Key practices for a successful and sustainable return to work

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Légende: Recommendation of our expert

Expert advisor:

Marie-Michelle GOUIN, assistant professor, human resource management, Université de Sherbrooke


Rachèle HÉBERT, research professional, Université de Sherbrooke
France ST-HILAIRE, associate professor, human resource management, Université de Sherbrooke
Marie-Eve MAJOR, associate professor, ergonomics, Faculty of Kinesiology, Université de Sherbrooke
Rébecca LEFEBVRE, research professional, Université de Sherbrooke
Étienne FOUQUET, research assistant, Université de Sherbrooke

This initiative was made possible through a collaboration with the Université de Sherbrooke.

The return to work after an injury or work-related illness involves numerous challenges for both organizations and employees. The return to work coordinator will play a very important role in a successful and sustainable return to work. But what must the coordinator do in concrete terms to help this happen?

We interpreted the study published in 2017 by Durand and colleagues that was conducted with large organizations in Québec, Canada. These authors had two objectives: 1) to identify coordinators’ tasks and activities during the return to work 2) to examine certain characteristics of organizations or coordinators that influence their return to work practices following an injury or work-related illness.

What do we mean by:

Return to work

An employee is considered as returning to work when they resume work tasks after a disability caused by an injury or an illness. The longer the absence, the more complex the return to work.

Long-term disability

Long-term disability is considered to last beyond the general time period for healing from a health problem: usually more than twelve weeks for musculoskeletal problems and more than six months for a mental health problem.

Return to work coordinator

The role of the return to work coordinator is held by a professional who may occupy various positions within an organization (e.g.: manager or human resource professional, occupational physician or nurse) or externally (e.g.: rehabilitation counsellor for an insurance company). The coordinator

  • facilitates the return to work of an employee in a disability situation because of an illness or injury;
  • works in collaboration with the different return to work stakeholders (e.g.: employee, manager, insurer, workers’ compensation adviser, health professionals, union and colleagues of the employee).

What do the results of the study tell us?


4 core competencies and targeted actions for a successful and sustainable return to work.

The authors sorted 49 of the return to work coordinator’s tasks and activities into 4 core competencies.

Adapt practices based on the needs and abilities of the absent employee and on the return to work process.
Engage stakeholders in the workplace and the appropriate external resources during the return to work process.
Develop practices that conform to laws, regulations, agreements and procedures related to absences and the return to work.
Review or reflect on your practices and understanding when it comes to absences and health at work, and invite stakeholders from the workplace to do the same.

Of the 49 tasks done by coordinators, 4 tasks are primarily recognized as practices that promote a successful and sustainable return to work. These are presented in the following table.


Profile of participants

  • 327 coordinators invited by email.
  • 195 questionnaires completed online.
  • Men 23.3% / Women 76.7%.
  • Between ages 35 and 54 (64.2%).
  • Private and public organizations in Québec.
  • Organizations of 500 or more employees.

The online questionnaire targeted disability management managers and return to work coordinators.

Task and activity promoting a successful and sustainable return to work
Specific approaches
Sample action

1)    Maintain communication with the employee who is absent.

(Competency 1)






  • Reassure the employee;
  • Find out about their recovery and help them prepare for their return;
  • Make sure the employee receives the same message from everyone.





  • The coordinator is best placed to accompany the employee;
  • The manager’s involvement can prove to be beneficial.







  • Develop a formal procedure to maintain communications with the absent employee.
  • Determine the frequency of and times for communication.
  • Contact the employee in writing (let them know they will be contacted within the next 10 days to discuss an eventual return).
  • Work with the other parties (e.g.: claims adviser, immediate manager).

2)    Examine the environmental factors in the workplace that could jeopardize the return to work. 

(Competency 1)


  • Know the possible obstacles upon the return to work.





  • Allow for tasks to be adapted based on the employee’s abilities;
  • Necessary to identify difficulties and put in place measures to better deal with them.



  • Talk to the employee.
  • Address the risk factors.
  • Modify working conditions (position, organization of the work).
  • Use a qualified resource person (e.g.: ergonomist) to make the modifications.


3)   Plan the return to work (all tasks).

(Competencies 1 and 2)






  • Adjust resources for the employee according to their ability to work and according to changes made to the conditions for carrying out the work.





  • Tasks for planning the return to work
  • Determine whether workplace accommodations are possible (competency 2);
  • Use the medical diagnosis and the limitations to plan the return to work (competency 1);
  • Identify the work tasks that fit with the employee’s abilities (competency 1).


  • Plan resources according to the employee’s progression of abilities.
  • Mobilize stakeholders around a common goal, despite competing concerns.
  • Research a satisfactory solution for all stakeholders.
  • Express concerns and expectations and be aware of those of other parties.


4)   Apply laws, policies and regulations regarding absences and return to work.

(Competency 3)



  • Respect the employee’s rights;
  • Promote a common understanding among stakeholders and guide their practices.



  • All personnel, including the employee, must have received clear explanations about internal procedures to follow.





  • Put in place a formal internal return to work policy (which procedures to follow and when).
  • The policy could include, for example, measures aiming for partial and gradual reintegration.
  • Inform all personnel of the organization’s policy and procedures.

