Disability management and organizational culture in Australia and Canada

Abstract

BACKGROUND:

Organizational culture has received increasing attention in terms of its influence on workplace health and productivity, yet there has been little research on its relationship with employer-based disability programs.

OBJECTIVE:

This study explored the relationship between disability management and organizational culture in Australian and Canadian organizations.

METHODS:

Thematic analysis was conducted on data from semi-structured interviews with 16 employees, including injured workers, human resource managers and disability managers in two Australian and two Canadian large organizations.

RESULTS:

Seven themes were identified: 1. Consistency between espoused beliefs and artifacts in organization; 2. Genuineness of interest in well-being of injured worker; 3. Level of ongoing support of worker following injury; 4. Communication with injured workers; 5. Level of support from supervisors and co-workers; 6. Promptness in claims processing and covering medical costs and; 7. Focus on wellness and injury prevention. It was found that organizational culture may impact the delivery and perceived value of employer-based disability management programs.

CONCLUSIONS:

Given the potential relationship between organizational culture and disability management, employers should facilitate a positive workplace culture by ensuring consistency among underlying values, espoused values and actual treatment of employees, including injured workers.

Keywords

Injured workers workplace espoused values artifacts

1 Introduction

Global costs of injury and illness at work are estimated to be 4% of GDP [1], which equated to US$4.3 trillion in 2014. Given the link between economic competitiveness and safety in an increasingly globalised economy [1], countries are seeking to reduce the incidence of workplace injuries and illness. One solution to this problem has been the introduction of employer-based injury prevention and return to work services, often referred to as disability management programs. Historically, disability management evolved from rehabilitation programs that were developed as a feature of workers’ compensation systems in the 1980s to control spiralling compensation costs [2]. It became evident to many policy makers and employers that to be effective, rehabilitation services were optimally located within the workplace and integrated with other employer-based programs such prevention and wellness services [2].

Considerable research has shown that disability management programs do not operate in isolation within an organization. Their success relies on a number of factors [3 –6]. For example, it has been found that organizational culture, underpinned by supportive leadership, shared decision making and worker engagement, is a key feature in their acceptance [3, 4]. Organizational culture can be defined as a pattern of shared basic assumptions, values and behaviours, which are taught to new employees as part of a socialization process [7]. Edgar Schein defines three levels of organizational culture. Artifacts represent the expressions of organizational culture that are easily observable in a workplace and include the layout of physical space, products, corporate clothing, formal descriptions of organizational processes and workplace rituals. These artifacts are often symbols, reflecting the shared assumptions of the culture. Espoused beliefs and values are the stated strategies, values and goals that become part of an organization’s philosophy, and guide employee behaviour. They are often explicitly stated by managers to employees in meetings and verbalize what the organization purports to represent. Basic assumptions are ‘taken for granted’, often unstated beliefs that regulate employee behaviour and provide a sense of identity. These assumptions are often implicitly shared and extremely difficult to change. In this context they can be dysfunctional in terms of preventing necessary organizational development [7]. Problems arise when there are incongruities and conflicts among these three levels of organizational culture. For example, if a company’s stated philosophy is one of valuing its employees, yet actual treatment of its injured workers is otherwise, reflecting an assumption that such workers are malingers and a nuisance, these contradictions will negatively impact organizational culture.

The pervasive nature of organizational culture raises the issue as to its impact on disability management programs. There has been considerable research on employment related barriers for people with disabilities seeking to enter the workforce [8], including corporate culture [9], and the role of organizational factors in the return to work of injured workers [3–5 , 11–14]. Some of these factors include the importance of supervisor and co-worker workplace support [3 , 10–13], timely provision of information [3, 13], effective communication [3 , 14], trust among stakeholders [3], teamwork [3 , 13], shared decision making [11, 12], provision of worksite accommodations [11, 14], job demands [12] and return to work coordination [14].

While it is arguable that many of these factors are components of organizational culture, little research explicitly examines the link between organizational culture and disability management. One exception is the work of Amick and colleagues [15 –17]. Several studies, using the Organizational Policies and Practices (OPP) Questionnaire, measured eight areas of workplace disability management practices. It was found that a people-oriented culture facilitates disability management programs [15] and is associated with lower disability incidence and duration [16]. A people-oriented culture results in positive return to work outcomes, which in turn is linked to the productivity and financial goals of the organization. This finding is consistent with general management literature [18]. Organizational culture is manifest in phenomena such as job satisfaction, workplace morale and worker participation. These factors, in turn, impact performance and productivity [19, 20]. For example, Denison reported that companies with positive, participative workplace cultures achieve a return on investment twice that of companies with less efficient cultures [18].

