IWH research helps shape new work integration initiative

In November 2010, Ontario’s Workplace Safety and Insurance Board introduced the new Work Reintegration Program. Many of its features address problems with the old vocational rehabilitation program that were described by Institute for Work & Health research.

Published: January 18, 2012

By 2009, Ontario’s Workplace Safety and Insurance Board (WSIB) was certainly getting the message that its vocational rehabilitation program for injured workers, called Labour Market Re-entry (LMR), was not working as intended. Although bad press and a value-for-money audit drove the point home, evidence from a research project started two years earlier also indicated problems were afoot.

That research was led by Institute for Work & Health (IWH) Scientist Dr. Ellen MacEachen. Although the results of the research are just now being published, they played an important role in shaping the WSIB’s new Work Reintegration Program, introduced in November 2010. The program, which integrates return to work and vocational rehabilitation, addresses many of the problems described by MacEachen’s research.

Study uncovers range of problems

MacEachen’s study, carried out from 2007 to 2009, had a deceptively simple aim: to understand how LMR actually operates for injured workers in Ontario. At the time, the Board’s vocational retraining program offered through LMR was geared to workers who were injured at work and could not return to their former workplace, usually because they had suffered a permanent impairment.

The LMR program’s aim was to help these workers re-enter the labour market with a different employer, in a job that would suit their functional abilities and pay them close to what they were previously earning. This often meant returning to school to get the needed credentials for employment.

The function of placing workers in vocational retraining programs was outsourced to seven firms, whose case managers priced, designed and oversaw an individual worker’s program. Through these programs, workers often ended up at private training schools throughout the province.

Using qualitative research methods, MacEachen and her team conducted interviews and focus groups with 71 people across Ontario who were directly involved with LMR, including workers, employers, educators at schools that provided retraining, case managers from the contracted firms, workers’ compensation staff and worker representatives. The study described a number of problems (see at-a-glance: LMR findings below).

WSIB’s new program tackles issues

MacEachen’s research is now getting published in peer-reviewed journals. One paper about the functioning of the program was published online ahead of print in September by the Journal of Occupational Rehabilitation (Epub 2011 Sep 6; DOI: 10.1007/s10926-011-9329-x).

Although results are just making their way into the academic world, they played a key role in shaping the WSIB’s Work Reintegration Program (WRP). In part, that’s because a WSIB representative was a member of the stakeholder group advising the research team.

As well, Judy Geary, vice-president of work reintegration at WSIB, was a partner in the research and thus privy to the results as they became available. Being the key person responsible for overhauling the return-to-work and vocational rehabilitation system at the WSIB, she wanted to incorporate the research evidence into its design. The Labour Market Re-entry study was instrumental in pointing us in the right directions for the new program, says Geary.

The new WRP phased out the use of external LMR service providers and brought case management back inside the Board. Geary traces a number of WRP features to MacEachen’s research. These include:

  • more opportunities for choice. Injured workers are being given more chances to make their own decisions about their occupation, the nature of their retraining (on-the-job versus school) and, if an academic route is chosen, what type of school they attend. This is directly related to the finding that injured workers felt they were put on treadmills of training programs that they didn’t want to be on, but had to stay on in order to maintain their workers’ compensation benefits, says Geary.
  • more retraining pathways. MacEachen’s research showed that offering just one pathway—the academic route—was a bad fit for many injured workers, says Geary. Therefore, the new program allows for other options, such as on-the-job training.
  • access to community colleges. The problems at private training schools noted by the research led the WSIB to build alliances with the province’s community colleges. If an injured worker chooses the academic route, he or she can now go to a community college or accredited private school, says Geary.
  • placement services. The WRP now offers 12 weeks of placement services, through contracted providers, for those not returning to their old employer. The research emphasized that injured workers face a lot of barriers and stigma as they’re searching for work, says Geary. Therefore, we’re providing enhanced support to find work.
  • part-time work. The research showed that the all-or-nothing approach of LMR— full-time work or none at all—did not fit the needs of workers who wanted to work but could only manage limited hours. We’ve opened up the possibility of part-time employment, says Geary. If an injured worker is able to work 20 hours a week and that is the best possible route, then the WSIB will pay the wage-loss difference.

Including stakeholders such as Geary in the loop as study evidence emerges represents a new model for disseminating research to policy-makers, says MacEachen. It means they don’t have to necessarily wait until results appear in print, which can take too long for stakeholders, she says. A lot has been done to improve vocational retraining at WSIB, and much was prompted by our research evidence. That’s exciting for us as researchers to see.

At-a-glance: LMR findings

The IWH qualitative study on the workings of LMR pointed to the following problems:

  • Some workers were not in a position to learn well. They were in chronic pain, on strong medication, subject to ongoing treatment and surgeries, etc.
  • Workers sometimes felt “coerced” into making choices.
  • Injured workers were sometimes being retrained for jobs that did not match their functional abilities.
  • Part-time work was not an option, even if it was better suited to a worker’s functional abilities and job sustainability.
  • The outsourced nature of the program introduced a communications disconnect between injured workers and the WSIB.
  • Some workers were being sent to school to retrain for occupations that would be better learned on the job (e.g. cashier).
  • Private training schools were sometimes pushing workers through their programs quickly and lowering learning expectations to make their own success rates look good.