Because studies must always be interpreted with caution

Because all study participants were volunteers, they may have been more committed to their work, which could have influenced the type of competencies and the tasks and activities.

The study was carried out with large Québec organizations; some differences may exist in other organizations (e.g.: small or medium-sized) and other countries.

 Actions employers can take


Focus on actions and tasks that conform to good practices for a successful and sustainable return to work.


  • Support collaboration between return to work coordinators and the colleagues of the absent employee (a factor overlooked by the study’s coordinators), as well as between the employee and their manager;
  • First establish the tasks or actions presented in the results above.


Focus on prior training and the profile for return to work coordinators.





Profile for coordinators who promote the desired return to work practices in an organization:

  • knowledge of the health field, especially for understanding medical terms;
  • good understanding of the interrelationships between the different systems involved in disability and return to work (work environment, medical system, benefits system and payroll system);
  • in-depth knowledge of the reality of the different stakeholders, as well as laws and policies that can affect disability, in order to focus on a sustainable return to work.

Responses from the expert

The tasks and activities interpreted in this study come from only three of the four key competencies. Why?

·      The fourth competency refers to overall workplace health and safety activities (e.g.: stay informed about the subject, implement prevention measures).

·      Reviewing your practices and understanding regarding return to work, and inviting stakeholders to do the same, remains essential in promoting a successful and sustainable return to work.

Can communicating quickly with the person who is ill or injured be seen as “pushy”?

·      Generally, staying in contact with your absent employee is seen as a form of support.

·      However, it is important to consider the context of the absence: it is usually recommended that you respect a certain recovery period, especially when the employee has a mental health problem (e.g.: depression).

How can we identify obstacles to the return to work?

·      Obstacles to the return to work can be identified through observations in the workplace or through discussions with the various stakeholders.

·      For example, the employee can talk about certain obstacles to the return to work.

·      It can also be appropriate to check whether the employee feels they can overcome the obstacles.

In the literature, the “concerted efforts” or “cooperation” of stakeholders are often mentioned as important elements for a successful return to work. Why?

·      During return to work planning (and even before), many decisions are made by stakeholders. These decisions are very important for the success of the return to work. Everyone must agree on the following points:

1)   the position involved in the return to work;

2)   a return to work plan explaining the tasks in which the requirements suit the employee’s abilities throughout the return to work process; and

3)   solutions to put in place when problems arise during the return to work process.

How can organizations benefit from a formal procedure overseeing returns to work?

·      When it is known and acknowledged, such a procedure can promote the return to work by

1)     formalizing the process;

2)     clarifying the procedures to follow;

3)     specifying the roles and responsibilities of the various stakeholders.

The interpretation and action steps are based on the work of the following researchers:
Corbière, M. et al., 2017. Validation du questionnaire Obstacles au Retour au Travail Et Sentiment d’Efficacité pour les Surmonter (ORTESES) auprès de travailleurs avec un trouble mental courant ou un trouble musculosquelettique. Montréal : IRSST, R-938.
Coutu, M.-F. et al., 2015. Programme de prise de décision entre l’ergothérapeute et le travailleur ayant une incapacité due à un trouble musculosquelettique persistant: Perspective des acteurs en réadaptation. Montréal: IRSST, R-896.
Gouin, M.-M., Coutu, M.-F., Durand, M.-J. 2017. Return-to-work success despite conflicts: an exploration of decision-making during a work rehabilitation program. Disability and rehabilitation. 1–11.
Nastasia, I. et al., 2017. Pratiques des milieux de travail pour assurer un retour en emploi sain et durable. Montréal : IRSST, R-983.

Here are two comprehensive guides to help and support you in your return to work approach in order to facilitate recovery and promote employee retention:


1.    For a mental health problem (Technical guide: RG-758): Guide supporting the return to work and promoting employee retention – Facilitating the return to work of an employee after an absence related to a mental health problem (Guide soutenir le retour au travail et favoriser le maintien en emploi – Faciliter le retour au travail d’un employé à la suite d’une absence liée à un problème de santé psychologique)

You can download this tool free by clicking here.

  • St-Arnaud, L. and Pelletier, M. (4 November 2013)
  • A practical tool that combines individual support and organizational changes. Includes informative video clips.

2.    For a musculoskeletal problem (Intervention tool: OMRT-Fr): Musculo-skeletal problems – Guide and tools for retention and the return to work (Troubles musculo-squelettiques – Guide et outils pour le maintien et le retour au travail)

You can download this tool free by clicking here.

  • Stock, S., Baril, R., Dion-Hubert, C., Lapointe, C., Paquette, S., Sauvage, J., Simoneau, S. and Vaillancourt, C. (2 November 2005)
  • Guide accompanied by a number of intervention tools (estimation grids and forms) to support organizations wishing to design and implement a return to work program.


Gouin, M.-M., Hébert, R., St-Hilaire, F., Major, M.-E., Lefebvre, R., Fouquet, E. (2018). Key practices for a successful and sustainable return to work. Global-Watch Scientific Interpretation available at


Durand, M.-J., Nastasia, I., Coutu, M.-F., & Bernier, M. (2017). Practices of Return-to-Work Coordinators Working in Large Organizations. Journal of Occupational Rehabilitation, 27(1), 137-147.

Karine Casault
Author: Karine Casault