Historically, many workplaces have relinquished control and responsibility for disability management to external parties such as insurance carriers, claims managers, workers’ compensation boards, physicians, therapists, case managers, rehabilitation professionals and others. This often resulted in unfavourable return-to-work outcomes and extended periods of lost time for disabled workers. Traditional services often preclude direct interactions between agency staff and workplace representatives, leaving workplace accommodations and transitional work options unexplored. The worker does not return to work until fully recovered, having possibly lost workplace skills and conditioning.

Recognition is growing that collaborative workplace-based disability management programs can help return workers with disabilities to meaningful employment. The following factors have influenced a growing emphasis on these programs:

•  Disability rates are increasing due to cumulative trauma and chronic disabling conditions in an aging workforce. In addition, older workers require longer times to recover from injuries and illnesses. By 2010, 26% of the North American population will be 55 and older and 14%, 65 or older (compared to 21% and 12.6% in 1990).
• As the labour force shrinks due to the gain of the general population, employers will find increasingly difficult to replace workers who have had to leave their jobs.
• Employers are concerned by the effect of increasing disability and disability insurance premiums on their cost of production.
• Downsizing of companies to remain globally competitive is increasing demands on workers, thereby increasing the potential for injury or illness.
• Governments are increasing legislative requirements for employers to accommodate workers with disabilities in the workplace in response to evidence of the significant challenges to employment of persons with disabilities and their declining labour force participation, and the increasing emphasis on human rights of all persons.
• There is growing recognition of the impact of mental health and stress-related disabilities on work productivity. Workers with alcohol/drug problems are more likely to have a time-loss injury or be fatally injured on the job. International studies show that stress is implicated in up to 19% of sickness. The annual prevalence rate of mental health problems in Canada and the USA is 20 to 25% of the total population, with only 10% getting the needed treatment, even though the success rate among those treated tops 70%. The economic cost of depression, anxiety and substance abuse is conservatively estimated at $11 billion a year.
• As the skill level of jobs throughout the Canadian economy increases, the cost of lost productivity and recruiting and training new workers to replace those who become disabled rises.

There is a growing body of evidence that organized, collaborative return-to-work strategies are successful in returning workers to employment, reducing the length of work disability and reducing costs. (see Keys to success)