Approaches to Occupational Rehabilitation and Return to Work in Four Jurisdictions: A Cross-National Analysis From the Perspective of the ISSA Guidelines on Return to Work and Reintegration

The guidelines published by the International Social Security Association, ISSA Guidelines: Return to Work and Reintegration, provide a policy imperative towards early intervention for people with nonoccupational health conditions at risk of exiting the workforce and moving to disability dependency. Socioeconomic and fiscal imperatives have been demonstrated by the Organisation for Economic Co-operation and Development's (OECD) review on sickness, disability and work (OECD, 2010), and by an accumulating evidence base for effectiveness. This study explored how social protection agencies are responding in terms of employment rehabilitation services for employed people with acquired disabilities. Specifically, this study reviewed job retention and return processes for workers with nonoccupational health conditions from the perspective of the ISSA guidelines in four jurisdictions with differing system frameworks. The methods used included a review of relevant literature and web resources and gathering detailed system descriptions from national respondents. Although the jurisdictions differed in the concepts used, service context, the structure of welfare systems and eligibility criteria, there was evidence of an acknowledgement of the needs of employed people with disabilities. This was not, however, consistently reflected in procedures, processes or outcome measurements. While some promising characteristics were identified, there was substantial room for improvement in the job retention and return to work strategies of the relevant agencies in all four jurisdictions. It was concluded that the deployment of the ISSA Guidelines: Return to Work and Reintegration, published in 2013, had yet to make a substantial impact on services and approaches in the domain of nonoccupational health conditions in these jurisdictions.