Despite growing recognition of the importance of psychosocial factors in reducing ongoing work disability, research into the psychological consequences for injured workers who remain at, or return to work is limited. This study compares injured workers who have returned to, or remained at, work with noninjured workers on measures of personality, trauma symptoms, and symptoms of psychological distress. Data from structured clinical interviews, psychological and self-report questionnaires were gathered from 29 workers, 14 of whom were recovering from an injury at the time of participation. Injured workers demonstrated higher levels of Neuroticism and lower Extraversion, indicating greater emotional instability and lower capacity for adaptively coping with stress when compared to noninjured workers. They also reported subclinical elevations on scales of trauma symptoms, and greater levels of depressive symptoms, somatic complaints, anxiety and sleep disturbance in comparison with noninjured workers. These results suggest that the psychological consequences for workers who return to, or remain at, work following injury may reduce adaptation and increase vulnerability to secondary work disability.

Purpose: This scoping review identifies the foci of research articles that address government laws, policies and programs designed to foster labour market integration of people who, due to illness or disability, face challenges entering or staying in the workforce. Method: A systematic search of English-language peer-reviewed articles published between 2000 and 2014 yielded 14,474 articles. Title and abstract review identified 723 included articles that addressed government-led programs, policy or legislation on work integration and/or income support after injury, illness or impairment. These were sorted by theme, work disability program or policy, disability type, jurisdiction and year published. Results: The number of articles published that address work disability laws, policies and programs increased steadily. Most articles addressed disability in general. Among articles with a specific health focus, mental health was the most common. Research gaps are identified for mixed method study designs, chronic and episodic conditions, illness and cancer, and for work disability policy studies outside of North America, Northern Europe and Australia. Conclusions: We find a growing number of published articles about work disability and policy and identify specific areas where is a need for further research.

Attempts to develop a better understanding of the interaction between the compensation environment and injured workers suggest that the compensation environment may negatively impact on the psychological wellbeing of injured workers. This study offers a complementary perspective to contemporary quantitative studies exploring the psychosocial aspects of workplace injury and disability, and contributes to the growing body of qualitative data on the interaction of personal and environmental factors influencing recovery from work injury. The beliefs and experience of injured workers, as explored through ethnographic interviewing, offer insight to the social meaning and relationships comprised in the compensation environment and reveal the pervasive impact of workplace injury across personal, social and occupational spheres. Poor claims administration and hostile interpersonal interactions are identified as particular sources of frustration and discontent for injured workers. Strong themes of perceived injustice emerge as a potentially valuable area for future research in improving the outcomes of compensable injury.

The aging workforce is likely to result in increasing numbers of workers with disabilities. The US Census Bureau projects that the 45- to 54- and 55- to 64-year-old population in the United States will grow by nearly 44.2 million (17%) and 35 million (39%) in the next 10 years (US Census Bureau, 2004). By the year 2010, this group will account for nearly half (44%) of the working age population (20–64), and the number of people with disabilities between the ages of 50 and 65 will almost double (Weathers, 2006). Disability management and accommodation policies and practices readily lend themselves to addressing the challenges employers will face with an aging workforce, and the increasing prevalence of disability that these demographics bring. Proactive education about ways to maximise the productivity of an aging workforce, effective case management, and workplace accommodation can significantly contribute to maximising aging worker retention.

Employment is a crucial part of adult life and is associated with improved health outcomes. However, despite the several advantages of hiring individuals with intellectual and development disabilities (IDD), the employment rate for this population is still low. An employment conference was organised to inform participants of successful employment initiatives, and to increase our understanding of local employer challenges regarding the recruitment, hire, and retention of employees with IDD. Descriptive statistics were used to assess common methods of recruitment, potential helpful hiring strategies, and recruitment, hire, and retention challenges, and an ordinal logistic regression was conducted to examine whether responses differed based on demographic variables. The conference was evaluated by gathering data on several facets of participant satisfaction. Findings brought to light several key challenges that can be used to create more targeted interventions and supports. Responses to several questions differed by demographics (such as company size and industry type), which represent important areas for future research to examine. Participants reported being satisfied with the conference, and many indicated that their attitudes had changed towards disability and that they were more likely to employ individuals with IDD in the future. Systematically addressing barriers to employment is essential in order to reduce the employment gap and improve outcomes for individuals with IDD. Ultimately, conferences that aim to educate participants about successful programs and strategies represent a promising practice that can increase employment opportunities for individuals with IDD.

