RTW program for workers with low-back pain

STEP 1: A worker who has been off work due to low-back pain for two to six weeks sees an occupational health physician, who stresses the importance of keeping up or returning to normal activities, including work. This physician keeps in touch with the worker’s family physician to ensure they are in agreement with respect to recovery advice and the importance of returning to work.

STEP 2: The occupational health physician refers the worker to an ergonomist or occupational health nurse (further references to an ergonomist below also refer to an occupational health nurse). The ergonomist meets with the worker at the worksite to learn about his or her workstation, job tasks and perceived RTW barriers. The ergonomist then meets with the supervisor to get his or her perspective on RTW barriers.

STEP 3: Based on the information collected from the worker and supervisor, the ergonomist prepares an inventory of RTW barriers with respect to the low-back pain. The three then sit down together to reach a consensus on the top three or four RTW barriers. Disagreements are mediated by the ergonomist. In a brainstorming session, they identify as many solutions as possible to these barriers. The solutions are evaluated and chosen, with preference for solutions that are easy to implement at little to no cost (e.g. lifting aids are preferred over a complete workplace redesign).

STEP 4: The ergonomist, worker and supervisor agree on a plan for implementing the chosen solutions, identifying who is responsible for each solution and within what timeframe. As much as possible, the worker or supervisor is held responsible (e.g. if a solution calls for a new ergonomic chair, the worker or supervisor will be asked to order and test the chair, not the ergonomist).

STEP 5: A month after the plan is agreed upon, the occupational health physician evaluates the degree to which it has been successfully implemented. Solutions and other workplace adjustments are fine-tuned at this point, if necessary. The implementation plan is called successful when the worker returns to the same job he or she held before the low-back injury (or to an equal job at the same pay) and remains in that job for at least four weeks.

Source: At Work, Issue 57, Summer 2009: Institute for Work & Health