Academic journal article The Journal of Rehabilitation

Application of the Menninger Return-to-Work Scale among Injured Workers in a Production Plant

Academic journal article The Journal of Rehabilitation

Application of the Menninger Return-to-Work Scale among Injured Workers in a Production Plant

Article excerpt

Many injured workers will return to work (RTW) within an expected length of time with little or no intervention. Some will never RTW, regardless of intervention. It is the group of injured workers between these extremes that should be targeted for use of employer resources in rehabilitation interventions.


Research on factors associated with RTW has been on-going since the 1960s. Developing a profile of the injured worker in terms of some of these factors offers the potential for predicting which workers will benefit most from rehabilitation assistance. Client profiles of older persons, without dependents or living alone, and who have little education and unskilled jobs, were found to have reduced probability of RTW (Foldspang, 1987; Gay & Wong, 1988; Milhous et al., 1989; Tate, 1992). Gay and Wong (1988) also associated personal characteristics of motivation and cooperation with client RTW.

Job satisfaction and perceptions of employer support were found to be significant indicators of positive rehabilitation outcomes (Allodi & Montgomery, 1979; Bear-Lehman, 1983; Bergquist & Larsson, 1977; Brewin, Robson, & Shapiro, 1983; Williams, 1991). Lancourt and Kettelhut (1992) found family stability to be a factor in RTW.

Wage replacement has been shown to have an inverse relationship to RTW (Brewin et al., 1983; Catchlove & Cohen, 1982; Guck, Meilman, Skultety, & Dowd, 1986; Sander & Meyers, 1984; Tate, 1992). Rehabilitation is positively influenced by the opportunity to be re-employed in the same job and with the existence of light-duty programs (Burton & Wilkinson, 1988; Deacon & Congdon, 1984; Gay & Wong, 1988; Williams, 1991).

The type and extent of injury also affects RTW. Them are various indices of severity, such as percentage of body affected (Helm, Walker, & Peyton, 1986), number of tests (Bear-Lehman, 1983; Milhous et al., 1989), whether surgery was performed (Beals & Hickman, 1972; Guck et al., 1986; Tate, 1992), complications (Gardner, Goodwill & Bridges, 1968), and persistence of pain symptoms (Bergquist-Ullman & Larsson, 1977; Catchlove & Cohen, 1982; Guck et al., 1986; Lancourt & Kettelhut, 1992). Regardless of the severity index used, these researchers have found a positive association between severity and amount of lost time.

The psychology of the disability syndrome has also been associated with increased time off from work. The disability syndrome is a condition in which subjective symptoms are not supported by objective findings, but the symptoms cause delayed recovery. Authors contend that a disabled individual's psychological reaction (compensation neurosis) to injury and the effect of secondary gains (reinforcement) which result, can be as disabling as the original injury (Burgel, 1986; Fitzler, 1983; Hanson-Mayer, 1984; Headley, 1989).

In 1986, researchers at the Menninger Clinic developed a scale using many of these factors to predict RTW and guide allocation of resources (Hester, Decelles, & Gaddis, 1986). The purpose of this study was to apply the Menninger Return-To-Work (RTW) Scale retrospectively to a population of workers who lost time due to work-related disabilities to determine the validity of the scale as a predictor of RTW in this population.

The Menninger Model

The Menninger Scale is a weighted scale from 0 to 100. A score greater than 65 assures RTW; a score of less than 39 equates to a 3% likelihood of RTW. According to Hester et al. (1986) scores provide direction for allocation of rehabilitation$resources. The Return to Work Center Project of the Menninger Research and Training Center of the Menninger Clinic focused on individuals who were gainfully employed, but due to disabling conditions were unable to engage in remunerative work for at least 5 months. Using data from 600 persons who were disabled five months to two years, investigators studied the association of ten variables to RTW following disability. …

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