A systematic literature review was conducted to assess the individual, organisation, societal, and legal influences of labour participation among individuals with a disability. Methods: Nine databases were searched, for peer-reviewed studies of individual, organisation, societal, and legal influences among disabled populations published between 1990 and 2010.

Results: Of a total of 809 papers initially selected, only 46 studies were deemed to be of sufficient quality to be included in the review. Conclusions: Numerous studies have examined labour participation among persons with physical disabilities, some among persons with chronic disabilities, and few among persons with mental disabilities. Strong evidence was found for individual and organisation influences of labour participation among persons with physical disabilities in particular pain, catastrophising, job strain, and support. Only individual influences provided strong evidence among persons with chronic disabilities and no influences provided strong evidence among those with mental disabilities. The results are presented along with methodological weaknesses and future recommendations.

The idea of corporate integration of people with disabilities, who often have become impaired in the course of their working career, has been reinforced by the German Social Code Book IX. With the implementation of the Section 83 and 84.2, preventive approaches such as integration agreements have put the emphasis on the role of social partners in the disability management process, that is, on to the employers' representative, the representative body of the disabled employees and the Works Council. A sectoral case study of the automotive industry, funded by the German government, was conducted to evaluate the integration agreement, using both quantitative and qualitative data. This article explores the goal-setting function of the integration agreement and its role in the management process.

Although the concept of healthy workplaces has historical roots in the extant literature, it remains an elusive concept to define and apply in the workplace. Nonetheless, the literature does suggest that it is a challenging and continuously improving process of supporting, protecting and promoting the health of the employee. The aim of this study was to devise a user-friendly, climate-specific assessment tool to evaluate employees’ perceptions and knowledge of the practices and procedures in the workplace that prioritise the development of a healthy, supportive workplace. After extensive literature review and early stage pilot-testing of several independent sites within an organisation, a 31-item Likert-type scale — The Workplace Scale (WPS) — was brought forward to test its psychometric properties using an independent international sample that was gathered using email distribution. These initial distribution contacts were two of the author's professional colleagues and thereafter the scale was cascaded electronically to respondents in several countries. The factor analysis conducted on the data obtained from 108 respondents yielded a solid five factor solution that was consistent with earlier test administrations and revealed interpretable and distinct factors that strongly loaded on pertinent dimensions relevant to a healthy workplace. The tangible product is a user-friendly tool to baseline the development of a healthy, supportive workplace, while providing employees with an efficient upward communication mechanism to enable management to monitor progress. Devising the WPS was undertaken as part of wider study that subsequently compared the WPS against measures of climate, leadership and culture and is reported elsewhere.

A significant problem in Sweden is the large number of people on long-term sickness absence and disability pension. To prevent long-term absenteeism, increased focus has been put on employers and disability management (DM). Effective DM, however, also requires a motivated employee. One way to motivate employees to return to work (RTW), is to provide economic incentives. The aim of the current study was to investigate the occurrence of economic incentives for people in Sweden to RTW after long-term sickness absence. The study is based on three fictitious cases. The results show that only marginal economic incentives presently exist in the Swedish RTW system. The necessity for economic incentives in the RTW process can, of course, be usefully debated. Research suggests, however, that such incentives play a part in the RTW process. With stronger economic incentives for the employee, the effectiveness of DM and prospects of job return would, arguably, be enhanced.

Since long-term sickness absence constitutes a problem in most western countries, research that can facilitate return to work (RTW) is important. Today there is evidence that the social context at the workplace has a significant impact on return to work. The dual aims of the study was firstly to investigate the pattern and quality of contact between employees on long-term sick leave and different actors at the workplace, and secondly to investigate whether contacts with the workplace were associated with expectations regarding return to work. An explorative method and descriptive design was used for the first aim. For the second aim, the data was analysed in a multivariate logistic regression model. The results show that employees had frequent and, in most cases, appreciated contact with their supervisor and co-workers. Contact with other workplace actors; that is, the occupational health unit, the union representative, and the human resources department, were less frequent. Employees who experienced the contact as supportive and constructive were far more positive and optimistic than others regarding return to work. It is concluded that supervisors and co-workers should be aware that they play a significant role in the return-to-work process, and that quality of contact is what matters.