There is also little research on employees’ perceptions of employer-based disability management programs in relation to workplace culture. Most research has relied on reports from management or return to work coordinators, which is problematic in terms of obtaining a true picture of the actual treatment of injured workers and the culture within which this occurs. Furthermore, based on the global nature of disability management, there is a need for transnational research in this area, particularly as there may be cultural factors that influence service provision [21, 22]. Given this situation the aim of this paper is to explore the relationship between disability management and organizational culture in Australian and Canadian organizations based on the perceptions and experiences of employees.

2 Method

2.1 Participants and measures

A qualitative methodology was employed to gain an understanding of participants’ experience of the disability management program in their companies. Qualitative approaches are viewed as ideal in gaining perspectives from the participants’ frame of reference [23] Specifically, semi-structured in-depth interviews were used to provide a framework within which participants could detail their experiences of the disability management programs in their own ‘voice’ [24].

Interview data was collected from a sample of employees in two large (more than 300 employees) Australian and two large Canadian companies during 2015. These companies were chosen from a sample of employers included in a larger study on the implementation of disability management in companies in Australia, Canada, Switzerland and China. Australian and Canadian employers were chosen because of the economic and political similarities between the two countries when compared to China and Switzerland. Participant companies were selected based on their contrasting approaches to disability management. For each country one company with excellent disability management practices and one company with poor disability management practices were identified and included in the analysis. These companies were selected based on the expressed levels of employee satisfaction with the company’s disability management program. Data from interviews was then thematically analysed in relation to disability management and workplace culture. In addition, statements regarding each company’s values regarding their workers were retrieved from participant company websites to gain an understanding of their espoused beliefs towards workers and provision of assistance to injured employees. Brief descriptions of the participant companies are as follows.

Australian Company 1 (AC1): Council with more than 1000 employees providing services to the community in areas such as water and waste, environmental health and community, infrastructure, planning and development;

Australian Company 2 (AC2): Company with more than 1000 employees providing facility management and security services;

Canadian Company 1 (CC1): Post-secondary institution with more than 800 employees providing educational services;

Canadian Company 2 (CC2): Engineering and technical services consulting company with more than 350 employees.

2.1.1 Interviews

Semi-structured interviews were conducted with managers and injured workers in the four companies as follows: AC1: two injured workers, human resources (HR) advisor and the disability manager; AC2: two injured workers, a senior manager, HR advisor and disability manager; CC1: two injured workers, the HR Advisor and disability manager and; CC2: two injured workers and HR Advisor. To avoid selection bias companies provided a comprehensive list of injured workers, from which potential participants were identified and contacted. Demographic details regarding participants’ gender, age, highest level of education and years employed with the company are described in Table 1. A description of injured workers’ occupation and injury type was not included to avoid comprising anonymity.

