ArticleJournal of occupational rehabilitation2010
The "toxic dose" of system problems: why some injured workers don't return to work as expected.
Article in Journal of occupational rehabilitation, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 74 papers, 4 of them syntheses that pooled it.
What it found
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
74 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Racial and Ethnic Inequities in the Return-to-Work of Workers Experiencing Injury or Illness: A Systematic Review.Journal of occupational rehabilitation · 2023Pooled it
- Interventions Developed with the Intervention Mapping Protocol in Work Disability Prevention: A Systematic Review of the Literature.Journal of occupational rehabilitation · 2019Pooled it
- Interactions between injured workers and insurers in workers' compensation systems: a systematic review of qualitative research literature.Journal of occupational rehabilitation · 2015Pooled it
- Healing or harming? Healthcare provider interactions with injured workers and insurers in workers' compensation systems.Journal of occupational rehabilitation · 2015Pooled it
- "He was Threatened and Told to Cooperate": Immigrant Worker Experiences with the Workers' Compensation System in the Canadian Context.Journal of occupational rehabilitation · 2026Article
- Workplace Injuries and Return-to-Work Challenges Among Immigrants in Canada: Implications for Occupational Health Policy and Practice.New solutions : a journal of environmental and occupational health policy : NS · 2026Article
- Capturing the Perspectives of "Laypeople" on Policy Effectiveness: Employers' and Precariously Employed Workers' Suggested Improvements for the Workers' Compensation System and Work Injury Processes.Journal of occupational rehabilitation · 2026Article
- Conceptualizing Stigma in the Injured Worker Literature: A Scoping Review.Journal of occupational rehabilitation · 2026Article
- Project ECHO Occupational and Environmental Medicine: A Qualitative Study of HealthCare Providers Supporting Workers with Work-Related Injuries and Illnesses.Journal of occupational rehabilitation · 2026Article
- Experiences of Workplace Bullying Among Workers With Work-related Musculoskeletal Disorders: A Qualitative Assessment Using the Negative Acts Questionnaire.Safety and health at work · 2025Article
- Facilitators and Barriers to Collaboration Between General Practice and Sickness Benefits Office in Return to Work Processes-A Scoping Review.Journal of occupational rehabilitation · 2025Review
- Clinician Experiences of and Responses to the Challenges of Working with Patients in the Australian Compensation Setting.Journal of occupational rehabilitation · 2025Article
- Patterns of Mental Health Service Use in Australian Workers with Low Back Pain: A Retrospective Cohort Study.Journal of occupational rehabilitation · 2024Article
- "I grabbed my stuff and walked out": Precarious workers' responses and next steps when faced with procedural unfairness during work injury and claims processes.Journal of occupational rehabilitation · 2023Article
- Competencies for Physiotherapists Working to Facilitate Rehabilitation, Work Participation and Return to Work for Workers with Musculoskeletal Disorders: A Scoping Review.Journal of occupational rehabilitation · 2022Article
- Factors associated with long term work incapacity following a non-catastrophic road traffic injury: analysis of a two-year prospective cohort study.BMC public health · 2022Article
- Experiences, impacts and service needs of injured and ill workers in the WSIB process: evidence from Thunder Bay and District (Ontario, Canada).Health promotion and chronic disease prevention in Canada : research, policy and practice · 2022Article
- Framing the Care of Injured Workers: An Empirical Four-Jurisdictional Comparison of Workers' Compensation Boards' Healthcare Policies.Journal of occupational rehabilitation · 2022Article
- Language Accommodations in Workers' Compensation: Comparing Ontario and Quebec.New solutions : a journal of environmental and occupational health policy : NS · 2022Article
- The relationship between work disability and subsequent suicide or self-harm: A scoping review.PLOS global public health · 2022Article
14 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Introduction Most workers who incur an injury on the job follow a relatively straightforward path through a workers' compensation claim, recovery and return to work. However, a minority of compensation claims is prolonged and can be disproportionately costly. We conducted this qualitative study in order to gain an understanding of systemic, process-related problems affecting injured workers who had failed to return to work as expected. Method A total of 69 in-depth interviews were conducted with injured workers with complex and extended workers' compensation claims and with return-to-work (RTW) providers such as health care providers, insurers, legal advisors, and workplaces. The study was based in Ontario, Canada. A modified grounded theory analysis led to the identification of common mechanisms in RTW problems. Results We identify problems with return to work and extended workers' compensation claims in dysfunctions in organizational dynamics across RTW systems including the workplace, healthcare, vocational rehabilitation and workers' compensation. These system problems are difficult to identify because they appear as relatively mundane and bureaucratic. These appeared to have damaging effects on workers in the form of a 'toxic dose' affecting the worker beyond the initial injury. Conclusions Worker's problems with extended claims were linked to RTW policies that did not easily accommodate conflict or power imbalances among RTW parties and by social relations and processes that impeded communication about RTW situations and problems. Avenues for intervention are located in a shift to a critical lens to RTW process that addresses differences of knowledge, resources, and interests among different parties.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.