Top Ten Tips for Vocation Rehabilitation...

People often ask me “how do you obtain such good Vocational Rehabilitation or Case Management results with so many of your clients?”

Like over 70% of injured personnel returning to work within a military career and over 50% back to their original job despite the usual rate being 20-40%.

Here’s some top tips that I use which you are welcome to try out. Remember that everyone is unique so pick what works best for you.

1.     Use Smart VR

As the Vocational Rehabilitation Association advises, using the right person, at the time and in the right way.

2.     Communication is key

It’s vital that expectations and steps to achieve a client vocational goal or outcome are clear. Any issues or feedback are communicated regularly between everyone. Client, Line Manager, HR, Solicitor, Insurer, Occupational Health, Vocational Case Manager and Work Colleagues. Actively listening as well as talking is needed to ensure that everyone communicates and feels heard.  

3.     Be like Marmite. A Vocational Case Manager should understand and know when to say “no” -what you can and can’t do? Set boundaries. Be realistic. Clients can then make an informed choice. Be up front. Be friendly yet firm.

4.     Flexible yet focused -

During the VR process, the VCM can agree and set goals with the client and everyone involved in helping them return to work or start work. Then “life happens”. Health symptoms vary. Work colleagues may have comments. Line Managers may be noticing productivity dips. HR or Occupational Health may have concerns. The client may lose motivation or find work too challenging.

What next? You may ask. Remain flexible. Stay open minded. Keep communication up between everyone. Look at my next top tip to help you get through the challenges.

5.     Think Outside the Box -whole brain process

I like to call it the Leonardo De Vinci method.


6.     It’s a three “horse” race – plan A, B and C

Once you have used the whole brain “toolbox” then you agree and arrive at the “3 horse race” moment together with your client.

Horse 1 – Have your top priority option as your vocational goal or return to work, retraining or start of work.

Horse 2 - This could be an adapted version of “horse 1”. Even something simple like part time rather than full time work. Or it could be a sedentary role as opposed to a manual handling role.

Horse 3 – I find this is usually something totally different to the other “horses” which I like to call the “surprise outsider” horse. This could be working with another employer or self employment. It could be transforming a hobby into a job whilst a person also works part time within PAYE. It could be a person developing a hidden talent or learning a new skill that may take time to develop until its ready to launch.  

In my thirty years’ experience I find that when clients know they have choices, no matter what, they tend to remain motivated and focused to achieve their own “winning horse”! In this case, it’s a longer term sustained work within their health symptoms.

Using this approach helps to beat the odds that typically disabled workers move out of work at twice the rate (8.8%) of non-disabled workers (4.9%).

7.     Support people through their whole journey

Remember that the vocational journey typically takes 1-2 years.

From when you first you agree to work with a person and they take their tentative steps to “climb aboard” the vocational trip with you to when your client sustains work within their final destination and you can “wave them a fond farewell”.  

Research shows that returning to work or starting work is not often the major issue. However sustaining productive work IS.

The vocational journey involves:

•        Maintaining regular communication in a sensitive realistic manner.

•        Planning and implementing workplace adjustments as required.

•        Helping people access professional advice or treatment.

•        Planning and coordinating a return to work plan.

•        Regular review and adapting that plan.

8.     Think Inside the IgLOO  -

The IgLOO framework for sustainable return to work, developed by the University of Sheffield and Affinity Health at Work, shows us different resources that can support return to work: at the individual level, the group level, the line manager level and the organisational level

Remember this framework applies to physical as well as mental health.

If you work well together with all these levels and your client, with everyone playing their part in the team then you have a greater chance of victory.

9.     Score the Goals – Once you have agreed the vocational goals, plan a realistic SMART method of actioning them with an outcome measure.  Review them regularly, update or amend as needed. Use the other top tips recommended. Remember that you always have horse 2 and 3 options if needed and nothing is written in stone!

10.  Turn Tragedy Into long term Victory. Using all the top tips I have recommended will help you and your client stay on track throughout the vocational journey to reach their destination. Remember to intervene quickly if something isn’t working quite as you thought to resolve any issues or change of heart and minds. I always encourage my clients to stay realistic and ask for help. It’s a strength not a weakness.

Sometimes it can be more realistic to say “this isn’t working”. Paid work is not for me. Or full time work is not for me. That’s OK too. Sustaining work (whatever that may be can be paid or non paid”. Sometimes voluntary work can fill a much needed gap in sense of purpose and using skills just as much as paid employment.

Why Bother? You may ask…

Because it just makes sense.

We can empower people, line managers, HR, occupational health and others to reduce the gap between disability, injury and tragedy turning that into many more victories.

Look at these figures…

In 2020, 118.6 million working days were lost due to sickness or injury and 560,000 workers suffered a new case of ill health which they believed to be caused or made worse by their work.

New cases of ill health alone are estimated to cost Britain £10.6 billion, the equivalent of £19,000 per case.

16,400 workers permanently withdraw from work each year because of a workplace injury or work-related ill health.

The good news is that it doesn’t have to be that way!

Using my top ten tips within VR can make a huge difference.

Work makes good business sense for everyone:

Good work is good for health.

Returning to work means a return to a sense of normality . It restores a person’s identity and sense of purpose. This leads to self-respect, self-esteem, improved mental wellbeing and social inclusion.

A poorly managed return to work can result in relapse, further absence or total exit from work. A loss of skills, talents and expenses. Not to mention rising costs of recruitment to replace them.

What about the impact beyond the person? Their colleagues, who take on additional duties, their family and friends, who take on additional responsibilities or share the financial burden of sickness absence.

Finally, I trust that you have found my insights helpful?

If you have some other tips to share that you use with clients or have seen used helping them return to work. I would love to hear about them in the comments.

“I am only one, but I am one. I cannot do everything, but I can do something. And I will not let what I cannot do interfere with what I can do." 

Edward Everett Hale

Posted on February 1st 2022

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