06 Apr WorkFitBC: Beyond the Worker’s Compensation Board
As a kinesiologist in an occupational rehabilitation program (OR1, specifically), I have been directly affected by how WorkSafeBC (Worker’s Compensation Board, or WCB) has increasingly recognized the value of early and frequent exercise therapy and work conditioning for helping injured workers: Whereas the program I was responsible for had just two clients when I started, the program is now almost always at/near maximum capacity. Overall, occupational rehabilitation programs are beneficial because they provide a treatment environment where exercise is emphasized and injured workers can perform guided physical rehabilitation longer and more frequently.
WCB’s mandate is to return workers to the pre-injury job as soon as possible. They cover treatment only for body parts covered under the claim and only for the purpose of enabling the worker to perform pre-injury job tasks. The limitations in WCB’s mandate means that employers and workers need to take additional proactive approaches towards occupational health and safety for several reasons:
1. Physical rehabilitation concludes when (or shortly after) the worker is deemed capable of performing the minimum pre-injury job demands
When they return to work following injury, workers may have suboptimal movement patterns/posture which either developed to compensate for the claim-related injury or which existed prior to the claim-related injury (and possibly contributed to the injury). As an occupational rehab program kinesiologist, I definitely am in favour of workers returning to work as soon as it is safe to minimize the negative psychological impacts of disability, prevent loss of employment and career opportunities, and allow myself and my colleagues to help more workers. At the same time, while rehabilitation professionals generally do not recommend workers to return to work when there are compensatory movement strategies that put them at high injury risk for injury, it is often not realistic to fully correct suboptimal movement patterns within the treatment timeline covered by WCB, if possible at all. This is particularly the case if workers have had these suboptimal movement patterns and/or postures for many years. Unfortunately, this means many workers return to work with these suboptimal movement patterns/postures but no longer have guidance on how to improve them.
2. Safe workplaces, not necessarily safe bodies: Exercise training is only covered reactively after an injury has already occurred
While WCB has policies and procedures in place to make workplaces as safe as possible, these do not ensure that workers have sufficient fitness and health for the job (unless the worker has a permanent disability accepted by WCB). As discussed in my previous article, workers often have poor movement patterns and insufficient fitness and health for their jobs, all of which predispose them to pain and injury. Addressing these issues to keep workers safe at work is not as simple as simply doing “stretches” pulled from the internet, but usually requires guidance from appropriately-trained professionals. Unfortunately, although While WorkSafeBC has recognizes the value of exercise training for injury rehabilitation, however, exercise training is never covered by WCB for the purpose of improving workers’ health and function for work.
3. What happens if an injured worker returns to a new job?
WCB pays close attention to a worker’s pre-injury job demands to ensure the worker receives the required treatment to return to that same job. This information is also crucial for determining when the worker is considered capable of returning to that job, i.e. the return to work date, at which point wage loss benefits and rehabilitation conclude.
However, WCB is not required to provide physical rehabilitation to improve the worker’s physical function beyond the minimum required for the pre-injury job. This means that a worker might not have fully regained pre-injury function when health care coverage and wage loss end. Most of the time, this is not an issue because the worker can continue the appropriate exercises after returning to work (as mentioned earlier, I fully support having workers return to work as soon as it is safe).
But what happens when a worker does not return to that same job following the injury (e.g. due to loss of employment, change in employers, change in the nature of the job, or change in position), even when considered capable by WCB? If the injury continues to negatively impact the worker’s physical abilities, the worker may be denied certain job opportunities.
Here’s an example scenario to make this issue more concrete:
Sally injured her right shoulder after stocking merchandise for 8 hours while working as a sales associate at a department store. At the time of injury, she worked in a department where she was required to lift products of up 5 lbs to shoulder height, move a light dolly with merchandise, as well as operate the phone, computer, and cash register. WorkSafeBC determined that she was capable of returning to her pre-injury job tasks once she demonstrated the ability to lift 5 lbs to shoulder height and to use her right arm for day to day tasks.
A week after Sally returnsher return to work, however, the store reorganizes reorganized its departments such that Sally would need to lift at least 20 lbs to shoulder height to perform the sales associate duties. While Sally was able to lift 5 lbs to shoulder height, she was unable to lift the 20-lb merchandise to shoulder height as her right shoulder did had not fully regained its strength yet. Because Sally is unable to perform all the expected job duties on her own, her employer scheduled her for fewer work shifts. Sally was also not considered for the promotion to department manager.
Sally could have avoided or reduced the severity of the injury if she had stronger shoulders, better posture, and learned to perform job tasks in a way to reduce stress on the shoulders.
What do WCB’s limitations in treatment coverage mean for employers and workers who care about occupational health and safety?
To stay safe and healthy at work, workers not only need a safe workplace, but also:
- Good movement, body mechanics, and posture during work and daily activities
- Good health
- Fitness levels that meet (ideally exceed) the physical requirements of the job
- Ongoing professional support upon return to work to correct compensatory movement patterns/postures after injury
Given how most people have priorities and obligations that make it difficult to do what is required to achieve the above conditions. Employers can greatly support the health and safety of their workers by making the required steps as easy as possible by: By
- creating an organizational culture where health is emphasized, and by
- providing workers the easy access to relevant guidance, resources, and education.
Engineered Bodies can help organizations keep their people healthy and safe at work by delivering corporate fitness services to the workplace.