Only a few months remain in the 2010-2014 Strategic Plan developed by the Commission de la santé et de la sécurité du travail (CSST). The plan includes five main priorities, one of which was improving CSST service quality that was broken down into the two main strategic themes: 1) optimizing the management and prevention of chronic injuries and their consequences and 2) improving CSST’s service offering. Luc Meunier, Chair of the Board and CEO, stated the following in the plan (translation):
“Another one of our priorities is improving service quality. Workers with a major injury or risk of chronic injury will require numerous resources over the coming years. These injuries represent nearly 75% of annual compensation and rehabilitation costs.”
Considering that 4% of claimant files compensated by the CSST account for 75% of annual compensation and rehabilitation costs, the CSST sought to focus its actions on long-term cases, that is, cases that take place over six months or more (data taken from the document De la réparation à la prévention de la chronicité, CSST, M. Grondin and R. Auclair, Eastern Township Conference, May 22, 2013). In response to this, the CSST implemented the Détectôt program to reduce the average duration of long-term compensation and optimize chronic injury management and prevention. The plan’s detailed targets include reducing average compensation duration by 5% for long-term cases from 2010 to 2012 and by 2% in 2013 and 2014.
The Détectôt (early detection) program, as its name suggests, aims to help CSST stakeholders detect risks of chronic injury early on, as soon as a claim’s eligibility is validated. Chronic injury has negative consequences for workers including challenges in returning to work, namely due to a loss of confidence or negative thoughts concerning the injury. Therefore, all managers should commend this initiative.
The following risk factors for chronic injury were identified by the CSST in connection with the Détectôt program (translation):
- Health care professionals who promote disability and who do not offer solutions to improve the worker’s condition
- Health care professionals who advise the worker to leave or change jobs
- Being in a state of emotional distress for over 90 days
- Spreading of pain to lower limbs (lumbar back pain)
- Recurrent pain at the injury site
- Work dissatisfaction
- Conflicts with colleagues or superiors
- Worker considering not returning to regular work within three months or indecisiveness
- Worker belief in inability to perform tasks again
- Stopping or avoiding physical activities related to daily life
- Reliance on passive adaptation strategies only
- Distressing thoughts
- Feelings of injustice
- Repetitive, monotonous or imposed pace of work
When a file has one or more of these risk factors, the CSST takes action. It meets with the worker individually and communicates with the employer to visit the workstation when the worker’s occupational injury took place. No doubt, practitioners might note a lack of consistency in the program’s application since, sometimes, certain files are not handled as a priority by the CSST when they should be. Therefore, it’s important, as an employer, to have vigilant managers who will ensure that the CSST honours its obligations, and even meet with the CSST if necessary.
Meetings held in the workplace involving all players (the worker, the employer, the hierarchical superior, union or prevention mutual representatives, compensation agents and CSST rehabilitation counsellors and managers) help resolve sometimes challenging and often costly situations for the employer, such as a work stoppage. Rallying efforts to promote a return to work is another one of the CSST’s objectives to optimize chronic injury management and prevention.
All too often, employers dismiss this approach as impractical or premature. In fact, meetings are frequently organized before even permanent functional limitations have been observed or the occupational injury has been consolidated. Yet, the above-mentioned factors may already be observed prior to the consolidation and thus justify the CSST’s actions. Therefore, meetings can help gain time and speed up the file process. Employers have an interest in getting their employees to quickly understand that they still have a job in the company, even if they experience chronic functional limitations. By doing so, they eliminate or mitigate the impact of one of the most frequent obstacles to returning to work; the employee’s belief that there is a conflict with the employer. These meetings are also a chance to discuss the worker’s ability to take on temporary employment while waiting for the occupational injury to consolidate and for chronic functional limitations to emerge.
Ultimately, once the meeting has been held and an ergonomist or occupational therapist’s report has been issued, the CSST must decide if the worker is able to return to the job held at the time of the injury, considering the chronic functional limitations indicated in the file. This professional rehabilitation process, which is governed by sections 166 and following in An Act Respecting Industrial Accidents and Occupational Diseases, must comply with a “concentric” approach. The concentric approach involves determining if the worker can return to work and then evaluating, if a return to work is not possible, if the worker can perform another job in the company. Under this approach, the CSST will only attempt to relocate an employee elsewhere as a last resort. Several criteria are employed but should be developed primarily to specify how the visit to the workplace will take place and the nature of the challenges at that point in time.
To conclude, while it remains to be seen if the statistical results will indicate that the sought-after compensation length reductions have been achieved, in the meantime, managing CSST files on a daily basis makes it easy to see the value of the Détectôt program. The program provides employers with efficient solutions to overcome the impact of chronic injury and quickly identify a solution for an employee’s return to work. Sound management of CSST files that requires all stakeholders to be proactive during a meeting can only be a good thing for employers. Even if the initial objective of a meeting is to get a description of physical work requirements by an ergonomist and occupational therapist supporting the CSST rehabilitation counsellor, the meeting can still achieve other important objectives, in particular, spurring the worker’s motivation to return to permanent employment.
Raymond Chabot Grant Thornton’s occupational health and safety professionals are results-oriented. We can support you during each step of your process to implement a suitable occupational health and safety file management plan that fits with your entity’s safety approach.
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