Abstract
Purpose: This study aimed to explore if and why the return-to-work (RTW) experiences of various workplace stakeholders in the Netherlands and Denmark differ between physical and mental health conditions, and to understand the consequences of potentially different experiences for the RTW process in both health conditions.Methods: We studied 21 cases of long-term sickness absence, and held a total of 61 semi-structured interviews with the various actors involved in these cases.Results: Physical cases were seen as “easy” and mental cases as “difficult” to manage, based on the visibility and predictability of health complaints. On this ground, assessing work ability and following required RTW actions were perceived as more urgent in mental than in physical cases. Despite these perceptions, in practice, the assessment of work ability seemed to impair the RTW process in mental cases (but not in physical ones), and the (non-)uptake of RTW actions appeared to have similar results in both mental and physical cases.Conclusions: With these outcomes, the effectiveness of a differential approach is questioned, and the relevance of a bidirectional dialog on work ability and a phased RTW plan is highlighted, regardless of the absence cause. Our study also demonstrates how policymakers need to strike a balance between obligatory and permissive legislation to better involve workplaces in RTW issues.Implications for rehabilitationBoth physically and mentally sick-listed employees could benefit from a bidirectional dialog on work ability as well as from a phased RTW plan.A greater role for employers in the RTW process should be accompanied with a support for sick-listed employees, in both physical and mental sickness absence cases.Dutch and Danish RTW legislation could be improved by carefully balancing obligatory and permissive rules and regulations to involve workplaces in RTW matters.
Highlights
During the past two decades, the main purpose of many European welfare states in case of sickness absence has changed from providing benefits, to activating sick-listed employees to return to work (RTW) early.[1,2] These “activation policies” regard work as a better form of welfare than passive benefit receipt,[3] and promote an early RTW of sick-listed employees before they have reached full recovery.[4]
The RTW process has become the domain of a multiplicity of workplace stakeholders, such as sick-listed employees, immediate supervisors, Human Resource (HR) managers, occupational health physicians (OHPs), unions, and coworkers.[4,7,8]
In comparing stakeholders’ RTW experiences between physical and mental health conditions, we will present the findings following the two main themes that have been revealed during data analysis: (1) conflicting interpretations of work ability, and (2) different perceptions of required RTW actions
Summary
During the past two decades, the main purpose of many European welfare states in case of sickness absence has changed from providing benefits, to activating sick-listed employees to return to work (RTW) early.[1,2] These “activation policies” regard work as a better form of welfare than passive benefit receipt,[3] and promote an early RTW of sick-listed employees before they have reached full recovery.[4] the focus is no longer on determining the inabilities of sick-listed employees, but on discovering their remaining ability to work, despite their illness.[5] The emphasis on work has led to an increasingly important role for employers (and workplaces) in the RTW process, which is based on the belief that they are well positioned to judge what work their employees can still perform as well as the required work(place) adjustments.[1] In doing so, employers are expected to be able to reduce the economic burden of sickness absence to society.[6] the RTW process has become the domain of a multiplicity of workplace stakeholders, such as sick-listed employees, immediate supervisors, Human Resource (HR) managers, occupational health physicians (OHPs), unions, and coworkers.[4,7,8]
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