Table 1
Participant gender, age, education and years employed

Company/Employee Gender Age Education Years

employed

Australian Company 1

Injured Worker 1 M 60 High school 8

Injured Worker 2 F 48 High school 10

Human Resources Advisor M 48 Postgraduate 1

Disability Manager M 53 Diploma 3

Australian Company 2

Injured Worker 1 M 38 Certificate III 3

Injured Worker 2 F 35 High school 6

Senior Manager F 61 Postgraduate 3

Human Resources Advisor M 60 Bachelors 3

Disability Manager F 35 Postgraduate 1

Canadian Company 1

Injured Worker 1 F 39 Postgraduate 5

Injured Worker 2 F 58 High school 20

Disability manger F 26 Postgraduate 1

Human Resources Advisor F 64 Postgraduate 5

Canadian Company 2

Injured Worker 1 M 48 Bachelors 6

Injured Worker 2 M 60 Diploma 5

Disability Manager F 45 Diploma 10

Human Resources Advisor F 39 Bachelors 2

Company/Employee	Gender	Age	Education	Years
Australian Company 1
Injured Worker 1	M	60	High school	8
Injured Worker 2	F	48	High school	10
Human Resources Advisor	M	48	Postgraduate	1
Disability Manager	M	53	Diploma	3
Australian Company 2
Injured Worker 1	M	38	Certificate III	3
Injured Worker 2	F	35	High school	6
Senior Manager	F	61	Postgraduate	3
Human Resources Advisor	M	60	Bachelors	3
Disability Manager	F	35	Postgraduate	1
Canadian Company 1
Injured Worker 1	F	39	Postgraduate	5
Injured Worker 2	F	58	High school	20
Disability manger	F	26	Postgraduate	1
Human Resources Advisor	F	64	Postgraduate	5
Canadian Company 2
Injured Worker 1	M	48	Bachelors	6
Injured Worker 2	M	60	Diploma	5
Disability Manager	F	45	Diploma	10
Human Resources Advisor	F	39	Bachelors	2

Interviews with managers focussed on aspects of the disability management program, including its nature and rationale, external influences (e.g. insurance, laws), benefits and drawbacks, strengths and weaknesses and measurement of outcomes. Interviews with injured workers also focussed on aspects of the disability management program, including who provided support, what support was provided, personal return to work experiences, workplace accommodations and perceived effectiveness of the program. Sample questions included: “Please tell me about your return to work experience”, “Who supported you and how did they support you in your disability management program?”, “Looking back on the support you received from the disability management program, tell me things that were done well and also things that could be improved” and “What measures were provided to assist you with your return to work?” The length of the interviews varied from 30 minutes to 1.5 hours. All interviews were recorded and transcribed for analysis.

2.1.2 Website information

Each company’s website was examined for value statements regarding the importance of workers to the organization and the provision of disability management services to injured workers. Comparing these statements with interview data enabled examination of the consistency among Schein’s three levels of organizational culture for each company, thereby contributing to an understanding of the nature of the culture and its relationship to disability management.

2.1.3 Ethical clearance

Ethical clearance was obtained from both the Griffith University and University of Northern British Columbia Ethics Committees.

2.2 Data analysis

Interview data was analysed using thematic analysis. Thematic analysis involved reading and re-reading the transcripts to identify patterns of meaning in the data in relation to the research aims [25]. The process involved initial coding to identify items of interest in the data [26] and included statements regarding organizational culture and return to work processes. Repeated examination of this basic data was conducted to identify combinations of items that reflected patterns or themes and from this thematic maps were constructed to examine relationships between themes.

3 Results

The interview data revealed seven key themes related to the research aim:

Consistency between espoused beliefs and artifacts in organization;

Genuineness of interest in well-being of injured worker;

Level of ongoing support of worker following injury;

Communication with injured workers;

Level of support from supervisors and co-workers;

Promptness in claims processing and covering medical costs and;

Focus on wellness and injury prevention.

Each of these themes is described in more detail below using relevant quotes from interview participants. In Theme 1 statements have been included from company websites regarding espoused beliefs regarding their employees. These have been paraphrased to protect the identity of the companies without impacting the meaning or intent of the statements.

Theme 1: Consistency between espoused beliefs and artifacts in organization

There was a significant contrast between companies in terms of the workers experience (artifacts) of the disability management programs and management’s espoused view (expressed beliefs) of these programs. In AC1 there was consistency, reflecting a positive workplace culture. AC1’s stated values on its website included:

Maintain and value an excellent workforce through adoption of contemporary human resource practices.

With regards to disability management the website also stated:

Health and safety of workers is a major priority.

Actively promote early return to work for those workers who have suffered work-related injuries.

These statements appeared to be consistent with both the expressed views of management and workers. For example, the HR Advisor of AC1 stated:

Uh, look, I mean, without trying to sound soppy, ... the business really does care about its staff.

In a similar manner, Injured Worker 1 at AC1 stated:

A culture that [AC1] have in place is about you going home every night to your family and your mates.... Uh what else can I say? It’s a really good culture.

In CC1 there was also consistency. The companies stated values included:

Employees are our most important asset and we take responsibility to ensure the health and well-being of our employees. Providing a safe and healthy workplace is a priority in order to support our employees in ensuring the success of the company.

Similar to AC1 these statements appeared to be consistent with both the expressed views of management and workers. For example, the Human Resource Advisor in CC1 stated:

So the employee pillar is just as equal as the others, so it’s sort of a direction to look after employees from all sorts of well-being’s....

At the same time in CC1, Injured Worker 1 stated:

There was never any question we were going to receive the support we needed.... It didn’t seem like a foreign experience. I didn’t feel singled out. It felt quite natural and so that to me was a good thing.

The situation at AC1 and CC1 can be contrasted with that in AC2 and CC2. AC2’s stated values on its website appear to focus on workers as an important asset:

Our people are integral to our success.

Regarding disability management the site also states:

Protecting the safety, health & wellbeing of our workers.

The Senior Manager at AC2 appeared to mirror these values stating:

You know, that the overarching, overriding principle is we must keep our people safe....having people injure themselves at work is not acceptable.

Yet, for Injured Worker 1 at AC2, in contradiction to the Senior Manager, the focus appeared to be on profit, leading to disconnect between the espoused values and actual behaviour towards employees:

The concern is not for the well-being of the employee, the concern is for the expense, the inconvenience and how it will look on paper... I was in the way of them getting on with the business of making money....

This inconsistency was also evident in the second Canadian company (CC2). Stated values, both on the website and from management were in contradiction with the expressed views of workers. CC2’s website states:

We value our community and care vehemently for our employees. We want to build a culture of mutual respect.

Similarly, the Human Resource Advisor in CC2 stated:

Ultimately this is a service organization... And if you want that to work well, there has to be a certain wellness level in the organization.

This contrasted with statements of injured workers in CC2. For example, Injured Worker 1 at CC2 felt like he was a problem, not a valued employee:

Felt the onus on me to figure this out and um, lots of guilt and even upon my return questions like how are you not going to let this happen again.

Clearly there was consistency between espoused values and actual behaviour in terms of treatment of injured workers in AC1 and CC1, but not so in AC2 and CC2. It demonstrates the incongruities that can occur among Schein’s three levels of culture, the negative impact of this on workplace culture and the consequences for the perceived value of the disability management program.

Theme 2: Genuineness of interest in well-being of injured worker

The notion of a caring organization, which is concerned about the health and well-being of its workers, is a characteristic of a positive workplace culture and is a philosophical underpinning of disability management programs. It was evident that AC1 and CC1 genuinely cared for their injured employees while this was less evident in AC2 and CC2; this was then reflected in their respective workplace cultures. Injured Worker 1 at AC1 was positive:

It’s a really good culture.....you know that they are going to look after you.

Injured Worker 1 at CC1 was also positive:

There were concerns that was I was going to be safe at work and I could safely perform my duties, right....They were pleased to have me back.

In contrast, Injured Worker 1 at AC2 was unhappy with the treatment he received from the company:

The prevailing feeling about injury management is, don’t report it because if you report it they’ll f*** you around…..there is a bit of culture of suck it up princess…there is a disconnect in employee engagement with what the line managers or the team leaders are trying to push as far as the KPI compliance objective and then that level of sense of care for workers….

Theme 3: Level of ongoing support of worker following injury

It was apparent that AC1 and CC1 took seriously the issue of ongoing support, ensuring injured workers received the necessary medical and case management services during their recovery from their injuries. Injured Worker 2 at AC1 was pleased with the level of support:

They’re going to go every step of the way with you until you come back to work properly.

Similarly, Injured Worker 2 at CC1 stated:

You know, the strengths to the program was there, the people were there, the company was there and everyone was there, you know, when I needed them, you know with support and with anything that anybody could do, they offered, right.

Ongoing support was not so evident in AC2 and CC2. For example, Injured Worker 1 at AC2 stated:

But there was never any contact with me face to face with anyone at all....I felt totally irrelevant, totally unsupported.

Injured Worker 1 at CC2 also commented on the lack of support from the company:

A lot of the solutions were on me to come up with and at that time I felt very lost and I don’t know how to create a solution in a system that hasn’t changed upon my return.

Feeling abandoned by companies is relatively common among injured workers as they struggle with trying to return to work. Inconsistencies between espoused beliefs, such as “We are committed to protecting the safety, health & wellbeing of our workers”, and an actual lack of support following injury, are quickly seen as disingenuous by employees. This incongruity is generalized in the worker’s mind as reflective of the general organizational culture, which is often the case.

