Injured workers should not return too soon

There might be pressure to return an injured employee to work as soon as possible by management, human resources, or supervisors. However, returning someone to work too soon can put the employee at risk, warns Mary D.C. Garison, RN, COHN-S, CCM, COHC, FAAOHN, an Angleton, TX-based occupational health nurse.

There is the potential for re-injury or aggravation to a worker's pre-existing condition. "This can turn out to be workers' comp, even if it is a non-occupational injury or illness," Garison adds.

Here are some suggested steps from Garison for occupational health managers to take if they feel pressured to return an employee to work sooner than they think is appropriate:

  • Have the attending physician to support with a letter stating the employee's need to stay out until healing is complete.
  • Request a return to work physical performance evaluation, and provide the physician with an analysis of the physical demands of the employee's job.
  • Remember that the occupational health manager is the employee's advocate.

Litigation possible

Small employers are often "frantic" about not reporting a legitimate injury to their worker's compensation insurance company, according to Judy Van Houten, director of the Glendale (CA) Adventist Occupational Medicine Center.

"They pressure the occupational health professional to delay treatment, minimize services, and return employees to their 'usual and customary' position far too early," she says.

Months may go by with the injury still remaining unresolved, Van Houten says. "Then, they become angry when the injured worker litigates," she says. "There are no easy answers as to how to resolve this phenomenon, especially in this economy."

Small employers are often the biggest deterrent to the occupational health process, because of lack of education and economic pressures, she notes. "The biggest challenge is educating them about what is, and is not, a first-aid claim," Van Houten says.

The best approach is for the occupational health manager to persuade the employer to provide the injured worker with the treatment and benefits that they are entitled to, she emphasizes. The occupational health manager can reinforce the legal ramifications of not doing so, Van Houten says. "This is a tough position for the occ health professional at best."

Act as translator

Communication might be the single most important factor with managing worker's compensation cases.

"The occupational health nurse is, by far, the most instrumental person who can facilitate this," Van Houten says.

Supervisors or employees might use language to describe tasks that is unfamiliar to occupational health professionals. The occupational health manager should translate this information into language that the primary care provider can better understand, Van Houten says. This "translation" is the key to developing work restrictions or defining modified duty assignments for an injured worker, says Van Houten.

There are many parties involved in the management of a workers' compensation claim, she says. The occupational health professional is "the key to balancing the different needs of the parties, to ensure prompt treatment, prompt recovery, and prompt return to work," Van Housten says.


For more information on returning an injured employee to work safely, contact:

  • Mary D.C. Garison, RN, COHN-S, CCM, COHC, FAAOHN, Angleton, TX. E-mail:
  • Judy Van Houten, Director, Glendale (CA) Adventist Occupational Medicine Center. Phone: (818) 502-2050. E-mail: