Introduction

For many Canadians, work is risky: approximately 800,000 workers are injured at work each year in Canada (Human Resources Development Canada, 1999). Fortunately, most of them do not sustain permanent disabilities. Approximately half do not even miss a single day from work, and most others recover from their injuries and return to work several days or weeks later. Unfortunately, however, a small fraction of workers who are injured on the job sustain serious injuries that result in permanent significant disabilities that keep them away from work for many months or even years.

Despite their proportionally small numbers, injured workers with permanent significant disabilities deserve serious attention because their injuries often have serious impacts on their personal, family, and work lives (Canadian Injured Workers Alliance, 1995a and 1995b). Studies of the post-injury employment histories of injured workers have found that many injured workers with significant disabilities experience difficulty returning to employment, either to their pre-injury employers and occupations, or to new employers and/or occupations (Johnson and Baldwin, 1993). Some never work again after their injuries. In addition, a disproportionately large share of the costs of workers’ compensation plans are devoted to the medical treatment, rehabilitation, and wage loss compensation of injured workers with permanent disabilities (Johnson, Butler, and Baldwin, 1995: 72; Allingham and Hyatt, 1995: 159; Thomason, 1992: 2).

Every workers’ compensation board in Canada provides or funds vocational rehabilitation services to facilitate the post-injury employment of injured workers whose injuries result in permanent disabilities. These services are intended to assist permanently-disabled injured workers through the often-challenging process of returning to productive employment. Additionally, vocational rehabilitation services have the potential to yield substantial cost savings to workers’ compensation boards by reducing the wage loss benefits that workers’ compensation boards pay to injured workers with disabilities who are not employed.

To the best of our knowledge, however, no workers’ compensation board in Canada has recently conducted research on the effects vocational rehabilitation services have on the post-injury employment outcomes of injured workers with significant disabilities. There have been numerous published academic studies of the post-injury employment patterns of injured workers with disabilities in Canada and the U.S., but few of these studies have devoted detailed attention to the influence of the availability, nature, and duration of vocational rehabilitation services.

There are many other factors which can also influence the post-injury employment prospects of injured workers with significant disabilities. The policies, practices, and attitudes of employers are the most crucial factor. Other factors include the policies, practices, and attitudes of the unions to which some injured workers belong; services provided by agencies which assist persons with disabilities; and initiatives of various organizations which advocate on behalf of injured workers (individually or as a group).

The primary goal of this study was to identify barriers to the successful vocational rehabilitation and re-employment of Manitoba workers who have sustained significant disabilities from workplace injuries. In pursuit of this goal, this study examines the roles each of the following play in assisting injured workers with significant disabilities to return to employment following their injuries:

• employers
• the Workers Compensation Board of Manitoba
• unions
• advocacy organizations for injured workers
• agencies that provide employment assistance and other services to persons with disabilities

The primary source of information for this research was injured workers with significant disabilities. Most studies of the post-injury employment of injured workers with disabilities have been based on administrative data collected by workers’ compensation boards, or surveys which gathered quantitative data on injured workers’ incomes, periods of employment, periods of unemployment, etc. Very few studies have gone directly to injured workers with significant disabilities to ask them to describe their post-injury vocational rehabilitation and employment experiences in detail.

Secondary sources of information were staff of the Workers Compensation Board of Manitoba, staff and representatives of unions and other labour organizations, staff of agencies which provide services to persons with disabilities, and advocates for injured workers.

“Significant disability” was operationally defined as major permanent restrictions in a person’s ability to perform one or more of the basic activities of daily living.

“Basic activities of daily living” are activities most people perform on a daily basis, and include:

• mobility (e.g. walking, climbing stairs)
• agility/coordination (e.g. bending, twisting, lifting and carrying objects, grasping and handing small objects)
• hearing
• seeing
• learning/thinking
• remembering
• healthy psychological functioning

This definition encompasses a fairly broad range of disability, from comparatively mild disabilities arising from soft tissue and back injuries, to severe disabilities like those resulting from spinal cord injuries, amputations, head injuries, and multiple injuries. In the findings of this report, references to participants with severe disabilities refer to persons with the latter kinds of disabilities. Most other participants will be described as having less severe disabilities.