Theme 4: Communication with injured workers

Good communication between employers and employees is an important principle in promoting both a positive workplace environment and an effective disability management program. Good communication was evident in AC1, with Injured Worker 2 at AC1 appreciating the high level:

…[they] would constantly check how I was…there was constant follow up…they would always check and make sure I could get to my [medical] appointments.

It was also evident in CC1 with Injured Worker 1 reporting:

I was in constant communication with [the Company] cos you know, every week I would visit the office and if I needed anything I would call the office, right. They were only too glad to help me with anything that I needed.

In contrast, in AC2 communication and giving of timely information was lacking, with Injured Worker 2 indicating poor communication and confusion about what was going to happen to her:

I didn’t have a lot of [contact from the DM team]....there’s just a lot of confusion, of people saying when I should be recovered and what I should be feeling.

Injured Worker 1 at AC2 was also unhappy with the level of contact and lack of information from the company:

There has been a lack of communication..... there was never any contact with me face to face with anyone at all. Somebody [needed] to take the time to sit me down in a room and go through the information with me.

These sentiments were mirrored by Injured Worker 1 at CC2:

…I had tried to call [Workplace Manager] and I had tried to call my immediate supervisor, and I was never getting any response, right. They wouldn’t return my calls, and I didn’t want to really talk to [Disability Manager] about work….

The lack of communication in AC2 and CC2 coloured injured workers’ overall views of their employer. The sense from them was that they were deeply unhappy, believing their employers had let them down in communicating in a range of areas such as the processing of their compensation claim, medical treatment, return to work program and future job security.

Theme 5: Level of support from supervisors and co-workers

In AC1 and CC1 there appeared to be a genuine concern from supervisors and co-workers about injured workers and their recovery, whereas in AC2 and CC2 there was almost cynicism about the companies’ efforts in this regard. Injured Worker 1 at AC1 spoke about the high level of caring his boss exhibited after his injury:

It was only 15 minutes [following the injury] before the boss was there to pick me up and take me into the clinic....Uh, how would you say, we look after each other in that regard.

Injured Worker 1 at CC1 also appreciated support from co-workers:

…when I returned to work I did get a lot of support from a lot of people contacting me when I arrived back to work saying you know, welcome back, glad you’re feeling better but take it easy, kind of thing.

This contrasted with the experience of Injured Worker 1 at AC2. He felt his supervisor saw him as a problem that should just go away:

We have a team leader on the site…But they don’t know what to do with anyone who is injured...I was an irritant….They’ve got no interest at all in my being there.

It was evident this approach by supervisors results in relationship deterioration between injured workers and co-workers. Injured Worker 1 at AC2 felt nobody helped him so why should he help others:

Every time I have done favours…the people that I work for, its cost me time, stress and money….I don’t do favours anymore.

It also affects morale, Injured Worker 1 at AC2 linking this with a negative workplace culture:

Communication is appalling. Competence is minimal. Everything is just a problem. There is a big morale problem in the staff. The company treats us all like liabilities instead of the assets that we are... ... We are the assets that they are selling but they treat us like liability. There is no single action that can solve such a deep set of cultural issues.

This situation was also evident for Injured Worker 1 at CC2:

I would get really upset because my supervisor and I would have weekly meetings.... to just touch base about where I was and she was cancelling them all the time or never showing up because, you know, she had other meetings or this was more important. It really pulls you down and makes you feel like you’re very de-valued.

Similarly, for Injured Worker 2 at CC2:

I came back with, there was five months’ worth of work waiting for me and there was nobody to do it. And so the steps that we set out in that meeting were never followed... I was filled with, um, bitterness and disappointment.

Theme 6: Promptness in claims processing and covering medical costs

AC1 ensured injured workers claims were quickly processed and they were not out of pocket. Injured Worker 2 at AC1 talked about how the company covered all her medical costs:

And I wasn’t left out of pocket at all, like everything was paid for, yeah.

Injured Worker 1 in the same company talked about the prompt processing of his workers compensation claim:

....it was only fifteen minutes before the boss was there to take me into the clinic. XXXX was waiting at the clinic when I got there and went through the whole process of the incident report with the boss.

This contrasted with AC2 where workers were quite stressed by the delay in claims processing, lack of information about the claims process and the financial burden of costs not being met. Injured Worker 1 in AC2 mentioned being out of pocket with his medical expenses and not knowing what was happening with his claim:

.....every time I’ve been to the physiotherapy, which up until the beginning of last month was once a week, I have had to pay a $30 gap above what the insurance company will pay as a scheduled fee. So that has cost me hundreds of dollars that I am out of pocket and have no idea if anyone will accept that as a claim.

Similarly, Injured Worker 1 in CC2 was resentful at having to use other leave to cover his injury absence:

…I went back to work full-time…and I know it was too soon because even I was, I had holiday days, I mean all your sick time is burnt up so if you get sick, you’ve got to use holidays, right, or make time up which I don’t want to make time up, right, because I can’t do the overtime.

Theme 7: Focus on wellness and injury prevention

Injury prevention is a key feature of any company based disability management program [27]. It was evident that AC1 and CC1 had strong health and safety cultures, taking these responsibilities seriously, with processes that encouraged staff to improve their health and identify and eliminate workplace hazards and risks. Interviews with AC1 employees identified a comprehensive range of health and safety activities introduced by the company including: (a) Formation of strong health and safety teams; (b) Implementation of a ‘take five’ training approach to managing injuries; (c) Regular ‘tool box’ meetings to discuss health and safety concerns; (d) Prompt resolution of safety issues and hazards; (e) Risk assessments of every new work task; (f) Analysis of the location and number of injuries; (g) Health and safety induction of new contractors entering the worksite; (h) Regular health checks and wellness programs focusing on high blood pressure, hearing, eyesight, skin cancer, obesity, diabetes and cholesterol, and: (i) Payment for staff to undertake CPR and first aid courses. Injured Worker 1 at AC1 linked the excellent work of his company in safety with the culture of his workplace:

…our employers place as much importance on [the safety of workers] as we do….Its a really good culture….We do have a lot of pride because they’re spending money on these wellness programs. You know that they’re going to look after you.

Injured Worker 1 at CC1 was also impressed with his company’s approach to safety:

…if somebody isn’t up to a task then nobody forces anybody to do anything that they’re not comfortable with. You know, your safety is the big issue and your health and your well-being. The company is, you know, pretty conscious of that.

This approach was in stark contrast to that of AC2 and CC2. Injured Worker 1 at AC2 referred to a culture where workers were scared to raise safety issues and the minimalist approach of the company in meeting legal obligations:

The only incidents that we’re encouraged to report are incidents of injury…I haven’t felt supported or safe to bring issues [of safety] up….they are covered barely, minimally in the legal sense. But they are not actually doing any of it. They’ve got all of the pieces of paper that show that they have the systems in place but they’re not implementing any of them.

Similarly, for Injured Worker 1 at CC2 there was a perception that the company was not serious about safety issues:

They wanted all management to attend (a workshop on sexual assault) because, you know, dealing with people who had gone through a sexual assault, you know, and it happens (in the workplace) so much they wanted to educate them a little bit, how to recognize how to deal with it, etc. And my supervisors never felt that it was important enough to go to.

4 Discussion

It was evident from our results that companies differed significantly in the perceived value and impact of company-based disability management programs and that this may be related to organizational culture. Where disability management programs were viewed as poorly implemented there was evidence of a negative workplace culture in which the espoused values of the company were not being translated into practice. Conversely, a positive workplace culture, in which espoused values were consistent with actual company behaviour towards workers, appeared to promote disability management interventions that were effective. These outcomes appeared to be consistent across Australian and Canadian companies, suggesting the potential transnational nature of this phenomenon.

A positive organizational culture appears to engender genuine interest in the recovery and well-being of injured workers and there is consistency between their stated principles of ‘valuing employees’ and their actions in facilitating return to work. Employers with such cultures have supportive workplaces, reinforcing findings from other research that found supervisors and co-workers play a critical role in facilitating the return to work of injured workers, particularly their re-integration back into the workplace [3 , 28]. These employers are also less likely to have attitudinal, behavioural and physical barriers for workers with injuries and disabilities [3]. This is also consistent with disability management research that indicates return to work is more sustainable in workplaces where transitional work, job accommodations, supervisor and co-worker support and early intervention services are provided [11 , 28–30]. In contrast, it was evident from our results that a negative workplace culture, characterised by lack of support, led to injured workers feeling bitter and angry, alienated within the workplace, and potentially at risk of leaving their employment.

