8. Topics in workers' compensation
Day/Time: Friday at 15:15
Room: St. David Room, 3rd Floor
Objectives:
Although there have been many studies of return to work, little scrutiny has been applied to injured workers who cannot return to their old jobs or workplace and require vocational retraining for a new kind of employment. This explorative qualitative study examined how vocational retraining is carried out in Ontario by providers subcontracted by the Workplace Safety & Insurance Board (WSIB). This talk focuses on disjunctures between the administrative logic about healthy workers in the program and the practical reality of incapacitating ill-health among the workers.
Methods:
Using a sociological approach that examines patterns of practice, we examined direct injured worker and provider experience of Ontario’s vocational retraining in the Labour-Market Re-Entry (LMR) program. The data consist of interviews and focus groups across regions of Ontario with 71 injured workers, employers, labour market re-entry service providers, educators, WSIB staff, and worker representatives. Publicly available documents, such as service provider advertising materials, were also included in the analysis. Following general analytic approaches of grounded theory and discourse analysis, we examined the situated narrative of participants and identified contradictory and recurrent themes.
Results:
Although the logic of the LMR program is that it adequately prepares workers for the labour market by focusing on vocational goals and retraining within the workers’ remaining functional abilities, we found that worker ill-health (depression, chronic pain, strong pain medication use, ongoing surgeries) was a key barrier to retraining success. Administrative rules defining ‘maximum medical recovery’, compensable injury, and workers’ vocational aptitudes could lead to over-estimated worker abilities and under-recognized health barriers. Incentives associated with provider contracts and contract renewal further stifled communication by and among service-providers about dysfunctions in the LMR program.
Conclusions:
It is important to examine the process of how different kinds of RTW programs are carried out in practice. This study found workers and LMR contractors ‘going along’ with program logic about healthy workers even when it placed each in an untenable position of trying to teach/learn new skills with workers in ill-health. Subcontracting arrangements with vulnerable populations such as permanently injured workers can be susceptible to poor visibility and resolution of problems. This study identifies new dimensions of the return-to-work continuum and directions for further study.
