Rehabilitation can be defined in many ways. However, following illness or injury, this term is the process of improving a person’s functionality.

When we talk of vocational rehabilitation, we’re referring specifically to an individual’s ability to return to the workplace.

What does effective vocational rehabilitation look like?

Vocational rehabilitation improves an individual’s activity tolerance and work ability, prevents chronicity, eases de-conditioning, and reduces the illness’s effects and pain.

When it’s effective, vocational rehabilitation enables workers to get back to work quicker. However, in best practice, vocational rehabilitation should incorporate medical and social rehabilitation concurrently and not sequentially.

Avoiding Unemployment

Unemployment has adverse effects on both mental and physical health. Therefore, vocational rehabilitation is essential in avoiding unemployment when a person already has an existing illness or injury.

Once people become unemployed following a work-related illness or injury, a significant number move on to disability and sickness benefits. Unfortunately, once in this group, many obstacles preventing re-employment occur. For example, once out of work, a person’s mental health and physical health often deteriorate. What’s more, they adapt to a life on benefits and see the financial gain of returning to employment as unacceptably small. Finally, they become more satisfied with their life out of work as they have time to pursue other interests.

Building confidence through vocational rehabilitation

The idea of vocational rehabilitation is not only to ensure that an individual is capable of returning to the workplace, but it also aims to improve confidence and general well-being.

Returning to work after a long absence

A return-to-work plan can help an employee ease back into work. This plan might include a programme of tasks for the employee to carry out to increase their stamina and help them return to a work routine. Returning hours can be negotiated and then increased gradually over several weeks.

If the employee’s absence has been long or they have an ongoing medical problem or condition, the employer and the employee should hold a meeting to discuss a return to work. In the meeting, the employer should:

• Ensure the employee is ready to come back
• Tell the employee about any critical work updates occurring while they were absent
• Look at any doctor’s recommendations for the employee
• See if the employee needs and particular support
• See if changes (reasonable adjustments) are needed to reduce or remove any disadvantages for employees who have a disability
• Consider referring the employee to occupational health or other medical services
• Discuss an EAP (employee assistance programme), if this is available
• Agree on a plan to suit all, e.g. a phased return

After the return to work

When an individual has succeeded in returning to work, there needs to be regular monitoring to support the employee as they get used to being back at work.

A right to reasonable adjustments

Under the Equality Act 2010, employees have a right to ‘reasonable adjustments’. A reasonable adjustment is a change enabling an individual to do their job. This could be an adjustment to the workplace itself or a procedure. For example, if an employee needs to use a wheelchair, a reasonable adjustment would be to provide an accessible car parking space near the office door.

If an employee is returning after a long illness that has resulted in fatigue, a reasonable adjustment might include looking at changing their working pattern or hours.

By law, employers need to consider reasonable adjustments:

• When a disabled employee is finding an aspect of their job difficult
• When an individual’s sickness or absence record is linked with their disability (or their delayed return to work is).

What is classed as ‘reasonable’?

This depends on an individual situation. Employers need to consider adjustments carefully so they

• Reduce or remove a person’s disadvantage
• Are practical
• Are affordable
• Don’t harm the health and safety of other employees

What can employers change?

Employers can:

• Change shift patterns or working arrangements
• Remove things from the workplace (e.g. a bright light)
• Provide specialist equipment
• Provide accessible parking
• Introduce a sign-language interpreter

Other reasonable adjustment examples include:

• Providing a phone that works with a hearing aid
• Replacing a chair with a more ergonomic one for an employee with back pain
• Providing more one-to-one support for someone suffering from anxiety
• Allow a phased return when someone has been off sick for an extended period
• Allow someone more frequent breaks, e.g. for a person who has diabetes, to check their blood sugar level or eat appropriately
• Allowing more time for a person who has dyslexia

Recording reasonable adjustments

It’s a good idea for employers to set up a record of reasonable adjustments. Not only is this good for record-keeping, but it also allows the adjustments to be reviewed and altered periodically. What’s more, should management change, the employee will not have to repeat the reasonable adjustments process over again.

Who pays for reasonable adjustments?

Any reasonable adjustments come out of the employer’s pocket. Many of them are straightforward and affordable. However, small businesses might be unable to offer adjustments on the same level as bigger enterprises.

Employers don’t have to make adjustments when they’re deemed to be unreasonable, but they can offer support in other ways. For example, if an employee needs to use a wheelchair and would like a lift installing, it is not reasonable if the installation of a lift would mean the company would go out of business because of the cost. In this instance, the employer can refuse the request. However, it is good practice to see if other adjustments can be made, like the employee working on the ground floor.

If rehabilitation fails

When an employee is struggling or has a lot of absences after their return to work, employers might have to look at what the next steps should be. Some workplaces use performance management or capability procedures that can help the employee focus on where they need to improve. Adjusting back to the workplace might mean they need additional training or mentoring, for example.