After injury, whose side are you really on?

An injured employee may plead with you to allow her more time to recover, while her supervisor claims there's no earthly reason she can't be at work tomorrow morning. You're the one in the middle of this difficult balancing act.

The key, says Donna C. Ferreira, ANP, MS, COHN-S, senior regional manager at Comprehensive Health Services, a Reston, VA-based provider of workforce health and productivity management solutions, is "to act somewhere in the middle of the interests of the individual employee and the interests of the company."

For instance, you may not give the employee as much time off as they would like, but you do make sure they get the time off that is appropriate for their injury. In order to accomplish this, you may utilize modified duty, and help the employee to understand that a timely return is good for their own health. At the same time, "be assertive. Do not allow pressures from the company to determine the return of an employee to duty when it is not appropriate," says Ferreira.

Just the facts

Are you being pressured to get an employee back to work sooner than you feel is appropriate? Ferreira suggests to handle this type of challenge by referring to requirements. Cite company policies, Occupational Safety and Health Administration (OSHA) regulations, workers compensation regulations, and standards of care to back your position.

"These can provide the leverage needed to find the 'win-win,' when the occupational health professional is challenged," she says. Ferreira gives these sample responses for common conflicts:

• A supervisor wants an employee to return to work, despite a physician's note to the contrary.

"You tell me the employee should return to work despite his treating physician's recommendation. This employee has a note from his treating physician to be out of work for one week, and I concur, given the severity of his injury. Because of the physician's documented note, this would be OSHA recordable as lost time, even if he came to work anyway. Rest assured, we'll work hard to be sure he gets the best of care and we'll get him back as soon as possible."

• An injured employee is taking narcotics to manage his pain, but the company wants him back right away.

"I know you need this employee back to work as soon as possible. But at this time, due to his current treatment for pain, he is unable to return. It would not be safe, and it would also violate the company's policy regarding the use of this type of prescribed medication at work. I know you need him back. We'll work hard to be sure he gets the best of care and is back as soon as possible."

• The employee reports to work Monday, stating he was injured Friday afternoon. He saw his own physician and has a note stating "out of work until Monday." The safety officer is angry with the occupational health nurse that intervention was not taken sooner. He's upset he has to record this as lost time, even though the employee was not scheduled to work Saturday and Sunday.

"We just found out about this case this Monday morning. I know you are upset about this lost time case for the OSHA log. He was hurt Friday and went to his own physician and was told to rest the weekend. He's now returned this Monday morning, which is the next scheduled business day. However, OSHA 1904.7(b)(3)(v) states it is OSHA recordable because we have a written note from the physician which states 'Rest until Monday (date).' I am happy to intervene and be in touch with the treating physician when I am aware of the case. But this was not reported until Monday. I understand your frustration, and the pressures you have to keep these numbers at a minimum."