Table 1.

Potential challenges for disability management in nonconventional work arrangements

RTW principles	Challenges and opportunities to provide RTW assistance
	Temporary work arrangement	Small and medium enterprise	Telework/work from home	Lone worker
1. Strong organizational commitment to health and safety	Employer feels less long-term obligation and liability for temporary worker	Workplace support occurs more organically, but organization may be unfamiliar with RTW strategies	Limited access to organizational support	Limited access to organizational support
2. Routine offer of modified duty to facilitate early RTW	Extensive job modification efforts may appear to have little return on investment for a worker with limited tenure and job skills	Job demands may be more flexible, but survival of company depends on maximal individual productivity	Injured or ill worker may have access to greater leeway and flexibility, but medical restrictions may be difficult to enforce and alternate tasks difficult to arrange	No opportunities for co-workers to provide occasional assistance, and fewer opportunities for job leeway and flexibility
3. Support coordination of RTW while not disadvantaging others	Worker may not have established trust and rapport with co-workers	Job modifications and special RTW arrangements may seem intolerable in a small working group	Co-workers may not understand the nature of work limitations if the ill or injured worker is working off-site	Limited access to others to provide RTW coordination and follow-up
4. Supervisors trained and included in RTW planning	Injured or ill worker may not have a designated permanent supervisor on-site to rely on	Relationships with supervisors may be more firmly established, but supervisor unlikely to have RTW training	Relationships with supervisors may be less firmly established, and worker frustrations may not be realized by supervisor	Supervisory role is diminished or distant
5. Early and considerate contact with injured/ill worker	Injured or ill worker may have fewer social ties and close colleagues for advice and support	SMEs may have stronger personal ties with workers to facilitate communication and support	Need for communication may be unclear if worker is off-site. No opportunity for face-to-face empathy and support	Regular communication with the organization may not be routine
6. Designated RTW coordinator	Organizational responsibility for communication and follow-up may be diluted or managed by a third party	SMEs may be less likely to have a designated RTW coordinator with relevant training and methods	RTW coordinator may be less effective by telephone and unaware of ergonomic challenges at home	RTW coordinator may be unaware of job demands
7. Communication between employer and healthcare provider	Injured or ill worker may rely on healthcare providers exclusively for RTW planning and guidance	SMEs have fewer ties with designated health care providers, but more direct communication with supervisors might be feasible	Healthcare provider may be unlikely to have ties with employer or knowledge of work demands	Healthcare provider may be unlikely to have ties with employer or knowledge of work demands
8. Labor laws and policies	Uncertain liability for injury and RTW	Exempt from legal and policy RTW provision	Difficulties in claiming sickness absence	Normal regulations and employer responsibility

RTW return to work