Purpose: This research project aimed to explore the views and perspectives of family physicians in regards to fulfilling their role in disability management (DM) — specifically, to examine the discrepancies between physicians' practice in DM and their professional guidelines, with special attention to physicians' experience in collaborating with key stakeholders. Methods: Seven family physicians were interviewed using a semi-structured interview format (8 evidence-based questions and 2 case examples). Interviews were recorded and transcribed. A content analysis of the interview data was conducted in addition to a thematic review of participant responses. Results: Data revealed that in accordance with previous literature, physicians' practice does not typically emulate Canadian Medical Association policy, and the participant physicians described several barriers as the reason for this discrepancy. This study revealed a multitude of frustrations encountered by physicians when interacting with other parties in DM. Participant physicians also reported potential solutions to these frustrations and other related issues. Conclusion: This qualitative study yields valuable insight into barriers, as well as facilitating factors, for physicians in the fulfillment of their DM role. Some practical recommendations for the DM community are presented, while noting that more research should be conducted, including input from key DM stakeholders, to both gain further understanding of physicians' DM function, and to identify viable interventions aimed at optimising their role.

The purpose of this study was to explore how employees perceive their organisation's efforts to address the management of stress in their workplaces and to examine differences based on demographic variables of organisational location and size. A convenience sample of 85 people at an international disability management conference completed a Management of Stress in the Workplace Questionnaire. Results of this survey indicated that employees were not positive about their organisations efforts to manage stress in either prevention or rehabilitation activities. Employees from smaller organisations rated their workplace environments more positively than larger organisations. A perceived high incidence of stress in an organisation was negatively related to perceptions about the work environment. Lower perceived levels of stress-related compensation claims were associated with higher ratings of prevention and higher workplace environment ratings. Effective disability management programs need to address a range of individual, organisational and system factors that cause and exacerbate stress injuries. In addition to the provision of a range of prevention and rehabilitation services, it is important that organisations look at ways to improve workplace culture and, by association, job satisfaction and workplace morale.

This article reviews published research on the effects of disability, age and gender on the job search process. Electronic databases (Medline [via Ovid], OT Seeker, CINAHL, AMED, and Proquest 5000) were used to identify studies focusing on job search and employment, disability, age, gender and other barriers to workforce participation. There has been extensive research on the effects of age and gender on the job search process, and the available evidence indicates that disability, age and gender play significant roles in shaping the job search processes of older workers. However, there has been little rigorous investigation of the role of disability and research specifically examining the relationships between disability, job search behaviours and employment outcomes was not identified. This is a significant gap in the literature on disability and participation in the labour market. Overall, this narrative review indicates that older workers with a disability face multiple disadvantages when seeking work, which impairs their ability to fully engage in the labour market.

Successful rehabilitation outcomes rest on the quality of the links among multiple stakeholders. However, the literature has increasingly recognised the challenges in creating effective partnerships between stakeholders such as external health professionals, employers and injured workers. This study presents findings from an industry-directed project aimed at investigating the links between external health professionals and the employer in relation to return-to-work rehabilitation. Semistructured interviews were conducted with general practitioners (GPs), psychologists, and organisation-based rehabilitation personnel. Findings indicated several major points of consideration to facilitate health professional and employer partnerships, including educating stakeholders about organisational rehabilitation services and key contact personnel within the organisation, establishing standard communication protocols, understanding organisational culture and providing explicit organisational support for the rehabilitation process. To ensure appropriate and timely outcomes for injured workers, the current findings highlight the proactive and educative role that employers must assume when acting in partnership for rehabilitation.

Acquired brain injury (ABI) is considered to be the primary cause of disability in our society. People with ABI face an array of challenges, which include emotional lability, disinhibition, irritability, distractibility, executive dysfunction, memory difficulties, inattention and noticeable changes to personality. Effective rehabilitation and community reintegration is considered essential for those with ABI but impeding the process is society's lack of knowledge and understanding. This is due in some part to the invisible nature of the disability. The focus of this article is to introduce the key areas that influence reintegration, being the rehabilitation process, service access and interventions. It is clear the reintegration process is greatly restricted by the lack of services and programs available to improve the long-term outcomes for people with ABI. To help facilitate successful community reintegration the article developed and lists a significant number of management strategies to assist those who are involved in the lives of people with ABI.