An important component of disability management is the provision of injury prevention and wellness programs, reflecting a commitment by companies to a health and safety culture. Companies with positive workplace cultures appear to evince strong programs in this area, going beyond legislative mandates to offer a range of wellness programs and engaging their staff in identifying and solving workplace risks and hazards. AC1, for example, adopted a comprehensive approach to safety that included formation and resourcing of health and safety teams, risk assessments, safety training, regular health checks, wellness programs and job modifications. It adopted a zero tolerance approach to safety matters, whereby workers were encouraged to identify all hazards and risks, no matter how insignificant. Employers’ investment of resources into prevention activities was appreciated by workers, making them feel valued, and contributing to a positive workplace culture. This finding is consistent with other research that has found a people-oriented culture engenders a strong safety climate, including ergonomic practices, which reduces risks and increases productivity [15 –17].

Our findings are also of economic importance based on the fact that organizations with strong positive workplace cultures, which integrate an effective set of specific values, beliefs, and behaviour patterns, tend to have higher levels of productivity [19]. The capacity of disability management to support this process indicates its potential value in contributing to an organization’s financial goals and economic bottom line. Therefore the relationship between workplace culture and disability management is not just a matter of good human resource management practice. If our findings generalize to other companies, those with workplace cultures that positively impact disability management programs may have an economic advantage.

One of the issues we identified is the discontinuity between espoused values and actual practices, reflecting a negative workplace culture. Although these companies websites appeared to have positive statements about valuing staff and caring for workers with injuries, these espoused values are inconsistent with the ‘artifacts’ of practice, namely actual treatment of injured workers. This treatment was manifest in lack of interest in injured workers and their recovery, lack of support and poor communication during the return to work process, and lack of support from supervisors and co-workers. Employees were not slow to draw the link between their adverse treatment and a negative workplace culture. For them, culture was identified as the context in which these attitudes and behaviours occurred, reinforcing the notion of an injured worker as a liability, not an asset. At the same time, where the experience of workers receiving disability management services was positive, this was also linked with culture; workers felt valued, looked after and welcomed back into the workplace by supervisors and co-workers, and thus the culture was described as ‘really good’.

Schein’s framework of organizational culture provides a useful lens in which to view these results. Employees quickly identify any disconnect between levels of organizational culture, recognizing contradictions in value statements and unstated assumptions that appear to reinforce behaviours that focus exclusively on profit margins rather than their health and well-being. Injured worker 1 in AC2 in our study articulated such contradictions on a number of occasions and explicitly linked them with culture, pointing out that his labour was sold as an asset but he is treated as a liability, reflecting in his view a deeply rooted cultural problem. It is evident that there is minimal value in companies espousing workers as their most valuable asset, when observed actions towards injured workers speak otherwise. For disability management programs to be effective there needs to be consistency between what the company says it does and what actually happens to injured workers on the ground–this is the essence of a positive workplace culture.

4.1 Limitations of the study and further research

Our study examined a relatively small, non-representative sample of employees in Australia and Canada, so the generalizability of our findings is unclear. A much larger study is required to establish whether these findings have applicability to other companies and other countries. Further, our study also did not directly measure organizational culture, so it not possible to definitively draw conclusions as to whether a company’s culture was positive or negative and the extent to which employees’ experiences are a result of workplace culture versus the impact of the disability management program per se. Although this limitation is acknowledged, Schein has indicated that organizational culture is extremely difficult to measure, particularly those deeper assumptions that are key determinants of culture and which strongly influence employee behaviour. In-depth interviews, such as the ones conducted in our study, are one method by which this phenomenon can be explored. However, it is acknowledged that further observational research is required to ‘measure’ organizational culture and its influence on disability management. Finally, the directional nature of the relationship between disability management and organizational culture cannot be established from our study. Although there appears to be a somewhat reciprocal relationship between these variables further research is needed to establish reciprocity or directionality between them.

5 Conclusion

This study found a possible relationship exists between organizational culture and disability management. Companies need to work on continuously improving organizational culture, ensuring consistency between Schein’s three levels, to maximise the effectiveness of the disability management program through improving the health, morale and job satisfaction of their workforce. However, further research is required to definitively establish this link.

Conflict of interest

None to report.

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