The Role of the Employer in Supporting Work Participation of Workers with Disabilities: A Systematic Literature Review Using an Interdisciplinary Approach

Purpose There is growing awareness that the employer plays an important role in preventing early labor market exit of workers with poor health. This systematic review aims to explore the employer characteristics associated with work participation of workers with disabilities. An interdisciplinary approach was used to capture relevant characteristics at all organizational levels. Methods To identify relevant longitudinal observational studies, a systematic literature search was conducted in PubMed, Web of Science, PsycINFO and EconLit. Three key concepts were central to the search: (a) employer characteristics, (b) work participation, including continued employment, return to work and long-term work disability, and (c) chronic diseases. Results The search strategy resulted in 4456 articles. In total 50 articles met the inclusion criteria. We found 14 determinants clustered in four domains: work accommodations, social support, organizational culture and company characteristics. On supervisor level, strong evidence was found for an association between work accommodations and continued employment and return to work. Moderate evidence was found for an association between social support and return to work. On higher organizational level, weak evidence was found for an association between organizational culture and return to work. Inconsistent evidence was found for an association between company characteristics and the three work outcomes. Conclusions Our review indicates the importance of different employer efforts for work participation of workers with disabilities. Workplace programs aimed at facilitating work accommodations and supervisor support can contribute to the prevention of early labor market exit of workers with poor health. Further research is needed on the influence of organizational culture and company characteristics on work participation.

Employer perspectives on their supportive role in promoting sustainable RTW of disabled workers

Background

Employers play an important supportive role in facilitating sustainable Return to Work (RTW) of workers with disabilities. Little is understood about how employers deal with their supportive role, what kind of support they offer and which facilitators of employer support are important to successful RTW.

Methods

A semi-structured interview study was conducted among 27 employer representatives (e.g. supervisors, HR managers, case managers) of companies in the Netherlands who had experience in retaining at least one disabled workers within their company. Participants were included through purposive sampling on sector and company size. Data was analyzed by means of thematic analysis.

Results

We identified three different types of employer support: 1. instrumental support (offering work accommodations), 2. emotional support (encouragement, empathy, understanding) and 3. informational support (providing information, setting boundaries). Facilitators of employer support were categorized into three main themes: 1. good collaboration, with subthemes (in)formal contact, trustful relationships, mutual responsibilities and (in)formal networks, 2. employer characteristics, including supportive organizational culture, leadership skills and flexibility, and 3. employee characteristics including flexibility and resilience.

Conclusions

Different types of employer support are considered as important in the RTW process of disabled workers. Besides offering work accommodations, also emotional and informational support are necessary. In addition, good collaboration and flexibility of both employer and employee may be viewed as facilitators for optimizing supervisor and employee interaction during the RTW process.

Key messages

Instrumental, emotional and informational support by the employer are important in the RTW process of disabled workers. Facilitating factors include collaboration, flexibility and leadership.