Early support
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With early support, you can influence your company’s work ability risks. If early signals are identified, have an early support discussion with the employee. If the matter is resolved during the early support discussion, continue to monitor the situation. If the employee needs support due to their health, an occupational health negotiation is arranged, where you discuss challenges and prerequisites related to work ability and work performance.
During the occupational health negotiation, you can consider ways to support work ability and return to work, such as work modification, partial sickness allowance or a work trial based on the Occupational Health Care Act. If the physician assesses that the employee has a risk of disability, the employee may apply for vocational rehabilitation from us.
Early signals
We at Elo have developed, together with our partner, an operating model that identifies early warning signals that may indicate an employee’s increased risk of disability. Based on these early signals and with the help of this model, the employee is guided to timely support.
Examples of early warning signals include changes in the employee’s behaviour, mood or way of working; withdrawal from social interaction; negative feedback from others; carelessness, indifference or unusual untidiness. The employee may neglect agreed schedules and responsibilities, have increased lateness, sickness absences or accidents, show decreased work performance, or their overtime hours or time spent on work may increase.
Identifying workload
Workload is not solely a negative factor. Appropriate workload supports an employee’s work ability and health. However, harmful workload factors can arise in any workplace and affect any employee. A key tool for managing workload factors is their systematic assessment and evaluation.
Harmful workload is typically caused by poor work organisation or a poor social climate. When prolonged, harmful stress and strain at work can lead to burnout. This is why recognising workload and addressing it are essential supervisory skills.
Work‑content‑related workload factors include monotony, fragmentation and constant interruptions, the need for continuous alertness, high demands and strict quality requirements. Work‑arrangement‑related workload factors may include an excessive or insufficient amount of work, information overload, unreasonable responsibility or time pressure, challenging customer‑interaction situations, shift or night work, on‑call duties or extensive travel. Work‑community‑related factors include working alone, poor flow of information, insufficient support from supervisors or colleagues, or inappropriate behaviour.
Nearly one in five (17%) respondents to Elo’s work community survey experience fairly or very high levels of harmful stress.
Early support discussion
The early support discussion is a confidential discussion between the supervisor and the employee about disruptions in work performance and work ability. Appreciative early intervention and listening support the discussion. The aim is to seek solutions as early as possible once the supervisor becomes concerned. The discussion also includes reflecting on what the employee can do to cope better at work.
The supervisor is responsible for initiating the discussion, but the employee may request it and may bring a support person if they wish. Early support discussions are documented according to the organisation’s practices.
Supervisors have the obligation to intervene in all concerns and to react no later than when sickness absences exceed the organisation’s defined thresholds. As a supervisor, you must be familiar with your employees’ work and regularly assess its hazards and risk factors.
The foundation of early support is fairness and equality: the supervisor addresses all signals and sickness absences that exceed workplace‑specific thresholds.
An employee’s work ability may deteriorate due to illness, ageing or substance abuse.
Elo’s work community survey shows that employees’ self‑assessment of their work ability has declined during the pandemic. Before the pandemic, 21% reported reduced work ability, whereas now 25% assess their work ability as reduced.
Addressing concerns
The purpose of addressing concerns is to find solutions to the employee’s situation. The discussion starts by expressing concern and explaining why the discussion is being held. Begin with open‑ended questions. If open questions are not effective, you may use guiding questions. At the end, involve the employee in considering solutions.
Supporting an employee with reduced work ability
Even if work ability is reduced, a significant amount of work ability usually remains. Prolonged sickness absence makes returning to work more difficult and increases the risk of permanent disability. Supporting return to work is an effective way to reduce costs related to disability.
Prolonged or recurrent sickness absences increase the risk of permanent disability. However, active work ability support measures at the workplace can help employees continue working and speed up return to work after sickness absence.
Support work ability by modifying work
The aim of work modification is to find a solution to the individual’s work ability challenge. Mapping out different possibilities in advance supports fast action. It is also good to remember that lighter work can sometimes have a more beneficial effect on recovery than sickness absence. In planning and implementing work modifications, the key partners are the employee and occupational health services.
Work modification is worthwhile because it reduces sickness absences, prevents disability, and supports the employee in continuing at work.
Work modification can be temporary or permanent. Work can be modified, for example, through delegating tasks, changing how tasks are performed for an agreed period, flexible working hours, remote work options, or scheduling holiday periods.
Versatile work modification options reduce the need for sickness leave and increase return to work after long absences. There is strong evidence that work modification shortens the duration of disability in musculoskeletal conditions.
(Ervasti et al., Finnish Government Publication Series 2022:7)
Three paths for return to work
Return‑to‑work support is part of the early support model. Successful return‑to‑work support lowers the threshold for employees to return, speeds up return from sickness absence, and increases motivation to remain at work. It also helps reduce employer costs related to long absences. If needed, return to work can be supported by an occupational health–arranged work trial, partial sickness allowance, or Elo’s vocational rehabilitation.
Regular contact with the employee on sick leave, appointing a return‑to‑work coordinator, and an ergonomic workplace visit conducted by occupational health all help shorten disability periods.
Source: Finnish Institute of Occupational Health (FIOH): Indicators for monitoring occupational health care – indicators for work ability management, follow‑up and early support processes
Work trial based on the Occupational Health Care Act
A work trial based on the Occupational Health Care Act is a good option when the employee’s work ability problems are not yet severe and there is no threat of disability.
In practice, a work trial at the workplace means giving the employee new tasks suited to their work ability or modifying their own duties with clear adjustments. A work trial may last up to 45 working days.
How to proceed:
- occupational health issues a notification of the rehabilitation decision (KU114)
- the employee applies for rehabilitation allowance via Kela’s e‑service
- the employer decides on implementing the work trial at the workplace and reports paid wages in Kela’s employer e‑service
- Kela pays the employer compensation (rehabilitation allowance) for the paid wages
Monitor the progress of the work trial together with occupational health.
Partial sickness allowance as support for return to work
Partial sickness allowance is used when the employee is unable to perform their regular work full‑time due to illness but is able to work part‑time.
During partial sickness allowance, the employee performs their own work 40–60% of regular hours. Kela may pay partial sickness allowance for up to 60 weekdays with an A medical certificate and up to 150 weekdays in total with a B medical certificate. The employee’s recovery must not be endangered by work.
- the occupational health physician issues an A or B medical certificate
- the employee submits the partial sickness allowance application to Kela
- the employer submits part‑time work details in Kela’s employer e‑service
- Kela pays the employer if full salary is paid; otherwise, Kela pays the allowance to the employee.
Monitor the employee’s situation frequently. If concerns arise, discuss with the employee and utilise occupational health. If partial return‑to‑work is not successful, Elo’s vocational rehabilitation may be a suitable solution.
Vocational rehabilitation to support return to work
Elo’s vocational rehabilitation is the best option when there is a risk of disability and it can be influenced with vocational rehabilitation measures. A work trial is the most commonly used form of vocational rehabilitation.
Using a work trial means that the employee returns to work that has been modified to match their work ability or moves to new duties. If necessary, the employee can begin the work trial with reduced hours and gradually increase hours.
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