The role of work environments in employability was examined at approximately 8 months postaccident in a sample of 69 trauma-exposed, injured adults with and without PTSD. Results showed that participants with PTSD reported significantly lower employability than those without PTSD and this translated into significantly poorer return-to-work rates. Two work environment dimensions, low work support and poor organisational structure, were significantly associated with low employability in the sample. Low levels of work support were significantly related to high PTSD symptom severity. A combination of 3 variables, PTSD symptom severity, physical functioning, and workplace organisational structure, accounted for 60% of variation in employability. Interventions in the workplace should aim to minimise and accommodate PTSD symptomatology and physical dysfunction. In addition, this study has also shown that workplace-based interventions should be aimed at clarifying expectations about job tasks, and promoting moderate managerial control in the workplace. These factors should be considered for inclusion as standard disability management practices for this population.

The aim of this study is to investigate the perceptions of female employees on long-term sickness absence due to common mental disorders (CMDs), in relation to what they perceive would best help them to return to work. Data were collected through a survey answered by employees at a municipality in Sweden on long-term sick leave. Results of the current study are based on a part of that material, namely from 56 women with CMDs who responded to the final open question. The analysis involves two steps. Initially, we explored themes that form the accounts in the findings. Secondly, based on the themes, collective narratives, storylines were identified. Three different storylines were found to be prominent in the findings. The storylines describe how the participants collectively expressed themselves in relation to the possibilities for return to work, and the following storylines were derived: It feels like too much, Things are moving too fast, and I have to get out of here!. The findings are related to perceived demands, control and support. From a disability management perspective, we have learned the importance of restoring the balance between demands, control and support — not only to prevent absence from work, but also to facilitate return to work after a period of long-term sickness.

Internalising disability management (DM) processes into an organisation needs careful planning and preparation particularly where the existing practice is to outsource DM services and supports to third-party providers. By using an action research methodology, the implementation process of an early intervention and rehabilitation pilot project in a large North American multisite health provider was tracked and monitored. An action researcher, who was the staff member responsible for line managing the DM pilot, kept an action research journal in which the actions taken, outcomes achieved, issues arising, insight gained and successful responses were regularly recorded over the initial phase of the pilot project. Organisational impact indicators for the pilot project were very positive. A content analysis of the action research journal revealed key components in a successful company DM program, the challenges faced when introducing a new program where pre-existing programs and policies exist, challenges arising from project implementation and mechanisms and strategies that worked well. The action research approach provided a useful insight into the day-to-day issues to be addressed when internalising DM into a large multisite organisation.

There is a growing consensus that professional action in occupational rehabilitation should be research-based, and that practice-based knowledge is needed to achieve contextual insight and new theoretical understanding. Few study design examples exist to help inform an evaluation plan and develop research-practice interactions to examine process complexity of targeted occupational rehabilitation programs. This study design article is a proposal on a theory-driven and interactive research methodology for a process evaluation of a pragmatic intervention trial, known as STAiR. The aim of the process evaluation is to examine the delivery and implementation of an inpatient and an outpatient occupational rehabilitation program, and explore active mechanisms pertaining to patient experiences of the return to work (RTW) process. Qualitative and interactive data collection methods will include (a) participant observation of program setting and activities; (b) participatory dialogue conferences with program providers to facilitate initial logic modelling; (d) individual patient interviews at program intake and follow up; and (d) focus groups with rehabilitation teams and external stakeholders. The qualitative data will be supplemented with description of program activities and patient questionnaires. Program logic modelling is suggested to inform a logic analysis of how expected RTW outcomes and delivery of program activities are aligned and how contextual characteristics may clarify differences in achieved RTW outcomes. The proposed process evaluation approach may inform future design discussions and theoretical understanding, and it is expected that the applied knowledge gained through this study may help rehabilitation professionals better navigate potential challenges in clinical evaluation efforts.