Step 6: Promote Worker Recovery through Health Care Management and Return-to-Work

Promote musculoskeletal health in the workplace

Work-related injuries and disability are associated with many negative health and social outcomes including reduced quality of life, job loss, reduced lifetime income, injuries among family caregivers, and premature death.  For example, a recent NIOSH-funded studyexternal icon found that workers who suffer serious injuries requiring days away from work are more likely to die sooner than workers with injuries requiring only medical treatment.

Other studies have shown that the chances of returning to work drop dramatically the longer the worker remains away from work. While more serious diagnoses are associated with longer periods off work, minor diagnoses can also lead to disability if the recovery and return-to-work processes are not properly managed.

Employees, employers, and health care providers are all responsible for preventing injury and disability in the workplace.

Table 6.1: How to Promote Musculoskeletal Health in the Workplace

Group Responsibilities
  • Develop a return-to-work program in which modified jobs, restricted duties, or temporary job transfers are provided to accommodate employees with work-related musculoskeletal disorders (WMSDs)
  • Educate and train employees to recognize and report signs and symptoms of WMSDs
  • Encourage employees who report symptoms of WMSDs to speak to the qualified health care provider
  • Give health care providers the opportunity to become familiar with the jobs and tasks in your workplace
  • Modify jobs, restrict duties, or put in a temporary job transfer to accommodate employees with WMSDs
  • Select a health care provider qualified in treating WMSDs
  • Ensure privacy and confidentiality of employees’ medical records
Health care providers
  • Meet with employers to learn the physical demands of jobs and job tasks
  • Become familiar with the physical capabilities and limitations of employees
  • Review job analysis reports, detailed job descriptions, job safety analyses, photographs, and video recordings
  • Conduct periodic walk-throughs to record changing work conditions
  • Evaluate employees’ descriptions of work activities and whether it causes, contributes to, or exacerbates MSD related pain
  • Evaluate employees’ medical histories
  • If an employee presents symptoms of MSDs, conduct a physical exam and plan to do a follow-up examination
  • Prescribe and monitor splints, braces, and other supports to relieve employees of MSD symptoms. However, if employees use different techniques at their jobs, splinting may cause new MSD problems
  • Determine the work restrictions for employees affected by MSDs
  • Advise employees affected by MSDs to limit hobbies, recreational activities, and personal habits that agitate their condition
  • Document improvements to employees’ MSD symptoms
  • Ensure privacy and confidentiality of employees’ medical records
  • Engage in safe work practices
  • Follow workplace safety and health rules
  • Report signs and symptoms of WMSDs

Worker Recovery and Return-to-Work Resources:

Division of Federal Employees’ Compensation (DFEC) POWER Initiative:external icon The Protecting Our Workers and Ensuring Reemployment (POWER) Initiative collected and analyzed data on the causes and consequences of frequent or severe injury and illness among Federal employees, and identified effective safety and health management programs. This includes resources on achieving successful return-to-work of injured employees:

Washington State Department of Labor and Industries Centers of Occupational Health and Education (COHEs):external icon These Washington State centers work with medical providers, employers, and injured workers in a community-based program. COHEs improve injured worker outcomes and reduce disability by training providers and coordinating cases.

Office of Disability Employment Policy (ODEP) Stay-at-Work / Return-to-Work (SAW/RTW)external icon: The Office of Disability Employment Policy (ODEP) is a non-regulatory federal agency that promotes policies and coordinates with employers and all levels of government to increase workplace success for people with disabilities. Since 2013, ODEP has utilized a Community of Practice and policy work groups led by subject matter experts to guide their SAW/RTW work. Through this collaboration, ODEP continues to explore effective practices to inform policy recommendations targeting federal and state agencies, as well as the private sector. For example, one policy working group is focused on adapting the Washington State WC COHE programpdf iconexternal icon.

International Association of Industrial Accident Boards and Commissions (IAIABC)external icon: IAIABC is a not-for-profit trade association representing government agencies charged with the administration of workers’ compensation systems throughout the United States, Canada, and other nations and territories.

The American College of Occupational and Environmental Medicine (ACOEM):external icon ACOEM represents more than 4,500 physicians and other health care professionals specializing in the field of occupational and environmental medicine.

The Institute for Work & Health (IWH)external icon: The IWH is an independent, not-for-profit organization whose mission is to conduct and share research that protects and improves the health of working people.

  • Return-to-Workexternal icon: The IWH conducts research on return-to-work as practiced by workplaces, workers’ compensation boards, insurance companies and rehabilitation providers. Return-to-work includes disability management and prevention, vocational rehabilitation, and work reintegration.
  • Clinical Treatmentexternal icon: The IWH conducts research on evidence-based practice for health care in treating back pain, neck pain, chronic pain, upper extremity disorders, and other soft-tissue injuries. This includes studies on health-care delivery and policy.
  • Compensation-Benefits (Canadian Provinces)external icon: The IWH has examined trends in workers’ compensation claims and benefits, their adequacy and equity, and their effects on workers.
  • Measuring Health-Functionexternal icon: The IWH conducts research to measure worker health, function, and disability; predict the course and pattern of recovering from disability; and determine the prevalence of certain health conditions among workers.


Page last reviewed: November 2, 2018